310852_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Type of Visit: Mompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 'QPRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
%
Arrival Time:
Departure Time: liz= County:
Farm Name:
S ,��
—Drety Worse-
Owner Email:
Region:
Owner Name: (y s �� Phone: 9 I a 2_9 0 01,65
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title: Phone:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Swine C►apacity Pop.
Wean to Finish
Design Current
Wet Poultry Capacity Pop.
Layer
Cattle
Dairy Cow
Design Current ~
Capacity Pop.
Wean to Feeder
]Non -Layer
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dai
Feeder to Finish
Design Current
D , P,oult . Ca aci_ P,o ,
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharzes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [�j No ❑ NA ❑ NE
❑Yes
❑No
NA
❑NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 21412015 Continued

Facility Number: - Ds ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [�M No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [jj NA 0 NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): I q
Observed Freeboard (in): -2
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 1p 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 P No D 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 [P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes - NJ 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. is there a lack of properly operating waste application equipment?
[:]Yes No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ NA [] NE
❑ Yes ❑ No ❑ NA NE
[:]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. ❑ Yes 1� 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 ❑ No ❑ NA -! 2 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes* ❑ No ❑ NA R NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
®No
❑ NA
❑ NE
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 first A
,� .�.
f"'D _ R2 4+s
structure(s) and date of survey indicating non-compliance: 8 ,
LA
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
[B No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
Qfl NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ❑ NA C@ 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 [SjrNo ❑ 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
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[�a No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
R No
❑ NA
❑ NE
Comments,(refer4tojques�tian #} Explainqany YES�answersNandlor any�add anal recomwmend ons or anysoth-er co me ts.
�...
Use dravwingsaof�:Eaciity�fobetterexplanksifuatons(useadditeonal pagesas.peces!,ary,). m
4 X�, ekh jo i,.c) -C C ID123 [16
� G
Cal
0 Is) � kfo (zv�
ID
040
9Z
Reviewer/]nspector Name:
Reviewer/Inspector Signa
Page 3 of 3
tor

Type of Visit: PICompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: eRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1! Arrival Time: : o Departure Time: County: �t „p��- Region:
Farm Name: C 0 s, 7)Cr j UU oetcsc Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: a d 5Qfz _ I
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator: -L
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I
INon-Layer
I
Dairy Calf
Feeder to Finish
I) , P,oultr
Layers
Design
Ca WE
P,o ,
Dairy Heifer
Dry Cow
Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other 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 DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes.' No ❑ NA ❑ NE
❑ Yes
[2-No
❑ NA
❑ NE
[-]Yes
Ca -No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes �o ❑ 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 P,4o ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Number: 3 15 Date of inspection: ?
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
D Yes
E3 no
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
E2r&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?
❑ Yes
I�o
❑ 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
❑ 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
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
';�,No
[2[ 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
®'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
la'NTo
❑ NA
❑ NE
maintenance or improvement?
l 1. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
P"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
gNo
❑ 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
❑ Yes
C2'No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
;214o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes ,J!114o
❑ 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:
2 1. Does record keeping need improvement? If yes, check the appropriate box below.
[:]Yes [—],No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes ;'FVo
❑ 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

Facility Number: jDateof Inspection: 2
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [;I No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes C2090
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 2�'No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ff No
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? ❑ Yes JZI�o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ,NNo. ❑ NA ❑ NE
34. Does the. facility require a follow-up visit by the same agency? ❑ Yes ��No ❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
0 Yes 4�TNo ❑ NA ❑ NE
❑ Yes N o ❑NA ❑NE
❑ Yes '1No ❑ NA ❑ NE
❑ Yes ,E No [DNA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any:other comments.
se drawings of facility to better explain situations (use additional pages as
(e t�cr,Ze�
r k-�_ UYr�
Reviewer/Inspector Name:
Reviewer/Inspector Signature: (� /
Page 3 of 3
nary). .
Phone:
Date: ry
2 412015

