330039_PERMIT FILE_20171231

r�
3( zz f I _L_
(Type of Visit: .0 CHance Inspection U Operation Review Q Structure Evaluation () 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: l3! County: Region:
Farm Name: �?jQj3-� t� Q. / U" Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone:
Onsite Representative: & 7 16 0- 1 lf2n Integrator:
Certified Operator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle ADANty Pop.
Wean to Finish
Layer
Non -La er
I
Dairy Cow
Dairy Calf
L—tWean
to Feeder
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dltr:4
Ca aci
Po ,
Non-Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes o ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑Yes gINo ❑ 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 DWQ) ❑ Yes ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ YesrNo
❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

fn cility Number: - Date of Inspection:
Waste Collection & Treatment
"�o�-NA
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ 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?
[]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 ❑ 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
th eat, 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
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
No NA
❑ NE
maintenance or improvement?
1 I . Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s): t3ir on lni i-✓
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
N ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
N ❑ 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
o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
NA
VNo[]
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
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
ffNo ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfe ❑ Weather Code
[]Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspection ❑ 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
❑ No ❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Faeili Number: 31 - 3 1 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Zf No -NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes o ❑ NA ❑ NE
2the 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 I o ❑ 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
0 No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the 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 reeommendations or'agy other comment"' �H
.. _ z i,
Use dralwings:of facility to betket'explain situations"(use additional pages as necessary):.,'
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: r% Il —t12-0 V
Date: 3 / 1 S 13 2-
2/412011

Type of Visit: �eU C�outine
nspection U Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergencv 0 Other 0 Denied Access
Date of Visit: / 1 Arrival Time: L . t7 Departure Time: Ld County: Region:
Farm Name: f h 5'' Owner Email:
Owner Name: Phone:
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
Design C►urrent
Design Current
apacity
Pop.
Wy Capacity Pop.
2015
C«attle Capacity Pop.
Wean to Finish
FLayer
DairyCow
DairyCalf
Wean to Feeder
Non -La er
Feeder to Finish
Dai Heifer
Farrow to Wean
a
D ,. P,oultr,°
Design Current
C•a acit P,o ,
D Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
OtherI
Other
i
I =0
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes eNo [] NA [] NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ 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 rNo
❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes❑ NA ❑ NE
of the State other than from a discharge'?
Page 1 of'3 21412015 Continued

Facilit Number: jDate of Inspection;
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
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?
(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
Structure 5
No NA ❑ NE
o ❑NA ❑NE
Structure 6
❑ Yes Z7No NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental rent, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes FN ❑ 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 2rNo
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): Li
13. Soil Type(s): X,
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?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available`? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes ❑ NA ❑ NE
❑ Yes g
ZNo
❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes No NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes (No ❑NA ❑NE
❑ Yes ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E7No ❑ 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 o ❑ 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: I Date of Ins eetion
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ 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 provide documentation of an actively certified operator in charge? ❑ Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ 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
❑ 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`drav�ings of facility ao better explainnsituati'ons (ate additional pages as necessary).° = f'
Reviewer/Inspector Name: 1
Reviewer/inspector Signature: (3k S k p%z lc!!LJZ_ / /
Page 3 of 3
Phone: t� Ze &
Date: (I-tV_/G
21412015

Facility Number
♦a Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit Complj�nde' Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit f_12uutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: tE UITKArrival Time: __3& Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Gilts
Boars
Other
❑ Other
Title:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 1 = {f Longitude: = o = d = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Nan -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Design Cur:.rent
Cattle Capacity, Porulatio
❑ Dai Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non-Dai
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: �.
DischarPes & 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?
❑ Yes vo ❑ NA ❑ NE
❑ Yes N NA ❑ NE
ElYes No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
VN NA ❑ NE
❑ NA ❑ NE
No ❑ NA ❑ NE
12128104 Continued

E
^Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): j <
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No ❑ " ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed El Yes
o ❑ NA ❑ NE
through a waste management or closure plan?
otify DWQ
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental thN�o
7. Do any of the structures need maintenance or improvement? ❑ Yes
NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
o NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑Yes
No ❑ NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
o ❑ NA ❑ NE
mai ntenance/i m prove ment?
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 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) fr2s , &:Z,.- t,_cfAj C�tY •— ,
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
N ❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ YesFNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18, Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
Reviewer/Inspector Name_g ------ ffi": Phone: 79&'y7-0`a
Reviewerllnspector Signature: t„ 49-L +Ll2 Date: D
Page 2 of 3 12128104 Continued

� l
Facility Number: —31 Date of Inspection �'IJ
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No A ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? 1f yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El maps [3 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections��❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? El Yes VN9,'-
❑ NA ❑ NE
23, if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes l.A o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ 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? (ic/ 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
Page 3 of 3 12128104

e of Visit: 10'Co 'ance Inspection Q Operation Review Q Structure Evaluation O Technical Assistance
son for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other 0 Denied Access
Date of Visit: Arrival Time: © Departure Time: EZ?= County:
Farm Name: SA 12,1 Owner Email:
Owner Name: Phone:
Mailing Address:
Region:
Physical Address:
;csz� t3—a?S!S
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pap.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
Layer
I INon-Layer
I
Dairy Cow
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D , P,oultr.
Ca aci
P,a
Non -Dairy
Farrow to Finish
I Layers
I Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
I Pullets
lReef Brood Cow
Turke s
Other
Turkey Poults
Qther
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?
❑ Yes ZNo❑ NA ❑ NE
❑ Yes �/o
❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DW R) ❑ Yes Now ❑ 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)
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 ❑ NA ❑ NE
❑YesfNo
❑NA ❑NE
❑ Yes ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Fae li Number: 2P -3 Date of Inspection: 1p - 34 - /0
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):
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 No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmenta hreat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes N9 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 V rNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E21 /No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes LQ ivu ❑ 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): �- CAS CA-2 I si-+j ojr. �� 5
P
13. Soil Type(s): /
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
fj
❑ NA
D 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
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
D NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ YesfNN
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
El Yes❑
NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes❑
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
NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transf s
❑ 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
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
21412014 Continued

Facile Number: - jDate of Inspection: — SO —12
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �No
0 NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, checkYes ❑ 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 P140,
NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes o ❑ ❑ 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.
❑ Yes ❑ No ❑ NA ❑ NE
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
0 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 ;#)Explah any YES answers and/or any additional recommendations or any other comments. ;
Use drawings of facilitytytq better: explain situations {use additional pages as necessary).
/45 cy-)Svp, �e vgv
Reviewer/inspector Name:
Phone: q q ( ,_ v Z v=v
Reviewer/Inspector Signature: _ ��[,[ ��y,J-2_ / Date: !3 JD —
Page 3 of 3 l 21412015

Type of Visit: s0 Com ce Inspection O Operation Review O Structure Evaluation O 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:
Farm Name: Qi Owner Email: e"r'E`mail:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Title:
Back-up Operator:
Location of Farm: Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current Design C*urren#
Wet Poultry Capacity Pop. Cattle Capacity Pop.
La er Dairy Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current Dry Cow
D_rTyl FUMEi P.o Non -Dairy
Layers Beef Stocker
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Puults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No -NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes No NA ❑ NE
i
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) ❑ Yes rNo[:]
NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ YesNA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ YesNA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

[Facility Number: -71 Date of Inspection: 'r
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes N NA
a. If yes, is waste level into the structural freeboard? ❑Yes No ❑ NA
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 fNo
NA
❑ Yes ❑ NA
❑ NE
❑ NE
7�
❑ NE
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental t at notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes ❑ 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 o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZZNoANA ❑ 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?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box,
❑ WUP ❑Checklists ❑ Design ❑ Maps []Lease Agreements
❑ Yes
� ❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
No ❑ NA
❑ NE
❑ Yes
❑ NA
jNo
❑ NE
❑ Yes
❑ NA
❑ NE
ElYes❑
NA
❑ NE
❑ Yes❑
NA
❑ NE
❑ Other:
/— /
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfer ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspection ❑ 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 ❑ No ❑ NA ❑ NE
Page 2 of 3 21412011 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 JDNo ❑ 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 o 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
❑ 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),
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ( / ��—y'20-0
Date:
21412011

-2-7-f
Type of Visit: '0 Coroutine
nee Inspection U Operation Review U Structure Evaluation O Technical Assistance
sit:
Reason for Vi0 Complaint Q Follow-up 0 Referral Q Emergency 0 Other 0 Denied Access
Date of Visit: .,�jLj j (t Arrival Time: Departure Time: County:
Farm Name: :SA Q Z 4�n Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Dr. P�oult .
Layers
Non -Layers
Design
Ca aci
Current
P,o
D Caw
Non -Dairy
Beef Stocker
Beef Feeder
Farrow to Finish
Gilts
Boars
Pullets
Beef Brood Cow
Other
er
Tus
Poults
IT�t§
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes o ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes o ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes 51I0 ❑ 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 DWQ) ❑ Yes ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ YesFNo
❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: Date of Inspection:
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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
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
o] 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 t at, 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
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
o NA
❑ NE
maintenance or improvement?
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" indow ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s): T 2' bf'--e� y --
—
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
[:]Yes
❑6/NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ 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
N ❑ 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
o ❑ 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 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 Inspection ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o] 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 21412011 Continued

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 2 <No❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 4 ' 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 to 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 o ❑ 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?
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'?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [—]No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question?#) Expla►n any °YES answers and/or any additional recommendations or any other cornin6ts- 11 i
Use drawings of facility to better explain, situations (use additional pages as necessary). '
Vzcjo :,4 n,--) wt !k d ( e- s
.e JS e 6-A-VM611_ CL; /Z- _C__
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ?gr ^ f/ 2er
Date: 2 _/q_
21412011
a

Type of Visit .0 Co lance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I l 7/ // ► (/I Arrival Time: 1 LtI-) Departure "Time: ® County:
Farm Name: h t? r XP�Li, Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: SO"? 5�0-1�"'—
Phone:
Integrator:
Phone No:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Region:
Latitude: = o ❑ 1 ❑ « Longitude: = o = s =
Design
Swine Capacity
Current Design Current
Population Wet Poultry C* I tfyj Population
Layer
❑ Non -Layer
Design Current
Cattle Capacity Population
❑
Wean to Finish A
❑ Dairy Cow
❑
Wean to Feeder
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry cow
❑
Feeder to Finish
Dry Poultry
Layers
❑ La
❑Non -La Non -Layers
❑ Pullets
❑ Turkeys
❑Turke I'ouIts
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
El Gilts
❑ Boars
Other
ElNon-Dairy
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of 5truetures:
❑ Other
❑ Other
Discharees & 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?
❑ Yes No ❑ NA ❑ NE
❑ Yes dN�o[]NA ❑ NE
ElYes l�Io ❑ NA ❑ NE
❑ Yes N NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page 1 of 3
12128104 Continued

4. IL
Facility Number: ?j —
Date of Inspection tyli
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ZI 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): _ �O �?
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ONo ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
thre t, 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
' ❑ NA ❑ NE i
(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
/[0:3A ❑ NE
maintenance/improvement?
l l . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
o ElNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN [:IPAN > 10% or ] 0 ]bs ❑ 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) (',�SY' W / ,4Y) 5 -tGr r
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 N - ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
o ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,V -' ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Comments (refer to queshon;#t) f �Er'plam:any YES answers and/or any:recommendat�onsorany� other,comments 94
ImUse drawings of facility to:better explain situations. (use'additional;pages as necessar) a
r..:,.`.F:
ReviewerlInspector Name �i �' Phone:
Reviewer/Inspector Signature: Date: ll
rZ1'601fvy I_Unlsnuru

Facility Number: —3 Date of Inspection
Re wired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Ej WNo
[I NA ❑ NE
20. Does the facility fail to have all components of the CAW MP readily available? If yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ONo ❑ 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 El Weather Code
E 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ElNA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes VNo ❑ NA ❑ NE
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
❑ Yes
lA N
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
[IYesFN
[I NA
❑ NE
El Yes
❑ NA
❑ NE
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Addlti6,nal bonnments andlor$Drawin
Page 3 of 3 12128104
Page 3 of 3 12128104

i3q q
Type of Visit: (ZrCom H a Inspection Q Operation Review p Structure Evaluation p Technical Assistance
Reason for Visit: Routine O Complaint Q Follow-up O Referral Q Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: _ L� Departure Time: County:
Farm Name: 7p : 'L CA6?, Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
On site Representative: tt/ S��l�/ - Integrator:
Certified Operator:
Phone:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Region:
Design C*urrent Design Current Design Current
Swine Capacity Fop. Wet Poultey Capacity Pop. C►attle Capacity Pop.
Wean to Finish Layet Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean Design Current
Farrow to Feeder Dr. F,o_ult . Ca aci P,o
Farrow to Finish Layers
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
lBeefBroodCow
Boars
Pullets
Oth
Other
keys
key Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No NA ❑ NE
2. Is th
3. Wer
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑Yes ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑Yes No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑Yes N ❑ NA ❑ NE
ere evidence of a past discharge from any part of the operation? ❑Yes N ❑ NA ❑ NE
e there any observable adverse impacts or potential adverse impacts to the waters ❑Yes No ❑ NA ❑ NE
he State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: jDate of Inspection: Z2
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes � ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes VNo ❑ 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 No 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 agency?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
F1 Yes ❑ No ❑ NA- ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ 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`necessaryj.'
Reviewer/Inspector Name:
Reviewer/Inspector Signature: 131,
Page 3 of 3
Phone: %'tom
Date: ZZ
21412011

Facility Number: - 3 Date of inspection: ZZ
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ef No/ ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? []Yes ZNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5. Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 IO < <
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 [] 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 t reat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 1; " ❑ 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 [3Frozen 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
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
rNo - 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 ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
[]Yes
No ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall InspectirNo
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes❑
NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes❑
NA
❑ NE
Page 2 of 3
21412011 Condnued

f
41(z^(16
Type of Visit Com nce Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: I(OI��77 Arrival Time: ® Departure Time: County:
Farm Name: &A, :5 Aa-j4zyi-\ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Phone:
Phone No:
Integrator: X/pr—
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: ❑ o ❑ I ❑ « Longitude: ❑ o = i
8 i •a} � >
Desis
g j
a' ` F�$xu' �'ii
+Q .e R
Swi,q s Ca aci
9 .L�C.•���P,.
f'r � j r
Current`;
'
f.R��S �R;t
Po Wahon
g
�a-{ L: s;E s _:: tT ��> i.s•
`i. D'est `n Cu'rrentt
.l�. k g 1 c:..
� tll,: la 6 ° EAR#
g g- R, t
WekPoultry s5 Capacity Poptilat�onYCaftle
6X'�.M
� .�-, � .� }
..°ign
�
.
ti;
t06
acity
Current
Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Layer
❑ Non -Layer
❑
Dairy Cow
❑
Dairy Calf
❑ Feeder to Finish
t p
Y Y
R
HE,try
��
❑ La ers
s i ' <
R sip dA
' =M
�� �( �,�' a�
' ti "'
❑
DairyHeifer
.
❑ Farrow to Wean
❑ Farrow to Feeder
❑
❑
D Cow
Non -Dairy
❑ Farrow to Finish:
❑
Beef Stocker
❑ Gilts
❑ Non -Layers
❑
Beef Feeder
❑ Pullets
❑ Boars
❑
Beef Brood Cow
❑ Turkeys
,t r a
Other t
*
'11AD
Number of'Structures
❑ TurkeyPoults
a
-_ ❑ Other
�-»1 ++: .':.,. .saw ...
e ❑ 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?
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 FN�o,.,�O
NA El NE
❑ Yes NA El
El YesNA ❑ NE
❑ Yes Vo
NA [INE
❑ Yes NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page I of 3 12128104 Continued

Facility Number: — Date of Inspection �21 f tlf
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
N NA
9No
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):]) t
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2 No NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ❑ NA
❑ 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 thr t, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes N ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes EZ'NoZ 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 ❑ 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 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 r��
NA [3 NE
15. Does the receiving crop and/or land application site need improvement? El NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? El YesFNo
❑ NA ElNE
17. Does the facility lack adequate acreage for land application? ❑ YesEl ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes❑ NA ❑ NE
:..h.
�Comnicnts refer;to ue"soon„# Ex latn=an YESanswers and/or an areeommendattons or'an athercomments��
;Use drawings,.of,"facility to better explain s�tuatibns {riseiadditional pages } A.+ „ . a.
.9.:x;•.=aR �.e.U;Y'a'��s3.� _3-___ .F ms,u r-���.ia-:_R"+h Y,
p } : r ta � x . s ' E :v Phone: 7 9� ry7-0
Reviewer/inspector ector Narne�
ReviewerAnspector Signature: a r Date: (Z( 10
Page 2 of 3 12128104 Continued

Facility Number: — 3 Date of Inspection
Required Records „& Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
ElYes 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 ❑ b Other
p
21. Does record keeping need improvement? If yes, check the appropriate box below. - ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes VN
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA ❑ NE
i
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes FNo
NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ 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
❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings: w.r
f
Page 3 of 3 12128104

Type of Visit (Dv6 mpliance Inspection O Operation Review O Lagoon Evaluation
Reason for Vislt 0 Routine O Complaint 0 Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 [late of Visit: C t mime:
Not O erational � Below Threshold
Af'
Permitted © Certified © Conditionally Certified © Registered Date Last Operated or Above Threshold: ....................
FarmName: ...13e ............... ................................ I.................. County:.....................................................................................
Owner Name:
Mailing Address:
Phone No:
FacilityContact: .............................................................................. Title:.........................................---.................... Phone No:...................................................
Onsite Representative: .................................. Integrator:......................................................................................
CertifiedOperator: ................................................... ............................................................. Operator Certification Number: ..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Morse Latitude ' 4 44 Longitude • 9 it
.. ..•
r :: � � - , +
R-i {�' 3 l ii tia �)! ! i" t�
���Current vM,} ;��� ,�.'�� �„ �,. �, �� � , ! E ,, Dest�
it
-i
, Current,_
� a,�
;SWine .� Point
'.-:,Ca k ulationt y,,"
s t,.r ,.. , >>Cattle ,z I�r , ,
ace �aPo ulatibn; 4 : E00n1ation
r �Yii ! r..s.,. „ .., ,l....CB
�., . . ,�;,.,..�Ca`�act
❑ Layer
Dairy
Feeder to Finish
�k
t , ❑ Non-!Layerj,
;
❑ Non-DairyVI
.'`w,- ` ' i. it r 3 rare ,a° !.i i Ir , '!
❑,
Other
E,',4, �,,� 4
Tntal DesgA''Capacfty°._
'
Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gavrnin?
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? [I Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ................................... .......................................................................
Freeboard (inches): y
12112103
❑ Yes
'Nf0 .'
❑ Yes L1 No
❑ Yes .
❑ Yes o
❑ Yes a
❑ Yes o
❑ Y No
Structure 6
Continued

Facility Number:
Date of inspection 1 t
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
I0. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
❑ Yes l o
❑ Yes 91 o
❑ Yes No
Yes No
❑ Yes �" 0
❑ Yes No
❑ Yes No
12.
Crop type r- �'`c.� ,4 f'
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
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?
El Yes
Odor Issues
17.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ yes
o
liquid level of lagoon or storage pond with no agitation?
18.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
19.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
[] Yes
❑ No
roads, building structure, and/or public property)
20.
At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
❑ No
Air Quality representative immediately.
Reviewer/Inspector Name
Field Copy ❑ Final Notes
Reviewer/Inspector Signature:
Date:
12112103 Continued

Facility Number: 7 - 311
Date of Inspection / r
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ 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?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
[]Yes No
❑ Yes No
❑ Yes o
❑ Yes
❑ Yes r❑'N0
❑ Yes
❑ Yes No
❑ Yes ❑ 0.,
❑ Yes No
❑ Yes
❑ _1_"
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103

Type of Visit 10 Comp i ce Inspection 0 Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up 0 Emergency Notification O Other ❑ Denied Access
F [itv Number Date of Visit: �.i -� Time:
10 Not Operational Below Threshold
Permitted ©certified / U Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: e County: L [(4S_ � -e
Owner Name:
Mailing Address:
Phone No:
Facility Contact: Title: Phone No: _
Onsite Representative: Integrator:
Certified Operator: d3 e h 5-4 a 1)(Dlt/ Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
.« 1 ' . 3 s s'j:3 - - F �..... 3S �i ' .a aCitY '_'PO 17E9 Curren
.Design Current �j a Design, , ,Current �Uesrgn
Skt Ca acity Po alatton Poultrt Csaciri.3Pa' tilation Cattle , C han ,
t
Wean to Feeder r ❑ La er Dairy
[] Feeder to Finish �_F(; ❑ Non La er ❑ Non -Dairy
+�❑Farrow to Wean
❑ Farrow to Feeder
Other j E. 7L,
{ 3I El1
Farrow to Finish
Total DesignjCapaCtt�'
❑ Gilts
.i a <Ai
gotAl S
❑ Boars 6i ,4 : .pq
rfotdtn Yonds'l,�oiid°"tra s ;�3'L..��iE€1 iiLJ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. 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:
Freeboard (inches): r
05103101
_ f
❑ Yes Io
❑ Yes o
❑ Yes o
❑ Yes 215/,
❑ Yes
❑ Yes No
❑ Ye No
Structure 6
Continued

a
Facility Number: — Date of Inspection1
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Ycseo<()
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? [I 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 2 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 Annlication
10. Are there any buffers that need maintenance/improvement?
Cl Yes
IL Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
Cl Yes
[3No
12. Crop type �%-�V :-2�/M 14
f
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑.Yes
0110
14, a) Does the facility lack adequate acreage for land application?
El Yes
;e o
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c).This facility is pended for a wettable acre determination?
❑ Yes
❑ NN
15. Does the receiving crop need improvement?
El Yes Yes
N`-
16. Is there a lack of adequate waste application equipment?
❑ Yes
1�No
Required
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.)
ElP Yes
�/
N�
.
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ YesVN9
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
El
21.
Did the facility fail to have a actively certified operator in charge?
ElYes
El
V0,
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
El Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comment (refer to ion #j Explain YES an reco�mmen letions,o'r cxammetits
rques any ranswers„and/or an yother
Use drawings of facility to better ez_ plain situations (use,additional stages as necessary) ❑Field Copy ❑ Final Notes #
-�'+l �R ... ",� .�yY,. .'W. 'v_ klN:r`v. e-1T."., .a�
(V ID 1JVs j -- 2 .� n
IF
Reviewer/Inspector NameI 77 :* 127, s :''8. A,:
Reviewer/Inspector Signature: Date: OL, ?'? G�Z
O5103101 Continued

Facility lvumher: 3 Date of Inspection 2 t7
Odor JuM
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
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.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes C2'-No
❑ Yes o
❑ Yes o
❑ Yes No
❑ Yes
❑ Yes 2rNo
❑ Yes No
Additional Comments and/or Drawings: s-
zr ,
-U1
05103101

w.dW1_
+ ��i Atka �a ^ :_ ' + r r F n N
Division oUWater Qual ty t mot. • R r t p
Facility.Number. A O Division of Soil and Water Conservation
!z
- 0 Other Agency r m
Type of Visit P"�RoutineelO
nspection 0 Operation Review 0 Structure Evaluation 0 Technical A ]stance
Reason for Vis' Complaint O Follow up 0 Referral O Emergency 0 Other ❑ D nled Access
Date of Visit: 'f— Arrival Time: Departure Time: County: Region:
Farm Name: `� 9- Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [� o = ; = u Longitude: [� o = 6 = 11
Design Current Design
;:_Swine Capacity Population Wet poultry Capacity Pa
❑
W o Finish
canto Feeder
iTQ
❑
Feeder to Finish
[:]Farrow
to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other �-
❑ Other
❑ Layer
❑ Non -Layer
i
Dry Poultry,
it r ;Design
on
Cattle Gapacu
❑ Daity Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey 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?
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
x
❑ Yes No ❑ NA ❑ NE
❑ Yes N ❑ NA El NE
El Yes o i❑ NA ElNE
❑ Yes ❑ NA ❑ NE
El Ye No ❑ NA ❑ NE
❑ Ye ❑ No ❑ NA ❑ NE
12128104 Continued

r
fo
Facility Number: 33— 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):
l�
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 No NA El
❑ Yes No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ZNo NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental thre , notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑Yes;No
No NA El 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 El Yes ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes "NoNA ❑ 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 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ElEvidence of Wind Drift ElApplication Outside of Area
1
12. Crop type(s) �/J�/rr-(� cal , 'VA""q r64 i'n 1
13. Soil type(s)
14, Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Z
❑ NA ElNE
15. Does the receiving crop and/or land application site need improvement? ElYes❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes NA ❑ NE
17. Does the facility lack adequate acreage for land application? ElPN
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes❑ NA ❑ NE
i
Comments (refer to question #) Explainany YESanswers and/or'any recommendationsfor,any other comments
'Use drawings of facility#o better explain situations `E,(use additional pagesas necessary)
7
Reviewer/Inspector Name .l Phone:
Reviewer/Inspector Signature: ii Date: 0
Page 2 of-3 12128104 Continued

Facility Number: 15�j Date of Inspection J �
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes rL1 N [I NA [I NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes No [I NA ❑ NE
the appropriate box. ❑ WUP El Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below, ❑ Yes No ❑ NA El NE
El Waste Application El Weekly Freeboard ❑ Waste Analysis El Soil Analysis [I Waste Transfers El Annual Certification
❑ Rainfall El Stocking El Crop Yield El120 Minute Inspections El Monthly and 1 " Rain Inspections eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑Yes NA El
NE
26. Did the facility fail to have an actively certified operator in charge?
ElYesrNo
NA
[I NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El YesA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No ❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ 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 ❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes ❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Facility Number
vision of Water'Quality
Division of Soil and Water Conservation.
Q Other Agency
Type of Visit Comp ' nce 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 ❑ Denied Access
Date of Visit: ,IArrival Time: Departure Time: County:
Farm Name: Q ''_h _h^ _ __ _ _ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: f30— n
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
Boars
Other
❑ Other
Title:
Phone:
Phone No:
Integrator•
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: = 0 0 i = [I Longitude: = o = 4 =
dl
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
I ❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey 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 Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
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)?
Number of Structures:
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?
i
❑ Yes a<o 0 NA ❑ NE
❑ Yes ❑ NA El NE
❑ Yes No, ❑ NA ❑ NE
❑ Yes mtNo
❑ NA ❑ NE
ElYes ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
12128104 Continued

Facility Number: — Date of inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain inspections ❑ Weathcr 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
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ 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
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ 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
❑ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

J
Facility Number: Date of Inspection b a
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:
❑ Yes n No ❑ NA ElNE
ElYes o ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 17i
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes N ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment�N�
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? Yes ❑ 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?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No NA El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El 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 Drifl ❑ Application Outside of Area
12. Crop type(s) _q it.f� f ��G-p7 1 "-pin
T
13. Soil type(s) j
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ;'N ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'? ❑ Yes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes / NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ NA ❑ NE
❑ Yes gNo ❑ 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):
WD S r-tw- 0"o+- t `le 5e
! s P.,r T'Ke-/� ,FLJ jgrc G7--w-b04,j ea cA./—/
5-1.,�ys
ReviewerAnspector Name Phone:
Reviewer/inspector Signature: Date: i7 P
1- 12128104 Confinued

Type of Visit Z Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Z?ZDT Arrival Time:l] Departure Time: County:
Farm Name: Q- h �' ct / Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: ❑ o ❑ i ❑ Longitude: = ° =' =
Design Current Design Current
Design
C►urrent
Swine Capacity Population Wet Poultry, Capacity Population
Cattle Cap=y
Population
❑ Wean to Finish ❑ La er
❑ Dairy Cow
❑ Wean to Feeder Layer
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean pry Poultry .
❑ Farrow to Feeder ❑ Layers
El Farrow to FinishEl
El Gilts ❑Non -La Non -Layers
❑ Pullets
❑ Boars
❑ Turkeys
❑ Dry Cow
ElNon-Dairy
Beef Stocker
El Beef Feeder
❑ Beef Brood Cow
Othe IMIIIIIIIIIIIIIII ILI Turkey Poults
❑ Other 1 10 Other
Number of Structures:
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 I of 3
❑ Yes ZNo❑ NA ❑ NE
❑ Yes " No NA ❑ NE
❑ Yes No NA ❑ NE
❑ Yes N ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: Date of Inspection Z 71 all
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): d {�
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 No ❑ NA ❑ NE
❑ Yes PIN-o❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes ZrNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation Poses an immediate public health or environmental thr, , notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes N / NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑Yes No NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ 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 o ❑ 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 types) f "C, f L f-- , Gam' A , 10 y L___D ���--
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
r0__O1
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
Vo ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA
❑ NE
i 8. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Reviewer/Inspector Name � -- --- — �--------� Phone:
ReviewerAnspector Signature: Date: 'Z
Page 2 of 3 12128104 Continued

Facility Number: —3 Date of Inspection i p-4
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ro[:] NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check []Yes []No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑'Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and 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
❑ No
❑ NA
❑ NE
24,
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ 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
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ 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
❑ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Gottiments and/or Drriivmgs ' ", � F"_ �, � .,�
12,r. /ems ti{en
j 72
p o G tUS14r < r=2a ►r & j p—,-o % e So 1 1 4- k-r+ "— 0 , 54r
X) n 11 C_ (0S-G t-4�11 11G4_,
Page 3 of 3 I2128104