Type of Visit:,/O Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Q'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: FvToyweparture Time: County: ►, )(.Region:"V j
Farm Name: Owner Email: �`��n`�
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: {i_S ( _
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Poultry C►apacity Pop.
Layer
C+attle
Da' Cow
Design
Capacity
C►urrent
Pop.
Wean to Feeder
Non -La er
Da' Calf
Feeder to Finish
Da' Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D . P,oul C*_a aci. P,o ,
Layers
Cow
Non-Da'iry
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes 4:� No ❑ NA ❑ NE
❑ Yes o ❑ NA NE
❑ Yes 6 No ❑ NA ❑ NE
❑ Yes ,fNo
❑ Yes WNoo
❑ Yes
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412014 Continued

Facility Number: - Date of Insection: l e /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes FZTNo ❑ NA ❑ NE
` a. If yes, is waste level into the structural freeboard? ' [:]Yes P3-No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ 3�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Ye 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 ❑ NA ❑ NE
waste management or closure plan? T
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 Ea'No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes IN-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 ';allo ❑ NA ❑ NE
maintenance or improvement?
Waste Annlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ;2'%o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes )D'Ro ❑ 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 )'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes RT"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?
❑ Yes Ca"No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 2No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes oNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMF readily available? If yes, check
❑ Yes ;2-No
❑ NA
❑ NE
the appropriate box.
❑WLIP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes L2^No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Z o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes VNo
❑ NA ❑ NE
❑ Weather Code
[:]Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of Ins ectian: /,4::!5 C
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes 3 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes] No ❑ NA 0 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 ONo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes �No
[D NA 0 NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document OYes Z 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
0 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
NA
NE
permit? (i.e., discharge, freeboard problems, over-application)�'No
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes
NA
NE
Application Field ❑ Lagoon/Storage Pond ❑ Other:
T
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
No
9No
0 NA
NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
M NA
NE
34. Does the facility require a follow-up visit by the same agency?
Yes
No
❑ NA
0 NE
Comments (refer to question ##): Explain any YES answersand/or any additional, recommendations or any other: bmments...
.
Use drawings of facility to better explain situations (use additional pages as necessary).
Ps arm a- /'ecorc�S
boo
and
z /y a-�S
12-�/�I�3
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 012, �� 7_1'a3
Date:
21412 14

Type of Visit: $Compliance Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: _Q40utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 3d Arrival Time: eparture Time: County: Region:.
Farm Name: `'jr�S lJl�� /�I��,►t, �/ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 0hn/_j Z�a _ r j
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Phone:
Integrator: &
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
01 Wean to Finish
Design Current
Wet Poultry Capacity Pop. Cattle
La er Dairy Cow
Design Current
Capacity Pap.
01 Wean to Feeder
I INon-Layer Dairy Calf
NJ I Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
=Dffsigh Current Dry Cow
Qr.y, Wultry Ca �Ti P,o . Non -Dairy
Layers Beef Stocker
Gilts
Non -Layers
Pullets
Beef Feeder
Beef Brood Cow
Boars
Her,
Turke s
HurkexPoultsOther ther
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)?
❑ Yes [A No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes �No
❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes No ❑ NA ❑ WE
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 I of 3
2/4/20I1 Continued
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes No ❑ NA ❑ WE
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 I of 3
2/4/20I1 Continued

Facili Number: - Ds ection: 1412
v 2
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 �a No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): -s-2 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes,Lallo ❑ 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 21No ❑ 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 DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ETWo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes P
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 [;�1Qo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes Eno ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E]"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 ❑ No ❑ 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 ❑ Yes ❑ No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
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 [I Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V 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 ❑ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Ins ecdon: d
24. Did the facility fail to calibrate waste application equipment as required by the perm' .
❑ Yes
No
❑ NA ❑ NE
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 to provide documentation of an actively certified operator in charge?
❑ Yes
0 No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
111No
❑ 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
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
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
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 # ): 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).
t" lf- I ,
3��I�t-z- � • �
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
larw o- /
%�CLs� �601C gaop�
Phone: / v 7 G ' 7
Date: !l ad Z-
2 4/2011

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,E] No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 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? ❑ Yes ;3'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 FzrNo
❑ 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 ,�allo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ YesrNo
❑ 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 L'Po
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �*o
❑ 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 t0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes j2rNo ' ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ONo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes O No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes r1No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes fNo ❑ NA ❑ NE
.. .m-. v�:Ar» xis' ti R�r +,"f
Comments (refer to question #) Explain any YES,ansRers and/or any recommendations oany other comments,
Use drawings of facility°to better explain situations: (usereadditeonal pages as necessary),
d- /-e G vr�� /mod a._) Cl
Reviewer/inspector Name / Phone: �r
Reviiewer/Inspector Signature: Date: l /6 d
12IZ81041 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �TNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes eNo ❑ NA ❑ NE
the appropriate box. 1. Cl WUp ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes 0io ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes J'No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes�!No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�ffNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ZNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
EfNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ONo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ZNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ONo
❑ 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
,TNo
❑ 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
VNo
❑ 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
dNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�No
❑ NA
❑ NE
Additional Commentiand/Or Drawings:
S-e jjV.--­e 7tr 1 411' `5
7710 % • /
!_ d
Page 3 of 3 12,128104

r
Type of Visit O Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O hollow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit:Arrival Time:-=� Departure Time: County: Region: ,
r
Farm Name: -f A /' ` t Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: ! . /7v/�?G.! Integrator: 'n�
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: 0 0 = g = 4i Longitude: = o = ,
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
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?
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 1 of 3
❑ Yes hlo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
Vlo
❑ Yes
VrNo
'[]NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes JZ No ❑ NA ❑ NE
❑ Yes 9No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes qNo ❑ NA ❑ NE
❑ Yes 91110 ❑ 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 IZNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ Ko El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) it
9. Does any part of the waste management system other than the waste structures require ❑ Yes PNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes V No ❑ NA ❑ NE
maintenance/improvement?
IL Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes P(No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
WNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2fNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
PNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
La<.o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
9llll4o
❑ NA
❑ NE
C mrments (refer to queshnn�#) Explainlany YES aanswers�ancllor anyla
recommendations or any other comments.
Use drawurgs.of fa lityto better explain situations (use additronal pRes�gs�necessa ):
Phone:
Reviewer/Inspector Name �T '
i
ReviewerfInspector Signature: Date: l
Page 2 of 3 I2/2810 Continued

Facility Number:. — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �Q/No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes KNo ❑ NA ❑ NE
the appropiate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �*o ❑ 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 ZNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes Z'No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
[--]Yes
Jallo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
2(No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ONo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
P�No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J;TNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ICJ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[;'No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
L2"%io
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PIo
❑ NA
❑ NE
AddiiionalComments and/or Drawtn `:. �� ; ; m �=� -YM }
oy/o
It I
A
I
Page 3 of 3 12/2&04

s 31,0 rs-.-:2.
Facility Number
AG -Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit Q<ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit JO Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 Arrival Time: �T �V Departure Time: County: Region: 511eo
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:�I/'/SeG✓
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
Other
❑ Other
Owner Email:
Phone:
Phone No:
Integrator:
�7
Operator Certification Number:
Back-up Certification Number:
Latitude: E] o = I 0 Longitude: = ° = t = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La yer
❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?,
Design Current-
Cattle Capacity Population'
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl
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 oNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
)'No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104 Continued

F/
Facility Number: S — S Date of Inspection U
Waste Collection & Treatment
4. Js 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 23-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? ❑ Yes �TNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ZNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 0 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 ;3 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
W. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes J2 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ['No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
1
❑ NA )aNE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
J:] No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
RNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
)_ Crac1C It, 10c c.K C" h-OU5( Lclat14ukl Mon 411 OW
+� escaf`e . 144 A^ of /yi yecA»
Reviewer/Inspector Name 161 ij 10 Phone:
Reviewer/Inspector Signature: Date:
1212810 Continued

Facitity Number: Date of Inspection
Reauired'Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ W­Up ❑ Checklists ❑ Design El Maps El Other
2rYes ❑ No ❑ NA ❑ NE
PKes ❑ No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
,❑ Yes ❑ No
❑ NA
❑ NE
[Waste Application I'Weekly Freeboard OWaste Analysis �3 Soil Analysis 0 Waste Transfers ElAnnual Certification
Rainfall 'Stocking P Crop Yield R120 Minute Inspections qMonthly and 1" Rain Inspections OweatherCode
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes 12 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes 2 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
B Yes ❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
Yes ❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes ,0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ❑ No
❑ NA
ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes �3 No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes J2 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 ZI No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ❑ No ❑ NA ,0'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? 0Yes ❑ No ❑ NA ❑ NE
Additional Comments and/or Drawings:
' �',ro�P� s74 %Le >�iyc� �rr/� 1-� �s ,��cC? Co r
``
q11' W Acorz_��-!5-
G�rh c cGr l� c��-oCv� a-(!
bl ;�C? /
ii%�cSGu�c
��1,9n
I�h - �Prl/H �p j
71�1 /off 7 ea Koll of a
6vi1M1'!9-AV1 /VC �yo�
PPCfSe /'IGT-c a�
t,Jr�l /leek iit9 b-2 /J'lal/e� / mite cl 5-0
1212VO4