Division of
►i of Soil and W:
livisi6n of Water Qu
i•vatron=•Operation Reviiew
VBtlon ` :Compliance Inspection 7
h
)hAnCETIiS}�eCtlon �Y �kilj
:p. ,i, 3
10'Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection S I
Time of Inspection EW=24 hr. (hh:mm)
0 Permitted Certified 0 Conditionally Certified 0 Registered 10 Not O eration;tl Date Last Operated:
FarmName: �?.. !...? e . rZh1- ................................................. County: -...........................................
Owner Name: ...........
....../..../................................................................................ Phone No: - ... ... '7.7...'...` ..5... .............................
ctJ+ti.
Facility Contact: :.�.. .. Title. Phone No.
Mailing Address: �� ...........
6 �...'F.........iz..e......./-1 g�c �� �C.......................
Onsite Representative. e Integrator:
Certified Operator•, 6 ............................................................
r a f � Operator Number'
.................................. Certification
Location of Farm:
IL
..................................................................................... ............. ........................................................
Latitude �� �•� Longitude
Design Current t Design Current "' Design 'Current ,
SwinCapacity PopulationPol�ttte y . y LuCapacity Population
M-Vvean to Feeder p � ❑ Layer 10 Dairy
❑ Feeder to Finish ,. ❑ Non -Layer ❑ Non -Dairy jl
' ❑ Farrow to Wean
's ❑Farrow to Feeder j,i ' 1 ❑ Other ; , 4
❑ Farrow to Finish �' Total Desigh Capacity .
❑ Gilts
❑ Boars TotaFSSLW
.,.rr
t _ �4Notnber of Lagoons,• ; ❑ Subsurface Drains Present ❑ Lagoon Area
Holding Ponds`LSolid Traps ❑ No Liquid Waste Management System
0
.. .. ... K _-
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)
Spray Field Area
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I
Identifier: r
Freeboard (inches): ...... 5!O...r`.................
Structure 2 Structure 3 Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes No
❑ Yes No
El Yes o
❑ Yes N
❑ Yes:N�
❑ Yes No
El Yes No
Structure 6
....................... I.................
❑ Yes eNo
Continued on back

1.
Facility Number,3 j 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?
I i. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
©AZOU
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?
(ic/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss reviewlinspection 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?
10 yiQla�tods:o:r• deficiencies were h ed• du hk! this'visit. • Yoit will receive Rio fu>j•th; r
ctirres oricieirce: aut this visit.......... . .
❑ Yes �'No
❑ Yes [a <
El Yes No
❑ Yes ;211"
[-]Yes No
❑ Yes No
;21<s ❑ No
❑ Yes o
s ❑ No
es ❑ No
El Yes ❑'No
❑ Yes No
❑ Yes No
Yes No
es ❑ No
❑ Yes �No
El Yes 90
❑ Yes �No
❑ Yes
[IYes No
❑ Yes No
4umrnerAGs�trerer w question ff) `cxt►im�� aiEyt,zee.oaa���weE�,auwur;as�y're�umiucuaaiioii� �r any v�ner �u�nmeniv �, t ;i�31r � .�'';
Use drawings of facihtytWbetterMxplam situations 7" 1. h (
, use add,lE�onal pages as necessary) , j � e t tx; t„il ,r `'
a •- ..,. ., �..�
Att1 LQ Yc cam_ J_T ".
l r rt -v J qy n mil' �•t/ , tL S �, G �7� S 7 �tc �-+ /fir e 4,9 s
a �G' ��7 +" J l� y, % c� 6j- 14 k"k e, ti jG C! 4-0 j e
J
e Y r► L1 �'vGr-� �,✓+n ai G_,�n � d_ 1/�S � .e
In Ad Qom,, rJ'I-'G ell" w' tt 104, /e
Reviewer/Inspector Name 14,1 w'; _ a ° a ,. Y °
Reviewer/Inspector Signature:
Date:
3/23/99

Divisiiirn bf Soil and Water Conservation - Operation Review
0rDivisi6n of Soil and Water Conservation'- Compliance Inspection
0 Divis>ion of Water Quality - Compliance Inspection
Other A enc"n O eratioti Review
10 Routine: 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DS`i°C review 0 Other
Y� Facility Number Date of Inspection '7% 6
- LTime of inspection 24 hr. (hh:mm)
❑ Permitted © Certified ❑ Conditionally Certified (] Registered 1E3 Not O erationa} Date Last Operated:
Farm Name: ......................................
�W .'11.............., . ` .i-t.!............................................ county:
Owner Name: Phone No:
Facility Contact: ................................................... ....l'itle Phone No
:Mailing Address
r.
Onsite Representative:..... r.:��' .:'7 ^... ! Intf.grator:......................................................................................
................. ...............
Certified Operator: ................... . .............................. ............................................................. Operator Certification Number:..........................................
Location of Farm:
a.
IV
Latitude 0 9 i Longitude 0 �•1
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Po ulation
�.i
can to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish JE3 Non -Layer I Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System t
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Dischargc originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. It'discharae is observed, was the conveyance than -made''
h. If discharge is observed, did it reach Watcr 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?
1 aste Collection & Treatment ] f
4. Is storage capacity (freeboard plus storm storage), less than adequate? IXI �pillway
Structure I Structure 2 Structure 3\ Suucture 4 Structure 5
ldcntifier:
Freeboard (inches): .............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosiori,
seepage, etc.)
❑ Yes F No
❑ Yes j No
❑ Yes ZNo
❑ Yes No
❑ Yes Q�No
1
❑ Yes p No
❑ Yes �No
Strucatrc h
❑ Yes ElAo
Continued a bac
3/2 3/99

Facility Number: lw pvL-lion
F
6. Are there structures on -site which arc not properly addressed and/or nnuutgycd through a waste tmuragement 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 mana4ocment system other than waste structures require maintenance/improvement"❑
Yes
-dNo
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
� o
11. Is there evidence of over application? ❑ Excessive PondinU ❑ PAN
❑Yes
Wo
12. Crop type U GJ j
,
_
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)
❑ e'
Yes ,�No
14. a) Does the facility lack adequate acreage for land application'?
❑ Yes
No
b) Does the facility need a wettahle acre determination?
❑ Yes
.�No
,No
c) This facility is pended for a wettable acre determination'?
❑ Yes
-
15. Does the receiving crop need improvement?
❑ Yes
allo
16. Is there a lack of adequate waste application equipment')
❑ Yes
Z(No
Required Records & Documents
IT Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
) IN
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists. desi"In, maps. etc.)
❑ Yes
VNo
19. Does record keeping need improvement? (ic/ 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
o
/
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
Po
'_=4. 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
0
�: Vo yiolatitjtis:o:r• &hc' ie' *n' 6es -were nofed. 00*6n9 Ois:visst; • Voii 'will •eeOMi cio; further
�.•.•correspondence.abaittith�s.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):
off 6 fZ 6-1�/l 5 e-lo c410 t" S rf -vc ti /6 P o -•- Gc,177 O r-x/r4 A.
cv X*75L 9 , d.0 R tz--e4ws t"5 e
a, I� 2 ICJ a= a m Fr `Ta
(}GA} /ZEU(5&M t14Oct v� ��3'44-410 nLr�vl2G�
GV ek GnJT L4-jttl � � �j/OG� C G � .tea T!
` J
AJ Oa xr� ll ( 4 ry d A" J �� �a `7`a t4 Aoc- WA-, r-c� S �i/' G e
w
Reviewer/Inspector Name /Y(r1 -Z-- 6 `Jr✓L F r
Reviewer inspector Signatur GYT� Jrj�%% Date: 77/G yCCj
�r73/g9

Facility Number: 33.— 3c7Date 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 ❑ Yes PT 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 A No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ErNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes19NO
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ONO
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes• ZNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes--i o
FMI
3/23/99

q&ql $
,
P
; on of Soil and Water Conservation ❑ Other Agency
vision of Water Quality
Routine O Complaint O Follow-up of DW2 ins ection O Follow-up of .DSWC review O Other
Date of Inspection
Facility Number
Time of Inspection ® 24 hr. (hh:mrn)
Ci Registered Certified © Applied for Permit © Permitted rNot Opera-M7.71 Date Last Operated:
Farm Name: /t% �� ..............e-..........................................
e`.....7�7.....!?-.............................................. County .......L
Owner Name: ZJ Z —
',.................................................................................................. Phone No: ?...........,........................
Facility Contact: ,,,11+^, Title: .. Phone No:
MailingAddress: ............................................................................S.�y�..........................x.............................................................. ..........................
Onsite Representative:.._5c-�!5.� ............................................... Integrator:... �C n !•�!-
...........................................................
Certified Operator:..... Qh.. 7,e�(.,..7 .7............................. I.......................... Operator Certification Number;.........................................
Location of Farm:
i..........................................................................................................................................................................................................................................................................1
Latitude Longitude 0 6 66
Desi 'Current ` ,'� Design" , Current DesignC1.1
Af­urrent
' ', r 'acit
Swinef Cu acit
P Y
Po u€ation Pouitr Ca acit Pa ulalian Cattle',
p Y P Y P, , z
Ga P, Po ulation
Y P
can to Feeder
0
K
p,..,
r
❑ Layer
.., ..
�,
❑ Dairy
,.
a
❑ Feeder to Finish
❑ Non -Layer
❑ Non Dairy
❑ Farrow to Wean
y� '
51-6
,
❑ Farrow to Feeder
El
3
3
❑ Farrow to Finish
•�
In esign
Total DCapacity
❑ Giltsr`
#
V
` Total SSLW'
❑ soars''
vFx,�t
a� g
Ntunber La oa / Hold€n Ponds
❑ Subsurface Drains Present
aArea rea
❑ g ❑ Spray Field A
,�
❑ No Liquid Waste Management System M
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
L If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaUinin?
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?
S. Does any part of the waste management system (other than lagoons/holding ponds) require
c
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?
7125/97
❑ Ye �No�
❑ Yes 0
❑ Yes No
ElYes No
❑ Yes
❑ Yes:�N�
❑ Yes;N7
N
❑ Yes
❑ Yes o
❑ Yes ❑ No

Facility NQmber. ,
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes 4E No
Structures (LaQoons.l oldine Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes 4�Yo
Structure l Stnicture 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:................................................................................................................................................................................
...................................
Freeboard(ft): ................................................................................................................................................................................... ....1�...'.�....
10.
Is seepage observed from any of the structures?
❑ Yes
No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
No
12.
Do any of the structures need maintenance/improvement?
❑ 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
o
Waste_ Application
14.
Is there physical evidence of over application?
❑ YcLB
No
(If in excess of WMP,, or runoff entering waters of the State, notify DWQ)
15.
Crop type rt, , ..Jam' . ft4"...... :.............................. I................. .................................................----........................................................
.....
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? ❑ Yes IdNo .
19. Is there a lack of available waste application equipment? ❑ Yes O
20. Does facility require a follow-up visit by same agency? ❑ Yes IdNo
21. Did Reviewerlinspector fail to discuss review inspection with on -site representative? ❑ Yes IdN
22. Does record keeping need improvement? ❑ Yes No
For Certified or Permitted Facilities Only
23. Does the facili y fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes N
24. Were y additional problems noted which cause noncompliance of the Certified AWMP? ❑Yes No
25. ere any additional problems noted which cause noncompliance of the Permit? ❑ Yes o
No.violations-or de iciencies.were noted during this.visit.- Yodw'ill i"ece'ive-no-further
. c0rr0P6bdencd atioiit -this; visit::.:..:.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 9 ��r

12 Routine- O Complaint O Follow-up of DW2 inspection O Follow-up of DSWC review O Other
ii wunwWrr�i�uii ni ui ui w� iu nu�uiwr^.rw
Facility Number Date of Inspection 7 V
Time of Inspection .24 hr. (hh:mm)
Registered 0 Certified © Applied for Permit © Permitted 0 Not O erational Date Last Operated:
FarmName: ............................................................................................................................... County:... .z72..C� ..............................
OwnerName: ................................................... ........................................................................ Phone No:...........
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Mailing Address: ..........................
Onsite Representative:15.e.. t)............. .............. ,......... Integrator:... 6k1j'TW—..c . . ........................................
Certified Operatorr...................................................
Location of Farm:
....................... Operator Certification Number;
Latitude �• C�' �" Longitude �• �' �"
General
l . Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. Udischarge 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
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 UNo
❑ Yes tzNo
❑ Yes �No
❑ Yes
No
❑ Yes
No
❑ Yes
o
El Yes
No
❑ Yes
RNo
❑ Yes
Continued
/o
•3

FaciUty Number: Ir
8. Ate there lagoons or storage ponds on site which need to be properly closed? ❑ Yes .,,eNo
Structures (LaeoonsAolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes )ZNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft): ........ ;�..f.....�....................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes I;INo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes 51No
12. Do any of the structures need maintenance/improvement? P14res ❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ) ��//11
13. Do any of the structures lack adequate minimum or maximum liquid level markers? El Yes �No
Waste Application
14. Is there physical evidence of over application? ❑ Yes P(No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ........................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
VINO
17.
Does the facility eq g PP have a lack of adequate acreage for land application?
❑ Yes
EdNo
18. Does the receiving crop need improvement?
FYes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
No
20. Does facility require a follow-up visit by same agency?
❑ Yes
eNo
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ONo
22. Does record keeping need improvement?
❑ Yes
A No
For_Certified or Pernutted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
gfNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑.Yes
gNO
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
[INo
0. No.vioilations.oz deFidencies:were.noted,during this'.visit._ You.Vi1 i-eceive:no-furthei� ::
correspQndekr d4obt this:visit:•::....:.
77 I'Y1 G�t1 iN 5 /YJ 45" gad P &S OF A4 6G 4W Vcc%(/
r cti s ��zr �
/4& w F en
'�01 79,64--
m s7?5&f-T-
/c6 r10rz /— E-5 5 /72�
I
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: /f�f� /�, --, , , e j "/f 16 Date:

r Revised January 22, 1999
-.JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number 333 .3 Operation is'flagged for a wettable
Farm Name: ,-t acre determination due to failure of
On -Site Representative: SaK fSe-/ Part ll eligibility item(s) F1 F2 F3 F4
Inspector/Reviewer's Name: L;We_1I
Date of site visit: S ��
Date of most recent WUP: r - �. TJ_
Operation not required to secure WA
determination at this time based on
exemption El E2 E3 E4
Annual farm PAN deficit: —'% 6 pounds
Irrigation System(s) - circle #: 1. hard -hose traveler; 2. center -pivot system; 3, linear -move system;
4. stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system w/portable pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system wlportable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part 11, overrides Part I exemption.)
E1 Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an 1 or PE.
E2 Adequate D, and D2/D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ill. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part 11. Complete eligibility
checklist, Part 11 - F1 F2 F3, before completing computational table in Part ill).
PART II. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Determination required because operation fails one of the eligibility
requirements listed below:
F1 Lack of acreage which resulted in over application of wastewater (PAN) on spray
eld(s) according to farm's last two years of irrigation records.
F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations (numerous ditches; failure to deduct required
bufferisetback acreage; or 25% of total acreage identified in CAWMP includes
small, irregularly shaped fields - fields less than 5 acres for travelers or less than
2 acres for stationary sprinklers).
F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part Ill.

Revised January 22, 1999
,it�r Number 33 -3 )'
art III. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT FIELD
NUMBERLUMBER',z
TYPE OF TOTAL
IRRIGATION ACRES
SYSTEM
CAWMP FIELD
ACRES %
COMMENTS'
FZ
4
I
cr—
�G
-h
4
4
I
I
I l
I
I
4
FIELD NUMBER' - hydrant, puli, zone, or point numbers may be used in place of field numbers depending on CAWMP
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer Wii have to combine fields to
calculate 7511,1,: field by field determination for exemption if possible; otherwise operation will be subject to WA
determination.
FIELD NUMBER2 - must be clearly delineated on map
COMMENTS - back-up fields with CAWMP acreage exceeding 75Q10 of its total acres and havirc received Less -than 5011/10
of its annual PAN as documented in the farm's previous two years' (1997 & 1998) of irrigation records, cannot serve as the
sole basis for requiring a WA Determination. Sack -up fields must be noted in the comment section and must be accessible
by irrigation system.

State of North Carolina
Department of Environment and Natural Resources
Raleigh Regional Office
James B. Hunt, Jr., Governor DIVISION OF WATER QUALITY September 19, 1997 Wayne McDevitt, Secretary
Mr.. Ben Shelton
Route 1, Box 322
Maccelsfield, North Carolina 27852
Subject: Compliance Evaluation Inspection
Facility # 33-39
Ben Shelton Farm
Edgecombe County
Dear Mr. Shelton:
On September 16, 1997, Mr. Buster Towell from the Raleigh Regional Office
conducted a compliance inspection of the subject animal facility. The inspection
is part of the Division's efforts to determine compliance with the State's animal
waste nondischarge rules.
The inspection determined that the operation was not discharging wastewater into
waters of the State and that operations were proceeding according to your
approved Animal Waste Management Plan. As a result of the inspection, the
facility was found to be in compliance with the State's animal nondischarge
regulations.
Effective wastewater treatment and facility maintenance are an important
responsibility of all animal waste producers. The Division of Water Quality has
the responsibility to enforce water quality regulations in order to protect the
natural resources of the State.
The Raleigh Regional Office appreciates your cooperation and compliance. If you
have any questions regarding this inspection please call Mr. Buster Towell at
[phone].
Sincerely,
&,.
J ry trett,
Water Quality Section Supervisor
cc: Edgecombe County Health Department
Mr. A. B. Whitley, Edgecombe Soil and Water
Conservation District
Ms. Margaret O'Keefe, DSWC-RRO
DWQ Compliance Group
RRO Files
3804 8untt Drive. Suite 101 • Raleigk NC 27609
Voice (919)5714700 1 FAX [phone]
An Equal Opportunity Affirmative Action Employer
500/. recycled 110% poo-cwsumer paper

�j Facility Number Date of Inspection
JTime of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ R red ElApplied for Permit (ex:.1.25 for 1 hr 15 min)) Spent on Review
Certified ❑ Permitted or Inspection (includes travel and processing)
❑l Not Operational)/ Date Last Operated: ............._.........................................................I..................................................._....._.................
Farm Name:... ............................................... Coun tl
........... ty:t!-' ................b. e........... _....... ......... _............
Land Owner Name: L2Q:1x.. F �t.a:.17v�1........... _..................................................... Phone No:...1J.1.......................................... _............................
Facility Conctact:
Mailing
Title: .xT..... ................. Phone No:
z
Onsite Representative: (/...!,..1.�e � 4vh..._... Z................. __......_................. Integrator: ............................. _..... _._...
......//....--
Certified Operator:.......... f� dam"" Operator Certification Number:
..........................................................................
Location of Farm: % d 2-,A) � rj � ,eo
.......................................................................................................................................................................................................................................
Latitude Longitude
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes dTNo
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?
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
❑ Yes
❑ Yes o
❑Y ❑No
Continued on back

Facility Number: —_.
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
StructuEs (1j.-opusand/or 11olding,Po,udS)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5
...... J.'s... l.... ............................ ............................ ............................ ............................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify-DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type.3..1!'.......................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certified FgcJitiCs Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes No
❑ Yes VNo
❑ Yes
❑ Yes
Structure 6
❑ Yes 1
❑ Yes o
❑ Yes o
❑ Yes o
❑ Yes o
❑ Yes allo
❑ Yes ��No_
❑ Yes �o
El Yes
❑ Yes N
❑ Yes No
❑ Yes
❑ Yes
❑ Yes
Comments (refer to,yuestton #) Ezplam any YES answers and/or any recommendations or any other comments a
Use¢drawm s;of facili to Better ex lam situat►ons. use add2tiona! a es as necess � x � _
g ,t �3' R: P g �Y)
..
1%1%C: JJ �, 0,.-1 tsf, LI& 97 L,44 4S ���s � ����v�--[, -r! J Y¢ &.,rtz r 4
1,A - -�L ►a- �W-r I a� v4s K} D r ,. ,s' v�- ps..-f
CA i v�_
Reviewer/Inspector Name �uNOW
t . r
Reviewer/Inspector Signature: Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

w
1
State of NorthlCarolina
Department if Envlronment,
Health and Natural Resources 1 VI's •
Raleigh Regional Office
James B, Hunt,'Jr., Governor F.HNF;Z
Jonathan B, Howes, Secretary
Division of Environmental Management
June 3, 1996
Mr. Ben Shelton
Route 1 Box 322
Macclesfield, NC 27852
Subject: Management Deficiency Notification
Shelton Swine Operation
Farm No. 33-39
Edgecombe County
Dear Mr. Shelton:
On May 16, 1996, Ted Cashion from this office conducted a
compliance inspection of the subject animal facility. Your
cooperation during the inspection was appreciated. This inspection
was a follow-up inspection as part of the Division's efforts to
determine potential problems associated with waste disposal
systems.
As a result of the inspection, the following management
deficiency was observed:
1. The lagoon had approximately 6 inches of freeboard.
Properly functioning lagoons in your area should maintain a
minimum of 19 inches of freeboard at all times.
In addition, other deficiencies noted in the July 27, 1995
inspection had been addressed. The trenched area in the lagoon
dam, and several animal holes in the top of the dam, had been
repaired.
You stated during the inspection that underground piping for
irrigation had been installed, and that you were waiting for a pump
to arrive to complete the system. You also stated that a waste
management plan had been prepared for your farm.
Please respond in writing to this report by July 3, 1996,
stating when the pump arrived, when spraying from the lagoon was
initiated, and the freeboard of the lagoon at the time of your
response. You are reminded that the waste management plan will be,
in effect, your permit to operate this facility. Please comply
with all conditions and documentation required by the plan,
including the minimum freeboard requirement. Any violation of your
plan may result in an enforcement action against you.
3800 Barrett Drive, Suite 101, NO
FAX [phone]
Raleigh, North Carolina 27609 C An Equal Opportunity Affirmative Action Employer
Voice 919-571-4700 50%o recycled/10% post -consumer paper

r
Mr. Shelton
June 3, 1996
Page 2
You are also reminded that you will be required to be trained
and certified as an animal waste management system operator, or
obtain the services of such operator, prior to January 1, 1997.
Effective wastewater treatment and facility stewardship are
the responsibility of all animal facility operators. The Division
of Environmental Management is required to enforce water quality
regulations in order to protect the natural resources of the State.
Accordingly, illegal discharges of wastewater to surface waters of
the State are subject to the assessment of civil penalties of up to
$10,000 per day.
The Raleigh Regional Office appreciates your cooperation in
this matter. If you have any questions regarding your inspection
please call Mr. Cashion at 919-571-4700.
Sincerely,
2e,
Kenneth Schuster, P. E.
Regional Supervisor
cc: Edgecombe County Health Department
Edgecombe County Soil and Water Conservation District
Facilities Assessment Unit
h:\animal\shelton2.ind

Facility Number:
Division of Environmental Management 33— 39
Animal Feedlot Operations Site Visitation Record
Date: 1 0L
Time: o(�`''
GeneralInformat' n:
Farm Name: h S Q ' `� County:�
Owner Name: e k f etto,
Phone
On Site Representative: 41 k,al egroat
s
Mailing Address: of :5 o o IPIF -'
. � ( I e� C c f � f)r,'
Physical Address/Location:_ Cash �` dT� US
Latitude: l I Lon itude: 1 I
Operation Description: (based on design characteristics)
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
a Sow Q Layer ❑ Dairy
❑ Nursery ❑ Non -Layer ❑ Beef
gFeeder v
OtherType of Livestock: Number of Animals:
Number of Lagoons: (include in the Drawings and Observations the freeboard of each lagoon)
Facility Inspection:
Lagoon
Is lagoon(s) freeboard less than I. foot + 25 year 24 hour storm storage?: Yesx
Is seepage observed from the lagoon?: Yes ❑
Is erosion observed?: Yes ❑
Is any discharge observed?
❑ Man-made 0 Not Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover crop need improvement?:
( list the crops which need improvement)
Crop type: k4x Acreage:
Setback Criteria
Is a dwelling located within 200 feet of waste application?
Is a well Iocated within 100 feet of waste application?
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream?
AOI -- January 17,1996
Yes ❑
Yes ❑ No
Yes ❑ Noj�
Yes ❑
Nolk
Yes ❑
No
Yes ❑
. Nolly
Yes ❑
NoA,,

Maintenance
Does the facility maintenance need improvement? Yes ❑ No
Is there evidence.of past discharge from any part of the operation? f Yes ❑ No
/ Does record keeping need improvement? Se �& w Yes El No ❑
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes ❑ No ❑
Explain any Yes answers: 610 f� ak r��, �� h P �Q r WRJ%t� /� q11? c�, e�
1
VQco�T rr
y t 4— h (q
1 f �/rlir ran �(n G (/ l r'1 / ~Ol G/ f. �'�r�� ,� Q / �1 •S" i/`'f / `i � C�, ,
f(1 / k 4 � r^'i / -•, o
R(Jtlf blS Dhy. '/ Iq7;
� r
Signature:
cc: Facility Assessment Unit
Drawin s or Observations:
Date: �t 0 s 4
Use Attachments if Needed
AOI -- January 17,1996

d.
State of North Carolina
Department of Environment,
Health and Natural Resources
Raleigh Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Boyce A. Hudson, Regional Manager
ANTI.KaWA
�Aw
DEHNR
Division of Environmental Management
July 31, 1995
Mr. Ben Shelton
Route 1 Box 322
Macclesfield, NC
Dear Mr. Shelton:
27852
Subject: Management Deficiency Notification
Swine Operation
Edgecombe County
On July 27, 1995, Ted Cashion from the Raleigh Regional Office
conducted a compliance inspection of the subject animal facility.
Your cooperation during the inspection was appreciated. This
inspection is a part of the Division's efforts to determine
potential problems associated with waste disposal systems.
As a result of the inspection, the following management
deficiencies were observed:
1. A trenched area in the lagoon dam was present, allowing
waste to be discharged to a wooded area. It could not be
determined if this waste was reaching surface waters of the
State. This trenched area must be filled in and sufficiently
compacted immediately to prevent future discharges from the
lagoon.
2. The lagoon had little freeboard, less than 8 inches in
some areas. Regulations require a minimum of 18 inches of
freeboard must be maintained at all times. When spraying to
reduce the lagoon volume care must be taken to ensure that the
applied waste is not allowed to run off the spray site. This
problem must receive prompt attention in order to prevent a
future discharge or a lagoon breech.
3. Several animal holes in the top of the dam were noted.
These must be filled in and sufficiently compacted to ensure
the integrity of the dam.
4. You informed Mr. Cashion that you would immediately begin
to repair the above items noted, and that additional cover
crop area would be put in place soon.
In addition to continued waste facility management, these
deficiencies must be immediately addressed to help prevent the
possibility of an illegal discharge. The Raleigh Regional Office
3800 Barrett Drive, Suite 101, Raleigh, North Carolina 27609 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/ 10%post-consumer paper

Mr. Shelton
July 31, 1995
Page 2
requires a written response to the aforementioned issues by August
22, 1995, specifically addressing how you corrected the problems
noted.
Effective wastewater treatment and facility stewardship are
the responsibility of all animal facility operators. The Division
of Environmental Management is required to enforce water quality
regulations in order to protect the natural resources of the State.
Accordingly, illegal discharges of wastewater to surface waters of
the State are subject to the assessment of civil penalties of up to
$10,000 per day, and may also result in the loss of deemed
permitted status, requiring immediate submission of a waste
management plan.
This office also reminds you that you are required to have an
approved animal waste management plan by December 1997. This plan
must be certified by a designated technical specialist or a
professional engineer. For a listing. of certified technical
specialists or assistance with your waste management plan you
should contact your local Soil and Water Conservation District.
The Raleigh Regional Office appreciates your cooperation in
this matter. If you have any questions regarding your inspection
please call Mr. Cashion at 919-571-4700.
Sincerely,
0oo,;5,"A"/ f,Is�r�
Kenneth Schuster, P. E.
Regional Supervisor
cc: Edgecombe County Health Department
Edgecombe County Soil and Water Conservation District
Facilities Assessment Unit
h:\animal\shelton.ind

J'UL-14-1995 15: 26 FROM DEN WwTEP OUPL I T`,' SECT I LIJ TO
RRLD P.22/ 2
Site Requires Immediate Atientjon- Ie
Facility No.
DIVISION OF EN-0RONMENTAL MANAGENLEN T
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE.: Z- d / , 1995 l_p' e- 93 a� 3 J
Time: 4 ,• if 0
Farts Name/Owner:
Mailing Address,,: —
County. - f a�- e <
Tntegator:
On Site Representative:
P}iysical Addmss/Locatxon:
a
e rx.
eS
Phone:
Phone: _ U /�' - 3 ./"7 - /
Type of Operation: Swine �_ Poultry Cattle
Design Capacity: Number of Animals on Site: �0 0 oyyfE5'}
DEM Certification Number: ACE DEM (Zerafication Number: ACNE%iW
Latitude: 3y 1 Longitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sa ficienr. freeboard of 1 foot + 25 year 24 hour s rm event
(approxii-nateiv I Foot + 7 inches) Yes or& Acrual Freeboard: F[. Inches
Was any seepage observed from the la oou(s)`? Yes o owas any erosion observed? Yes o No
Is adequate land available for spray`. Ye or No 1s the cover crop adequate? Yes or No
Crop(s) being utilized-._
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? 'Yes or No
100 Feet from Wells? Yes or No
_i:[ a^imal waste stockpiled within 100 Feet of USGS Blue Line Strcam? Yes or No
`.� altimal waste Iand applied or spray irrigated within 25 Ft�et of a USGS Nap Blu.p Line') Yes or No
ani.mal waste discharger) into waters of the state by inan-made ditch, flushing system. or urher
Jmi;ar macs -made devjces'= Yes or No If yes. Please E:tpl:lin.
' 1r ti u,c r:.tc:ility maintain adequate waste warrageTue it records (volumes of manure, land applied.
Spray irrigated on specific acreage with ccNvex crop)'? Yes or No
Additional rrr onal Coments: `Y w c � ed� arrp.r 1c�. �c►
'woe,i . I_( fe-.t 0U-4,P� ��Gfl1 IArcrti i�H. 1`61��r �FCrf/Ccw� of
CIP4
s1 r C of - Cy
... r 61 Ci f df P ev
cc: Facia [y Assessment Unit
l�
eh o _67' claw_ i'` !y 1~olrs
rvC e - p -ks�
a a n 2' �Uyc's 47C ?y PI ti e 9'
- 4
Signature
r
Use Attachments if Needed.
TOTAL P.�2

19'Routine O Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other J
Facili ty. Number 3 Date of Inspection Z a
Time of Inspection = 24 hr. (hh:mm)
ermitted [3 Certified [3 Conditionally Certified [3 Registered JE3 Not ]erational Date Last Operated:
Farm Name:...y`...5�../T'7.......�1�.+-.............................................. County:..1-�f��.vry`'✓...�................. .......................
OwnerName:.............] q.M..Q......................................................................................... Phone No: ............. ..... I .......... I..
.......................................................
Facility Contact: .....f?FJ.!rr.-..................................................Title:..........................
Mailing Address:...........6.. k32..l.........w.-.� ..CCes
.........................„........................................
Onsite Representative:" S� /`
Certified Operator % Qh,,,, ,p J�Q ....
............................................................
Location of Farm: Ll ",
Phone No:
Integrator: ...... rltTl.:��....................................................
Operator Certification Number:.............. ............................
Latitude. ©�� Longitude ©• j�7 ��
Design 'Current
Destgn Current r ,E`, �a ,E136i � Current
�Swti'C�QaeEe
T6
Poult
Ca P
„ cit ulation
y0F ,�,Ca at �qPo ulati6i"
can to Feeder
Layer
❑Dairy;
r,
a,
❑ Feeder to Finish
❑ Nan -Layer
❑ Non -Dairy
�d ❑Farrow to Wean
�� , 'h� E .i , :=E �tr��ri r E , a ` K �4 rk
❑ Farrow to Feeder
❑Other
I I F
sC3 Farrow to Finish
V.
E ,€ 1T6t6 Design°CilpaCltyi At
it
❑ Gilts
a r
` Boars '„
_
� k k Total' SSLW
..i
Pe.,
h yr it
Number of Lagoons
i 3 i E
� [k i
�"
�E
[] Subsurface Drains Present I[] Lagoon Area ❑Spray Feld Area
j�,;
E�
Holdin �Pbnda I'SohdiTra s�;E'
1}
❑ No
Liquid Waste Management System ; s
Discharges & Stream Impacts
I. 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 gallmin?
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:
Freeboard (inches): .......................................................
d..........................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes J—ewo
❑ Yes Zl
❑Yes Etvo
❑ Yes
effislo
❑ Yes
❑ Yes
51""
❑ Yes ❑
Structure
❑ Yes No
Continued on back
3/23/99

Facility Number: — 3 Date of Inspection
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 WNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ONo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes NKNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes
12, Crop type S'I d .
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes N;
14. a) Does the facility lack adequate acreage for land application? ❑ Yes �—
b) Does the facility need a wettable acre determination? ❑ Yes ZN
c) This facility is pended for a wettable acre determination? ` ❑ Yes
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there'a lack of adequate waste application equipment? ❑ Yes o
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes lE5Nc
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
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 PNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes
23. Did Reviewer/Inspect _fdil to discuss review/inspection with on -site representative? ❑ Yesj1NO1
24. Does facilit quire a follow-up visit by same agency? ❑ Yes
25. We any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes o
INQ •YiplAt iOijs.ot- dgf jcjertcies wgre pot o. f ut:1ng fbjs:vjsjt! • Y:oo Wi1i•tecciy6 00 fuftbtf. .
• correspondence. ahiruti this visit........ ' :.......................... .
A
ector Name Reviewer/Ins r tir"�-ln7, -r-ca
i t y
p .•� •�'f � L .�1L..r - it i 7 ! �.��;��� it ^1 _�i.�
Reviewer/Inspector Signature: �,� Date:. & 7 '91 e2

Facility Number: — Date of Inspection/ZT
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
O
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
Ja 0
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
o
31. Do the animals Feed storage bins fail to have appropriate cover?
❑Yes
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
;0/
[Z ° 6 2'q (3 oq-

I
i �■
Type of Visit . ,O;2tine
i inspection O Operation Review O'Lagoon Evaluation I
Reason for Visit O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facil y-Number Date of Visit: I Time:
Q Not Operational Q Below Threshold
Permitted © Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .................
Farm Name: ..h.... fi I 2h r Count ............................................
Owner Name: Phone No:
Facility Contact:..............................................................................'Title:..........
MailingAddress:.............................................................................................
Onsite Representative:.,.,
Certified Operator:,.....1„ S
� ....................................... 4o / 4 .,
..............................................
Location of Farm: Z 5-v
......................................... Phone No:...................................................
Integrator: j5e..!J' ...........................................................
.............. Operator Certification Number:......
❑ Swine ❑ Poultry ❑ Cattle [3 Horse Latitude 9 66 Longitude �• �' �"
Design
Swiine
Ci. act `
eanto Feeder
�? ` ❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
��i; ❑ Gilts
❑ Boars
-ent Design Current, Design
iiion Poultry Capacity Populati+n r � Cattle a ' Capacity ='P
1❑ Non -Layer Non -Dairy
❑ Other f
Total Design Capacity
Total SSLW
Number of La rea
goo ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Ar
o E
H
olding Ponds'/Solid Traps ] ❑ No Liquid Waste Management System r
Discharges & Stream Impacks
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
Str cturc I Structure 2 Structure 3 Structure 4 Structure 5
11 -
Identifier:................0..................................................................................... .............
Freeboard (inches):
5100
❑ Yes 0
❑ Yes o
❑ Yes o
❑ Yes o
El Yes o
❑ Yes VO
❑ Yes
Structu
Continued on back

acility Number: —3f I Date of Inspection � Printed on: 1/9/2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] Yes
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes o
(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 maintenancelimprovement?
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
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14, a) Does thefacility 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. Fait 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?
• N4.*i01.a000S` r 40ciepc{es wire pof - Airing tjiis'visit; . Y:oa W)il •lree0ij+e IrXo fu $r
• cor'res.oridence: a�auti this visit: - • - • � • � . - -
.ottaments (refer to quesaba #) , Explain any YFS answeirs and/or auy, 1
' 4 3 3 - jl , 3 � t
Usa drawit�s of [acf ity to$etter explain'situations (use additional page;
S, 4 'Vj1r'
r'4 2tra
A d 4-0 Ilc�
r� 6 r,
❑ Yes 214
❑ Yes L
❑ Yes
❑ Yes 7No
<0
El Yes
❑ Yes PI
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Ja""
❑ Yes l o
es ❑ No
❑ Yes LSO
es ❑ No
❑ Yes No
❑ Yes 0
❑ Yes a<0
❑ Yes
❑ Yes To
❑ Yes No
. n ,L- /y s 0, •S.
_ �*
Reviewer/Inspector Name �x l � .1t'i i, i Pi L
Reviewer/Inspector Signature: Date: 990

Facility Number: 7 Date of Ills ection PrinteA on: "! /9/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
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.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
AdditionaMomments andtor,Draw'
0 Yes Cf �xo
0 Yes No
El Yes 0
El Yes No
E] Yes No
0 Yes No
[] Yes,, No
5/00

State of North Carolina
Department of Environment
and Natural Resources
Raleigh Regional Office
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Division of Water Quality
April 17, 2001
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Mr. Ben Shelton
Route 1, Box 322
Macclesfield, North Carolina 27852
Subject: Notice of Violation
Ben Shelton Farm
Permit No. AWS330039
Edgecombe County
Dear Mr. Shelton:
WMUFA
Ami
NCDENR
MCFVTH G►rzouNA D r�r or
ENVIRONMEMY AND N/QL.IRAL RMS0L}F4CG4
On April 16, 2001, Mr. Buster Towell of the Raleigh Regional Office conducted an inspection
of the subject swine operation. The inspection revealed the following violations of your
Certificate of Coverage (COC) and General Permit:
General Permit Condition I.,4., states thaftopy of the COC and General Permit be on site and
available for inspection.
Neither the COC or the General Permit was available during the inspection.
Permit Condition 111.,2, requires that lagoon freeboard levels be recorded on a weekly basis
and maintained for inspection.
While there were some freeboard records on site, there were several missing months of
required freeboard level records.
Please note that the above referenced violations may be subject to civil penalties of up to $
10,000.00 per day, per violation, and in some cases $ 25,000.00 per day, per violation.
1625 Mail Service Center, Raleigh, NC 27699-1628 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled110% post -consumer paper

Mr. Ben Shelton
Page 2
Please respond to this Notice in writing within fourteen days of your receipt. Your response
should include a summary of your plans to correct the referenced violations.
The Raleigh Regional Office has conducted a records search which indicates that your facility
received the General Permit on May 10, 2000. The data base also shows that your facility is
below the Steady State Live Weight (SSLW) that would require you to submit an annual permit
fee for the operation of your farm.
If you have any questions regarding this Notice you should contact Buster Towell at (919) 571-
4700.
Sincerely,
Kenneth Schuster, P.E.
Regional Water Quality Supervisor
cc: Edgecombe County Health Department
Mr. A.B. Whitley, Edgecombe Soil & Water Conservation District
Ms. Margaret O'Keefe, RRO-DSWC
DWQ Nondischarge Compliance Group
RRO Files

PAT MCCRORY
Goa°errrnr
DONALD R, VAN DER VAART
r Secrerarr
Water Resources S. JAY ZIMM_ ERMAN
ENviRONMENTAL QUALITY " -
Uirecmr'
February 23, 2016
Ben W Shelton
Ben Shelton Farin
1012 Webb Chapel Rd n�
Macclesfield, NC 27852
Re: Renewal of the Expired permit C'�rCc?
Pen -nit No.: AW1330039
Edgeeombe County
Dear Ben W Shelton:
Your facility was approved for operation under one of the Animal Waste Operation Individual Non -
Discharge Permits, which expired on 9/30/2014.Our records indicate that the Division has not received a
completed renewal application form from your facility to date. In order to maintain coverage under the
current Permit, please complete one of the following actions:
1. Please indicate if your facility is depopulated and the lagoon(s) or storage pond(s) at your facility
have been properly closed according to the NRCS standards. In that case, you may send us a written
request to rescind this permit by submitting a completed and the permit is rescinded. A blank Lagoon
& Waste Storage Pond Closure Form can be found at: http://portal.ncdenr.org/web/wq/aps/afo/report
2. Please submit a renewal application form that must be completed, signed and returned to DWR, The
application form for the State or NPDES Individual Pert -nit for Existing Operations can be found at:
http://portal.ncdenr.org/web/wq/aps/afo/apes. Please include two (2) copies of your most recent Waste
Utilization Plan along with the field maps, if your facility is still active.
3. if you are a cattle facility that has gone below the threshold animal numbers (< 100), you may request
the rescission of your pennit provided if the average size of the confined cattle herd at the cattle facility,
calculated on an annual basis during the three years prior to the request for rescission, is less than one
hundred confined cattle.
Please submit the requested information within thirty (30) days of receipt of this letter to the following
address:
Ill EN�1►y .4
Animal Feeding Operations Program
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Telephone number: [phone]
Continued...
Suite of North Carolina I Environmental Quality J Water Resources
1636 Mail service Center I Raleigh, North Carolina 27699-1636
I n 807 6464

Failure to request renewal of your coverage under a permit within the time period specified may result in a
civil penalty. Operation of your facility without coverage under a valid permit would constitute a violation
of NCGS 143-215.1 and could result in assessments of civil penalties of up to $25,000 per day.
If you have any questions about this request, please feel free to contact me at 919-807-6341.
Sincerely,
/�1�
J. R. Joshi, Soil Scientist
Animal Feeding Operations Program
cc: Raleigh Regional Office, Water Quality Regional Operations Section
Edgecombc County Soil and Water Conservation District
WQROS Unit Central Files - AW1330039

RMA
w►�..�
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E, Skvai III
Governor Secretary
November 21, 2014
Ben W Shelton
Ben Shelton Farm
1012 Webb Chapel Rd 3 F3V 2 4 2014
Macclesfield, NC 27852
Re: Renewal of the Expired Lh\IR %zleich Regional Ofpce
Pen -nit No.: AW133003
Edgecombe County
Dear Ben W Shelton:
Your facility was approved for operation under one of the Animal Waste Operation Individual Non -
Discharge Permits, which expired on 9/30/2014. Our records indicate that the Division has not received a
completed renewal application form from your facility to date. In order to maintain coverage under the
current Permit, please complete one of the following actions:
1. Please indicate if your f-acility is depopulated and the lagoon(s) or storage pond(s) at your facility
have been properly closed according to the NRCS standards. 1n that case, you may send us a request
to rescind this permit by submitting a completed and the pen -nit is rescinded. A blank Lagoon &
Waste Storage Pond Closure Form can be found at: http://portal.ticdenr.org/web/wqlaps/afo/report
2. Please submit a renewal application form that must be completed, signed and returned to DWR. The
application form for the State or NPDES Individual Permit for Existing Operations can be found at:
http://portal.nedcnr.or W web/wq/aps/afo/apes. Please include two (2) copies of your most recent
Waste Utilization Plan along with the field maps, if your facility is still active.
3. If you are a cattle facility that has gone below the threshold animal numbers (< 100), you may request
the rescission of your pen -nit provided if the average size of the confined cattle herd at the cattle
facility, calculated on an annual basis during the three years prior to the request for rescission, is less
than one hundred confined cattle.
Please submit the requested information within thirty (30) days of receipt of this letter to the following
address:
NCDENR—DWR
Animal Feeding Operations Program
1636.Mail Service Center
Raleigh, North Carolina 27699-1636
Telephone number: [phone]
Continued...
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Phone: [phone]Internet: htto://www.ncdenr,aov/
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

Failure to request renewal of your coverage under a permit within the time period specified may result in
a civil penalty. Operation of your facility without coverage under a valid permit would constitute a
violation of NCGS 143-215.1 and could result in assessments of civil penalties of up to $25,000 per day.
If you have any questions about this request, please feel free to contact the Animal Feeding Operations
Program staff at 919-807-6464.
Sincerely,
J. R. Joshi, Soil Scientist
Animal Feeding Operations and Ground
Water Protection Branch
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
Enclosures
cc (w/o enclosures): Raleigh Regional Office, Water Quality Regional Operations Section
Edgecombe County Soil and Water Conservation District
WQROS Unit Central Files - AW1330039

CDEH
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Ben Shelton
Ben Shelton Farm
1012 Webb Chapel Rd.
Macclesfield, NC 27852
Dear Mr. Shelton:
Division of Water Quality
Coleen H. Sullins
Director
October 6, 2009
Subject:
Permit No. AW1330039
Ben Shelton Farm.
Animal Waste Management System
Edgecombe County
Dee Freeman
Secretary
In accordance with your application received September 4, 2009, we are hereby forwarding to you this
Permit issued to Ben Shelton authorizing the operation of the subject animal waste management system.
You had indicated the animal population at this facility to be zero until such time as the waste storage
lagoon at this facility is properly closed.
This approval shall consist of the operation of this system including, but not limited to, the management
of animal waste structures on the Ben Shelton Farm, with an annual capacity of no greater than an annual
average of zero (0) Swine.
The Permit shall be effective from the date of issuance until September 30, 2014 and replaces the COC
No. AWS330039 issued to this facility on October 1, 2004. You are subject to the conditions of this
permit until the closure of all waste storage basins and the rescission of this .permit. You must submit a
letter to the Division of Water Quality to request rescission of the Permit by providing documentation of
closure of all containment basins.
The issuance of this Permit does not excuse the Permittee from the obligation to comply with all
applicable laws, rules, standards, and ordinances (local, state, or federal) nor convey any property rights
in either real or personal property.
Per 15A NCAC 2T. 0111(c), a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary. Per NRCS standards, a 100-ft separation
shall be maintained between water supply wells and any lagoon, storage pond, or any wetted area of a
spray field.
Please be advised that any violation of the terms and conditions specified in this Permit may result in
revocation of this Permit. or penalties in accordance with NCGS 143-215.6A through 143-215.6C, the
Clean Water Act, and 40 CFR 122.41, including civil penalties, criminal penalties, and injunctive relief.
If you wish to continue the activity permitted under this Permit after the expiration date of this Permit, an
application for renewal must be filed at least 180 days prior to expiration.
1636 Mail Service Center, Raieiah, North Carolina 27699.1636
Location. 272B Capital Blvd. Raleigh, North Carolina 27604 One
Phone: [phone] t FAY, 919-715-0588 l Customer Service: 1-877-623-674r; North Carols n a
imeme: www.nmatemuali#y.orr ��
An dualOprtortunuy1AffirmativeAcunnEMwoyel (' ►"atutJ f

This Permit is not automatically transferable. A name/ownership change application must be submitted to
the Division prior to a name change or change in ownership.
This facility is located in a county covered by our Raleigh Regional Office. The Regional Office Aquifer
Protection Staff may be reached at [phone]. If you need additional information concerning this
Permit, please contact the Animal Feeding Operations Unit staff at [phone].
Sincerely,
for Coleen H. Sullins
cc: Edgecombe County Health Department
Edgecombe County Soil and Water Conservation District
Raleigh Regional Office, Aquifer Protection Section
Notebook File AWI330039
Permit File AW1330039
NORTH CAROLINA

ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
INDIVIDUAL SWINE ANIMAL WASTE MANAGEMENT SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Ben Shelton
Edgecombe County
FOR THE
continued operation and maintenance of an animal waste management system for the Ben Shelton Farm,
located in Edgecombe County, consisting of zero (0) Swine and the application to land as specified in the
Facility's Certified Animal Waste Management Plan (CAWMP).
This permit shall be effective from the date of issuance until September 30, 2014 and shall be subject to
the following specified conditions and limitations:
I. PERFORMANCE STANDARDS
1.. The animal waste management system operated under this Permit shall be effectively
maintained and operated as a non -discharge system to prevent the discharge of pollutants
to surface waters, wetlands, or ditches. Application of waste to terraces and grassed
waterways is acceptable as long as it is applied in accordance with Natural Resources
Conservation Service (NRCS) Standards and does not result in a discharge of waste to
surface waters, wetlands, or ditches. If the Facility has a discharge of waste that reaches
surface waters or wetlands resulting from a storm event more severe than a 25-year, 24-
hour storm.. it will not be considered to be in violation of this Permit, as long as the
Facility is in compliance with its CAWMP and this Permit.
2. No discharge of waste shall result in a violation of the water quality standards established
for receiving waters as per Title 15A, Subchapter 213, Section .0200 of the North Carolina
Administrative Code (NCAC) and Title 15A, Subchapter 2L of the NCAC.
The facility's CAWMP is hereby incorporated by reference into this Permit. The
CAWMP must be consistent with all applicable laws, rules, ordinances, and standards
(federal, state and local) in effect at the time of siting, design, and certification of the
Facility.
Any proposed increase or modification to the annual average that exceeds the thresholds
set by North Carolina General Statues (NCGS) 143-215.1OB(1) will require a
modification to the CAWMP and the Permit prior to modification of the Facility.

5. Animal waste shall not be applied within one hundred (100) feet of any well, with the
exception of monitoring wells. The allowable distance to monitoring wells shall be
established on a case -by -case basis by the Division.
II. OPERATION AND MAINTENANCE REQUIREMENTS
The collection, treatment, and storage facilities, and the land application equipment and
fields shall be properly operated properly and maintained at all times.
2. A vegetative cover shall be maintained as specified in the Facility's CAWMP on all land
application fields and buffers in accordance with the CAWMP. No waste shall be
applied upon areas not included in the CAWMP.
Soil pH on all land application fields must be maintained in the optimum range for crop
production.
4. Land application rates shall be in accordance with the CAWMP. -In no case shall land
application rates exceed the agronomic rate of the nutrient of concern for the receiving
crop. In no case shall land application rates result in excessive ponding or any runoff
during any given application event.
If manure or sludges are applied on conventionally tilled, bare soil, the waste shall be
incorporated into the soil within two (2) days after application on the land. This
requirement does. not apply to no -till fields, pastures, or fields where crops are actively
growing.
Pesticides, toxic chemicals, and petroleum products shall not be disposed of in the animal
waste management system.
Domestic and/or industrial wastewater from showers, toilets, sinks, etc. shall not be
discharged into the animal waste management system. Washdown of stock trailers
owned by and used to transport animals to and from the Facility only will be permissible
as long as the system has been evaluated and approved to accommodate the additional
volume. Only those cleaning agents and soaps that are EPA -approved according to their
labels, will not harm the cover crop, and will not contravene the groundwater standards
listed in 15A NCAC 2L may be utilized in the Facility covered by this Permit.
Instruction labels are to be followed when using cleaning agents and soaps.
8. Disposal of dead animals resulting from normal mortality rates associated with the
Facility shall be done in accordance with the Facility's CAWMP and the North Carolina
Department of Agriculture and Consumer Services (NCDA&CS) Veterinary Division's
statutes and regulations.
9. Unless accounted for in temporary storage volume, all uncontaminated runoff from the
surrounding property and buildings shall be diverted away from the waste
lagoons/storage ponds to prevent any unnecessary addition to the liquid volume in the
structures.

10. A protective, vegetative cover shall be established and maintained on all earthen
lagoon/storage pond embankments (outside toe of embankment to maximum pumping
elevation), berms, pipe runs, and diversions to surface waters or wetlands. Trees, shrubs,
and other woody vegetation shall not be allowed to grow on the lagoon/storage pond
embankments. All trees shall be removed in accordance with good engineering practices.
Lagoon/storage pond areas shall be accessible, and vegetation shall be kept mowed.
11. At the time of sludge removal from a lagoon/storage pond, the sludge must be managed
in accordance with the CAWMP. When removal of sludge from the lagoon is necessary,
provisions must be taken to prevent damage to the lagoon dikes and liner.
12. Lagoons/storage ponds shall be kept free of foreign debris including, but not limited to,
tires, bottles, light bulbs, gloves, syringes or any other solid waste.
13. The Facility must have at least one of the following items at all times: (a) adequate
animal waste application and handling equipment, (b) a lease, or other written agreement,
for the use of the necessary equipment, or (c) a contract with a third party applicator
capable of providing adequate waste application.
14. No waste shall be applied in wind conditions that might reasonably be expected to cause
the mist to reach surface waters or wetlands.
15. The Permittee shall maintain buffer strips or other equivalent practices as specified in the
Facility's CAWMP near feedlots, manure storage areas, and land application areas.
16. Waste shall not be applied on land that is flooded, saturated with water, frozen, or snow
covered at the time of land application.
17. Land application of waste is prohibited during precipitation events. The Permittee shall
consider pending weather conditions in making the decision to land apply waste.
18. Land application activities shall cease on any application site that exceeds a Mehlich 3
Soil Test Index for Copper of greater than 3,000 (108 pounds per acre) or Zinc of greater
than 3,000 (213 pounds per acre).
19. Any major structural repairs to lagoons/storage ponds must have written documentation
from a technical specialist certifying proper design and installation. However, if a piece
of equipment is being replaced with a piece of equipment of the identical specifications,
no technical specialist approval is necessary [i.e. piping, reels, valves, pumps (if the
gallons per minute (gpm) capacity is not being increased or decreased), etc.) unless the
replacement involves disturbing the lagoon/storage pond embankment.
III. MONITORING AND REPORTING REQUIREMENTS
An inspection of the animal waste collection, treatment, and storage structures, and
runoff control measures shall be conducted and documented at a frequency to insure
proper operation For example, lagoons/storage ponds, and other structures should be
inspected for evidence of erosion, leakage, damage by animals or discharge.

2. Highly visible waste -level gauges shall be maintained to mark the level of waste in each
lagoon/storage pond that does not gravity feed through a free flowing transfer pipe into a
subsequent structure. The gauge shall have readily visible permanent markings. The
waste level in each lagoon with a waste level gauge shall be monitored and recorded
weekly on forms supplied by, or approved -by, the Division.
3. A representative Standard Soil Fertility Analysis, including pH, phosphorus, copper, and
zinc, shall be conducted on each application field receiving animal waste at least every
three (3) years. An analysis of the animal waste shall be conducted in accordance with
recommended laboratory sampling procedures as close to the time of application as
practical and at least within sixty (60) days (before or after) of the date of application.
This analysis shall include the following parameters:
Nitrogen Zinc
Phosphorus Copper
4. The Permittee shall record all irrigation and land application event(s) including hydraulic
loading rates, nutrient loading rates and cropping information. The Permittee shall also
record removal of solids and document nutrient loading rates if disposed on -site or record
the off -site location(s). These records must be on forms supplied by, or approved by, the
Division.
If, for any reason, there is a discharge from the animal waste management system
(including the land application sites), to surface waters or wetlands, the Permittee is
required to make notification in accordance with Condition III. 9. The discharge
notification shall include the following information:
a. Description of the discharge: A description of the discharge including an estimate of
the volume discharged, a description of the flow path to the receiving surface waters
or wetlands and a site sketch showing the path of the waste. Also, an estimation of
the volume discharged.
b. Time of the discharge: The length of time of the discharge, including the exact dates
and times that it started and stopped, and if not stopped, the anticipated time the
discharge is expected to continue.
c. Cause of the discharge: A detailed statement of the cause of the discharge. If caused
by a precipitation event, detailed information from the on -site rain gauge concerning
the inches and duration of the precipitation event.
d. All steps being taken to reduce, stop and cleanup the discharge. All steps to be taken
to prevent future discharges from the same cause.
e. Analysis of the waste: A copy of the last waste analysis conducted as required by
Condition III. 3.
A copy of this Permit, the Facility's permit, certification forms, lessee and landowner
agreements, the CAWMP, and copies of all records required by this Permit and the
Facility's CAWMP shall be maintained by the Permittee in chronological and legible
form for a minimum of three (3) years.

Within fifteen (15) working days of receiving the request from the Division, the
Permittee shall provide to the Division one (1) copy of all requested information and
reports related to the operation of the animal waste management system. Once received
by the Division, all such information and reports become public information, unless they
constitute confidential information under North Carolina General Statutes (NCGS) 132-
1 2, and shall be made available to the public by the Division as specified in Chapter 132
of the NCGS.
The Division may require any additional monitoring and reporting (including but not
limited to groundwater, surface water or wetland, waste, sludge, soil, lagoon/storage pond
levels and plant tissue) necessary to determine the source, quantity, quality, and effect of
such waste upon the surface waters, groundwaters or wetlands. Such monitoring,
including its scope, frequency, duration and any sampling, testing, and reporting systems,
shall meet all applicable Division requirements.
Regional Notification:
The Permittee shall report by telephone to the appropriate Division Regional Office as
soon as possible, but in no case more than twenty-four (24) hours following first
knowledge of the occurrence of any of the following events:
a. Any discharge to ditches, surface waters or wetlands.
b. Failure to maintain storage capacity in a lagoon/storage pond greater than or
equal to that required in Condition V. 2. of this Permit.
C. Over applying waste either in excess of the limits set out in the CAWMP or
where runoff enters surface waters or wetlands.
d. Failure of any component of the animal waste management system resulting in a
discharge to surface waters or wetlands.
e. Any failure of the animal waste management system that renders the Facility
incapable of adequately receiving, treating or storing the waste and/or sludge,
f. Any deterioration or leak in a lagoon/storage pond that poses an immediate threat
to the environment or human safety or health.
For any emergency, which requires immediate reporting after normal business hours,
contact must be made with the Division of Emergency Management at 1-800-858-0368.
The Permittee shall also file a written report to the appropriate Division Regional Office
within five (5) calendar days following first knowledge of the occurrence. This report
shall outline the actions taken or proposed to be taken to correct the problem and to
ensure that the problem does not recur. The requirement to file a written report may not
be waived by the Division Regional Office.

IV. INSPECTIONS AND ENTRY
The Permittee shall allow any authorized representative of Department, upon the
presentation of credentials and other documents as may be required by law and in
accordance with reasonable and appropriate biosecurity measures, to:
a. Enter the Permittee's premises where the regulated Facility or activity is located or
conducted, or where records must be kept under the conditions of this Permit;
b. Have access to and copy, at reasonable times, any records that must be kept under the
conditions of this Permit;
Inspect, at reasonable times any facilities, equipment (including monitoring and
control equipment), practices, or operations regulated or required under this Permit;
and,
d. Sample or monitor, at reasonable times, for the purpose of assuring permit
compliance, any substances or parameters at any location.
V. GENERAL CONDITIONS
The issuance of this Permit shall not relieve the Permittee of the responsibility for
compliance with all applicable surface water, wetlands, groundwater and air quality
standards or for damages to surface waters, wetlands or groundwaters resulting from the
animal operation.
2. The maximum waste level in lagoons/storage ponds shall not exceed that specified in the
Facility's CAWMP. At a minimum, maximum waste level for lagoons/storage ponds
must not exceed the level that provides adequate storage to contain a 25-year, 24-hour
storm event plus an additional one (1) foot of structural freeboard except that there shall
be no violation of this condition if: (a) there is a storm event more severe than a 25-year,
24-hour event, (b) the Permittee is in compliance with its CAWMP, and (c) there is at
least one (1) foot of structural freeboard.
3. Any containment basin, such as a lagoon or a storage pond, used for waste management
shall continue to be subject to the conditions and requirements of this Permit until
properly closed. When the containment basin is properly closed in accordance with the
Natural Resource Conservation Service (MRCS) North Carolina Standard.for Closure of
Waste Impoundments, February 2005 or any subsequent amendment, the containment
basin shall not be subject to the requirements of this Permit. The Permittee must submit a
letter to the Division to request rescission of the Permit by providing documentation of
closure of all containment basins.
Closure shall. also include a minimum of 24 hours pre -notification of the Division and
submittal of the Animal Waste Storage Pond and Lagoon Closure Report Form to the
address identified on the form within fifteen (15) days of completion of closure.