_Je'Division of Water Quality /
Facility Number 3 g Q Division of Soil and Water Conservation V
-- - e) Other Agency
Type of Visit 01compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: / Arrival Time: ,&
T Departure Time: County: Region: ZL&
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: ) Title: Phone No:
Onsite Representative: '--r�u/ Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = e = f Longitude: = ° =' =
lahve
Design `"Currents Design Current;: .. Design Current
Swine Capacity Population Wet Poultry CapacityPopulation Cattle Capacity Population:`
Wean to Finish y�
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to dFeeder❑ Farrow to
❑ Gilts
❑ Boars
,.Other:
.
❑ Other
La er
PEI
El
Cow
�
Non-La er
Dry Poultry
ElLayers
ElNon-Layers
El Pullets
❑ Turkeys
❑ Turke 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?
El Dai Calf
❑ Dairy Heifer
❑ Do, Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowi;.
Number.of Structures: n
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes .41'No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[I NA
El NE
❑Yes
El No
❑ Yes
❑'No
❑ NA
❑ NE
❑ Yes
,E]"No
❑ NA
❑ NE
12128104 Continued

• Facility Number: —k>Date of inspection 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Strur
1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes J] No ❑ NA ❑ NE
Cl Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 2 No ❑ NA ❑ NE
❑ Yes ,0 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ffNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes B 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 2 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes � No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ONo ❑ 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) 1/l U �D/'"�1. W * S6
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [3No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? F21yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes j' No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes RNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 2No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or -.any other comments
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name tom/ —� Phone:
Reviewer/Inspector Signature: Date: lQ
Page 2 of-3 12128104 Continued

Facility Number: Date of inspection d
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,Qto ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes x] No ❑ NA ❑ NE
the appropriate box. p El Other
❑ WUP El Checklists ❑ Design❑ Maps
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application J2 Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking f2 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
QNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
ETNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
1:�NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
E;.NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes ., No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[:]No
❑ NA
J:JE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes i No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Q14o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[]-No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�2No
❑ 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
P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
['No
❑ NA
❑ NE
Additional Comments and/or Drawings:
P��oQrc�'a�j 1 l�/dv old o S 6 a /O
ee 4,Qedooal-d �- �S o✓` c���o%2CQ
-� runs
l� ��al.� a � 5 (ay _t e y5 via
�
'blfbf s C&nn01- be
ViQeds us)n5 afpfc) -4n
�ecG-dS (yk 5ood 8i'aW
Page 3 of 3 12128104

Type of Visit QrCompliance Inspection Q Operation Review Q Lagoon Evaluation
,r-
Reason for Visit A<Routine Q Complaint Q Follow up Q Emergency Notification Q Outer ❑ Denied Access
Facility Number 0 Date of Visit: /J- 3 cry Time: [
Not OneratioKual O Below Threshold
13 Permitted 13 Certified 13 Conditionally Certified 13 Registered Date -Last Op or Above Threshold: -
Farm Name: r!s. ��r� _Y c� r County: �
Owner Name. -
Mailing Address:
Facility Contact: _ Title:.
Onsite Representative: T
Certified Operator:
Location of Farm:
Phone No:
Phone No: .
Integrator:
Operator Certification Number:
I&
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude • !�" �it Longitude • 44
Discbarees - StreamImpacts
1. Is any discharge observed from any part of the operation? ❑ Yes WfNo
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 pNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ;41*No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ;2- o
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
�. Identifier: ._..... - - - .�.�..... - _._._.
Freeboard (inches):
12112103 Continued