4. Failure of the Permittee to maintain, in full force and effect, lessee and landowner
agreements, which are required in the CAWMP, shall constitute grounds for revocation
of its COC to operate under this Permit.
This Permit is not transferable. In the event there is a desire for the Facility to change
ownership, or there is a name change of the Permittee, a Notification of Change of
Ownership form must be submitted to the Division, including documentation from the
parties involved and other supporting materials as may be appropriate.
6. The issuance of this Permit does not prohibit the Division from reopening and modifying
the Permit, revoking and reissuing the Permit, or terminating the Permit as allowed by the
appropriate laws, rules, and regulations.
7. The Groundwater Compliance Boundary is established by 15A NCAC 2L and 15A
NCAC 02T .0111 (c). An exceedance of Groundwater Quality Standards at or beyond the
Compliance Boundary is subject to the requirements of 15A NCAC 2L and the Division
in addition to the penalty provisions applicable under the NCGS.
VI. PENALTIES
Failure to abide by the conditions and limitations contained in this Permit; the Facility's
CAWMP; and/or applicable state law; may subject the Permittee to an enforcement
action by the Division including but not limited to the modification of the animal waste
management system, civil penalties, criminal penalties, and injunctive relief.
2. The Permittee must comply with all conditions of this Permit. Any Permit
noncompliance constitutes a violation of state law and is grounds for enforcement action;
for Permit coverage termination, revocation and reissuance, or modification; or denial of
Permit coverage renewal application.
It shall not be a defense for a Permittee in an enforcement action to claim that it would
have been necessary to halt or reduce the permitted activity in order to maintain
compliance with the conditions of this Permit.
This Permit issued the 6th day of October, 2009.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
fir Coleen H. Sullins, Director
North Carolina Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number AWI330039

1
PAT MCCRORY
At
Gnver+tor
DONALD R. VAN DER VAART
Serrelarr
Water Resources
' S. JAY ZIMMERMAN_
LKWRONMENTA? QUALITY -
Z
m�'i�'
March 8, 2016 r
�
Ben Shelton
Ben Shelton Farm
1012 Webb Chapel Rd.,
Macclesfield, NC 27852
G_7 Gr3w`
AS
Subject: Permit No. AWI330039
Ben Shelton Farm, r; w
Animal Waste Management Systems
@ LEEdgecombe County a'
Dear Mr. Shelton:
In accordance with your renewal application received March 4, 2016, we are hereby forwarding to you
this Permit issued to Ben Shelton authorizing the operation of the subject animal waste management
system. You had indicated the animal population at this facility to be zero until such time as the waste
storage lagoon at this facility is properly closed.
This approval shall consist of the operation of this system including, but not limited to, the management
of animal waste structures on the Ben Shelton Farm, with an annual capacity of no greater than an annual
average of zero (0) Swine.
The Permit shall be effective from the date of issuance until February 28, 2021 and replaces the COC No.
AWS330039 issued to this facility on October 6, 2009. You are subject to the conditions of this permit
until the closure of all waste storage basins and the rescission of this permit. You must submit a letter to
the Division of Water Resources to request rescission of the Permit by providing documentation of
closure of all containment basins.
The issuance of this Permit does not excuse the Permittee from the obligation to comply with all
applicable laws, rules, standards, and ordinances (local, state, or federal) nor convey any property rights
in either real or personal property.
Per 15A NCAC 2T. 0111(c), a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary. Per NRCS standards, a 100-ft separation
shall be maintained between water supply wells and any lagoon, storage pond, or any wetted area of a
spray field.
Please be advised that any violation of the terms and conditions specified in this Permit may result in
revocation of this Permit or penalties in accordance with NCGS 143-215.6A through 143-215.6C, the
Clean Water Act, and 40 CFR 122.41, including civil penalties, criminal penalties, and injunctive relief.
State of North Carolina I Environmental Quality I Water Resources
1636 Mail service Center I Raleigh, North Carolina 27699-1636
919 807 6464
/I—

In accordance with Condition IL 17 of this Permit, waste application shall cease within four (4) hours of
the time that the National Weather Service issues a Hurricane Warning, Tropical Storm Warning, or a
Flood Watch associated with a tropical system for the county in which the facility is located. You may
find detailed watch/warning information for your county by calling the Raleigh, NC National Weather
Service office at [phone], or by visiting their website at: httn://www.weather.�zov/rah/
If you wish to continue the activity permitted under this Permit after the expiration date of this Permit, an
application for renewal must be filed at least 180 days prior to expiration.
This Permit is not automatically transferable. A name/ownership change application must be submitted to
the Division prior to a name change or change in ownership.
This facility is located in a county covered by our Raleigh Regional Office. The Regional Office staff
may be reached at [phone]. If you need additional information concerning this Permit, please
contact the Animal Feeding Operations Program staff at [phone].
Sincerely,
for S. Jay Zimmerman, F.G.
Director, Division of Water Resources
cc: Raleigh Regional Office, Water Quality Regional Operations Section
Edgecombe County Health Department
Edgecombe County Soil and Water Conservation District
WQROS Central Files (AWI330039)

LW
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
INDIVIDUAL SWINE ANIMAL WASTE MANAGEMENT SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Ben Shelton
Edgecombe County
FOR THE
continued operation and maintenance of an animal waste management system for the Ben Shelton Farm,
located in Edgecombe County, consisting of zero (0) Swine and the application to land as specified in the
Facility's Certified Animal Waste Management Plan (CAWMP).
This permit shall be effective from the date of issuance until February 28, 2021 and shall be subject to the
following specified conditions and limitations:
I. PERFORMANCE STANDARDS
The animal waste management system operated under this Permit shall be effectively
maintained and operated as a non -discharge system to prevent the discharge of pollutants
to surface waters, wetlands, or ditches. Application of waste to terraces and grassed
waterways is acceptable as long as it is applied in accordance with Natural Resources
Conservation Service (NRCS) Standards and does not result in a discharge of waste to
surface waters, wetlands, or ditches. If the Facility has a discharge of waste that reaches
surface waters or wetlands resulting from a storm event more severe than a 25-year, 24-
hour storm, it will not be considered to be in violation of this Permit, as long as the
Facility is in compliance with its CAWMP and this Permit.
2. No discharge of waste shall result in a violation of the water quality standards established
for receiving waters as per Title 15A, Subchapter 2B, Section .0200 of the North Carolina
Administrative Code (NCAC) and Title 15A, Subchapter 2L of the NCAC.
The facility's CAWMP is hereby incorporated by reference into this Permit. The
CAWMP must be consistent with all applicable laws, rules, ordinances, and standards
(federal, state and local) in effect at the time of siting, design, and certification of the
Facility.
4. Any proposed increase or modification to the annual average that exceeds the thresholds
set by North Carolina General Statues (NCGS) 143-215.1OB(l) will require a
modification to the CAWMP and the Permit prior to modification of the Facility.

Animal waste shall not be applied within one hundred (100) feet of any well, with the
exception of monitoring wells. The allowable distance to monitoring wells shall be
established on a case -by -case basis by the Division.
IL OPERATION AND MAINTENANCE REQUIREMENTS
1. The collection, treatment, and storage facilities, and the land application equipment and
fields shall be properly operated properly and maintained at all times.
2. A vegetative cover shall be maintained as specified in the Facility's CAWMP on all land
application fields and buffers in accordance with the CAWMP. No waste shall be
applied upon areas not included in the CAWMP.
Soil pH on all land application fields must be maintained in the optimum range for crop
production.
4. Land application rates shall be in accordance with the CAWMP. In no case shall land
application rates exceed the agronomic rate of the nutrient of concern for the receiving
crop. In no case shall land application rates result in excessive ponding or any runoff
during any given application event.
5. If manure or sludges are applied on conventionally tilled, bare soil, the waste shall be
incorporated into the soil within two (2) days after application on the land. This
requirement does not apply to no -till fields, pastures, or fields where crops are actively
growing.
Pesticides, toxic chemicals, and petroleum products shall not be disposed of in the animal
waste management system.
Domestic and/or industrial wastewater from showers, toilets, sinks, etc. shall not be
discharged into the animal waste management system. Washdown of stock trailers
owned by and used to transport animals to and from the Facility only will be permissible
as long as the system has been evaluated and approved to accommodate the additional
volume. Only those cleaning agents and soaps that are EPA -approved according to their
labels, will not harm the cover crop, and will not contravene the groundwater standards
listed in 15A NCAC 2L may be utilized in the Facility covered by this Permit.
Instruction labels are to be followed when using cleaning agents and soaps.
Disposal of dead animals resulting from normal mortality rates associated with the
Facility shall be done in accordance with the Facility's CAWMP and the North Carolina
Department of Agriculture and Consumer Services (NCDA&CS) Veterinary Division's
statutes and regulations.
Unless accounted for in temporary storage volume, all uncontaminated runoff from the
surrounding property and buildings shall be diverted away from the waste
lagoons/storage ponds to prevent any unnecessary addition to the liquid volume in the
structures.

10. A protective, vegetative cover shall be established and maintained on all earthen
lagoon/storage pond embankments (outside toe of embankment to maximum pumping
elevation), berms, pipe runs, and diversions to surface waters or wetlands. Trees, shrubs,
and other woody vegetation shall not be allowed to grow on the lagoon/storage pond
embankments. All trees shall be removed in accordance with good engineering practices.
Lagoon/storage pond areas shall be accessible, and vegetation shall be kept mowed.
11. At the time of sludge removal from a lagoon/storage pond, the sludge must be managed
in accordance with the CAWMP. When removal of sludge from the lagoon is necessary,
provisions must be taken to prevent damage to the lagoon dikes and liner.
12. Lagoons/storage ponds shall be kept free of foreign debris including, but not limited to,
tires, bottles, light bulbs, gloves, syringes or any other solid waste.
13. The Facility must have at least one of the following items at all times: (a) adequate
animal waste application and handling equipment, (b) a lease, or other written agreement,
for the use of the necessary equipment, or (c) a contract with a third party applicator
capable of providing adequate waste application.
14. No waste shall be applied in wind conditions that might reasonably be expected to cause
the nest to reach surface waters or wetlands.
15. The Permittee shall maintain buffer strips or other equivalent practices as specified in the
Facility's CAWMP near feedlots, manure storage areas, and land application areas.
16. Waste shall not be applied on land that is flooded, saturated with water, frozen, or snow
covered at the time of land application.
17. Land application of waste is prohibited during precipitation events. The Permittee shall
consider pending weather conditions in making the decision to land apply waste.
18. Land application activities shall cease on any application site that exceeds a Mehlich 3
Soil Test Index for Copper of greater than 3,000 (108 pounds per acre) or Zinc of greater
than 3,000 (213 pounds per acre).
19. Any major structural repairs to lagoons/storage ponds must have written documentation
from a technical specialist certifying proper design and installation. However, if a piece
of equipment is being replaced with a piece of equipment of the identical specifications,
no technical specialist approval is necessary [i.e. piping, reels, valves, pumps (if the
gallons per minute (gpm) capacity is not being increased or decreased), etc.] unless the
replacement involves disturbing the lagoon/storage pond embankment.
III. MONITORING AND REPORTING REQUIREMENTS
An inspection of the animal waste collection, treatment, and storage structures, and
runoff control measures shall be conducted and documented at a frequency to insure
proper operation For example, lagoons/storage ponds, and other structures should be
inspected for evidence of erosion, leakage, damage by animals or discharge.

2. Highly visible waste -level gauges shall be maintained to mark the level of waste in each
lagoon/storage pond that does not gravity feed through a free flowing transfer pipe into a
subsequent structure. The gauge shall have readily visible permanent markings. The
waste level in each lagoon with a waste level gauge shall be monitored and recorded
weekly on forms supplied by, or approved by, the Division.
3. A representative Standard Soil Fertility Analysis, including pH, phosphorus, copper, and
zinc, shall be conducted on each application field receiving animal waste at least every
three (3) years.
4. An analysis of the animal waste shall be conducted in accordance with recommended
laboratory sampling procedures as close to the time of application as practical and at least
within sixty (60) days (before or after) of the date of application. This analysis shall
include the following parameters:
Nitrogen Zinc
Phosphorus Copper
The Permittee shall record all irrigation and land application event(s) including hydraulic
loading rates, nutrient loading rates and cropping information. The Permittee shall also
record removal of solids and document nutrient loading rates if disposed on -site or record
the off -site location(s). These records must be on forms supplied by, or approved by, the
Division.
6. If, for any reason, there is a discharge from the animal waste management system
(including the land application sites), to surface waters or wetlands, the Permittee is
required to make notification in accordance with Condition III. 10. The discharge
notification. shall include the following information:
a. Description of the discharge: A description of the discharge including an estimate of
the volume discharged, a description of the flow path to the receiving surface waters
or wetlands and a site sketch showing the path of the waste. Also, an estimation of
the volume discharged.
b. Time of the discharge: The length of time of the discharge, including the exact dates
and times that it started and stopped, and if not stopped, the anticipated time the
discharge is expected to continue.
c. Cause of the discharge: A detailed statement of the cause of the discharge. if caused
by a precipitation event, detailed information from the on -site rain gauge concerning
the inches and duration of the precipitation event.
d. All steps being taken to reduce, stop and cleanup the discharge. All steps to be taken
to prevent future discharges from the same cause.
e. Analysis of the waste: A copy of the last waste analysis conducted as required by
Condition III. 3.

A copy of this Permit, the Facility's permit, certification forms, lessee and landowner
agreements, the CAWMP, and copies of all records required by this Permit and the
Facility's CAWMP shall be maintained by the Permittee in chronological and legible
form for a minimum of three (3) years.
8. Within fifteen (15) working days of receiving the request from the Division, the
Permittee shall provide to the Division one (1) copy of all requested information and
reports related to the operation of the animal waste management system. Once received
by the Division, all such information and reports become public information, unless they
constitute confidential information under North Carolina General Statutes (NCGS) 132-
1.2, and shall be made available to the public by the Division as specified in Chapter 132
of the NCGS.
9. The Division may require any additional monitoring and reporting (including but not
limited to groundwater, surface water or wetland, waste, sludge, soil, lagoon/storage pond
levels and plant tissue) necessary to determine the source, quantity, quality, and effect of
such waste upon the surface waters, groundwaters or wetlands. Such monitoring,
including its scope, frequency, duration and any sampling, testing, and reporting systems,
shall meet all applicable Division requirements.
10. Regional Notification:
The Permittcc shall report by telephone to the appropriate Division Regional Office as
soon as possible, but in no case more than twenty-four (24) hours following first
knowledge of the occurrence of any of the following events:
Any discharge to ditches, surface waters or wetlands.
b. Failure to maintain storage capacity in a lagoon/storage pond greater than or
equal to that required in Condition V. 2. of this Permit.
Over applying waste either in excess of the limits set out in the CAWMP or
where runoff enters surface waters or wetlands.
d. Failure of any component of the animal waste management system resulting in a
discharge to surface waters or wetlands.
e. Any failure of the animal waste management system that renders the Facility
incapable of adequately receiving, treating or storing the waste and/or sludge.
Any deterioration or leak in a lagoon/storage pond that poses an immediate threat
to the enviromnent or human safety or health.
For any emergency, which requires immediate reporting after normal business hours,
contact must be made with the Division of Emergency Management at 1-800-858-0368.

The Permittee shall also file a written report to the appropriate Division Regional Office
within five (5) calendar days following first knowledge of the occurrence. This report
shall outline the actions taken or proposed to be taken to correct the problem and to
ensure that the problem does not recur. The requirement to file a written report may not
be waived by the Division Regional Office.
In the event the waste level in a lagoon/storage pond is found to be within the designed
structural freeboard, the Permittee shall file a written report to the appropriate Division
Regional Office within two (2) calendar days following first knowledge of the
occurrence. This report shall outline actions taken or proposed to be taken to reduce
waste levels below the designed structural freeboard within five (5) calendar days of first
knowledge of the occurrence.
H . In the event of a discharge of 1,000 gallons or more of animal waste to surface waters or
wetlands, the Permittee must issue a press release to all print and electronic news media
that provide general coverage in the county in which the discharge occurred setting out
the details of the discharge. The press release must be issued within forty-eight (48)
hours after it is determined that the discharge has reached the surface waters or wetlands.
A copy of the press release and a list of the news media to which it was distributed must
be kept for at least one (1) year after the discharge and must be distributed to any person
upon request.
12. In the event of a discharge of 15,000 gallons or more of animal waste to surface waters or
wetlands, a public notice is required in addition to the press release described in
Condition IIl 15. The public notice must be placed in a newspaper having general
circulation in the county in which the discharge occurred and the county immediately
downstream within ten (10) days of the discharge. The notice shall be captioned
"NOTICE OF DISCHARGE OF ANIMAL WASTE". The minimum content of the
notice is the name of the facility, location of the discharge, estimated volume of waste
entering state waters, time and date discharge occurred, duration of the discharge,
identification water body that was discharged into including creek and river basin if
applicable, actions taken to prevent further discharge, and a facility contact person and
phone number. The owner or operator shall file a copy of the notice and proof of
publication with the Department within thirty (30) days after the notice is published.
Publication of a notice of discharge under this Condition is in addition to the requirement
to issue a press release under Condition 11I.11.
13. If a discharge of 1,000,000 gallons or more of animal waste reaches surface waters or
wetlands, the appropriate Division Regional Office must be contacted to determine in
what additional counties, if any, a public notice must be published. A copy of all public
notices and proof of publication must be sent to the Division within thirty (30) days after
the notice is published.
IV. INSPECTIONS AND ENTRY
The Permittee shall allow any authorized representative of Department, upon the
presentation of credentials and other documents as may be required by law and in
accordance with reasonable and appropriate biosecurity measures, to:

Enter the Pennittee's premises where the regulated Facility or activity is located or
conducted, or where records must be kept under the conditions of this Permit;
b. Have access to and copy, at reasonable times, any records that must be kept under the
conditions of this Permit;
c. Inspect, at reasonable times any facilities, equipment (including monitoring and
control equipment), practices, or operations regulated or required under this Permit;
and,
d. Sample or monitor, at reasonable times, for the purpose of assuring permit
compliance, any substances or parameters at any location.
V. GENERAL CONDITIONS
The issuance of this Permit shall not relieve the Permittee of the responsibility for
compliance with all applicable surface water, wetlands, groundwater and air quality
standards or for damages to surface waters, wetlands or groundwaters resulting from the
animal operation.
2. The maximum waste level in lagoons/storage ponds shall not exceed that specified in the
Facility's CAWMP. At a minimum, maximum waste level for lagoons/storage ponds
must not exceed the level that provides adequate storage to contain a 25-year, 24-hour
storm event plus an additional one (1) foot of structural freeboard except that there shall
be no violation of this condition if: (a) there is a storm event more severe than a 25-year,
24-hour event, (b) the Permittec is in compliance with its CAWMP, and (c) there is at
least one (1) foot of structural freeboard.
3. Any containment basin, such as a lagoon or a storage pond, used for waste management
shall continue to be subject to the conditions and requirements of this Permit until
properly closed. When the containment basin is properly closed in accordance with the
Natural Resource Conservation Service (MRCS) North Carolina Standard for Closure of
Waste Impoundments, February ZOOS or any subsequent amendment, the containment
basin shall not be subject to the requirements of this Permit. The Permittee must submit a
letter to the Division to request rescission of the Permit by providing documentation of
closure of all containment basins.
Closure shall also include a minimum of 24 hours pre -notification of the Division and
submittal of the Animal Waste Storage Pond and Lagoon Closure Report Form to the
address identified on the form within fifteen (15) days of completion of closure.
4. Failure of the Pertittee to maintain, in full force and effect, lessee and landowner
agreements, which are required in the CAWMP, shall constitute grounds for revocation
of its COC to operate under this Permit.
5. This Permit is not transferable. In the event there is a desire for the Facility to change
ownership, or there is a name change of the Permittee, a Notification of Change of
Ownership form must be submitted to the Division, including documentation from the
parties involved and other supporting materials as may be appropriate.

6. The issuance of this Permit does not prohibit the Division from reopening and modifying
the Permit, revoking and reissuing the Permit, or terminating the Permit as allowed by the
appropriate laws, rules, and regulations.
7. The Groundwater Compliance Boundary is established by 15A NCAC 2L and 15A
NCAC 02T .0111(c). An exceedance of Groundwater Quality Standards at or beyond the
Compliance Boundary is subject to the requirements of 15A NCAC 2L and the Division
in addition to the penalty provisions applicable under the NCGS.
VI. PENALTIES
Failure to abide by the conditions and limitations contained in this Permit; the Facility's
CAWMP; and/or applicable state law; may subject the Permittee to an enforcement
action by the Division including but not limited to the modification of the animal waste
management system, civil penalties, criminal penalties, and injunctive relief.
2. The Permittee must comply with all conditions of this Permit. Any Permit
noncompliance constitutes a violation of state law and is grounds for enforcement action;
for Permit coverage termination, revocation and reissuance, or modification; or denial of
Permit coverage renewal application.
It shall not be a defense for a Permittee in an enforcement action to claim that it would
have been necessary to halt or reduce the permitted activity in order to maintain
compliance with the conditions of this Permit.
This Permit issued the Sth day of March, 2016.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
(Lqh)��
for S. Jay Zimmerman, P.G. , Director
North Carolina Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number AW1330039

Water Resources
EN'IIR0Rt1 F,N7A: '. LA_ITY
March 8, 2016
Ben Shelton
Ben Shelton Farm
1012 Webb Chapel Rd.
Macclesfield, NC 27852
PAT MCCRORY
Gorerllor
DONALD R. VAN DER VAART '
S. JAY ZIMMERMAN
Subject: Permit No. AW1330039
Ben Shelton Farm.
Animal Waste Management System
Edgecombe County
Dear Mr. Shelton:
bitertor
In accordance with your renewal application received March 4, 2016, we are hereby forwarding to you
this Permit issued to Ben Shelton authorizing the operation of the subject animal waste management.
system. You had indicated the animal population at this facility to be zero until such time as the waste
storage lagoon at this facility is properly closed.
This approval shall consist of the operation of this system including, but not limited to, the management
of animal waste structures on the Ben Shelton Farm, with an annual capacity of no greater than an annual
average of zero (0) Swine.
The Permit shall be effective from the date of issuance until February 28, 2021 and replaces the COC No.
AWS330039 issued to this facility on October 6, 2009. You are subject to the conditions of this permit
until the closure of all waste storage basins and the rescission of this permit. You must submit a letter to
the Division of Water Resources to request rescission of the Permit by providing documentation of
closure of all containment basins.
The issuance of this Permit does not excuse the Permittec from the obligation to comply with all
applicable laws, rules, standards, and ordinances (local, state, or federal) nor convey any property rights
in either real or personal property.
Per I SA NCAC 2`I'. 0111(c), a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary. Per NRCS standards, a I00-ft separation
shall be maintained between water supply wells and any lagoon, storage pond, or any wetted area of a
spray field.
Please be advised that any violation of the terms and conditions specified in this Permit may result in
revocation of this Permit or penalties in accordance with NCGS 143-215.6A through 143-215.6C, the
Clean Water Act, and 40 CFR 122.41, including civil penalties, criminal penalties, and injunctive relief.
Staic ol'North Carolina Environmental Qualify f Water Resources
1636 Mail service Center I Raleigh, North Carolina 27699-1636
919 847 6464

In accordance with Condition I1.17 of this Permit, waste application shall cease within four (4) hours of
the time that the National Weather Service issues a Hurricane Warning, Tropical Storm Warning, or a
Flood Watch associated with a tropical system for the county in which the facility is located. You may
find detailed watch/warning information for your county by calling the Raleigh, NC National Weather
Service office at [phone], or by visiting their website at: http://www.weather.gov/rah/
If you wish to continue the activity permitted under this Permit after the expiration date of this Permit, an
application for renewal must be filed at least 180 days prior to expiration.
This Permit is not automatically transferable. A name/ownership change application must be submitted to
the Division prior to a name change or change in ownership.
This facility is located in a county covered by our Raleigh Regional Office. The Regional Office staff
may be reached at [phone]. If you need additional information concerning this Permit, please
contact the Animal Feeding Operations Program staff at [phone].
Sincerely,
CAA,t-, tF,5 �Q
Lor S. Jay Zimmerman, P.G.
Director, Division of Water Resources
cc: Raleigh Regional Office, Water Quality Regional Operations Section
Edgecombe County Health Department
Edgecombe County Soil and Water Conservation District
WQROS Central Files (AW1330039)

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
INDIVIDUAL SWINE ANIMAL WASTE MANAGEMENT SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED, TO
Ben Shelton
Edgecombe County
FOR THE
continued operation and maintenance of an animal waste management system for the Ben Shelton Farm,
located in Edgecombe County, consisting of zero (0) Swine and the application to land as specified in the
Facility's Certified Animal Waste Management Plan (CAWMP).
This permit shall be effective from the date of issuance until. February 28, 2021 and shall be subject to the
following specified conditions and limitations:
I. PERFORMANCE STANDARDS
The animal waste management system operated under this Permit shall be effectively
maintained and operated as a non -discharge system to prevent the discharge of pollutants
to surface waters, wetlands, or ditches. Application of waste to terraces and grassed
waterways is acceptable as long as it is applied in accordance with Natural Resources
Conservation Service (NRCS) Standards and does not result in,a discharge of waste to
surface waters, wetlands, or ditches. If the Facility has a discharge of waste that reaches
surface waters or wetlands resulting from a storm event more severe than a 25-year, 24-
hour storm, it will not be considered to be in violation of this Permit, as long as the
Facility is in compliance with its CAWMP and'this Permit. .
2. No discharge of waste shall result in a violation of the water quality standards established
for receiving waters as per Title 15A, Subchapter 213, Section .0200 of the North Carolina
Administrative Code (NCAC) and Title 15A, Subchapter 2L of the NCAC.
The facility's CAWMP is hereby incorporated by reference into this Permit. The
CAWMP must be consistent with all applicable laws, rules, ordinances, and standards
(federal, state and local) in effect at the time of siting, design, and certification of the
Facility.
4. Any proposed increase or modi fication to the annual average that. exceeds the thresholds
set by North Carolina General Statues (NCGS) 143-215.1 OB(1) will require a
modification to the CAWMP and the Permit prior to modification of the Facility.

5. Animal waste shall not be applied within one hundred (100) feet of any well, with the
exception of monitoring wells. The allowable distance to monitoring wells shall be
established on a case -by -case basis by the Division.
iI. OPERATION AND MAINTENANCE REQUIREMENTS
i . The collection, treatment, and storage facilities, and the land application equipment and
fields shall be properly operated properly and maintained at all times.
2. A vegetative cover shall be maintained as specified in the Facility's CAWMP on.all land
application fields and buffers in accordance with the CAWMP. No waste shall be
applied upon areas not included in the CAWMP.
Soil pH on all land application fields must be maintained in the optimum range for crop
production.
4. Land application rates shall be in accordance with the CAWMP. In no case sh611 land
application rates exceed the agronomic rate of the nutrient of concern for the receiving
crop. In no case shall land application rates result in excessive ponding or any runoff
during any given application event.
If manure or sludges are applied on conventionally tilled, bare soil, the waste shall be
incorporated into the soil within two (2) days after application on the land. This
requirement does not apply to no -till fields, pastures, or.fields where crops are actively
growing.
6. Pesticides,. toxic chemicals, and petroleum products shall not be disposed of in the animal
waste management system.
7. Domestic and/or industrial wastewater -from showers, toilets, sinks, etc. shall not'be
discharged into the animal waste management system. Washdown of stock trailers
owned by and used to transport animals to and from the Facility only will be'permissible
as long as the system has been evaluated and approved to accommodate the additional
volume. Only those cleaning agents and soaps that are EPA -approved according to their
labels, will not harm the cover crop, and will not contravene the groundwater standards
listed in 15A NCAC 2L may be utilized in the Facility covered by this Permit.
histruction labels are to be followed when using cleaning agents and soaps.
8. Disposal of dead animals resulting from normal mortality. rates associated with the
Facility shall be done in accordance with the Facility's CAWMP and the North Carolina
Department.of Agriculture and Consumer Services (NCDA&CS) Veterinary Division's
statutes and regulations.
Unless accounted for in temporary storage volume, all uncontaminated runoff from the
surrounding property and buildings shall be diverted away from the waste
lagoons/storage ponds to prevent any unnecessary addition to the liquid volume in the
structures.

t0. A protective, vegetative cover shall be established and maintained on all earthen
lagoon/storage pond embankments (outside toe of embankinent to maximum pumping
elevation), berms, pipe suns, and diversions to surface waters or wetlands. Trees, shrubs,
and other woody vegetation shall not be allowed to grow on the lagoon/storage pond
embankments. All trees shall be removed in accordance with good engineering practices.
Lagoon/storage pond areas shall be accessible, and vegetation shall be kept mowed.
11. At the time of sludge removal from a lagoon/storage pond, the sludge must be managed
in accordance with the CAWMP. When removal of sludge from the lagoon is necessary,
provisions trust be taken to prevent damage to the lagoon dikes and liner.
12. Lagoons./storage ponds shall be kept free of foreign debris including, but not'limited to,
tires, bottles, light bulbs, gloves, syringes or any other solid waste.
13. The Facility must have at least one of the following items at all times: (a) adequate
animal waste application and handling equipment, (b) a lease, or other written agreement,
for the use of the necessary equipment, or (c) a contract with a.third party applicator
capable of providing adequate waste application.
14. No waste shall be applied in wind conditions that might reasonably be expected to cause
the mist to reach surface waters or wetlands.
15. The Permittee shall maintain buffer strips or other equivalent practices as specified in the
Facility's CAWMP near feedlots, manure storage areas, and land, application areas.
16. Waste shall not;be applied on land that is flooded, saturated with water, frozen, or snow
covered at the time of land application.
17. Land application -of waste is prohibited during precipitation events. The Permittee shall
consider pending weather conditions in snaking the decision to land apply waste.
18. Land application activities shall cease on any application site that exceeds a Mehlich 3
Soil Test. Index for Copper of greater than 3,000 (108 pounds per acre) or Zinc of greater
than 3,000 (213 pounds per acre).
19. Any major structural repairs to lagoons/storage ponds must have written documentation
.from a technical specialist certifying proper design and installation. However, if a piece
of equipment is being replaced with a piece of equipment of the identical specifications,
no technical specialist approval is necessary [i..e. piping, reels, valves, pumps (if the
gallons per minute (gpm) capacity is not being increased or decreased), etc.] unless the
replacement involves disturbing the lagoon/storage pond embankment.
IIL MONITORING AND"REPORTING REQUIREMENTS
1. An inspection of the animal waste collection, treatment, and storage structures, and
runoff control measures shall be conducted and documented at a frequency to insure
proper operation For example, lagoons/storage ponds; and other structures should be
inspected for evidence of erosion, leakage, damage by animals or discharge.