Facility Number: j - S' Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes �No
' seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes gNo
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 maintenancerunprovement?
❑ Yes : 0 No
8. Does any part of the waste management system other than waste structures require maintenancernmprovement?
❑ Yes Z N' o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes EfNo
elevation markings?
Waste Application
10_ Are there any buffers that need maintenanoe/improvement?
❑ YesIRNo
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes RNo
b) Does the facility need a wettable acre determination?
❑ Yes ❑ No
c) Tbis facility is pended for a wettable acre determination?
❑ Yes ❑ No
15. Does the receiving crop need improvement?
ZYes ❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes [TNo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ,ETNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes Flo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes .ETNo
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 , MM
Air Quality representative immediately. 1�
(rCflr tO:n.) amy YFS ad/Gr aayr Atrj*/01r
_
�TJse d�rawaigs>aglam samationRs. (aweilitia�paes as;? p F la C 0 ❑ Final Notes ,
iry
Vim+
E'�'G� & /A ,o-e %� /C�£ cCan i JJJ///
�' �,��✓l � �1�1 Novi Tor/ � \ e/ re (,(l re • 0nf-S'N
4
• PPasc 'be- Sure Li -Se �r4' '�� fr►-, S
H7
Reviewer/Inspector Name 2- �-y�� 8- ='r=,' �-
Reviewer/Inspector Sigaahm. Date:
12112M I Cowed

Facility Number, 3 j —VS-.�t Date of inspection r G
Reauired Records & Documents
21 _ Fdil to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes 'J21No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ,OWo
23. Does record keeping need improvement? If yes, check the appropriate boa below. 0 Yes gNo
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes .BJio
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes j`No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(it/ discharge, freeboard problems, over application) ❑ Yes PNo
27. Did Reviewerlfnspector fail to discuss review/inspection with on -site representative? ❑ Yes Q-No
28. Does facility require a follow-up visit by same agency? ❑ Yes E No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ONO
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes B-No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate boa below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1 " Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112M3

Type of Visit OCompliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit oRoutine 0 Complaint 0 Foliow up 0 Emergency Notification 0 Other ❑ Denied Access
F_ I rO Facility Number 1 31 $s Date of Visit: A Z Time: r 2 D
Not O erational 0 Below Threshold
Permitted Q Certified ©Conditionally Certified D Registered Date Last Operated or Above Threshold:
Farm Name: C r ' 'f -Df ew NyTser-y County: �T_^
Owner Name: C 1, s 'D ! eW Phone No:
Mailing Address:
Facility Contact:
Onsite Representative: _De b o ,--k Dret,.i
Certified Operator:
Location of Farm:
Title:
Phone No:
Integrator:
Operator Certification Number:
OSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 6 0u Longitude a ° ff
Design Current
Design Current . Design Current
Swine Ca achy P,o ulation
Poultry Y
Ca achy P,o ulation Cattle Ga achy Eo ulation
Wean to Feeder 2&00
❑ La er
❑ Dairy
❑ Feeder to Finish
Non -La er
NO Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑Other
Total D_ esign Capacity
❑ Farrow to Finish
❑ Gilts
Total SSLW
❑ Boars
Number of Lagoons
❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds 1 Solid Traps C�
❑ No
Liquid Waste Management Sy stem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes 0 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 ONO
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes JEJ'No
Waste-Unection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ONO
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Freeboard (inches):
05103101 Continued

Facility Number: — S Date of Inspection Z 1 D Z
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
A No
seepage, etc.)
b. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
[2fNo
(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
[3 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
0
elevation markings?
❑ Yes
No
Waste Annlication
_,j
10. Are there any buffers that need maintenance/improvement?
El Yes
2 No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
ElNo
12. Crop type C O ,. vt 1 S-Oy &C g ^.5 Bee rn V 6(of oy e rSed, -_r+ o
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
Z No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
VNo
b) Does the facility need a wettable acre determination?
❑ Yes
A No
c) This facility is pended for a wettable acre determination?
❑ Yes
JZNo
15. Does the receiving crop need improvement?
❑ Yes
ONo
Ib. Is there a lack of adequate waste application equipment?
❑ Yes
�ZNo
Re uired 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?
10
(ie/ W"UP, checklists, design, maps, etc.)
❑ Yes
JO No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
XfYes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
A No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
VNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
JZ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
;A No
24. Does facility require a follow-up visit by same agency?
❑ Yes
ONo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
. ..:. f°
Comments (refer;�to.gaestion.) Explain any YES:answ,ers and/orany recommendations or anvofher comments +...
Use drawings of faty to better "explain situattons :;.(use addihanal pages as necessary) A 17 ❑ Feld Copy ❑ Final Notes
lq. -Xrm -Z'S S4vw -ft ej,ppII' cg4;or 0,1 d,1Pe.reA4-C,elds Lrv11s) a•%
AL.e Se,w-e dct4c A-4 Ae Skvi ,e i...�e t;�' is ha4 ,- as5i Ie q.! d1� Diye
l`
�r•LVG1 s,C �s used Y+�S• �rPw �4iGt -�4e eveYl�s Mus4 ►^Ve i,1+an, Ogle
Y-eczr-As _(o,r L,ierC --00-
cJ4 vJ- Z o % 2V2►'i'1 S . S. 1>rcW .s�a & s he W -rle o K4 4lie Z RJ2-j+2'3
0., 'Zve►^1; ••,' o-F Z% 4/0Z 4,l o� M,. I)re%%J 'S -Feld ✓h,04el. (C.10 »4 f m llt'rQt�
H,
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 2, 1 7.
05103101 Continued

Facility Number: Date of 1.1tspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes JXNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes VNo
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 (2'No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ,fNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ONo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ;2'No
Additional omments and/orDrawings:
�o�+.,ve•{ �R2- z.75 neeel 4o be vfdg-ae.d od )eAs-1 QIa1)y qs
a-ve-n4S OceOe- true MS. TrCw a blare k-1
12d�- j.,_ cire kef-� q�d gv�tlgble for ir�sptc �a�
A l s el ,�Z,Gr� n're n o so ;1 4es� ,ne s ,� )4'.� �'r a �., Z 00 ? .
J
5/00

rm
-
_ Drvesion of Water Qizality1z.
h Q DrvEsron of Scitl and• Water Conservation "
Q Other`Agency
r?''.?:'.+r--
lType of Visit 10 Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for Visit ARoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit. -�} �CiC1 -rune: �, Q Printed on: 7/21/2000
Facility Number '�
Q Not operational Q Below Threshold
,Permitted © Certired r�13 Conditi9!::t�
nally Certified 13 Registered Date Last Operated or Above Threshold: -----------------------
Farm
Name: _ ' .5....1?Y Counh D — -Nl.'--.....................................................
...............................................
Owner Name:
Facility Contact:
.....Title:.•
Phone No:
Phone No:
Mailing ,address: ..................
Onsite Representative: DO p t „ Integrator:.... i.'-` Lv��
-•...................................................................... 11 -...1 .......................................
Certified Operator ................................................... ... Operator Certification Number:..........................................
Location of Farm:
ja!-s _ls e}CC�- �yG�G�.. � •�- ,� �►,e� �Gtr�r� Ct� � � ` �l t'_2 `!
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude C]• ' -L Longitude • ° «
Design Current
Swine Capacity Ponulatinn
Wean to Feeder
1>640a
❑ 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 I I ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 110 Lag -on Area I0 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the conveyance man-made-? ❑ Yes ❑ No
b. If discharge is observed. did it reach Water cif the State'? (If yes, no fy DWQ) ❑ Yes (] No
c. jr discharge is observed. what is the estimated flow in gal/stain'?
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 M No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Q�`No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes NfNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ....................................
Freeboard (inches): 3
5100 Continued on back