Z. Highly visible waste -level gauges shall be maintained to mark the level of waste in each
lagoontstorage pond that does not gravity feed through a free flowing transfer pipe into a
subsequent structure. The gauge shall have readily visible permanent markings. The
waste level in each lagoon with a waste level gauge shall be monitored and recorded
weekly on forms supplied by, or approved by, the Division.
3. A representative Standard Soil Fertility Analysis, including pH, phosphorus; copper, and
zinc, shall be conducted on each application field receiving animal waste at least every
three (3) years.
4. An analysis of the animal waste shall be conducted in accordance with recommended
laboratory sampling procedures as close to the time of application as practical and at lease
within sixty (60) days (before or after) of the date of application. This analysis shall
include the following parameters:
Nitrogen. Zinc
Phosphorus Copper
5. The Permittee shall record all irrigation and land.application event(s) including hydraulic
loading .rates, nutrient loading rates and cropping information. The Permittee shall also
record removal of solids and document nutrient loading rates'if disposed on -site or record
the offsite location(s). These records must be on forms supplied by, or approved by, the
Division.
6. If, .for any reason, there is a discharge from the animal waste management system
(including the land application sites), to surface waters or wetlands, the Permittee is
required to make notification in accordance with Condition Ill. 10. The discharge
notification, shall include the following information:
a. Description of the discharge: A description of the discharge including an estimate of
the volume discharged, a description of the flow path to the receiving surface waters
or wetlands and a. site sketchshowing the path of the waste. Also, an estimation of
the volume discharged.
b. Time of the discharge: The length of time of the discharge, .including the exactdates
and times that it started and stopped, and if not stopped, the anticipated time the
discharge is expected to continue.
c. Cause of the discharge: A detailed statement of the cause of the'discharge. If caused
by a' precipitation event, detailed information from the on -site rain gauge concerning
the inches and duration of the precipitation event.
d. All steps being taken to reduce, stop and cleanup the discharge. All steps to be taken
to prevent future discharges from the same cause.
e. Analysis of the waste: A copy of the last waste analysis conducted as required by
Condition III.3.

7. A copy of this Pennit, the Facility's permit, certification forms, lessee and landowner
agreements, the CAWMP, and copies of all records required by this Permit and the
Facility's CAWMP shall be maintained by the Permittee in chronological and legible
form for a minimum of three (3) years. .
Within fifteen (.15) working days of receiving the request from the Division, the
Permittee shall provide to the Division one (1) copy of all requested information and
reports related to the operation of the animal waste management system. Once received
by the Division, all such information and reports become public information, unless they
constitute confidential information. under North Carolina General Statutes (NCGS) 132-
1.2, and shall be made available to the public by the Division as specified in Chapter 132
of the NCGS.
The Division may require any additional monitoring and reporting (including but not
limited to groundwater, surface water or wetland, waste, sludge, soil, lagoon/storage pond
levels and plant tissue) necessary to determine the source, quantity, quality, and effect of
such waste upon the surface waters, groundwaters or wetlands. Such monitoring,
including its scope, frequency, duration and any sampling, testing, and reporting systems,
shall meet all applicable Division requirements.
10. Regional Notification:
The Permittee shall report by telephone to the appropriate Division Regional Office as
soon as possible, but in no case more than twenty-four (24) hours following first
knowledge of the occurrence of any of the following events:
a. Any discharge to ditches, surface waters or wetlands.
b. Failure to maintain storage capacity in a lagoon/storage pond greater than or
equal to. that required in Condition V. 2. of this Permii.
C. Over applying waste either in excess of the limits set out in the CAWMP or
where runoff enters surface waters or wetlands.
d. failure of any component of the animal waste management system resulting in a
discharge to surface waters or wetlands.
C. Any failure of the animal waste management system that renders the Facility
incapable of adequately receiving, treating or storing the waste and/or sludge.
f. Any deterioration or leak in a lagoon/storage pond that poses an immediate threat
to the environment or human safety or health.
For any emergency, which requires immediate reporting after normal business hours,
contact must be made with the Division of Emergency Management at 1-800-858-0368.

The Pern-ittee shall also file a written report to the appropriate Division Regional Office
within five (5) calendar days.following first knowledge of the occurrence. This report
shall outline the actions taken or proposed to be taken to correct the problem and to
ensure that the problem does not recur. The requirement to file a written report may not
be waived by the Division Regional Office.
In the event the waste level in a lagoon/storage pond is found to be within the designed
structural freeboard, the Permittee shall file a written report to the appropriate Division
Regional Office within two (2) calendar days following first knowledge of the
occurrence. This report shall outline actions taken or proposed to be taken to reduce
waste levels below the designed structural freeboard within five (5) calendar days of first
knowledge of the occurrence.
11; In the event of a discharge of 1,000 gallons or more of animal waste to surface waters or
wetlands, the Permittee must issue a press release to all print and electronic news media
that provide general coverage in the county in which the discharge occurred setting out
the details of the discharge. The press release must be issued within forty-eight (48)
hours after it is determined that the discharge has reached the surface waters or wetlands.
A copy of the press release and a list of the news media to which it was distributed must
be kept for at least one (1) year after the discharge and must be distributed to any person
upon request.
12. In the event of a discharge of 15,000 gallons or more of animal waste to surface waters or
wetlands, a public notice is required in addition to the press release described in
Condition Ill 15. The public notice must be placed in a newspaper having general
circulation in the county in which the discharge occurred and the county immediately
downstream within ten (10) days of the discharge. The notice shall be captioned
'NOTICE OF DISCHARGE OF ANIMAL WASTE". The minimum content of the
notice is the name of the facility, location of the discharge, estimated volume of waste
entering state waters, time and date discharge occurred, duration of the discharge,
identification water body that was discharged into including creek and river basin if
applicable, actions taken to prevent further discharge, and a facility contact person and
phone number. The owner or operator shall file a copy of the notice and proof of
publication with the Department within thirty (30) days after the notice is published.
Publication of a notice of discharge under this Condition is in addition to the requirement
to issue a press release under. Condition III.11.
13. If a discharge of 1,000,000 gallons or more of animal waste reaches surface waters or
wetlands, the appropriate Division Regional Office must be contacted to determine in
what additional counties, if any, a public notice must be.published. A copy of all public
notices and proof of publication must be sent to the Division within thirty (30) days after
the notice is published.
IV. INSPECTIONS AND ENTRY
The Permittee shall allow any authorized representative_ of Department, upon the
presentation of credentials and other documents as may be required by law and in
accordance with reasonable and appropriate biosecurity measures, to:

a. Enter the Permittee's premises where the regulated Facility or activity is located or
conducted, or where records must be kept under the conditions of this Permit;
b. Have access to and copy, at reasonable times, any records that must be kept under the
conditions of this Permit;
c. Inspect, at reasonable times any facilities, equipment (including monitoring and.
control equipment), practices, or operations regulated or required under this Permit;
and,
d. Sample or monitor, at reasonable times, for the purpose of assuring permit
compliance, any substances or parameters at any location.
V. GENERAL CONDITIONS
The issuance of this Permit shall not relieve the Permittee of the responsibility for
compliance with all applicable surface water, wetlands, groundwater and air quality
standards or for damages to surface waters, wetlands or groundwaters resulting from the
animal operation.
The maximum waste level in lagoons/storage ponds shall not exceed that specified in the
Facility's CAWMP. At a minimum, maximum waste level for lagoons/storage ponds
must not exceed the level that provides adequate storage to contain a 25-year, 24-hour
storm event plus an additional one (1) foot of structural freeboard except that there shall
be no violation of this condition if. (a) there is a storm event more severe than a 25-year,
24-hour event, (b) the Permittee is in compliance with its CAWMP, and (c) there is at
least one (1) foot of structural freeboard.
Any containment basin, such as a lagoon or a storage pond, used for waste management
shall continue to be subject to the conditions and requirements of this Permit until
properly closed. When the containment basin is properly closed in accordance with the
Natural Resource Conservation Service (MRCS) North Carolina Standard for Closure of
Waste Impoundments, February 2005 or any subsequent amendment, the containment
basin shall not be subject to the requirements of this Permit. The Permittee must submit a
letter to the Division to request rescission of the Permit by providing documentation of
closure of all containment basins.
Closure shall also include a minimum of 24 hours pre -notification of the Division and
submittal of the Animal Waste Storage Pond and Lagoon Closure Report Form to the
address identified on the form within fifteen (15) days of completion of closure.
4.. Failure of the Permittce to maintain, in full force and effect, lessee and landowner
agreements, which are required in the CAWMP, shall constitute grounds for revocation
of its'COC to operate under this Permit.
5. This Permit is not transferable. In the event there is a desire for the Facility to change
ownership, or there:is a name change of the Permittee, a Notification of Change of
Ownership form must be submitted to the Division, including documentation from the
parties involved and other supporting materials as may be appropriate.

The issuance of this Permit does not prohibit the Division from reopening and modifying
the Permit, revoking and reissuing the Permit, or terminating the Permit as allowed by the
appropriate laws, rules, and regulations.
The Groundwater Compliance Boundary is established by 15A NCAC 2L and 15A
NCAC 02T .01 l 1(c). An exceedance of Groundwater Quality Standards at or beyond the
Compliance Boundary is subject to the requirements of 15A NCAC 2L and the Division
in addition to the penalty provisions applicable under the NCGS.
VT. PENALTIES
Failure to abide by the conditions and limitations contained in this Permit; the Facility's
CAWMP; and/or applicable state law; may subject the Permittee to an enforcement
action by the Division including but not limited to the modification of the animal waste
management system, civil penalties, criminal penalties, and injunctive relief.
The Permittee must comply with all conditions of this Permit. Any Permit
noncompliance constitutes a violation of state law and is grounds for enforcement action;
for Permit coverage termination, revocation and reissuance, or, modification; or denial of
Permit coverage renewal application.
3. It shall not be a defense for a Permittee in an enforcement action to claim that it would
have been necessary to halt or reduce the permitted activity in order to maintain
compliance with the conditions of this Permit.
This Permit issued the 8th day of March, 2016.
NORTH CAROL,INA ENVIRONMENTAL. MANAGEMENT COMMISSION
for S. Jay Zim mennan, P.G. , Director
North Carolina Division of. Water Resources
By Authority of the Environmental Management Commission
Permit Number AW1330039

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Ben Shelton
Ben Shelton Farm
Rt 1 Box 322
Macclesfield NC 27852
Dear Ben Shelton:
/ •
r` NCDENR
ENVIRONMENT AND NATURAL RESOURCES
December 30, 1999
,.,I 12
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 33=39::"
Edgecombe.County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. IRR1, IRR2, DRY1, DRY2, DRY3, SLUR1, SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
if you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincerely
X
Kerr T. Stevens, Director
Division of Water Quality
cc: Raleigh Regional Office
Edgecombe County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
December 1, 1999
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Ben Shelton
Ben Shelton Farm
Rt 1 Box 322
Macclesfield NC 27852
Farm Number:;337393
Dear Ben Shelton:
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
You are hereby notified that Ben Shelton Farm, in accordance with G.S. 143-215. IOC, must apply for coverage
under an Animal Waste Operation General Permit. Upon receipt of this letter, your farm has sixty (60) days to submit the
attached application and all supporting documentation. In accordance with Chapter 626 of 1995 Session Laws (Regular
Session 1996), Section 19(c)(2), any owner or operator who fails to submit an application by the date specified by the
Department SHALL NOT OPERATE the animal waste system after the specified date. Your application must be
returned within sixty (60) days of receipt of this letter. Failure to submit the application as required may also subject your
facility to a civil penalty and other enforcement actions for each day the facility is operated following the due date of the
application.
The attached application has been partially completed using information listed in your Animal Waste Management
Plan Certification Form. If any of the general or operation information listed is incorrect please make corrections as noted on
the application before returning the application package. The signed original application, one copy of the signed application,
two copies of a general location map, and two copies of the Certified Animal Waste Management Plan must be returned to
complete the application package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
If you have any questions concerning this letter, please call Dianne Thomas at [phone] extension 364 or
Charles Alvarez with the Raleigh Regional Office at [phone].
Sincerely,
.a'
c
for Kerr T. Stevens
cc: Permit File (w/o encl.)
Raleigh Regional Office (w/o encl.)
1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
May 10, 2000
Ben Shelton
Ben Shelton Farm
Rt 1 Box 322
Macclesfield NC 27852
0A4;1 •
MOM
NCDENR
NORTH C.AROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Certificate of Coverage No. AWS330039
Ben Shelton Farm
Swine Waste Collection, Treatment,
Storage and Application System
Edgecombe County
Dear Ben Shelton:
In accordance with your application received on January 29, 2000, we are forwarding this Certificate of
Coverage (COC) issued to Ben Shelton, authorizing the operation of the subject animal waste collection,
treatment, storage and land application system in accordance with General Permit AWG100000. This
approval shall consist of the operation of this system including, but not limited to, the management of
animal waste from the Ben Shelton Farm, located in Edgecombe County, with an animal capacity of no
greater than 800 Wean to Feeder and the application to land as specified in the Certified Animal Waste
Management Plan (CAWMP).
The COC shall be effective from the date of issuance until April 30, 2003. Pursuant to this COC, you
are authorized and required to operate the system in conformity with the conditions and limitations as
specified in the General Permit, the facility's CAWMP, and this COC, with no discharge of wastes to
surface waters. An adequate system for collecting and maintaining the required monitoring data and
operational information must be established for this farm. Any increase in waste production greater than
the certified design capacity or increase in number of stocked animals above the number authorized by
this COC will regdire a modification to the CAWMP and this COC and shall be completed prior to
actual increase in either wastewater flow or number of animals.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive relief.
Upon notification by the Division of this COC's expiration, you shall apply for its renewal. This request
shall be made within 30 days of notification by the Division.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper
IL

Certificate of Coverage AWS330039
Ben Shelton Farm
Page 2
This COC is not automatically transferable. A name/ownership change application must be submitted to
the DWQ prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an individual non -discharge permit by contacting the engineer listed below for -information on
this process. Unless such a request is made within 30 days, this COC shall be final and binding.
The subject farm is located in the Raleigh Regional Office. The Regional Office Water Quality Staff
may be reached at [phone]. If you need additional information concerning this COC or the
General Permit, please contact Sue Homewood at [phone] ext. 502.
Sincerel ,
,Y, Kerr T. Stevens
cc: (Certificate of Coverage only for all cc's)
Edgecombe County Health Department
-Raleigh Regional Office, Water Quality Section
Edgecombe County Soil and Water Conservation District
Permit File
NDPU Files

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
December 1, 1999
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Ben Shelton
Ben Shelton Farm
Rt 1 Box 322
Macclesfield NC 27852
Farm Number: 3� 3:-:39:S
Dear Ben Shelton:
1 • •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT ANa NATURAL, RESOURCES
You are hereby notified that Ben Shelton Farm, in accordance with G.S. 143-215.10C, must apply for coverage
under an Animal Waste Operation General Permit. Upon receipt of this letter, your farm has sixty (60) days to submit the
attached application and all supporting documentation. In accordance with Chapter 626 of 1995 Session Laws (Regular
Session 1996), Section 19(c)(2), any owner or operator who fails to submit an application by the date specified by the
Department SHALL NOT OPERATE the animal waste system after the specified date. Your application must be
returned within sixty (60) days of receipt of this letter. Failure to submit the application as required may also subject your
facility to a civil penalty and other enforcement actions for each day the facility is operated following the due date of the
application.
The attached application has been partially completed using information listed in your Animal Waste Management
Plan Certification Form. If any of the general or operation information listed is incorrect please make corrections as noted on
the application before returning the application package. The signed original application, one copy of the signed application,
two copies of a general location map, and two copies of the Certified Animal Waste Management Plan must be returned to
complete the application package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
If you have any questions concerning this letter, please call Dianne Tbomas at [phone] extension 364 or
Charles Alvarez with the Raleigh Regional Office at [phone].
Sincerely,
for Kerr T, Stevens
cc: Permit File (w/o encl.)
Raleigh Regional Office (w/o encl.)
1617 Mail Service Center, Raleigh, NC 27699-1617 -telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Non -Discharge Permit Application Form
(THIS FORM MAYBE PHOTOCOPIED FOR USE AS AN ORIGINAL)
General. Permit - Existing Animal Waste Operations
The following questions have been completed utilizing information on file with the Division. Please review the
information for completeness and make any corrections that are appropriate. If a question has not been completed by
the Division, please complete as best as possible. Do not leave any question unanswered.
1. GENERAL INFORMATION:
1.1 Facility Name: Ben Shelton Farm
1.2 Print Land Owner's name: Ben Shelton
1.3 Mailing address: Rt 1 Box 322
City, State: Macclesfield NC Zip: 27852
Telephone Number (include area code): 827-5571
1.4 County where facility is located: Edgecombe
1.5 Facility Location (Directions from nearest major highway. Please include SR numbers for state roads. Please include a copy
of a county road map with the location of the farm identified): From Tarboro 14 miles east on 258, turn right on Corbett
Farm Rd.I 110, 1st farm on right.
1.6 Print Farm Manager's name (if different from Land Owner):
1.7 Lessee's / Integrator's name (if applicable; please circle which type is listed):
1.8 Date Facility Originally Began Operation: 01/01/80
1.9 Date(s) of Facility Expansion(s) (if applicable):
2. OPERATION INFORMATION:
2.1 Facility No.: 33 (county number); 39 (facility number).
2.2 Operation Description: Swine operation
Wean to Feeder
800- Certified Design Capacity
Is the above information correct? 1Zyes; Qno. If no, correct below using the design capacity of the facility
The "No. of Animals" should be the maximum number for which the waste management structures were designed.
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
0 Wean to Feeder —O—I` - 0 Layer 0 Dairy
0 Feeder to Finish 0 Non -Layer 0 Beef
0 Farrow to Wean (# sow) 0 Turkey
0 Farrow to Feeder (# sow)
0 Farrow to Finish (# sow)
Other Type of Livestock on the farm: No. of Animals:
FORM: AWO-G-E 5/28/98 Page 1 of 4 33 - 39

3.
2.3 Acreage cleared and available for application (excluding all required buffers and`areas not covered by the application
system): 2__ ; Required Acreage (as listed in the AWMP): 1.7
2.4 Number of lagoons/ storage ponds (circle which is applicable):
2.5 Are subsurface drains present within 100' of any of the application fields? YES or NO (please circle one)
2.6 Are subsurface drains present in the vicinity or under the lagoon(s)? YES or NO (please circle one)
2.7 Does this facility meet all applicable siting requirements? (Swine Farm Siting Act, NRCS Standards, etc.) (Swine Only)
YES or NO (please circle one)
What was the date that this facility's swine houses and lagoon were sited? /P / a
What was the date that this facility's land application areas were sited? Ir to
REQUIRED ITEMS CHECKLIST
Please indicate that you have included the following required items by signing your initials in the space provided next to each
item.
3.1 One completed and signed original and one copy of the application for General Permit - Animal
Waste Operations;
3.2 Two copies of a general location map indicating the location of the animal waste facilities and
field locations where animal waste is land applied;
3.3 Two copies of the entire Certified Animal Waste Management Plan (CAWMP). If the facility
does not have a CAWMP, it must be completed prior to submittal of a general permit application
for animal waste operations.
The CAWMP must include the following components. Some of these components may not
have been required at the time the facility was certified but should be added to the
CAWMP for permitting purposes:
3.3.1 The Waste Utilization Plan (WUP) must include the amount of Plant Available
Nitrogen (PAN) produced and utilized by the facility.
3.3.2 The method by which waste is applied to the disposal fields (e.g. irrigation,
injection, etc.)
3.3.3 A map of every field used for land application.
3.3.4 The soil series present on every land application field.
3.3.5 The crops grown on every land application field.
3.3.6 The Realistic Yield Expectation (RYE) for every crop shown in the WUP.
3.3.7 The PAN applied to every land application field.
3.3.8 The waste application windows for every crop utilized in the WUP.
3.3.9 The required NRCS Standard specifications.
3.3.10 A site schematic.
3.3.11 Emergency Action Plan.
3.3.12 Insect Control Checklist with chosen best management practices noted. .
3.3.13 Odor Control Checklist with chosen best management practices noted.
3.3.14 Mortality Control Checklist with the selected method noted.
3.3.15 Lagoon/storage pond capacity documentation (design, calculations, etc.). Please be
sure to include any site evaluations, wetland determinations, or hazard classifications
that may be applicable to your facility.
3.3.16 Operation and Maintenance Plan.
If your CAWMP includes any components not shown on this list, please include the
additional components with your submittal.
Aimlicants Initials
Ls
FORM: AWO-G-E 5/28/98 Page 2 of 4 33 - 39

Facility Number: 33 - 39
Facility Name: Ben Shelton Farm
4.
I,
APPLICANT'S CERTIFICATION;
(Land Owner's name listed in question 12), attest that
this application for t'_-,e- Id r r (Facility name listed in question 1.1)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included, this application package
will be returned to me as in -complete.
Signature
Date /r'dG , '), DGc,
5. MANAGER'S CERTIFICATION: (complete only if different from the Land Owner)
I, (Manager's name listed in question 1.6), attest that this
application for (Facility name listed in question 1,1)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included, this application package
will be returned as incomplete.
Signature
Date
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND MATERIALS,
SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF WATER QUALITY
WATER QUALITY SECTION
NON -DISCHARGE PERMITTING UNIT
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
FAX NUMBER: [phone]
FORM: AWO-G-E 5/28/98 Page 3 of 4 33.39

)rVISION OF WATER QUALITY REGIONAL OFFICES (1198)
ksheviZk Regional WQ Supervisor
59 Woodfin Place
Asheville, NC 28801
, szg) 251-6208
Fax (e zg) 251.6452
Avery ' Macon
Buncombe . ' Madison
Burke
McDowell
Caldwell
M iitcbell
C3ctlkce
Polk
Clay
Rutherford
Graham
Swain
Haywood
Tmasylvada.
Hende:sae Yancey
Tackson
Faye:tevi]le Regional WQ Supervisor
Wachovia Building, Suite 714
Faye=viile, NC 28301.
[phone]
Fax [phone]
Washington Regional WQ Supervisor
943 Washington Square Mall
Waddington, NC 27989
(25z)546-6481
Fax (fit; 975-3716
Beaufort Jones
Berde - Lenoir
Cbowaa
Pamlico
Craven
Pasquotank
C urmiaw t
Pergmmans
Dare
Pitt
Gates
iyre11
10reene
Washing=
Hertford
Wayne
Hyde
Mooresville Regional WQ Supervisor
919 North Main Strcet
Mooresville, NC 28115
[phone]
Fax (704) 66.1,6 40
Raleigh Regiotal WQ Supervisor
39M Sancti Dr.
Raleigh, NC 27611
[phone]
Fax [phone]
Chatham
Nash .
Durham
Nordmxzpton
Edgecambe
Franklin
Orange
Person
Granville
Vance
Halifax
Wake
Johnston
Warren
Lae
Wilson
'%rdmington Region. WQ Supervisor
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
[phone]
Fax [phone]
Anson
Moore
wtrS xlw Lincoln Brunswick New Haaavcs
Blades
Richmond
C4bstrus MeckIenburg Carteret Onslow
�beriaad
Robeson
Catawba Rowan Columbus Pcedrx
Harnett
Sampson
Cleveland Stanly Dupliu
Hoke
Scotland
Gaston Union
Nkoutgotaery .
Lredell
Wiatton-Sal= Regi anal WQ. S upervisor
585 Waughtcwn Strut
i -moon-Salem NC 27107
raQ 7714600
Fax GIL) 771- 631
4lamaace Rocbngham
ueghany Randolph
Awe Stokes
;Aswan S urry
'Davidson Watanp.
Davie Wt a=
Facsyth yadldn
3uilfard
FORM: AWO-G-E S12 S Page 4 of 4

OPERATION 'AND MAINTENANCE PLAN FOR SWINE WASTE MANAGEMENT SYSTEM
Producer: eEti! . Mf R)nl
The purpose of this plan is to provide guidelines for carrying out the
routine operation and maintenance work needed to keep this swine waste
management system functioning as planned. Routine maintenance is -
considered to be normal good care of the system. Good maintenance adds
to beauty, usefulness, and permanence.
A. Maintenance
The routine maintenance of the lagoon involves the following:
I. Maintenance of a vegetative cover on the embankmentftop and side
slopes: 55,-ln uvl is being
established on these areas. _. Beginning. in. 19 . 7 and each year ...
thereafter, the embankment should be fertilized with 800-pounds
y of. 10-10-10 per acre to maintain a vigorous stand. -
2. Control of brush and trees on the embankment. This may be done
by mowing, spraying, or chopping, or a combination of all three._
This will need to be done at least once each year and possibly
twice in years favorable to heavy growth of vegetation.
Maintenance inspections of the lagoon should be made during the
initial filling of the lagoon and at least annually. Items to be
checked should include, as a minimum, the following:
1. Waste Inlet Pipes, Overflow Pipes
a. condition of pipes
(1) separation of joints
(2) cracks or breaks -
2. Pool Area
a. undesirable vegetative growth
b. floating or lodged debris
3. Embankment
a_ settlement, cracking or "jug" holes
b. side slope stability - slumps or bulges
c. erosion and rodent damage
4. Transfer Pump
1

OPERATION AND MAINTENANCE PLAN FOR SWINE WASTE MANAGEMENT SYSTEM
B. Operation
Your animal waste management facility was designed for a total of
oa sows ( wE4n1 to eD ). The lagoon contains both
permanent and temporary storage.. The permanent storage is not to be
pumped in order to ensure that anaerobic action will occur. The
design includes permanent storage of one cubic foot per pound of
steady state live weight.
The temporary storage portion of the lagoon includes capacity for the
volume of waste produced over 180 days, the amount of rainfall in a
25 year 24 hour storm event, and rainfall in excess of evaporation.
Your facility is designed for 180 days of temporary storage;
therefore, it will need to be pumped every six months. Begin pump -
out of the lagoon when fluid level reaches elevation 4S,Z as marked
by permanent markers. Stop pump -out when the fluid level reaches
e7.eva-tio-h Y"d. o
The attached waste management plan should be followed. This plan
recommends sampling and testing of waste (see Attachment B) before
land application. The waste material should be analyzed before each
application cycle to determine its nutrient content. A soil test of
the area of application should be made annually to insure the waste
is applied as reasonably and practically possible to recommended
rates.
It is strongly recommended that the treatment lagoon be pre -charged
to 1/2 its capacity to prevent excessive odors during start-up. Pre -
charging reduces the concentration of the initial waste entering the
lagoon. -thereby reducing odors. Solids should be covered with
effluent at all times.
The Clean Water Act of 1977 prohibits the discharge of pollutants
into waters of the United States. The Department -of Environment,.
Health, and Natural -Resources, Division of -Environmental Management,
has the responsibility for enforcing this law.
f
2

mnx THIS DESIGN IS FOR A SINGLE STAGE LAGOON
CLIENTS NAME
COUNTY
TODAYS DATE
DISTANCE TO NEAREST NONFARM RESIDENCE =>
NUMBER OF PIGS WEANLING TO FEEDER
NUMBER OF PIGS FEEDER TO FINISH =======>
NUMBER OF SOWS FARROW TO WEANLING
NUMBER OF SOWS FARROW TO FEEDER =-_---_>
NUMBER OF SOWS FARROW TO FINISH
DEGREE OF ODOR CONTROL
(minimum 1.0 cu. ft. per lb SSLW)
(maximum 3.0 cu. ft. per lb SSLW)
NUMBER OF YEARS OF SLUDGE ACCUMULATION >
TOP LENGTH AT NORMAL WATER LEVEL
TOP WIDTH AT NORMAL WATER LEVEL
NORMAL WATER LEVEL ELEVATION ==========>
SEASONAL HIGH WATER TABLE ELEVATION =__>
LAGOON BOTTOM ELEVATION
Depth of Permanent Water 7.0
(minimum depth without sludge = 6 feet)
(minimum depth with sludge = 8 feet)
SIDE SLOPES __________________-________>
Permanent Volume Required 33600.0
Permanent Volume Provided 42289.3
ADDITIONAL DRAINAGE AREA IN SQUARE FEET>
(i.e. pumpout pond & other outside area)
LENGTH OF PUMPING CYCLE
GALLONS OF FRESH WATER ADDED DAILY ====>
EXCESS RAINFALL ABOVE EVAPORATION =====>
25YR/24HR STORM RAINFALL
FREEBOARD
Ben Shelton
Edgecombe
Sept. 6,1995
1800 FEET
800
0
0
0
0
1.0
5.0 YEARS
180.0
FEET
50.0
FEET
46.0
FEET
44.0
FEET
39.0
FEET
feet
2.0:1
cubic feet
cubic feet
0 SQUARE FEET
180 DAYS
0 GALLONS
13.4 INCHES
6.7 INCHES
1.0 FEET
ESTIMATED TOP OF DAM ELEVATION ========> 50.0 FEET
Temporary Storage Volume 27528.7 cubic feet
Top of Dam Elevation = 50.0 feet
Inside Dimensions of Lagoon at Top of Dam
Length = 196.0 feet Width = 66.0 feet
Begin Pumping Elevation = 48.2 feet
Stop Pumping Elevation = 46.0 feet
Volume To Be Pumped = 20306.1 cubic feet

mnx 1. STEADY STATE LIVE WEIGHT
800
head
weanling
to feeder
x 30 lbs.
24000
lbs
0
head
feeder
to
finishing x 135 lbs. -
0
lbs
0
sows
farrow
to
weanling
x 433 lbs. =
0
lbs
0
sows
farrow
to
feeder x
522 lbs. -
0
lbs
0
sows
farrow
to
finish x
1417 lbs. -
0
lbs
TOTAL STEADY STATE LIVE WEIGHT (SSLW) W 24000 lbs
2. SLUDGE ACCUMULATION
Sludge accumulates at the rate of 0.080 cu. ft. per year
per pound of STEADY STATE LIVE WEIGHT in swine.
Years of sludge accumulation in design? 5.0
Sludge Volume = 9600.0 cubic feet
3. REQUIRED LIQUID VOLUME OF LAGOON
Design for 1.0 cu. ft. per pound SSLW
Total Volume = (SSLW * Design factor) + Sludge Volume
Total Volume = 33600.0 cubic feet
4. NORMAL LAGOON LIQUID LEVEL
Maintain normal lagoon liquid level at elevation 46.0 feet
Construct lagoon bottom elevation 39.0 feet
Lagoon size for normal lagoon liquid volume using prismodial formula
SS/END1 SS/END2 SS/SIDE1 SS/SIDE2 DEPTH
2.0 2.0 2.0 2.0 7.0
AREA OF TOP
LENGTH *WIDTH =
180.0 50.0
AREA OF BOTTOM
Lb * Wb =
152.0 22.0
AREA OF MIDSECTION
(Lm * Wm) _
166.0 36.0
9000.0 (AREA OF TOP)
3344.0 (AREA OF BOTTOM)
5976.0 (AREA OF MIDSECTION)
CU. YD. = [AREA TOP + (4*AREA MIDSECTION) + AREA BOTTOMS * DEPTH/6
9000.0 23904.0 3344.0 1.167
VOLUME OF LAGOON AT NORMAL LAGOON LIQUID LEVEL =42289.3 CU. FT.
VOLUME NEEDED = 33600.0 CU. FT.
THE SURFACE DIMENSIONS OF THE LAGOON AT NORMAL LIQUID LEVEL
ARE 180.0 FEET LONG BY 50.0 FEET WIDE

m 5. DIKE
Place spoil as a continuous dike to elevation 50.0 feet.
6. TEMPORARY STORAGE REQUIRED
DRAINAGE AREA: -
Lagoon (top of dike)
Length * Width =
196.0 66.0 12936 square feet
Additional Drainage Area
0 square feet
TOTAL DA 12936 square feet
Pumping cycle to be 180 days.
6A. Volume of waste produced
Volume = 24000 SSLW * 0.0101481 gallon/lb. SSLW/day
in the pumping cycle / 7.48 gallons per cu. ft.
Volume = 5860.9 cubic feet
6B. Volume of wash water
This is the amount of fresh water used for washing floors or
volume fresh water used for a flush system. Flush systems that
recycle the lagoon water are accounted for in 6A.
Volume = 0 gallons/day * 180 days in the pumping
cycle divided by 7.48 gallons per cu. ft.
Volume = 0.0 cubic feet
6C. Volume of rainfall in excess of evaporation
Use period of time when rainfall exceeds evaporation by largest
amount.
Excess rainfall (difference) = 13.4 inches
Volume = 13.4 inches * DA / 12 inches per foot
Volume = 14445.2 cubic feet
6D. Volume of 25 year —24 hour storm
Volume = 6.7 inches * DA / 12 inches per foot
Volume = 7222.6 cubic feet
TOTAL REQUIRED TEMPORARY STORAGE
6A. 5860.9 cubic feet
6B. 0.0 cubic feet
6C. 14445.2 cubic feet
6D. 7222.6 cubic feet
TOTAL TEMPORARY STORAGE 27528.7 cubic feet

7. DEPTH OF STORAGE REQUIRED (ABOVE NORMAL LIQUID ELEVATION OF LAGOON)
Depth required = Volume'of temporary storage divided by surface
area of lagoon.
Depth required =
Depth required =
27529 cu.ft. / 9000 sq. ft.
3.0 feet
Normal lagoon liquid elevation = 46.0 feet
Depth required = 3.0 feet
Freeboard = 1.0 feet
Top of Dam - 50.0 feet
THE DIMENSIONS OF THE INSIDE EDGE OF THE DAM AT ELEVATION
ARE 196.0 FEET BY 66.0 FEET
8. SET BEGIN PUMPING ELEVATION
PUMPED STORAGE VOLUME
6A.
6B.
6C.
TOTAL PUMPED VOLUME =
5860.9 cubic feet
0.0 cubic feet
14445.2 cubic feet
20306.1 cubic feet
50.0
Depth required = Volume of pumped storage divided by surface
area of lagoon at normal water level.
Depth required = 20306.1 cu.ft. / 9000.0 sq. ft.
Depth required = 2.2 feet
DESIGNED BY: /T
DATE: !/ l�/S—
APPROVED BY: A_B_ 4-
DATE:

Insect Control Checklist for Animal Operations
Source Cause BMPs to Control Insects Site Specific Practices
Flush Gutters • Accumulation of solids lush system is designed and operated
sufficiently to remove accumulated solids from
gutters as designed.
❑ Remove bridging of accumulated solids at
ischarge
Lagoons and Pits + Crusted Solids Maintain lagoons, settling basins and pits where
pest breeding is apparent to minimize the
crusting of solids to a depth of no more than 6 -
8 inches over more than 30% of surface.
Excessive Vegetative • Decaying vegetation Maintain vegetative control along banks of
Growth lagoons and other impoundments to prevent
accumulation of decaying vegetative matter
along water's edge on impoundment's perimeter.
Dry Systems _
Feeders T • Feed Spillage ❑ Design, operate and maintain feed systems (e.g.,
bunkers and troughs) to minimize the
accumulation of decaying wastage.
❑ Clean up spillage on a routine basis (e.g., 7 - 10
day interval during summer; 15-30 day interval
during winter).
Feed Storage Accumulations of feed residues M Reduce moisture accumulation within and
around immediate perimeter of feed storage
areas by insuring drainage away from site
and/or providing adequate containment (e.g.,
covered bin for brewer's grain and similar high
moisture grain products).
❑ Inspect for and remove or break up accumulated
solids in filter strips around feed storage as
needed.
AMIC - November 11, 1996, Page 1

Source Cause
BMPs to Control Insects. Site Specific Practices
Animal Holding Areas • Accumulations of animal wastes
0
Eliminate low areas that trap moisture along
and feed wastage
fences and other locations where waste
accumulates and disturbance by animals is
n,
lJ�
O
minimal.
Maintain fence rows and filter strips around
I 1
animal holding areas to minimize
accumulations of wastes (i.e., inspect for and
remove or break up accumulated solids as
needed).
Dry Manure Handling • Accumulations of animal wastes
©
Remove spillage on a routine basis (e.g., 7 - 10
Systems
day interval during summer; 15-30 day interval
during winter) where manure is loaded for land
application or disposal.
0
Provide for adequate drainage around manure
stockpiles.
C1
Inspect for and remove or break up accumulated
wastes in filter strips around stockpiles and
manure handling areas as needed.
For more information contact the Cooperative Extension Service, Department of Entomology, Box 7613, North Carolina State University,
Raleigh, NC, 27695-7613.
AM IC - November 11, 1996, Page 2

Swine Farm Waste Management Odor Control Checklist
Source Cause BM Ps to Minimize Odor Site Specific Practices
Farmstead • Swine production ❑ Vegetative or wooded buffers;
�ommended best management practices;
Good judgment and common sense
Animal body surfaces + Dirty manure -covered animals ❑ Dry floors
Floor surfaces • Wet manure -covered floors Slotted floors;
❑ Waterers located over slotted floors;
17 Feeders at high end of solid floors;
❑ Scrape manure buildup from floors;
Q,,dnderfloor ventilation for drying
Manure collection pits + Urine; ❑ Frequent manure removal by flush, pit recharge,
+ Partial microbial decomposition or_rrape;
Ventilation exhaust fans • Volatile gases;
Dust
ventilation
Fin maintenance;
air movement
surfaces • Dust Cr Washdown between groups of animals;
❑ Xed additives;
CY Feeder covers;
❑ Ferd delivery downspout extenders to feeder
Flush tanks + Agitation of recycled lagoon 6J/lush tank covers;
liquid while tanks are filling tend Fill lines to near bottom of tanks with
�ti-siphon vents
Flush alleys • Agitation during wastewater Underfloor flush with underfloor ventilation
conveyance /
Pit recharge points • Agitation of recycled lagoon Extend recharge lines to near bottom of pits
liquid while pits are filling with anti -siphon vents
Lift stations • Agitation during sump tank ❑Sump tank covers
filling and drawdown [�
Outside drain collection Agitation during wastewater
or junction boxes conveyance
AMOC - November 11, 1996, Page 3
Box covers
0

Source Cause BMPs to Minimize Odor Site Specific Practices
End of drainpipes at • Agitation during wastewater Extend discharge point of pipes underneath
lagoon conveyance I on liquid level
Lagoon surfaces • Volatile gas emissions; QIlprpper lagoon liquid capacity;
• Biological mixing; Oycotrect lagoon startup procedures;
• Agitation fY inimum surface area -to -volume ratio;
all,
agitation when pumping;
�❑ Mechanical aeration;
00 oven biological additives
irrigation sprinkler • High pressure agitation; V���K:nimum
igate on dry days with little or no wind;
nozzles • Wind drift recommended operating pressure;
Pump intake near lagoon liquid surface;
❑ Pump from second -stage lagoon
Storage tank or basin • Partial microbial decomposition;` ❑ Bottom or midlevel loading;
surface . Mixing,while filling; ❑ Tank covers;
• Agitation when emptying ❑ Basin surface mats of solids;
❑
Proven biological additives or oxidants
Settling basin surface
Partial microbial decomposition;
❑
Extend drainpipe outlets underneath liquid
•
Mixing while filling;
vel;
•
Agitation when emptying
Remove settled solids regularly
Manure, slurry or sludge •
Agitation when spreading;
❑
Soil injection of slurry/sludges;
spreader outlets .
Volatile gas emissions , ` v❑
Wash residual manure from spreader after use;
`V
❑
Proven biological additives or oxidants
Uncovered manure, •
Volatile gas emissions while
fO
Soil injection of slurry/sludges
slurry or sludge on field
drying
Cl
Soil incorporation within 48 hrs.;
surfaces
❑
Spread in thin uniform layers for rapid drying;
❑ Iroven biological additives or oxidants
Dead animals • Carcass decomposition Proper disposition of carcasses
Dead animal disposal • Carcass decomposition ❑ Complete covering of carcasses in burial pits;
Pits � O Proper location/construction of disposal pits
• Incomplete cotnbustion El Secondary stack burners
� � -k
AMOC - November 11, 1996, Page 4

Source Cause HMPs to Minimize Odor Site Specific Practices
water around • Improper drainage;
facilities • Microbial decomposition of
organic matter
Manure tracked onto
public roads from farm
access
Additional Information :
Grade and landscape such that water drains
away.from facilities
access roads 9' Farm access road maintenance
Swine Manure Management; 0200 Rule/BMP Packet
Swine Production Farm Potential Odor Sources and Remedies; EBAE Fact Sheet
Swine Production Facility Manure Management: Pit Recharge - Lagoon Treatment ; EBAE 128-88
Swine Production Facility Manure Management: Underfloor Flush - Lagoon Treatment; EBAE 129-88
Lagoon Design and Management for Livestock Manure Treatment and Storage ; EBAE 103-83
Calibration of Manure and Wastewater Application Equipment; EBAE Fact Sheet
Controlling Odors from Swine Buildings; PIH-33
Environmental Assurance Program; NPPC Manual
Options for Managing Odor ; a report from the Swine Odor Task Force
Nuisance Concerns in Animal Manure Management: Odors and Flies; PRO107, 1995 Conference Proceedings
AMOC - November 11, 1996, Page 5
Available From:
NCSU, County Extension Center
NCSU -BAE
NCSU - BAE
NCSU - BAE
NCSU - BAE
NCSU - BAE
NCSU - Swine Extension
NC Pork Producers Assoc
NCSU Agri Communications
Florida Cooperative Extension

Mortality Management Methods
(check which method(s) are being implemented)
Burial three feet beneath the surface of the ground within 24 hours after
knowledge of the death. The burial must be at least 300 feet from any flowing
stream or public body of water.
❑ Rendering at a rendering plant licensed under G.S. 106-168.7
❑ Complete incineration
❑ In the case of dead poultry, only, placing in a disposal pit of a size and design
approved by the Department of Agriculture
❑ Any method which in the professional opinion of the State Veterinarian would
make possible the salvage of part of a dead animal's value without endangering
human or animal health. (Written approval of the State Veterinarian must be
attached)
December 18, 1996

EMERGENCY ACTION PLAN
PHONE NUMBERS
DWQ 919-571 - 4700
EMERGENCY MANAGEMENT SYSTEM 919--641 7643
SWCD 919-641-7900
NRCS 919-641-7900
This plan will be implemented in the event that wastes from
your operation are leaking, overflowing, or running off
site. You should not wait until wastes reach surface waters
or leave your property to consider that you have a problem.
You should make every effort to ensure that this does not
happen. The following are some action items you should
take.
I. Stop the release of wastes. Depending on the
situation, this may or may not be possible. Suggested
responses to some possible problems are listed below.
A. Lagoon overflow -possible solutions are:
a. Add soil to berm to increase elevation of dam.
b. Pump wastes to fields at an acceptable rate.
C. Stop all additional flow to the lagoon.
d. Call a pumping contractor.
e. Make sure no surface water is entering lagoon.
B: Runoff from waste application field- actions
include:
a. Immediately stop waste application.
b. Create a temporary diversion to contain waste.
C. Incorporate waste to reduce runoff.
C: Leakage from the waste pipes and sprinklers --action
include:
a. Stop recycle pump.
b. Stop irrigation pump.
c. Close valves to eliminate further discharge.
D: Leakage from flush systems, houses, solid
separators -action include:
a. Stop recycle pump.
b. Stop irrigation pump.
C. Make sure no siphon occurs.

E: Leakage from base or sidewall of lagoon. Often
this is seepage as opposed to flowing leaks -possible action:
a. Dig a small well or ditch to catch all seepage,
put in a submersible pump, and pump back to
lagoon.
b. If holes are caused by burrowing animals, trap
or remove animals and fill holes and compact
with a clay type soil.
2.. Assess the extent of the spill and note any obvious
damages.
a. Did the waste reach any surface waters?
b. Approximately how much was released and for what
duration?
C. Any damage noted, such as employee injury, fish
kills, or property damage?
3: Contact appropriate agencies.
a. During normal business hours, call your DWQ
(Divisionrof Water Quality) regional office; Phone
919- 5_i1-ggoa . After hours, emergency number: 919-
733-3942. Your phone call should include: your
name, facility, telephone number, the details of
the incident from item 2 above, the exact location
of the facility, the location or direction of
movement of the spill, weather and wind conditions.
The corrective measures that have been under taken,
and the seriousness of the situation.
b. If spill leaves property or enters surface waters,
call local EMS Phone number 919-4p%41 - 76Y3 .
C. Instruct EMS to contact local Health Department.
d. Contact CES, phone number 919-&41 --7915 , local SWCD
office phone number 919-L41 - 7`ioo, and local NRCS
office for advice/technical assistance phone number
919 - &41 - I'1 a 0.
4: If none of the above works call 911 or the Sheriff's
Department and explain your problem to them and ask that
person to contact the proper agencies for you.
5: Contact the contractor of your choice to begin repair
of problem to minimize off -site da age.
a. Contractors Name:
b. Contractors Adress:
C. Contractors Phone: '

6: Contact the technical specialist who certified the
lagoon (NRCS, Consulting Engineer, etc.)
a. Name : A-73.W Nt I' r�rzCS )
b. Phone: 671 q)
7: Implement procedures as advised by DWQ and technical
assistance agencies to rectify the damage, repair the
system, and reassess the waste management plan to keep
problems with release of wastes from happening again.

TOM CROCKETT IRRIGATION, INC. • A.O.BOX 39.0 • WII,LIAMSTON, NORTH CAROLINA 27892 • 919-792,3121
RECEIVED.
__ -- ........ WATER QUAUTY SECTION
'JAN 2 9 2000
BEN SHELTON
RT 1 BOX 322
MACCL.ESFIELD NC 27852
827-5571
Non -Discharge Permitting
SPRINKLER 7025 RD SPRINKLERS, 1/4 NOZZLE, 60 PSI, 14.2 GPM, 135'
SPACING 60% X 135 = 81'; USE 80 X 80 SPACING
TDH 220', 3" PR-160 PVC PIPE, .72 PER. 100' @ 100 GPM 1.58
2" LATERAL WITH 4- SPKM<LEFRS 2.4 Y
• 4' ELEVATION INCLUDING RISER HIEGHT 1.73
5' SUCTION'LIFT 2.16
2k CHECK VALVE @ 100 GPM .-4
3" GATE VALUE @ 100 GPM .3
SPRINKLER PSI 60.0
68.57 PSI OR
158,4'
PUMP I BER1M EY B112-TPM, 71-2 HP, 100 GPM @ 73.6 PSI
PIPE'AND PIPE IS SDR-26 EXCEPT 1" RISER PIPE IS SCH 40. FITTINGS
FITTINGS ARE SCH 40 EXCEPT 1" FEMALE ADAPTORS ARE SCH'80.
ACRES 80 X 80 = -6400 = .15 ACRES PER HEAD
43560 3� 14 X .15 = 2.10 ACRES
APPLICATION 96.3 X 14.2 = 1367.46 = .21"
RATE 80 X 0 6400
HORSE POWER 158.4 X 99.4 w 15 744.96 = 3.98 = 5.45 HP
3960 36990�r 3
VERN PARKER 3/13/96

rod-�-�►!�
SYD Yv4 t/7
f �
777
-`r
-- •
.,mar
~�ti ... . n.n rr_r
r.,�r
—' --- . ._ ..- ....._._.. - - —� —�
n■nSliiME■
■i■MI
N�M>f�r
Mq■■
!®OMNR■S<MNNI■N■
■
S■■■
FN
NNiMr�■
■INNS
iiii■II®iB�I�ASiiii■
®!®®i■MIME■INN
i
7■
m"14N
�em
7
■/.!i■N■
■MIMES
eI■s
WAX
l:all■N/
ii■■■m■■
M®NIgNNF®NliiA419I■■i
OEM
N®■e.���flil.
mono
ie■■■■
�■■I■■■®■
II■i■®iIM■INNe
i■■■■INI■
i■■0■
MerNNlar
■■e■
�/■
■MINE
NiM■■I■I!■/I
�■■■
■sI
�■
wN■®■Seel
N■■■
■®®iiNl®■ii■■E■
NIN
inia®e
■am
2
Mi■■®N■■OEmami■■
WE
0Ns
■
NG1■i■
®Ise®N■>■iI■ms■em
■ ■■ �■■■■ No ■■N ■�i ■
■■N ■ei�' ■ in ■nla�■
si'N
iHEINE
®

Smith's Landscaping & Construction
.Rt. 4, Box 326 Tel: (919) 442�-8989
Rocky Mount, NC 27801 Mobile (9I9)450-.9752
Residential & Commercial
Lot Clearing Custom Hauling Septic Tank Driveways & French Concrete
Backhoe Service Topsoil .Installations Driveway Tiles Drain Drives &
Bulldozer Service Gravel and Repairs Systems Carports
Demolition Services Sand
Rock
INVOICE' 061396
Customer: Mr. Ben Shelton
Rt. 1, Box 322
Macclesfield, NC 27852
Services:
Pipe Fitting, Pump
Labor
Trencher
Miscellaneous Fitting
Rock
Concrete
Date: June 13; 1996
Cost:
$3,210.20
$1,800.00
$ 125.00
$ 100.00
$ 65.00
$ 175.00
Total Due: $5,475 0
THANK YOU!
NET I s DAYS SMITH'S LANDSCAPING & CONSTRUCTION

Smith's Landscaping & Construction. �s
Rt. 4, Box 326 Tel [phone]'
:Rocky Mount, NC 27801 mobile [phone]
Installed and tested irrigation system for hog lagoon, found no leaks, is
spraying same pattern as on blueprint, and blueprint is attached.
Fred Smith

IRRIGATION SYSTEM DESIGN PARAMETERS
Landowner/Operator Name: S n
Address: Ou Gjbow a
Teiephone: Yg27 '�?(
TABLE I - Field Specifications'
�i
County: da e 6 �
Date:
Approximate
Maximum
Useable Size
Field of Field Slope
Number= (acres) Boll Type N.)
Crop(s)
Maximum
Application
hale+
{inlhr)
Maximum.
Application
per trrlgatlon
bycle4
(inches) comm�nts
All(P
e u r'�
43
'Table to be completed in Its entirety by Field Office personnel and forwarded to the irrigation system designer.
'See attached map provided by the Field Office for field location(s).
'Total field acreage minus required buffer areas.
'Refer to N. C. Irrigation Guide, Field Office Technical Guide, Section II G. Annual application must not exceed the agronomic rates for.the'soii-and.crop;used
Irrigation Parameters cUSDAIRCS.
October 1995 pa9e4 Norih Carolina

i
TABLE 3 - Solid Set Irrigation Gun Settings BIN SMTON '
Make, Model and Type of Equipment: 7025 RD SPRINKLERS, 1 /4 NOZZLE
OP FFiAT1NG PARAIN07
Field No' Netted Hydrant Spacing (t;) Appr�catkm N=� ' Opesstlng Dperalinq
and Number of Dia+rwar Atom Between Rite Diameter Pressure lure
Lime Noe Hydranu (feet) Plpeiine Platrmes (inllrc) rhx,:I as) Gun (Paq Hydrant (hr) Comments
1 7 I 135' 1 80' 80' 1 - ! I I4 HRS! 1.03 ACRES
21 7 I 1 ,� I ,. I I I I " 1
1.03
1 1 I I 1 I I I1.0tACRES
I 1 1 1 ! I 1 1 !
I I I I I ! 1
! ! 1 ! 1 ! I ! -
i
I I ! I I I 1
1 I I ! I I ! I l
I 1 1 ! ! I I 1
1 I I 1 J I I 4 1
'See attached map provided by the Feld Office for field Iocabon(s).
,1Show separate entries for each pipeline with hydrants in each field.
Irrigation Parameters USDA -Nitta'
October 199.5 oave�

Irrigation .Parameters
October 199S
TABLE 4 - Irrigation System Specifications BEN =ToN
TABLE 5 -Thrust Block Specifications'
designer may provide thrust block details on separate sheet
THRUST M.=
LOCAMON AFMA (z= IL)
sa- Sena 3" .
need End 2" I
... 311
Scs USDA-MCS Ficld OM= Tcdz i=l GuiAc� Ssaian N,.Pr=ice C c. de 430-DD.
BEARING STRENGI H OF SOIL USED 1200
page
t

I r .
IRRIGATION SYSTEM ❑ESIGNER
Name: _PRESTON L PARKER, JR (VERN)
Company: TOM CROC= IRRIGATION INC
Address: P 0 BOX 390/751 E MAIN ST/WILL.IAMTON NC 27892
Phones [phone]
REQUIRED DOCUMENTATION
Thefadowincg detafls of desig and materials must a=mpany all irrigation: deagns_
1. Ascale-drawingoftherproposedirHgationsystem which includes hydrant locations, travel lanes, pipelineroutes, thrust blocic
Iaca iansandbuffrareaswhere•appffcable.
Z Assumptions and computations fordetermining;total dynanuc head and horsepower requirernents.
3 Computations used to determine aff mainffn=and Iatexal. pipcsiz=
4 Saurces-;indtarcalcuta iansuse3Fardetemi ning:appucatiarrrates_
i Computations used to detetmiaethe size afthn=blacks and. Mustrations afaR thrust block conEgurations required in the system:
6_ 'sspeciffc atians fiirthe-irrigasiompump, traveferand.spdin1der(s).
T s specifcations Farthe-irrigation pipe•andlorUSDA-MRCS standard rar ftrigatio m Water Canveyance:
N.C_ Ei`efd Office: Tech nic al. Guide;. Sectioa LV, Practice Code 430-D D.
Si The irtfortmdorr required by this farrn are the: minimurn requirementr.� ' Itis the responsibilay of the
deaignertac=nslderall relevant:iaGor rata particularsite and address thern as appmpriate.
S. Irrigation pipes should not be` instated in lagoon orstarage pond embankments withoutthe approval
of the designer_
NOTE , A buffer strip SO feet wide or wider must: be maintained between the limits of the irrigation system and ali perennial
streams and surface waters per DEHNR DEiYi Code Settian 15A NC.kC 2B .0200 -Waste Not Discharged to Sutfhce `.
Waters_
Irrigation PMMOters SO
Qeinber 1995 pages Nen Csra riaa Fr• '

SOLID -SET SYSM
Narrative of Irrigation System Operation
Describe the operation of the system in the space provided below or on a similar slSeet most convenient to the designer/supplier.
Include procedures such as star -up, shut -down, winterization and regular maintenance of all equipment
1"Igatlon Parameters USDA"VRCS
Oc:oher 194S . page-o" North Carolina

IRRIGATION SYSTEM DESIGN PARAMETERS
Landownerloperator Name: &0 5 0
Address: Q Ou t G Ox. 3 a.
L.
Telephone: 7 — yS7
TABLE 'I - Field Specifications 1
County: G 1° 6
Date:
Field
Number2
Approximate
Maximum
useable Size
or Fleld1
(acres)
Sail Type
Slope
(%)
Crop(s)
Maximum
Application
Rate 4
(Inlhr)
Maximum
Application
per Irrigation
6ycle4
(inches)
Comments
/. 3
'Table to be completed in its entirety by Field Office personnel and forwarded to the irrigation system designer.
2See attached map provided by the Field Office for field location(s).
3Total field acreage minus required buffer areas.
'Refer to N. C._ Irrigation Guide, Field Office Technical Guide, Section II G. Annual application must not exceed the agronomic rates for the soil and crop used.
Irrigation "Parameters USDA-IRCS
October 1996 page4 North Carolina

TABLE 3 - Solid Set irrigation Gun Settings BEN SHELTON
Make, Model and Type of Equipment. 7025 RD SPRINKLERS, 1 /4 NOZZLE
Field No'
and
Line Noe
Number of
Hydrants
Wetted
Diameter
(feet)
Hydrant Spacing (ft)
Along Between
Piperme Pipelines
Application
Rate
pn/hr)
OPERATING PARAMETERS
Nozzle Operating Operating
Diameter pressure Time
(inches) @ Gun (psi) @ Hydrant (hr) Comments
5 7
1 135'
I 80' 80'
Z1
I114I
I'4 HRS 1.03 ACRES
—1I
2 F 7
I ��
{ �� I „
I
t ( „
I „
0
I
I
1 1
'See attached map provided by the Feld office for field location(s).
1Show separate entries for each pipeline with hydrants in each field.
Irrigation Pararneters USDA -MRCS
October 1995 page- North Carollna

TABLE 4 - Irrigation System Specifications BEN SHELTON
Traveling Solid Set
Irrigation Gust Irrigation
Flow Rate of Sprinkler (gpm)
I I14.2
Operating Prt=ura at Pump ipai)
I
Design Precipitation hate (ice*)
� � .21 .
!•lase Length (feet)
I xxxx7C=
Type of Speed Compensation
I I RXxxxxxx
Pump Type (PTO. Entina Electric
IEL.ECTRIC
Pmnp P»++er P-quircrnatt (bp)
I 5.45
{ I
I I
I
TABLE 5 - Thrust Block Specifications'
Designer ma provide thrust block
details on se arate.sheeL
LOCATION
THRUST 13L=
AREA (s4.1L1
9e• Eeod 3"
Desd End 2"
I
3"
ITee '
I
"See USDA,%4RCS Field Otiice Tecimical Guide, Section N, Pr=ice Code 430.DD.
BEARING STRENGTH OF - SOIL USED 1200
Irrigation Parameters USpA-!RCS
October 1995 page4 North Carolina

IRRIGATION SYSTEM DESIGNER
Name:
Company:
Address:
Phone:.
PRESTON L PARKER, JR (VERN)
TOM CROCKETT IRRIGATION INC
P 0 BOX 390/751 E MAIN ST/WILLIAMSTON NC 27892
[phone]
REQUIRED DOCUMENTATION
The fallowing details of desigrr and materials must a=ompany all irrigation designs-
1. A -scale drawing afthe proposed irrigation system which includes hydrant locations, travel. lanes: pipeline routes', thrust block-
Iocations and buffir areas when= applicable-
7- Assumptions and computations for determining total dynarnic hea& and horsepower requirements.
-T Computations used to determine all mainline and lateral pipe sizes_
4. Sour=rfindlorcaicadatians used. for determining application: rates.
Computations used to determine'the size of#hrustblocks and Rusuations ofalt gist block configurations required in the system.
5. Manuflw uremspecilic ations forthe irrigationt pump, traveler and. sprinkler(s).
T. Manufu=ees-specifi'cationsfortheirrigatiorrpipe andlorUSDA-NRCSstandard, forLnigatiomWater Conveyance;
N.0 frseld Officer Technical Guide;, Section IV,. Practice Code-430-DD.
M. The informatiom required by this tams are the: minimums requirements Iris the mespansibility of the
designertaconsiderall relevantfaetorsata parficularsite and address them as apprupdatp_�
9. Irrigations pipes should not be installed in lagoon orstorage pond embankments withouttheapproval
of the designer_
NOTE: A buffer strip 50 feet wide or wider must be maintained between the limits of the irrigation system an.d all'perertnial
streams and surface waters per DEHNR DEIM Cade Section. 15A NCAC 2B .0200 -Waste Not Discharged to Surface
Waters.
Irrigation Parameters USDA VRCS
October 1995 page-S North Carolina

SOLID -SET SYSTEt'!
Narrative. of Irrigation System Operation
Describe the operation of the system in the space provided below or on a similar sheer most convinient to the desimerlsupplier.
incfude procedures such as start-up,' shut -down, winterization and regular maintenance of all equipment.
Irrigation parameters USDA-NRCS
October 1995 page- North Carolina

r �� j t a� ,,,5�^, z• PLEASE INDICATE THIS
MA g�� a• r 4 t BEgVVHENORDERING
M1Z/20/95
r * SY"wtiF rxtl�-�f'}'�' ` ,. f' �, !' "4y'� `; 4 YOUR INOUIHY DATED
q,—` I „,`q",{� SLk +it '►d.. k!1*.iC* _ *r�^"t"`.""''ts 4r-s ��`Sra� ' I r .A�'f►+o -'kfraaro*rny .. . , .. i
� iJ� �•+:'t�.s�,}r �..�.,��C h� `t�i •�'"� F sr k � h''•y� _ -w - r s l �}r •,�, ,..•.- r ., .
PROPOSED SHIPPING DATE
32 "'"r•.e 7. �$ �¢�' •.w L,t-¢p •r; sF �i. ar+.r... 'A.s`ds'�bw..,u,..:.wi%wr'`+u vrrr-" .. ,V i
iq
wi 1'lH� i♦�r1+ ` !;{JfZuv ytw° S Sx .., . F.O.B.
M ..l� , 'f _ "r►* "`µx h' � ''�.p{`w� x� �r TERMS, SHIPPING POINT
+{ta of 3 s '� 3 ,l4%l4' L+`x•?y_' s}1 - �.,_ ,. S. r.c �Y -
�a,r/��. f 5 SALESPERSON
� � , �F ' � , i `41'yq ' �i,�l.� a;�;,�=�a� #E.4"i s'.!i�d ; . ' i �,F!'nssi� J t, �xM'�r t �if•%N, ....
L 8275571 �,•,-r•i ti^ y 'L fi°W IT, ✓
BE SHIPPED VIA. aao.OR C LL
6be quAllb eli iNg �bt�d3 hartf�d, § 616fl6ffs nb#e�1
4 � d 16 W 666dl
CONDITIONS: The odiaAs Arid fohil3 dri this gwIvtlart are hd! sub/set Id, Wftl Charrgas or dtheraord9rfrellte unless Approved In WrRrrtg by Nie Nom9 Office of the Seller. All quotations
iod A th#61s AM ca Mijerrl UpdA AWAbaWrtis, AieA, b[+sAdtilllt�.i3f ihafeiials Ahd all Yfth�%fuses bejrwdd iittl t�orfbdl pri6s'Are bawd oh. bds!s And aohdfflons exrsum on hate
61 gw1A6h Afid drri suti d fo L'iiAi W 6j% Nib tON b Wl d
F<.' ty�7ogrAj3llicAr and ElBiib@iilpli Urr i� dtib t[ Ia I ror�''� An Aw-i4�r�4 et or�¢A bo{ ril fJ1Pae s of fen p9rt dnt ro be dwrge'd for pro-rala.
�rfit�t8s9fAssiirfreAh bfGfyl�SFp�1Alillgitf�� ��FfIN�tAl1 94 fifAdi 1"bA4WAY64WdON"AhWalt6bgbin(s 60Ythe pur hmf,,
4inple dltolirANed inu3t bb rilA� fb�'FBAsciiabld aptslljg� dlidlifAiAffit/$'ftf3[ br'3 di b�lJttabd�l}#N!y !li}'A� �l!'Tdldli� fhpreidtlbtltlil." W �, t` `u' ',,, `� • ;� �••..
Cd►ldrllorf3ho!$ 11�HyblAh lCiarefrfShaNblidi6l iliah�by#��lA6hs1►Adtri#dd'rxt fdrH ►r�is�McarfsfSf�fhlWffh&ii1towhbrnlriMarhayA*Wr6hPurchasers formal
3rlder OA rfdt be. blofrd+idwb`df t r "R" �+ .T I; y;,
OUANTftY' rr, Yy: _ ., •.ti D�$CplP?IDM * sue' �' ! ,�.: :� e� PRICE AMOUttT
' r7r� '+9�^alf; L - N iY. �• tj -trM '�i
�22l7� '1 13n r. r S, ,y," w ,•�f r�,L�
�y p� f :54 $, 118.80
wPrj•r7UV tR ,f;-.42r ' ' ^� a•s ''i+ .-K tx(' Jh r+k 1rs 'yr . rM1i�l114 a^a7 '. r:�i. -L,n. 4.32 ,1-
�.. s i�
20 f s1 40 �'yC; pips, m , : x 27. - 5.40
"m� a�ap4to „ ` t �,_ - s� 17: 79
2 - "' 30.38 60.67
48.47 � , +, i ' J t s.i •tlyry.,4..1, ...' '44.Vi�, ". r�+,�.f, �.3awM. ���, V w
1 3" tee 4.;� cC .. 34.31
4 '
r _ r 1I.38 45.52
4 3.29 13.16
1G t . rx}� .�r ,. 8.47.... 118:53
28 { �, 9b� •elbows 41i
;s 'u� _` 2.18.: 61.04
;�14 : 19 4
b.l]4 ft�G�gctpsa�isbbe ovek r sarf f..,19:4 9:30 .
' 7_ +:' 29+GQ
�µ B rs . - /+ -rtti z1`'! -•�,E t 38 s 37 275.59
r r "iie�i r ti1 1� t pr, Ot t m �e n a?.7 2$123.il1J
167.50
eX�tkit�g��e�'fitibgs.',=53.33 S8.c�O
44,y^+vk -. 4f 049.69
' � J _ r.� : ,.� �, ,h r ys• - ; rr". { ' +:. wL s :; ,r t w p�'' •f
t} �
��.`�'z�� _ LFSS 80%,..1tem9 ,4i12 �r3'1 47G. 54
�a ; LESS ;25�;:=items 13 16 - 676.82
2, 9 .33
t - f
, .y INA
`Nyp .r
iryL f ' - r „f `nT-- -S'V ._ iNL r r r'
S�.q. 1 �."�: 3' •f,�a .`1sy'''�rr }r � ,Y �� ik�+ f�� s r 1�., F�r� �'>,�" - i+r�+-k.iw1-' n ...
s -'' �L iv r•L;, : f..* s - wn p �.a f �q, ii"`"'"Yi 1.wr "g"� . � £ p '
..r.� .kG:- 'i""�k si a �l:L�'•7�'+#FKf"'�'•`= a�y�
•.t%^'"MM+r.�iiESirw
s
xGx""A'rn�oF
,400/07,..PAPfDNXVASs TO; 4Fi M CALL /06-LS7M 'N FAX [phone]l1:'.,f
.ter �, 3c•.: * �, �
y Re
n `
., _ r.l'S" '_ �'"!F` F`�}=.i,Y•� 4.,.• fv�r-M'
j} � !: �.l�i. ,I �J3K.. i•,iy .Y ? t..:hr'�„ !',�, �'•f �. S -� ..'.';Js 5rr- 5,« .i_m :�e•.�w�f, ��

I
ll
L%c&4 c-
pen, IV, P/7-,-
J-,tp�qr0k*A& SPAC,--J 86
ltl
)to
pp P-sok h p
— . �'

BERKELEY PUMPS
CURVE e075
DATE 1-2-66
TYPE "B'.' RATING CURVES 'AGE 1.02
Q SUPERSEDES
MOTOR DRIVE All WtvicullY i1sved —
4075 Curves
k, Cr.r: U~w C-1. PwLsb& L01018 ss-o,%.LOIOJS Nominal it.pm. 3600
r-1. S07397 mmft ki. S07367 p., 61 Full 13wsed on Fresh Water 43 80r* F.
MeAlmum Working Pressure: 150 PSI
20
t... ..... . .
19
........... .. .. .. .... ... .... ....... ..... . ........ 0 . ........
........... ..
........ ..
........ . .......... ........ .... . ... ........
200 !0
.... ........ . . .......... . . .. ...... .. .........
'-T
J
f
Z. 175 z SiL4jL (51 RPI__
0
15
X t
7 .7
. ......... I
1 25
. .......... .......
7
....... ... ...
73'
...... . ... . ... . . . ... . . . . . . . . . . .
50
... ........ A
25
. . . . . . . . . .
00 10 20 30 40 50 so 70 go 90 100 110 120
CAPACrrr W U.R. MALLOM ro 1111"ROW
N C-5035 T-3207 &W-wo- C-51=5 br-t 3-1-72 0— 7-30-65 IMES 1i27L
CM&I uwjww CL Pimme, L01018 aroma L01016
Nominal 1Lj'.14 36M
www.t uww C.L p.a. jkL M(;296J718U6wvjL a& Ste below m& 6-9/1 r
Based an Fresh Water 9 80r F.
S32401( 111. ul
Maximum Working Pressure: 150 PSI
.4
30
IMPELL!jt- WACA , NO.i
4.
r
77%r
20
HeAD
22�
10
60% ..... . ......
'71
mo76m
S34=
5-.9mir flo.-HP).
65%\• 70%­i3i.--..j:,.*.* .
#4072*­'.
S3201--
200
z
ww
173-
4- (74 HF4J
.........
_1
... ...
'7
I so!
U is HP11.
I-
125f
\INV A.
0 50, 100
T-3957. .1. -2
. .. . .............. ..... ....... ........
J"1!0 2000 250
Q!"AW."r r. U.S. GALLOP46 FTA m1PJVM
C-83N D~ 12-7-83 7-m-a5 t:
7

General Installation
Recommendations:
FOR GASKET PIPE
Installation
Excavation, Laying, Testing, and Back -
filling instructions are usually provided
bythe Engineerin charge of the project.
Reference may also be made to Ameri-
can Society for Testing and Materials
Standard, ASTM D-2774'Recommended
Practice for Underground Installation of
Thermoplastic Pressure Piping."
Excavation
1. The trench bottom shall be stable,
continuous, relatively smooth, and free
of rocks or other objects detrimental to
the pipe. It shall provide continuous
support for the pipe, and bell holes shaft
be provided for the bell and spigot Joints,
valves, and other system components
that might act as a fulcrum. When made
through a rock cut, at least 4" of com-
pacted satisfactory bedding material
shall be provided.
2. The trench depth shall place the pipe-
line at least 6" below the lowest recorded
frost depth, and shall place the pipeline
depth at least 30" below grade.
3. The trench width at the top of the pipe
shall be as narrow as practical to allow
adequate room for joining the pipe and
to allow.proper compaction of the sidefiil.
Minimum trench width Is normally con-
sidered 12" plus the pipe O.D.
4. Pipelines shall be cased, bridged, or
otherwise protected at locations where
they will be subject to heavy surface
bads due to shallow burial. Casing shall
also be used In spanning creeks and
gullies, extending 6 ft on either side of
the creek or gully.
Jointing
1. The pipe shall be jointed In the trench,
orabove ground, In accordancewith the
Jointing Instructions.
2. It is Important that the gasket be clean
and properly seated, the spigot and well
lubricated, and the bell and spigot ends
aligned correctly In both planes.
3. If Jointing Is done above ground, care
should be taken when lowering pipe Into
the trench that the depth of the joint ent ry
remains correct. "Check that the depth
of entry mark on the spigot ends is flush
with the face of the belt. Jointing of 6"
and large pipe Is usually done in the trench.
1. AT NO TIME should a back -hoe or
slmliar device be used to assemble pipe.
Thrust Blocking
As with other push -fit rubber gasketed
Joints, the pipe will not take end thrust
without restraints. Thrust blocks are
usually required at dead ends and
wherever the line changes direction of
30 degrees or more.
1. Thrust blocks shall be placed so that
the bearing surface Is In direct line with
the major force created by the pipe or
fitting. Concrete having a compressive
strength of 2000 psi Is the recommended
blocking material, and may be poured
between the simplest of forms and the
undisturbed earth bearing surfaces.
2. Thrust blocking size maybe calculated
as follows:
a) Multiply the pressure level desired
for testing by the value shown In the
table for thrust on fittings:
Thrust In Pounds . .
Pipe
Size
90
Elbow
45
Elbow
22%
Bend
Dead End
or Tee
8"
48.74
26.38
13.45
38.10
6"
82.61
44.72
22.80
61.18
10"
128.84
69.47
1 36.42
95.05
12"
180.54
77.23
49 82
133.70
b) Determine the bearing strength of
the soil from the following table:
BEARING STRENGTH OF SOILS
SOIL
lb. per Sq. Ft.
Muck, peat, etc.
0
Soft clay
1,000
Sand
2,000
Sand and gravel
3,000
Sand and gravel cemented with clay 4,000
Hard ahele
10,000
c) Divide the total thrust on the fitting
(step a) by the bearing strength of
the soft (step b). The result Is the
square feet of area needed on the
face of the thrust block
d) Thrust blocks should haunch the
pipe or fitting, not encase it.
Backlilling
1. Place select backfill and compact
under the haunch, along the sides of,
and over the top of the pipe to a com-
pacted depth of at least 6". This backfill
shall be soils that allow good compaction
and placed In 6" layers, wet I compacted.
It shall be free of rocks, f rozen clods, or
other hard objects.
2. The final backfIII maythen be made In
the usual manner, but care should be
taken not 10 dump large rocks or heavy
objects on the initial backflll and pipeline.
3. If the Joints and fittings must be left
exposed while under test, backfill to
within one foot of each side of the joint
or fitting 10 prevent deflection of the
pipe while under test pressures.
Testing
1. ALL AIR IN THE PIPELINE SHALL BE
BLED OFF CAREFULLY WHILE FILLING
THE LINE WITH WATER FOR TESTING.
Entrapped air in the fine can cause ex-
cessive test pressures, and create un-
necessary problems. Air shall be bled
off at the high spots In the line. Air
removal may also be accomplished by
pushing a foam plug through the line by
Incoming water pressure.
2. Test pressures may be 1 y: times the
'designed operating pressure of the
pipeline, but shall not exceed the maxi-
mum pressure rating of the pipe.
3. After pressure test and acceptance
of testing, the uncovered Joints and fit-
tings shall be Initially backfilled with
well compacted soil, and then covered
with final backfill,
4. Hydraulic pressure testing of the
pipeline shall be carried out Initially at
Intervals not exceeding 500 yards and
thereafter at intervals not exceeding
1,000 yards.
Radius Bends
Gradual change of direction may be
achieved by deflecting orcocking RIEBER
Joints a maximum of 3 degrees without
affecting the hydraulic seal of the Joint.
Offsets are made only after the straight
In -line assembly is made. Deflections at
the Joint and minimum curve radii (ft.)
obtainable are listed below:
Degree of
Deflection
at the Joint
Offset, Inches Radius, feet
1
4.2"
10 50'
2
8.3"
572'
3
12.3"
381'
-4-

on each side of the pipe to provide'tupport fret from voids. final backfill only after the iniMmtim depth of cover has been
Cue should be takers to Avoid defol•ming, displacing, or placed and only with pipe ;having wall thicknesses greater than
damaging the pipe during this phase of the operation. that of SDR,41:
6A Pirial backfill
6A.1 Gineril: After pipeline testing, final back[iil shall be StCTI0I-SPECI�iL CO1dSfI]ERATIONS
]aced and s read in a rnzirilatel utiifatrn la ere In such a 7.l l3e11 hotel fidf- i'itbbir sktlt
P P pP y Y 4e jelrkti. When the Ripe bSing Id -
manner as to fill the trench completely so that there will be no stalled is prbAded with rubber g9sket joints, bell holes shall be
unfilled spaces under or about rocks or lumps of earth in the excavated In the bedding matetial to allow for the unobstructed
backfill. Final backfill shall be free of large racks, frozen clods assembly of the joint. Cate Should be taken that the bell, hole is no
and other debris greater than 76 mm (3 in.) fit diametcr, Rolling larger thin necessary to accomplish ptoper joint assembly, When the
equipment or heavy tampers sh6tild be dsed 18 consolidate the joint has been thade; tht bell, hole should be carefully filled with
TABLE 11 - THIWST BLOCKING AND ANCHORS P't7R URI) ERG Rtl tINE! fRitidAtION" PIPELINES
Steb 1. tttiltlply the woilthig bresstir5 by the ipPiapriate value
shown In the following table to obtalo total thrust in N-(lb):
y*•t
PIPELINE THRUST PACpORS*, t
Pipe Size Dead knd 90 450 224/e
_tt! �. Air is'•+ lit. ram nr't'ee Elbow Elbow Elbow
1-1/2
38.1,
2.94
4.16
2.25
115
2
60.8.
J 59
6.46
3.50
1.78
2-1/2
63.5
6.66
9.40
5.10
2.60
A�
76.2
9 80
8
7.51
3.82
3-1/2
88.0
1�
18.1
9.81
4.99
4
101.6
10.2
23.0
12.4
6.81
6
127.0
24.7- •:.
35.0
18.9
9.63
6
162.4
84.8
49.2
26.7
13.6
8
208.2...
59.0
96.5
46.2
23.0
10
254.0
OLS
180.0
70.0
36.8
12 ' '
'" 304.8
129.0 "'
' 182.0
98.6
50.3
+ Based on thrust per kPA (Oil) 6resstire
t Blocklnr for cross may trbt be needed with long branch likes.
Step 2. Deterinlab the bearing `etreneth of the stilt from the table
below:
BEARING STRENGTH OF SOILS
Solis and Site Beaiui8 Losds
Ib/ft2 .
kPa
Soaiid Shade
10 000
479.8
Ceinehted Gravel and "hd
difficult to pick
d o00
191.E
Coaree And fine comple't Sand.
9 000
143.E
Medium Clay=Can bd ipaded ''
' 000
96.8
Soft Clay
1 000
47.9
Muck
..•a
0
Step 3. Divide the total thrust obtained In Step 1 by the bearing
strensth of the roll to 16t the area deeded, rn2 (ft2).
SIDE TH1tU9T AI.'t'kNATIE itftoCEliflii8
In.
PIPr Size
ram
Side Thtnst-per Dearee•
Ib N
1-1/2
38.1
5.1 22.7
2
60.8
7.9 95.1
2-1/2
63.5
11.6 61.6
3
76.2
17.1 76.1
3-1/2
88.0
22.4 90.6
4
101.0
28.3 125.9
is
127.0
43.1 191.7
6
152.4
60.9 270.6
6
203.2
103.0 456.1
10
254.0
160.0 711.7
12
904.8
r' 226.a 1000.8
i Based on dde thrust per 689 Lka (106 pat) pressure per decree of
deflection. ,.
a,r•i�,,+/ NOTE, Multiply side U"st fid ii tiili)e by"desze6s of Athectlon
times kPa (psi) dlvidid by 100te obtslti Wal side thrust In N (lb).
i
r�
��1

360' rotation
' impact sprinkler
Models 7025RD-1-1"M EFF, 7025RD-1-3/4" F EFF.
1025RD-1-I F EFr 7025RD-1-11/4'f F EFF
PERFORMANCE DATA*
Nozzle Pressure tO)
35 40 45 50 55 60 69 .70 75 so
#14 Nozzle (7h2')
Flow (gpm)
8.34
8.91
9.45
9.97'
10,5
10.9
11.4
11.8
12.2
12.6
Spkr. Base Press. (psi)
35.8
40.9
45.9
51.0
•56.0
61.0
66.1
71.2
76.2
81.2
Dlam. on 1.5' Rlser (ft)
104
108
113
118
121
126-,
129
132
135
137
Diam. on 6' Rlser (ft)
112
118
123
12.6
132
135
139
142
145
147
Dlam. on 12' Riser (ftl .
121
127
132
13'7
..140 °.:
AAA
146
148.
' 150
151
#16 Nozzle (Y.")
Flow wthl
10.8
11.6
12.3
.13.p
46 14.2. 14.8
15.3
15.9 -
16.4
5pkr. Base Press. (psi)
36.0
41.2
46.2
51.4
56.4 61.5
66.6
71.8
76.8
81.9
Warn. on 1.5' Rlser (ft)
112
116
121
127
131.:. 135;. _.
138"
141
144
146
Dlam. on 6' Rlser A)
120
128
133
138
142., ; .14 i.
142
150
153
155
Dlam. on 12' RISer fftl
128
134 , ..139
04' _.,
_ �4
153
156 .
158
160.
#18 Nozzle (02") **
Flow lgpm)
13.6
14.s
15.5
16.3
17.9 1i1,
18.6
19.3
20.6
20.6
SPkr. Base Press. (psi)
36.4
41.6
46.8
S1.9
57.0 62.2
67.3
72.4
77.5
82.6
Dlam. on 1.5' Riser (ft)
120
124
129 .
133 '
137 142 _.
• .145 -
148
151
154
DIM on 6' Riser (ft)
127
i34.
139
143
14�.'z•, 15U ;:
,i53
156,
159
161
Diam. on 12' Rlserrft).
134 .
146 ...
146 , .:.150
.....;153
.:,-.150;
.,a6U.,
163
165
167
#20 Nozzle Wis')
Flow (9pm)
16.8
17.9
10.0
20.6
21.0
22.6
22.9
23.7
24.5
25.3
5pkr. Base Press. fpsU
37.0
42.2
47.4
52.5
57.7
62.8.
68.2
73.3
78.5
83.7
Dlam. on 1.5' Riser (ft)
124
128
134
138
143
147 •
151:
154
157
159
Warn. on 6- Riser (ft)
130 *
137
143
147
151
155
158
161
164
166
Dlam. on 12' Riser (ft)
138
144
949
154
159
162
.166
96B
171
173
#22 Nozzle Pvm')
Plow (gpml
20.2
21.6
22.9
24.1
25.3
26.4 '
27,5
28.5
29.6
30.5
5pkr. Base Press. fpsU
37.6
43.0
48.2
53.4
58.7
64.0
69.2
74.4
79.6
85.0
Dlam. on 1.5' Wet (ft)
127
132
137
143
147
152
155
159
162
164
clam. on 6' Riser (ft)
133
140
145
150
155
- 159
163
166
169
17i
Diam. tiri 12' Rlses' (ft)
142 .
148
154
159
164
161
171,
173
176
178
424 Nozzle (-%")
Flow (gpinl
23.8
25.4
26.9
28.4
29.8
MA
32.4
33.6
34,8
35.9
5pkr. Base Press. (psi)
38.4
43.7
49.0
54.4
59.8
65.2
70.5
75.6
80.8
86.6
Dlam. on 1.5' Riser (ft)
129
135
141
146
151
156
160
163
. 166
168
Dlam. on 6' Rlseh (ft)
136
143
148
154
159
16S .:..
167
470
173
175
Dlam. on 12' Riser A)
146
152
158
163
168
172 .
. 176
178
180
182
'Figures reflect actual teal data. Pmductitm models may show slight variation.
"Standard nuzzle size.
Note: Maximum stream height is 15' (fr.) Above nozzle using Is" (#20) nozzle at 50 psi operating pressure.
7025R EFF 048

`
`SIZE
1.00
1.3i5
1.660
1.900
.0 i 4 -
ab
ID
1.195
.
1.532 ,
1.754
WALL i
o.o6d
0.064
0.073
K
rai LVQo rem ivu rcr- i uh r i r t: Irbil iuu FTI'
Sizes 1" lhr i 5". Plow GPM 1.1hfi! 1250.
2.06 2.5d 3.6b ' ' ' '
'3.56
s' .. 4.00
2.375..: 2.876 3.S06
4.000
4.500
2.193' , • 2.655 , ., ..230': ; :.,,
3.692
4.154
0.091. 0.110 0.135
0.154
6.173
5•�
SIZE
5.563
00
6.133
ID
0.214
WALL
THK
O.
Lp
21 6.
V] p
V7 G
n 0.
CA 0
v 4
&i p
$ d
1/! 0
0.-
y 0
0
d 0:
fJ7 a
a d
V7 0
4S
`J IL
�J
rf lL
QrJ
3LL
dJ
yµ.
ri1
�1L
O.J
rr u.
d J
�Y.
O.J
'i !L
dJ
rM W
dJ
IL L7
1
0.28
0.02
0.17
0.01
0.13
0.00
0.57
0.06
0.34
0.02
0.26
0.01
1 0.16
0.00
4:
' 0.85
0.14
0.52
0.04
0.39
0.02
'0.25
0.01
>
<
3
1.14
0.23
0.69
0.�7
D.53
0.04
0.33
0.01
0.23
0.00
4
1 4
035
0 88
0.1
0.66
0,05
0 42
0.02
0 2
0.01
1.71
0.49
' 1.04
0.15
0.79
0.08
0.50
0,03
0.34
0.01
0.2'J
O.OQ
6
7
1.99
0.66
1.2i
0.20
0.92
0.10
0.59
0.03
0.40
O.
0.27
0.01
7
$
:�.28
_0.84
.•1.39
0.25
1.06
0.13
D.67
O.D4
0,48
,
0.02
0,31
0.01
6
1!
2.67
1.a5
1.§6
6.31
1.19
0,16
U.76
_0:1s
=O.G2
9:02
'0.35'
-0Of
0.26
'.AAO
__•-
9•
10
2.85
.1.27
1.73
0.38
1.32
0.20
. 0,84
0.07
0.57
0.03
0.39
0.01
OS9'
`0.01
1
11
3.14
1.52
1.91
0.45
1.45
0.23
0.93
0.08
0.63
0.03-
0.43
0.01
0,32
0.01
11
12
3.42
1.78
2.08
0.53
1.59
0.28
"1.01
0.09
0.69
0.04
0.46
b.01
0.35
0.01
0.29
0,00
12
14
3.99
2.3.7
2.43
0.11
1.85
0.37''
�.111
0.12
0.81
0.05
d.54
0.02
0.41.
0.01
0.33
0,01
14
16
4.97
.3.04
2.18
0.91
2.12
0.47.
1.36
0:18
0.42
.0.0g
b.62
0.47
0.01
0.37
0,91
16
18
5.14
j.781
312
1.13
2.38
0.58
1.r.2
oJo
I vdd
:0.68
0.10
,A_�2
dID3
O.i3l
0.0
(JAZ
0.01
1
20
6.71
4.59
3.47
1.37
2.66
"0:71
" 1169
0.24
1.1,$
0.09
0.713
0.04
0.59
0.02
0.47
0.0
20
22
8.28
6.4
3.92
1.64
2.9.1
v#ti5
,1,86
0.29
1.�7
- o.f r
.a.Be
0.04
0.135
6.02,
0.52
0.01\'04
0. 0
22
24
6.85
'8•d4
4.iy
1.92
3.18
1.00
2.03
0:34
1.38
.Q:13
D.93
6.05
Q.71
0.03
0.58
D.02
.01
24
26
'142
7.47
4,61
2.2a
3.44
`
7,2p
0.39
•1,14
OAS
1.01
.,0.08
0.77
0.03
0.61
0.02
0.01
28
28
7.90
8.67
4.86
2.56
3.771rt.32
7.0.45
1.82
0AS
i.09
b,07
. 0.93
0.04
0.66
'md
.0.4
0
30
6.67
9.74
5.21
2.91
3.97
1.50
2.54
0.51'
1.73
0.20
1.17
0.08
0.99
0.04
' 0.70
0.02
19.
30
35
9.90
t2.9d
6.06
3.87
4.84
2.00
2.96
0.66
-2.02
0.27
1.36
0.10
' 1.04
0.05
0.82
0:03
54.01
).Ol
35
40
11:42
18.50
,
'6.95
4.90
,6.30
.2.56
3,39•
.0.86
2.31
0.34
1.56
0.13
-1.19
0.07
0.94
OA4
0.131
:01
40
45
11.AB
20.63
7:k2
6.Id
SRO.3.19
3.91
1,D8
2.60..
.42
••4.75
0.16
1.34
O,D9
1.06
0.0
0.139
0.02
:45
50
14.2
28.b7
13.69
7.49
6,63
. 3:69
. 4 2a
1.31
.99
! `1
1.96
0.20
1.49
0.1b
' 1.18.1
6.08
0:27
0.02A
50
55
15.71.
29.91.
,9.88
8.93
. 7.29
.4.62
.4,66
1.56
3.18
0.631
2.15
0.24
64
O.t2
1;30
, 9.97
0.85
D•0
5
6D
t %j4
36.14
fb.43
10.41;
7.9$
'5.43
6.�
'.f:A3
3,47
R.7
2,�4
0.28
'1.70
0,16
1,41
0.08
.92
0.
8
85
td.67
4Q•76
i1.29
12.i7
g.B2
' 8:30
6.81
"iM
3.76
0.84
;.54
0.32
1.04
0.17
1:53
0.0$
1 OD
' O 3
85
70
19.99
8.1'6
12.16
11-bil
9.28
7.23
•6.83
2.dd
4.63
6.96
2.73
0.37
2.09
0.19
1:.65
0.11
1. 8
04
70 -
76
3
16.86
:'9 4
• 8.21
6.36
2.7
,
4.34
1.
3
0.42
2.24
0.2
= 1.7t
0.1
1.1
04
76
80
13.90
17.88
10.60
9.26
6.78
•3.1Z
4.63
1.23
.302
• 0.47
'2.39
.0.25
1.89
0.14
.1:23
0.05
80
85
14.77
262
11.27
io.36
":3rt
'3:49
4-9
1.38
:3,
:tl.53
2.54
O.;rB
2.b0
Q.18
1.3.
D.a6
88
90
.e4
22:73
1to
i 1.61
7.�,3
'3.88
� !� 2Q'y1.61
7.B1
59
2.69
0.31
2.12
OA7
1' 9
.06
9
95
:51
V
24.B9
f2.B8
,12.y2
8.Q";
429
�.49
s':J.6$
( -
.65
2.64
-Q:34'
2.24
`0,19
.47
07
9
00
.
27A3
13.99
l<i
•'D
9
0
3
4
110
f 12
3Z.24
14,56
16.69
5.63
..743
: 2:22
. .30
. QAS.
'r 3:29
0.49
2.00
0,25
1.70
0. 9
1
_1s0
10.91.
1$.8t
•B.g1
11#.94
2:81
4.69
. t.01
'3:g9
a.62
, 2.83
' 0.30
-1.85
0.11
1
130
1-1.24
22.74
,1
11.61'
'7�i
'•3.03
$•08"
1. 11.
3.89
0. 1
• 3.07
0,34
2.01
0. 2
1
140
-
18.58
.18:b9
_1.1.Oy
-_dAd
..182
8:10
3.47a3:ad
4a9
'.0.7d,
:'3.31
0.39
- 2.16
. 0 4
9$4
394
.
1.
44
'
3
f80
r
1�
c.'�'
t f-� 1
Zxx
11.8i
, ..26
' OAS
4.45
4 91
' 82S
.B.b4
1,71
.1.0
4:78
8:08
0. 9
.r�i�b
378
4.0i
"fag
0,50
0.66
47
2.
O:YB170
0.3til
.-
:'�
+
q13.1517i1
f4.02
40.4E
§,6
wi o:1
'2.1a
, f3 Sri
�f!
' o83:
2a§o
_
4,:._.:�
7,y225
21:10'
1 :02
8:36
800
3.22
,'6.73
'7.48
1 68
:,6
.0.$
'1.�8
260
-
i ,47
fa.i
9.77
3.91
;,2.04
tl.91
,07
0.4 .
276
{
16.91
i2A
10.76
4.87
:• C23
2,44
6.5d
' i.39-
4.25
0.4
• 300
t
: 4;
17 38
14:3<4
1:73
9.46
. 9,97
' 2.89
;'. 7.09
. Id t'
4.64
0. 8
'
r y
35Q
-,
,!•
4`
`
i968
.30
1041
3 1'
,8.27
•'215
5.41
.77
87
97B
h
r:
11 M
:8.2s
17:23
»4.13
a 6s
7+4
"IA'
B Ba
4DD
;
�= _.
:'rtr
,::;
'
�•:
16 84
$.36,
.i f f7
'A aB
OAS
'6.19
6.99
426
�'`
; y
j:
.
�: '
1+ .8'�
f0.48
12:72
i6.413
tOQ4
3.b7
BS
1.10
4
`�'•.
,
11.6
13 A6
'O 7
1 9
3.4
75
" �•;
?n.
,; .
;11:57
1Z:85
14.21
1 .23
. 3.78
7.3
1.3B
f"
00
f
19;59
14.13
14.66
�6.7D
7.31
11.82
4:i5'
' 1, 4
d
1.
r
+:.
6.d5
fi:QO
13.110
4 58
:•8. 1'
1.7
0i.95
'10.33
14:16
6.82
'9.29
f'
r
i
1 45
1 t.9
15.3
7
,7.78
4
FF i Q0�
16.55
Id:63
-
1
%500
17.73
1891
8.80
9.92
1
3.5
rr
',i :
,r.
.' ..
,1
y
13.
:1.!
b
j 0
_
13.i.
a
0
.r..
*
14 t
17.80
' vr4.rl goat of rhmrt inr1',Iif i c nvai Orr cktar d'. Wltb ()�utfon, 7 .
I

ANIMAL WASTE UTILIZATION PLAN
Producer: Ben Shelton
Location: Route 3 Box 224
Macclesfield NC 27852
Telephone: [phone] +
Type Operation: Existing Wean to Feeder swine
Number of Animals: 800.00 pigs
(Design Capacity)
STORAGE STRUCTURE: Anaerobic Waste Treatment Lagoon -
APPLICATION METHOD: Irrigation
The waste from your animal facility must be land applied at a
specified rate to prevent pollution of surface water and/or
groundwater. The plant nutrients in the animal waste should be used
to reduce the amount of commercial fertilizer required for the crops
in the fields where the waste is to be applied.
This waste utilization plan uses nitrogen as the limiting nutrient.
Waste should be analyzed before each application cycle. Annual.soil
tests are strongly encouraged so that all plant nutrients can be
balanced for realistic yields of the crop to be grown.
Several factors are important in implementing your waste utilization
plan in order to maximize the fertilizer value of the waste and to
ensure that it is applied in an environmentally safe manner:
I. Always apply waste based on the needs of the crop to be
grown and the nutrient content of the waste. Do not apply
more nitrogen than the crop can utilize.
2. Soil types are -important as they have different infiltration
rates, leaching potentials, cation exchange capacities, and
available water holding capacities.
3. Normally waste shall be applied to land eroding at less than
5 tons per acre per year. Waste may be applied to land
eroding at 5 or more tons per acre annually, but'less than
10 tons per acre per year providing that adequate filter
strips are established.
4. Do not apply waste on saturated soils, when it is raining,
or when the surface is frozen. Either of these conditions
may result in runoff to surface waters which is not allowed
under DWQ regulations.
Page: 1

ANIMAL WASTE UTILIZATION PLAN
5. Wind conditions should also be considered to avoid drift and
downwind odor problems.
6. To maximize the value of the nutrients for crop production
and to reduce the potential for pollution, the waste should
be applied to a growing crop or applied not more than 30
days prior to planting a crop or forages breaking dormancy.
Injecting the waste or disking will conserve nutrients and
reduce odor problems.
This plan is based on the waste application method shown above. If
you choose to change methods in the future, you need to revise this
plan. Nutrient levels for different application methods are not the
same.
The estimated acres needed to apply the animal waste is based on
typical nutrient content for this type of facility. Acreage
requirements should be based on the waste analysis report from your
waste management facility. In some cases you may want to have plant
analysis made, which could allow additional waste to be applied. .
Provisions shall be made for the area receiving waste to be flexible
so as to accommodate changing waste analysis content and crop type.
Lime must be applied to maintain pH in the optimum range for specific
crop production.
This waste utilization plan, if carried out, meets the requirements
for compliance, with 15A NCAC 2H .0217 adopted by the Environmental
Management Commission.
AMOUNT OF WASTE PRODUCED PER YEAR (gallons, ft3, tons, etc.)
800 pigs x .40 tons waste/pigs/year = 320 tons
AMOUNT OF PLANT AVAILABLE NITROGEN (PAN) PRODUCED PER YEAR
800 pigs x .48 lbs PAN/pigs/year = 384 lbs. PAN/year
Applying the above amount of waste is a big job. You should plan
time and have appropriate equipment to apply the waste in a timely
manner.
The following acreage will be needed for waste application based on
the crop to be grown, soil type and surface application.
Page: 2

ANIMAL WASTE UTILIZATION PLAN
TABLE 1: ACRES OWNED BY PRODUCER
TRACT
FIELD
SOIL TYPE & CLASS-
CROP
YIELD
LBS
COMM N
**
* LBS
DETERMINING PHASE
CODE
AW N
PER
ACRES
AW N
PER AC
AC
USED
-----
or
------
APPLY
RESID.
APPLIC
METH
N
TIME
1501
5
NoB
BP
4.6
230
2.06
473.8
I
APR-SEP
1501 1-5 1NOB
WA 11 150
I
I
- Indicates that this field is being overseeded (i.e.
interplanted) or winter annuals follow summer annuals.
2.06 1103
OCT-MAR
TOTAL1576.8
NOTE: The applicator is cautioned that P and K may be over applied
while meeting the N requirements. In the future, regulations
may require farmers in some parts of North Carolina to have a
nutrient management plan that addresses all nutrients. This
plan only addresses nitrogen..
Page: 3

ANIMAL WASTE UTILIZATION PLAN
TABLE 2: ACRES WITH NOTARIZED AGREEMENT OR LONG TERM LEASE
(Agreement with adjacent landowners must be attached.)
(Required only if operator does not own adequate land.
See required specification 2.)
TRACT
FIELD
SOIL TYPE & CLASS-
CROP
YIELD
LBS
COMM N
**
* LBS
DETERMINING PHASE
CODE
AW N
PER
ACRES
AW N
PER AC
AC
USED
---
or
------
APPLY
RESID.
APPLIC
METH
N
TIME
END
TOTAL 10
-- Indicates that this field is being overseeded (i.e. interplanted) or
winter annuals follow summer annuals.
** Acreage figures may exceed total acreage in fields due to
overseeding.
* lbs AW N (animal waste nitrogen) equals total required nitrogen
less any commercial nitrogen (COMM N) supplied.
The following legend explains the crop codes used in tables 1 and 2 above:
CROP CODE
CROP
UNITS
PER UNIT
BP
WA
HYBRID BERMUDAGRASS-PASTURE
WINTER ANNUALS (I.E. Small Grains, etc.)
TONS
50
50
TOTALS FROM TABLES 1 AND 2
ACRES LBS AW N USED
TABLE 1 2.06 1 576.8
Page: 4

ANIMAL WASTE UTILIZATION PLAN
TABLE 2 0
TOTAL 2.06
*** BALANCE
C
576.8 1
-192.8 I
-------------------
*** This number must be less than or equal to 0 in order to
fully utilize the animal waste N produced.
Page: 5

ANIMAL WASTE UTILIZATION PLAN
*** This number must be less than or equal to 0 in order to fully
utilize the animal waste N produced.
Acres shown in each of the preceding tables are considered to be the
usable acres excluding required buffers, filter strips along ditches,
odd areas unable to be irrigated, and perimeter areas not receiving
full application rates due to equipment limitations. Actual total
acres in the fields listed may, and most likely will be, more than
the acres shown in the tables.
See attached map showing the fields to be used for the utilization of
animal waste.
SLUDGE APPLICATION:
The waste utilization plan must contain provisions for periodic land
application of sludge at agronomic rates. The sludge will be nutrient
rich and will require precautionary measures to prevent over application
of nutrients or other elements. Your production facility will produce
approximately 60.8 pounds of plant available nitrogen per year in the
sludge.
If you remove the sludge every 5 years, you will have approximately 304
pounds of PAN to utilize. Assuming you apply this PAN to hybrid
bermudagrass hayland at the rate of 300 pounds of nitrogen per acre, you
will need 1.01333333333 acres of land. If you apply the sludge to corn at
the rate of 125 pounds of nitrogen per acre, you will need 2.432 acres
of land. Please be aware that these are only estimates of.the PAN and
land needed. Actual requirements could vary by 25% depending on your
sludge waste analysis, soil types, realistic yields, and application
methods.
APPLICATION OF WASTE BY IRRIGATION
The irrigation application rate should not exceed the intake rate of the
soil at the time of irrigation such that runoff or ponding occurs. This
rate is limited by initial soil moisture content, soil structure, soil
texture, water droplet size, and organic solids. The application amount
should not exceed the available water holding capacity of the soil at the
time of irrigation nor should the plant available nitrogen applied exceed
the nitrogen needs of the crop.
If surface irrigation is the method of land application for this plan,
it is the responsibility of the producer and irrigation designer to ensure
that an irrigation system is installed to properly irrigate the acres
shown in Tables 1 and 2. Failure to apply the recommended rates and
Page: 6

ANIMAL WASTE UTILIZATION PLAN
amounts of nitrogen shown in the tables may make this plan invalid.
The following table is provided as a guide for establishing application
rates and amounts.
I
Tract l Field I Soil Type
I
1501 15 I NoB
1501 I -5 I NOB
I (Application RatelApplic. Amount
I Crop (in/hr)
I
BP I - I *1
I WA I
I *1
(inches)
* This is the maximum application amount allowed for the soil
assuming the amount of nitrogen allowed for the crop is not over
applied. In many situations, the application amount shown cannot
be applied because of the nitrogen limitation. The maximum
application amount shown can be applied under optimum soil
conditions.
Your facility is designed for 180.00 days of temporary storage and
the temporary storage must be removed on the average of once every
6.00 months. In no instance should the volume of the waste be stored
in your structure be within the 25 year 24 hour storm storage or one
foot of freeboard except in the event of the 25 year 24 hour storm.
It is the responsibility of the producer and waste applicator to
ensure that the spreader equipment is operated properly to apply the
correct rates to the acres shown in Tables 1 and 2. Failure to apply
the recommended rates and amounts of nitrogen shown in the tables may
make this plan invalid.
Call your technical specialist after you receive the waste analysis
report for assistance in determining the amount of waste per acre and
the proper application rate prior to applying the waste.
NARRATIVE OF OPERATION
Page: 7

WASTE UTILIZATION PLAN
REQUIRED SPECIFICATIONS
1. Animal waste shall not reach surface waters of the state by
runoff, drift, manmade conveyances, direct application, or
direct discharge during operation or land application. Any
discharge of waste which reaches surface water is prohibited.
2. There must be documentation in the design folder that the
producer either owns or has an agreement for use of adequate
land on which to properly apply the waste. If the producer does
not own adequate land to properly dispose of waste, he/she shall
provide a copy of an agreement with a landowner who is within a
reasonable proximity, allowing him/her the use of the land for
waste application. It is the responsibility of the owner of the
facility to secure an update of the Waste Utilization Plan when
there is a change in the operation, increase in the number of
animals, method of utilization, or available land.
3. Animal waste shall be applied to meet, but not exceed, the
nitrogen needs for realistic crop yields based on soil type,
available moisture, historical data, climatic conditions, and
level of management, unless there are regulations that restrict
the rate of application for other nutrients.
4. Animal waste shall be applied to land eroding less than 5 tons
per acre per year. Waste may be applied to land that is eroding
at 5 or more tons, but less than 10 tons per acre per year
providing grass filter strips are installed where runoff leaves
the field. (See FOTG Standard 393 -Filter Strip)
5. Odors can be reduced by injecting the waste or disking after
waste application. Waste should not be applied when there is
danger of drift from the irrigation field.
6. When animal waste is to be applied on acres subject to
flooding, it will be soil incorporated on conventionally tilled
cropland. When applied to conservation tilled crops or
grassland, the waste may be broadcast provided the application r
does not occur during a season prone to flooding. (See "Weather
and Climate in North Carolina" for guidance.)
7. Liquid waste shall be applied at rates not to exceed the soil
infiltration rate such that runoff does not occur offsite or td
surface waters and in a method which does not cause drift from
the site during application. No ponding should occur in order
to control odor or flies.
8. Animal waste shall not be applied to saturated soils, during
rainfall events, or when the surface is frozen.
9. Animal waste shall be applied on actively growing crops in such
a manner that the crop is not covered with waste to a depth that
would inhibit growth. The potential for salt damage from animal
waste should also be considered.
Page: 8

WASTE UTILIZATION PLAN
REQUIRED SPECIFICATIONS
10. Waste nutrients shall not be applied in fall or winter for
spring planted crops on soils with a high potential for
leaching. Waste nutrient loading rates on these soils should be
held to a minimum and a suitable winter cover crop planted to
take up released nutrients. Waste shall not be applied more
than 30 days prior to planting of the crop or forages breaking
dormancy.
11. Any new swine facility sited on or after October 1, 1995 shall
comply with the following: The outer perimeter of the land area
onto which waste is applied from a lagoon that is a component of
a'swine farm shall be at least 50 feet from any residential
property boundary and from any perennial stream or river (other
than an irrigation ditch or canal. Animal waste other than
swine waste from facilities sited on or after October 1, 1995),
shall not be applied closer than 25 feet to perennial waters.
(See Standard 393 - Filter Strips).
12. Animal waste shall not be applied closer than 100 feet to
wells.
13. Animal waste shall not be applied closer than 200 feet of
dwellings other than those owned by the landowner.
14. Waste shall be applied in a manner not to reach other property
and public right-of-ways.
15. Animal waste shall not be discharged into surface waters,
drainageways, or wetlands by a discharge or by over -spraying.
Animal waste may be applied to prior converted cropland provided
they have been approved as a land application site by a
"technical specialist". Animal waste shall not be applied on
grassed waterways that discharges directly into water courses,
and on other grassed waterways, waste shall be applied at
agronomic rates in a manner that causes no runoff or drift from
the site.
16. Domestic and industrial waste from washdown facilities,
showers, toilets, sinks, etc., shall not be discharged into the
animal waste management system.
17. A protective cover of appropriate vegetation will be
established on all disturbed areas (lagoon embankments, berms,
pipe runs, etc.). Areas shall be fenced, as necessary, to
protect the vegetation. ' vegetation such as trees, shrubs, and
other woody species, etc., are limited to areas where considered
appropriate. Lagoon areas should be kept mowed and accessible.
Berms and structures should be inspected regularly for evidence
of erosion, leakage or discharge.
Page: 9

WASTE UTILIZATION PLAN
REQUIRED SPECIFICATIONS
18. If animal production at the facility is to be suspended or
terminated, the owner is responsible for obtaining and
implementing a "closure plan" which will eliminate the
possibility of an illegal discharge, pollution and erosion.
19. Waste handling structures, piping, pumps, reels, etc., should
be inspected on a regular basis to prevent breakdowns, leaks,
and spills. A regular maintenance checklist should be kept on
site.
20. Animal waste can be used in a rotation that includes vegetables
and other crops for direct human consumption. However, if
animal waste is used on crops for direct human consumption it
should only be applied preplant with no further applications of
animal waste during the crop season.
21. Highly visible markers shall be -installed to mark the top and
bottom elevations of the temporary storage (pumping volume) of
all waste treatment lagoons. Pumping shall be managed to
maintain the liquid level between the markers. A marker will
be required to mark the maximum storage volume for waste
storage ponds.
22. Waste shall be tested within 60 days of utilization and soil
shall be tested at least annually at crop sites where waste
products are applied. Nitrogen shall be the rate - determining
element. Zinc and copper levels in the soils shall be
monitored and alternative crop sites shall be used when these
metals approach excessive levels. pH shall be adjusted for
optimum crop production and maintained. Soil and waste
analysis records shall be kept for five years. Poultry dry
waste application records shall be maintained for three (3)
years. Waste application records for all other waste shall be
maintained for five (5) years.
23. Dead animals will be disposed of in a manner that meets North
Carolina regulations.
Page: 10

ANIMAL WASTE UTILIZATION PLAN
WASTE UTILIZATION PLAN AGREEMENT
Name of Farm:
Owner/Manager Agreement
I (we) understand and will follow and implement the specifications
and the operation and maintenance procedures established in the
approved animal waste utilization plan for the farm named above. I
(we) know that any expansion to the existing design capacity of the
waste treatment and storage system or construction of new
facilities will require a new certification to be submitted to the
North Carolina Division of Water Quality (NCDWQ) before the new
animals are stocked. I (we) also understand that there must be no
discharge of animal waste from this system to surface waters of the
state from a storm event less severe than the 25-year, 24-hour
storm. The approved plan will be filed on -site at the farm office
and at the office of the local Soil and Water Conservation District
and will be available for review by NCDWQ upon request.
Name of Facility Owner: Ben Shelton
(Please print)
Signature:-� �l�Date: v
Name of Manager(If different from owner):
Signature:
Name of Person Preparing Plan:
Affiliation:EDGECOBME SWCD
Address (Agency): P o BOX 10
Date:
(Please print)MARGARET KNIGHT
Phone No. 919-641-7900
TARBORO NC 27886-0010
Signature: Date:
Page: 11

ANIMAL WASTE UTILIZATION PLAN
I,
ANIMAL WASTE UTILIZATION AGREEMENT
(Needed only if 'additional land has to be leased, etc.)
, hereby give
permission to apply animal waste from his Waste Utilization System
on acres of my land for the duration of time shown below.
The field(s) on which waste can be applied are shown on the
attached map.
I understand that this waste contains nitrogen, phosphorous,
potassium, and other trace elements and when properly applied
should not harm my land or crops. I also understand that the use
of waste will reduce my need for commercial fertilizer.
Adjacent Landowner: Date:
Waste Producer:
Date:
Technical Representative: Date:
SWCD Representative: Date:
Term of Agreement:
,19 to
(Minimum of Ten Years on Cost Shared Items)
(See Required Specification No. 2.)
Page: 12

ANIMAL WASTE UTILIZATION PLAN
STATE OF NORTH CAROLINA
COUNTY OF
I,
Public of said County, do hereby certify that
a Notary
, personally appeared before me this day and acknowledged the due
execution of the foregoing instrument.
WITNESS my hand and official seal this day of
1.9
My commission expires
(SEAL)
Notary Public.
Page: 13

ANIMAL WASTE UTILIZATION PLAN
I,
Waste Utilization - Third Party Receiver Agreement
hereby agree to apply waste
generated by in a manner that meets the
Waste Utilization Standard (633), or use an alternative waste
utilization system that has been accepted in writing by the
Division of Water Quality.
Third Party Receiver: Date:
Term of Agreement: to
(Minimum Ten Years on Cost -Shared Items)
STATE OF NORTH CAROLINA
COUNTY OF
I, , a Notary
Public of.said County, do hereby certify that
, personally appeared before me this day and acknowledged the due
execution of the foregoing instrument.
WITNESS my hand and official seal this
ff 19
My commission expires
(SEAL)
day of
Notary Public.
Page: 14

MKI
A4, 'I W'V
IN
T
A

i
FOUNTAIN QUADRANGLE
NORTH CAROLINA h`yp
aP{P�
7.5 MINUTE SERIES (TOPOGRAPHIC) yse
NW/4 FALKLAND IS' QUADRANGLE `p�0
* 40 259 260 2 400 000 FEET 261
_ TARBORO ie KM77 17'30"
_ do Cris
730 000
::Cem FEET
1004
h •' �51 ' �� I Cem 33.3 m
J .�_ !
30 / B M 3 A
3958
16
Cem
o -
em
7 '
r � 6nn / 2 70 3957
zas \
j 1 \
o
1956
1.3
_ �--� � • `� � % �/ � ram, _ / � _ _
1617
r CONVERSION
scka
— i ••' O / / �� feet , Meters
1618
/ (� (" J �l 140DO
lob ( 42'30"
01 13000 e004
GEm o 1 yo
►' C i
12000
Cem ! �+ 1 - Cem
31.4 1619
11000

State of North Carolina
Department of Environment,
Health and Natural Resources
Raleigh Regional Office
James B, Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Ben Shelton
Rt. 1 Box 322
Macclesfield, NC 27852
e��
1DEHNR
Division of Soil and Water Conservation
May 31, 1997
SUBJECT: Operation Review Summary
Ben Shelton Farm Facility No. 33-39
Edgecombe County
Dear Mr. Shelton.
On May 28, an Operation Review was conducted of Ben Shelton Farm, facility no. 33-39. This Review,
undertaken in accordance with G.S. 143-215.101), was one of two visits scheduled for all registered livestock operations
during the 1997 calendar year. The Division of Water Quality will conduct a second site inspection.
It was determined that no corrective actions are necessary as the result of this Review, since waste was not being
discharged to the waters of the State, and the animal waste collection, treatment, storage and disposal systems were
maintained and operated under the responsible charge of a certified operator, A copy of the completed review form is
enclosed for your information.
The review determined that the farm was operating in accordance with the approved animal waste management
plan. Please remember that you are required to obtain either an amendment to your existing plan or a new waste utilization
plan before any changes are made in crop type or harvest method on land included in your plan. All land used for nutrient
application from animal waste systems must be included in the waste utilization plan. The plan must be certified by either
a designated technical specialist or a professional engineer. For additional assistance with the plan, please contact your
local Soil and Water Conservation District Office or local Cooperative Extension Service Office.
As we discussed. I spoke to Sue Homewood of the Division of Water Quality about the removal request that was in
the computer files. The removal request has been removed from the system. It came from the previous owners of the farm
in a letter stating that they were out of the hog business.
The Division of Soil and Water Conservation appreciates your cooperation with this Operation Review. Please do
not hesitate to tali me at 919/571-4700 ext. 208 if you have any questions, concerns or need additional information.
Sincerely, i
-
Margaret O'Keefe
Environmental Engineer I
cc: Edgecombe Soil and Water Conservation District
Judy Garrett. Water Quality Regional Supervisor
DSWC Regional Files
3800 Barrett Drive, Suite 101, FAX [phone]
Raleigh, North Carolina 27609 NICK An Equal Opportunity Affirmative Action Employer
Voice 919-571-4700 60% recycled/ 10°k post -consumer paper

State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Macey and Nancy Harrell
Macey/Nancy Harrell Farm
Rt 1 Box 642
Macclesfield NC 27852
1:)EHNR
November 13, 1996
SUBJECT: Operator In Charge Designation
Facility: Macey/Nancy Harrell Farm
Facility ID#: 33-39
Edgecombe County
Dear Mr. and Ms. Harrell:
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form must be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our office.
Examinations have been offered on an on -going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this requirement please
call Beth Buffington or Barry Huneycutt of our staff at 9191733-0026.
Sincerely,
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
Enclosure
cc: Raleigh Regional Office
Water Quality Files
P.O. Box 27687, i
Raleigh, North Carolina 2761 1-7687 ��C An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 50% recycled/10% post -consumer paper

V;41 NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
RALEIGH REGIONAL OFFICE
Division of Water Quality
June 3, 1999
Mr. Ben Shelton
Route 1, Box 322
Maccelsfield, North Carolina 27852
Subject: Notice of Deficiency
Ben Shelton Swine Farm
Facility # 33-39
Edgecombe County
Dear Mr. Shelton:
On May 18, 1999, Mr. Buster Towell of the Raleigh Regional Office conducted
a compliance inspection at the subject swine facility. The inspection revealed the
following deficiencies:
The IRR-2 land application records showed that waste was applied to coastal
bermuda in January. Coastal Bermuda is a warm season grass, and should have a
Spring\Summer application window.
You stated that despite your records indicating bermuda as the receiving crop, rye
had been overseeded in the field to extend the application window into the cooler
months and that rye was the crop that had been applied on in January.
Please note that any crop that is to receive animal waste must be included in your
waste utilization plan. This Office recommends that you contact your local Soil and
Water Conservation District Office to have your plan amended to include the rye
overseed.
3900 BARRETT DRIVE, SUITS 101, RALEIGH, NORTH CAROLINA 27609
PHONE [phone] FA% 919.871-4718
AN EQUAL OPPORTUNITY /AFFIRMATIVE ACTION EMPLOYER - 50% RECYCL46110% POST-CONSUMIKR PAPER

Mr. Ben Shelton
Page 2
Please respond to this Notice, in writing within fourteen days of your receipt. The Raleigh
Regional Office appreciates your cooperation in correcting this matter. If you have any
questions regarding this Notice, please call Mr. Buster Towell at [phone].
Sincerely,
U
Kenneth Schuster, P.E.
Regional Water Quality Supervisor
cc: Edgecombe County Health Department
Mr. A.B. Whitley, Edgecombe Soil & Water Conservation District
Ms. Margaret O'Keefe, RRO-DSWC
DWQ Non -Discharge Compliance Unit
'RRO Files
shelnod

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
RALEIGH REGIONAL OFFICE
Division of Water Quality
June 3, 1999
Mr. Ben Shelton
Route 1, Box 322
Maccelsfield, North Carolina 27852
Subject: Notice of Deficiency
Ben Shelton Swine Farm
Facility # 33-39
Edgecombe County
Dear Mr. Shelton:
On May 18, 1999,. Mr. Buster Towell of the Raleigh Regional Office conducted
a compliance inspection at the subject swine facility. The inspection revealed the
following deficiencies:
The IRR-2 land application records showed that waste was applied to coastal
bermuda in January. Coastal bermuda is a warm season grass, and should have a
Spring\Summer application window.
You stated that despite your records indicating Bermuda as the receiving crop, rye
had been overseeded in the field to extend the application window into the cooler
months and that rye was the crop that had been applied on in January.
Please note that any crop that is to receive animal waste must be included in your
waste utilization plan. This Office recommends that you contact your local Soil and
Water Conservation District Office to have your plan amended to include the rye
overseed.
$800 BARRETT DRIVE, SUITE 101, RALEIGH, NORTH CAROLINA 27600
PNoNE 91 9-571 -4700 FAX D I D-571 -471 8
AN EQUAL OPPORTUNITY /AFFIRMATIVE ACTION EMPLOYER - 30% RECYCLED/10% POST-CONBUMER PAPER

Mr. Ben Shelton
Page 2
Please respond to this Notice, in writing within fourteen days of your receipt. The Raleigh
Regional Office appreciates your cooperation in correcting this matter. If you have any
questions regarding this Notice, please call Mr. Buster Towell at [phone].
Sincerely,
IrKenneth Schuster, P.E.
Regional Water Quality Supervisor
cc: Edgecombe County Health Department
Mr. A.B. Whitley, Edgecombe Soil & Water Conservation District
Ms. Margaret O'Keefe, RRO-DSWC
DWQ Non -Discharge Compliance Unit
RRO Files
shelnod