F'acilit}Number: -31 — I j a I Date of Inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
[] yes
NNo
seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed through a waste management or
ciosure plan?
❑ Yes
t'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
,�rNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
r,
elevation markings?
❑ Yes
®'No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
XNo
IL Is there evidence of over application? ❑ Excessive Ponding ElPAN ❑ Hydraulic Overload
ElYes
jNrNo
12. Crop type 10 I C tj
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
XNo
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
_9No
16. Is there a lack of adequate waste application equipment?
Yes
❑ No
Reauired Records & Document;
17.
Fail to have Certificate of Coverage & General Permit readily available?
El Yes
ONO
18-
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Yes
i
9No
(ie/ WUP, checklists, design, maps, etc-)
❑
19-
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
JXNo
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
. ❑ Yes
RNo
21.
Did the facility fail to have a actively certified operator in charge?
9yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
XNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
❑ Yes
hvo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
ANo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
b(No
N-0-*i6]h(i6ris:or-Micierrcies 4t re iroted-du,rift fhis;visiC- Y:oir Wii!-reeeiye Rio further -:
. - . ' coriesporideirce: about: this visit. ::::: : - ::::.::::: :: ' : ' ::::::: :
Comments (refer to question #): Explain any YES answers and/or any recommendations or any.other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
A.
�� t� �i L--B� Qt't.Gi.-�� S�G�c: �''`� . 1 t-�� � cl�l�^4''� ��-�� c�ctst ✓�t�tt. i�� ' c�r
Y c c `�s • . �L� !�:.` 1� [�c„Q c..� ►,.tee_ �� � pz� �, J� I�(\c-. 1,
5
s � ��� s �-ti �S 3G ci— ►^-mot e. �� �L� �--� t-..��7 �o�
Reviewer/Inspector Name l V 3 �3 0U X--D�
Reviewer/Inspector Signature- Date: j 0 5/00

Facilify Number: `j Date of Inspection GG Printed on: 7/21/2000
Odor Issues
26_ Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below ❑ Yes ONO'
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes KNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes XNo
Additi.o.n.-omments'an or.. Drawings-
c;Qk CGG 5-,*k OU
P\ r -�, � Dckj- u -
CLC5
5 4 `k � �\sNQ
i
S
J
5100

19 Koutine p uompiamt p ronow-up of uwq inspection p roiiow-up or uawt review p tuner
Facility Number _j I Date of Inspection
Time of Inspection 24 hr. (hh:mm)
■ Permitted p Certified 0 Conditionally Certified p Registered in Not Operatiana Date Last Operated:
Farm Name: Chris.Drrw.Nursery...................... ..... County: Daplin W1RO
.................... .............
Owner Name: Chris ....................................... Drew.
Facility Contact:...............................................................................Title:
Mailing Address: 48A,BIae.N.ewKirk.Road......................................
Onsite Representative: Chris.and.Dehorah.Drew.........................
CertifiedOperator: .................................................. ...................................
Location of Farm:
Phone No: 9111 289-3MA......................................
PhoneNo: ....................................................
Magnolia.NC......................................................... 284153 ..............
Integrator: Murphy..Family.Farms....................
Operator Certification Number: ..........................................
Latitude ®+©° ®64 Longitude ®0 ®4 ©;&
1. Is any discharge observed from any part of the operation? p Yes ® No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made? p Yes ® No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) 0 Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min? n/a
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) p Yes ® No
2. Is there evidence of past discharge from any part of the operation? p 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? 13 Spillway p Yes ®No
Structure I Structure 2 Stricture 3 Structure 4 Structure 5 Structure 6
Identifier: 1.....................
Freeboard(inches): ...............2.Q...............................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, 0 Yes ® No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 31_852 Date of Inspection FTITXIWI
6. Are there structures on -site which are not property addressed and/or managed through a waste management or
closure plan? p Yes N 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?
p Yes
N No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
p Yes
N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
p Yes
® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
p Yes
® No
11. Is there evidence of over application? p Excessive Ponding p PAN
p Yes
®No
12. Crop type Coastal Bermuda (Graze) Corn Small Grain
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
N Yes
p No
14. a) Does the facility lack adequate acreage for land application?
p Yes
®No
b) Does the facility need a wettable acre determination?
p Yes
®No
c) This facility is pended for a wettable acre determination?
p Yes
®No
15. Does the receiving crop need improvement?
® Yes
p No
16. Is there a lack of adequate waste application equipment?
p Yes
®No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
p Yes
®No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
p Yes
® No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
® Yes
13 No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
® No
21. Did the facility fail to have a actively certified operator in charge?
p Yes
® No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
p Yes
® No
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
®No
24. Does facility require a follow-up visit by same agency?
p Yes
® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
p Yes
® No
a : X0 ,.Vjuiations:ar. -defiriencit:s.were.nnted .during: this visit. - Yoir will '> ereive, tia fitrtiter.: .
....... ........... ... ... ......................
::�icorxespvndence:ab:ou�tbis :�:�:�:�:�:�:�....:..........:::...::.
Reviewer/inspector Name
Reviewer/Inspector Signature:

Printedon 9
acifiy Number: 31_852 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 13 Yes p No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? p Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, p Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? []Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) p Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? p Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? p Yes p No
14) Farmer has an irrigation design, but underground piping was put in differently than shown in the irrigation design. Farmer says
at.pull acreages still match up pretty well and that an additional -hydrant was added when the underground pipe was installed.
Farmer should have wetted acres determined' for this extra hydrant and have this acreage added into the waste plan acreage along
with the crops and PAN loading rates for this hydrant.
15)� Farmer needs to improve the wet areas in the bermuda fields. Work to better establish coastal in these areas. Also, be cautious
when spraying in these areas. Also, farmer applied on corn in Field 4' from 9/2/99 to 9/20/99 for a total of 41.92' lbs/acre on 2.37
acres. Farmer should adhere to the recommended application windows for crops given in the waste management plan.
16) Farmer borrows reel and pump to make waste applications. This could be a potential problem with farmer not having access to
pray equipment as needed. Farmer should investigate all options (leasing, hiring sprayers, buying, etc) as alternatives.
I) Keep a seperate IRR-2 for each -hydrant/pull and for each, crop; Make sure acreages on iRR-2's match acreages from irrigation
Id esign.
contact your technical'specialist with questions about any of the items mentioned above.

Division of Soil and Water Conservation r] Other Agency
0 Division of Water Quality
Routine 0 Complaint O Follow-up of DWQ ins cation Q Follow-upof DSWC review O Other
Date of Inspection
Facility Number
Time of Inspection 24 hr. (hh:mm)
© Registered E; Certified © Applied for Permit 0 Permitted JE3 Not Operational I Date Last Operated:
FarinName: ................ ��..++...(....... &W.......... N.)OVri............................................... County: ......14"........................................ .......................
OwnerName: ........ . .................. ....... ..... 1C.&W ...................................................... Phone No: 1110 r _. ....................... ...................................................
Facility Contact:
Title:
Mailing Address: .......ft...... 3.ut~...... W.ekr.L.IC.K.......9).............
Onsite Representative: ........... C- Yv s........bmt1
Certified Operator: ..................................................
Location of Farm:
............................. I........................ Phone No:...................................................
............... ............P.j....................................... 1�.�.�.........
............... Integrator: ......... M:�1!(..................................---.......---..........
............... Operator Certification Number;.........................................
Q.,.....`3...,CtsS........�i.....A............5..1. ....911�.t.1�.�' xl+s.4.....X117r........°...................................................................................
...........................................
Latitude 0 6 it Longitude • 6 46
Wean to Feeder
&600
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
General
1. Are there any buffers that need maintenancelimprovement?
❑ Yes
IM No
2. 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
No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
No
c. if discharge is observed, what is the estimated flow in gaVmin?
>J
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
[A No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7I25I97

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes 0 No
Structures (Laeoonsaolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (ft)............��:5...................
10. Is seepage observed from any of the structures? ❑ Yes % No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes 0 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
No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ............... e:t'.MuJ4Y------.------. ......smSAN...................�.orj-,......................................................................
..........................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
ONo
IT
Does the facility have a lack of adequate acreage for land application?
❑ Yes
10 No
18.
Does the receiving crop need improvement?
❑ Yes
® No
19.
Is there a lack of available waste application equipment?
❑ Yes
E3 No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
JZ No
22.
Does record keeping need improvement?
00 Yes
J, No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? KYes [KNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes No
0 No.vioil aitionsor. deficiencies. were noted -during this:visit. Yoit_ .will receive-i�o-ftiri heri, : -
:: correspQitdence fi out4 this:visit:
Q- Cotn�Inut Wo,)Q 46 V,&e6t 6,rcuS on. c .-xr- Wc,.((. trc -ruk Ski,-(d 'I(--
, No Ytd.MS of- Sim aJ `ft U� ib.S�eCI�On• ��Ca' 1 of
W aS� 5 ►'�4V1� {� e- urn, t
1 LZ erg
Ce f4-ca:6-o' t
7125/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: _ 1)15;n. L� _ _ Date: