660013_PERMIT FILE_20171231

Type of Visit Comp' ce Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Date of Visit: b ime:
F!ciWNumber
Not O erational Bclow Threshold
F4f
ermitted 13Certifieedd D/Conditiona�lly ,Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: _-_R i./1J L/ [9 h2f- _ - County:
Owner Name: Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:.�2i! 6'GJ 0- (L
Location of Farm:
Phone No:
Integrator: -yJ/I/ / r / -S
Operator Certification Number:
❑ 5wine ❑ Poultry ❑ Cattle ❑Horse Latitude 0 ' 44 Longitude 0 4 11
Design Current Design Current " Design' I Current w
Swine Capacity PopulationPoultry CaacPopulatiorCatle :Ca aci ,;Po elation:;.
❑ Wean -to -Feeder ❑ Layer ❑ Dai
eeder to Finish ❑ Non -Layer 1LL 10 Non-Dairy
i
❑ Farrow to Wean -
❑ Farrow to Feeder ❑ Other
[0 Farrow to Finish Total Design Capacity
❑ Gilts:
ElBoars Total SkW
�,
Holden Ponds/ Solid Tra s IU Subsurface Drains Present �EL� Lagoon Area lLJ Spray Field Area
Ng mberoL,Lagovns _ ....._ ......- _- -
z_❑ No Li uid Waste Mana ement System
k,
Discharges & Stream Impacts
1, Is any discharge observed from any part of the operation? ❑ Yes o
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes;�No,,�,
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes
c, if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes o
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure
Identifier:
Freeboard (inches): .3
I
05103101 Continued

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El 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 Noo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes LJ-iQ0
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? Cl Yes o
aaste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over ap lication? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes o
12. Crop type /
13. Do the receiving crops differ with Kose 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?
lb. Is there a lack of adequate waste application equipment?
Reouired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other 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?
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
TN,
❑ No
❑ No
❑ No
❑ No
❑ Yes Id'No
❑ Yes eo_
❑ Yes V, ""'
El Yes Ezo
❑ Yes
❑ Yes EI: 1�
❑❑ YesEo
Yes
❑ Yes
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ACoinments (refer to nts
RUse drawln 's5 offacility to better explaiiisituatiUl { u. ..
e paeanessField Covv ❑ '
Final Notes
,ary)
L h
Reviewer/Inspector Name_ �-
G
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: — Date of Inspection
Qdor Issues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes N
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes o
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.) ElYes
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ;No,
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes '1J No
Additional omments and/or Drawings. . .
A.
05103101

IType of Visit 40 Compliance lLpection O Operation Review O Lagoon Evaluation
Reason for Visit Otine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facili "ben Date of Visit: 1
Permitted [ Certified © Conditionally Certified 0 Registered
Farm Name: .. ��.�... �f...........ot11.0�....yl-h.................... ..........................
Time:
Not Operational O Below Threshold
Date Last Operated or Above Threshold: .........................
County: .............................................................. .......................
OwnerName: ...................................... i ........... ........................................................................ Phone No:.......................................................................................
[ailing Address:........
Facility Contact:
Title:
Onsite Representative: ...........................................................................................................
Certified Operator:......7 _c,. 1v11� t�► [
....................................................................
Location of Farm:
PhoneNo: ...................................................
Integrator:, Y ✓1
Operator Certification Number: ...........................................
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude * 4 " Longitude • ° 64
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes 09 o
El Yes
❑ Yes LT _o
❑ Yes o
❑ Yes No
❑ Yes o
es ❑ No
Structure 6
Identifier: .............................................................................................................. ...............................
Freeboard (inches):
12112103
Continued

Facility Number: 6 — Date of Inspection Z
Required Records & Document.
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?
(ie/ 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?
❑ Yes G-No '
ElYes o
❑ Yes Loe
❑ Yes l
❑ Yes �
❑ Yes ,-
❑ Yes �"
❑ Yes 0
❑ Yes
'a �o
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Farm ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Facility Number: Z�L_— Date of Inspection p
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 0
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ yes o
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? ❑ Yes o
8. Does anart of the waste management system other than waste structures require maintenance/im rovement? ❑ Yes No
YP g Y q P
9. Do any stuctures Iack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes d'Vo
_1_"
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes [;
❑ Excessive Ponding Q PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type ( . -<wt q r 14 1 ­7 .5
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?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
Reviewer/Inspector Name LVI,
Reviewer/Inspector Signature:
❑ Yes
❑'<lo
❑ Yes
O'No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ Yes
❑ No
❑ Yes
ONo
❑ Yes 0<0r
❑ Yes o
❑ Yes �N�o
❑ Field Copy ❑ Final Notes
/ J /" (D L-t- J,-,-) 3 � r &h ( ,r,o 2 a, ) L1 r e
Date:
P
12112/07
Continued

%
MAR. -07' 03 (FR11 I0 : 04 NCDENR RRO
TEL:9I9 571 4718 P.002/004
PLAN OF ACTION (PoA) FOR HIGH FREEBOARD AT ANIMAL FACILITIES (� THIRTY (3a) DAY DRAW DOWN PERIOD
I. TOTAL PAN TO BE LAND APPLIED PER WASTE STRUCTURE ii
1. Structure Narne/Identifier (IX 860,16-tL,10 � ` C 3 L
2. Cumlw%t (quid uatume kn 25 yr.124 hc, stasm stamge & strudural freeboard
a. current liquid level aceorrdlrtg to marker
b. designed 25 yr.124 hr. storm & structural freeboard
c, line b - line a (inches in red zone) =
d. top of dike surface area according to design
(area at below structural freeboard elevation)
e. lines x line d x 7,48 aallm -
12 ft'
3. Projected volume of waste liquid produced during draw down period
i laches
E I inches
Z inches
3��15,Zallons
f. temporary storage period according to structural design 180 days
g. vnM1ume of waste pfnduced air.crnding 1DruclTal design d
110
II
h. actual waste produced = x line g = b W2., w fe
certified herd #
i. volume of wash water according to structural design
excess said sa4 o�mr to design
k. Vines h + i +0 x 7.48 x 3a days =
line f
4. Total PAN to be land applied during draw dow eriod
`I,/
f_ current waste analysis dated
(t as e + k,? x line 1 =
1000
REPEAT SECTION I FOR EACH WASTE STRUCTURE ON SITE
0 ft3
gallons
z�o
SbfIM gal.
3 c ib PA
PaA (30 Davl 7121f00 4

PLAN OF ACTION (PoA) FOR HIGH FREEBOARD AT
Facility Number: - County:
Facility
Name:
U0 �
ANIMAL FACILITIES
f I
Certified Operator Name: 1 ! L� _....__ Operator # A q9 Z b
1. Current liquid levei(s) in inches as measured from the current liquid level in the lagoon to the
lowest point on the top of the dam for lagoons without spillways; and from the current liquid level
in the lagoon to the bottom of the spillway for lagoons with spillways.
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Stricture 6
Lagoon Name/identifier (ID): --
Spillway (Yes or No):
Level (inches): i
2. Check all applicable items
Liquid level is within the designed structural freeboard elevations of one or more structures. Five
and 30 day Plans of Action are attached. Hydraulic and agronomic balances are within
acceptable ranges.
V Liquid level is within the 25 year 24 hour storm elevations for one or more structures. A 30 day
Plan of Action is attached. Agronomic. balance is within acceptable range.
Waste is to be pumped and hauled to off site locations. Volume and PAN content of waste to
pumped and hauled is reflected in section III tables. Included within this plan is a list of the
proposed sites with related facility number(s), number acres and receiving crop information.
Contact and secure approval from the Division of Water Quality prior to transfer of waste
to a site not covered in the facility's certified animal waste management plan.
Operation will be partially or fully depopulated.
- attach a complete schedule with corresponding animal units and dates for depopulation
- if animals are to be moved to another permitted facility, provide facility number, lagoon
freeboard levels and herd population for the receiving facility c�
3. Earliest possible date to begin land application of waste:
i hereby certify that I have reviewed the Information listed above and included within the attached Plan
of Action, and to the best of my knowledge and ability; the information is accurate and correct.
t G
Facility Owner/Manager (print)
Phone:
PoA Cover Pane 2121/00

4R. -01' 031FR11 10:04 NODENR RRO
TEL[phone] P.003i004
il. TOTAL pC)UIjD3 OF PA% STQ9,F-0 WtTRINI STRUCTURAL FREEBOARD AND/OR 25 YR.124
HR. STORM STORAGE ELEVATIONS IN ALL WASTE STRUCTURES FOR FACILITY
1. structure ID: �G line m = ' lb PAN
2, structure JD: line m = Ib PAN
3. StTut` ws SO:
4. structure iD:
5, structure ID:
line m = lb PAN
line m = lb PAN
l'ne m = lb PAN
6. structure ID: fine m = ib PAN
n. lines 1+2+3+4+5+6 = lb PAN
Ill. TOTAL PAN BALANCE REMAINING FOR AVAILABLE CROPS DURING 30 DAYDRAW DOWN
Qs:Qinn nn unT i i-crt P&M C&q blOT aE APPUES DURING THIS 30 DAY PERIOD.
o. tract # I p. field #
f
q. crop
r, acres
s. remaining
IRR 2 PAN
balance
(l�iacre}
I,, TOTAL PAN
BALANCE
FOR FIELD
(lbs.)
column r x s
I ua
application
window'
{
'State current crop ending application
date or next crop aoolication
beainnino date for available receivino
crops during 30 day drawn dawn period
v. Total PAN available for all fields (sum of column Q = tib. PA14

MAR. -OT OWRH 10:04 NGDENR RRO TEL:[phone] P. 004/004
IV. FACUTTS PDA 10VER AU. PAL% BA4.ARCE
w. Total PAN to be land applied (line n from section IQ r Z 3 (0 r 6 M. PAN
x. Crop's remalning PAN balance (line v from section ill) 314fo lb. PAN
y. Overall PAN balance (w - x) = - ? + lb. PAN
Line y must show as a deficit. If line y does not show as a deficit, list course of action here
knct+, ing pump avd haLd. depopulatian, hexd reduction, eta. For Pump & haul and hexd
reduction options, recalculate new PAN based on new information. If new fields are to be
Included as an option for lowering lagoon lever, add these frerds to the PAN balance table and
recalculate the overall PAN balance. If animal waste is to be hauled to another permitted
faculty provide information regarding the herd population and lagoon freeboard levels at the
receiving facility.
N ARRATWE:

L
f Visit .0 Com ce Inspection O Operation Review O Structure Evaluation O Technical Assistance
for Visit GrRoutine O Complaint O Follow up O Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: T ff
Arrival Time: a a Departure "rime: C� County:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone No:
Onsite Representative: II
Certified Operator: T,'-, f �CI
Back-up Operator:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Location of Farm: Latitude: 0 0 ❑ 1 0 Longitude: = e = ' =
esign Current
Fin,
Destgn Currents
�'i
Design
Current
Swine p��ci�ty Pop I tlon
KLG
Wet Poultry
�pt1ac ty� Population
Cattle
Capacity
Po Cation
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ W to Feeder
❑ Non -Layer
❑ Dairy Calf
Feeder to Finish
s`
❑ Dairy Heifer
❑ Farrow to Wean
Dry Pnultryx
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑Beef Stocker
❑ Gilts
❑Non -La ers
;; ❑Beef Feeder
❑ Boars
L
❑ Pullets
❑Beef Brood Cowl
I
7;
❑ Turkeys
; F
Other
❑ Turkey Pou Its
❑ Other
❑ Other
Number of Structures:
,
Discharges & Stream Imoacts
1. Is any discharge observed from any part of the operation`?
❑ Yes
ZTNo ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?'
❑ Yes
o ❑ NA
El NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
WNo❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
ZN NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation? -
❑ Yes
No NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No ❑ NA
❑ NE
other than from a discharge?
12128104 Continued

' f
Facility Number: — Date of Inspection-`�f--
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes No A ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 2< ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 60,6 N14(QAV
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ a',
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes o ❑ 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 three , 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 El 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 ElD Yes o ❑ 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 oEINA ❑ 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) A A- 4 / —Y , riot .f'ef-4L_0 ,
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
,:No " NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
ON ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes;fNo,.,NA
ElNE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Reviewer/ins ector Name
p
Reviewer/Inspector Signature:
'` t
�, ,: � '.�, - �::.
����� Phone:
Date:
G __5r
1212104
Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the approprrate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
es ❑ No ❑ NA ❑ NE
❑ Yes 12 <ocl NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections
❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
�`Noo❑ NA NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
ElYes
❑ No AA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
,2,"NA❑
El No 9<A___LJ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ZNo ❑ 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
Addirtional,vC minents';'ariil/or 1)rawin st f xi
I2/28/04
I2/28/04

(Type of Visit QJCom ce Inspection Operation Review Structure Evaluation Technical Assistance I
Reason for Visit Routine O Complaint O Follow up O Referral o Emergency 0 Other ❑ Denied Access
Date of Visit: I Arrival Time: ® Departure Time: County: Region:
Farm Name: 6 y Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone No:
Onsite Representative: Integrator:
Certified Operator: �� �-✓� Operator Certification Number:
r
Back-up Operator: Back-up Certification Number: r,
Location of Farm: Latitude: ° Longitude: °
Design
C►urrent
Design C►►urrent Design Current
Swine Capacity
Population
Wet Poultry Capacity Population Cattle Capacity Population
❑ La er ❑ Dairy Cow
Non -Layer ❑ Dairy Calf
❑ Dairy Heifer
Dry Poultry, ❑ Dry Cow
❑ Wean to Finish
❑ We to-Feeder11E]
eeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Non -Dairy
❑ La ers ❑ Beef Stocker
❑ Farrow to Finish
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Coyd
❑ Turkeys
Other
❑ Turkey Poults
❑ Other Number of Structures:
❑ 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)
?. Is there evidence of a past discharge from any part of the operation?
Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
` �ge 1 of 3
❑ Yes No ❑ NA
❑ NE
❑ Yes ❑ NA
❑ NE
�No
El Yes ❑ NA
❑ NE
❑ ❑
❑ NE
Yes L2rNo NA
❑ Yes 6"N'oDNA
❑ Yes Q- o \ ❑ NA/
12128104 C
1AAA

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 I 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 1] NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ;ZNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmenta;No
re , 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 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
mai ntenancehmprovem ent?
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) � / 11_021 i __._. t; ' -I r-4- r'- 3" r
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
El Yes
❑ NA
IQXN/O,
El
15. Does the receiving crop and/or land application site need improvement?
❑ Yesr/011E]
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ YesNA
❑ NE
17. Does the facility lack adequate acreage for land application?
El Yes
NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Comments (refer to question #): Explain any YESEanswers and/or any recommendaEians or'any ather,Acomments
Use'drawings of facility to better explain situations::^(use: additional pages as n'eceMary): ^h'
Reviewer/Inspector Name ,: Phone:
Reviewer/Inspector Signature: Gt Date: P I%
page 2 o, f 5 I ZIZ61U4 Gontinuea

.f . '4
Facility Number: Date of Inspection 13 4&.70
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ONo ❑ 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 El Maps [I 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 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 VJ N/EINA
El NA El NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [INE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes N,6❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes N ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes Ld Nod ❑ NA [I NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes�4 o ❑ 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
[:1 NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/]nspector 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

Type of Visit /U Compfo&e Inspection O Operation Review O Lagoon Evaluation j
Reason for Visit tioutine O Complaint. O Follow up O Emergency Notification Q Other 1 ❑ Denied Access
Facility NumberEZ1D_C=
Date of Visit: Time:
Q Not Operational Q Below Threshold
0 Permitted 13 Certified 1/Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
FarmName: ...... N.bb... l..lp ."/ ....I---n 0rii............... ........................... County:.....................................................................................
l l
Owner Name:
Phone No:
FacilityContact: ............................................................................... Title:................................................................ Phone No:...................................................
MailingAddress: ..................................................................................................................... ..................................................................................... ..........................
Onsite Representative: ...................................................
Certified Operator: .......... 74.tit:-....... ...... ..........
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse
Design Cu'
Swine Ca ci ' ' Po ula
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Ny Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Integrator:% !F...{ .f....................................................
Operator Certification Number:
Latitude ' 6 46 Longitude s 6 44
Design _'Curren! „ Desigp .r Cu r
Pty . Ca aci Po eatioCattlen ln Ca acN ;, Po 'iiih
❑ Layer ❑ Dairy
❑ Non -Layer I Non -Dairy
❑ Other.
Total DesignCapacity ,
Total SSLW,
)Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area g+
k
4 a , Holdmg Ponds / $olyd Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes
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: ........... .r"�1................ ..............!.......... ................................... .................................... ....................................
❑ Yes 01
o
❑ Yes
❑ Yes o
❑ Yes No
Structure 6
Freebow-d (inches):
5/00 Continued on back

acility'Number: a— j Date of Inspection }'
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN []Hydraulic Overload
❑ Yes No
❑ Yes
❑ Yes o
❑ Yes
❑ Yes o
❑ Yes o
❑ Yes o
12. Crop type - �'f I ktx
13. Do the receiving crops differ with those design ted in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 4:tM .
14. a) Does the facility lack adequate acreage for land application? ❑ Yes SVO
b) Does the facility need a wettable acre determination? ❑ Yes p No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ N
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 9X<
o
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
r.
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis &sail sample reports) ❑Yes o
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? El J.d�o
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes jd'No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes o
23. Did Reviewer pector fail to discuss review/inspection with on -site representative? ❑ YesFNo
24. Does fac' y require a follow-up visit by same agency? ❑ Yes
25. W e any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Ye
�'�1Q +iQlp iggs:off- d #�c�encie rare pntd• ih ring (bjs'vjsjt; • y6ja wi1j- ee iye no fhethte
corres aridence: abouf this visit:
I, 1 I .vi9. t Y9 ! h i "'S M1 h - i °a• i I 1
Corriments (refer to question #) Eplaus any YES answers and/©r any recommendations or aay other,cominents, ai4l
Usr `drawin € Qf faciili "tO;better ex` laln situations use addltiorial6 Fa i4rS'as'necessa` €1 �! IEE�� F eIE Ell �'�IE?
�,,,..,._, pP9
> k ._ , .;A . r-.«✓� 3 c! ;;i•. ! ' � � �t
Reviewer/Inspector Name , i, a ! �, '1 ". i ! t ,i a€ ! ❑ s + �1 . E4 �' .:Is
Reviewer/Inspector Signature: Date: Z Slap

Facility Number —3-1 Date of Inspection Z3
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes eNZ
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 e<�
❑ Yes
❑ Yes ZN<o
❑ Yes 1" O
❑ Yes Ube!
5/00
J

11
19-Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection Z
Time of Inspection D .D 24 hr. (hh:mm)
Permitted Certified Q Conditionally Certified © Registered JE3 Not Operational I Date Last Operated:
Farm Name: 4-A ....6..V7......! '912 County:.... ..... ..............................
Owner Name:........ QY!"�'.... �.g Phone No: .........................................................
Facility Contact: ...... ....L..l.G� Title. Phone No:
•................................................................
Mailing Address: .........
Onsite Representative: ............................. Integrator: 6j _i' .............
..............................
.....
Certified Operator:..... ><•••" n.... /, / / ...................... Operator Certification Number:..........................................
Location of Farm:
A
............................................................................................... .............................................
Latitude 6 6 Longitude �• 6 ]64
Destgn Current
Design Current '1'4CDeggn 'V Cur'rent
Swine.
t'k0 i Po elation
Poultry .CattlecaY-
❑ We -to Feeder
JE1 Layer I ❑ Dairy
eeder to Finish p
❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity ,
El Gilts
F
❑Boars
Total Sk }
Number of'Lagoons f `l
JCI Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
`Holding,Ponds / Soli d Traps_ ' ❑ No Liquid Waste Ylanagement System i ' i'
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'? (Il'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
❑ Yes l*J ivo
❑ Yes No
❑ Yes I� ►vo
❑ Yes No
❑ Yes ;R�
El Yes
❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 4t�
Freeboard(inches): ..................1✓...........................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, El Yes No
seepage, etc.)
Continued on back
3/23 99

Facility Number: 5- — �� Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
/_ 1
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
.... yi.. tioiis:or• deficiencies were hated during this visit' • Ybit Wiil•reeoiye Rio: Further: • :
corres• oridence'. about: this :visit : : :
#_ ff 9
❑ Yes 01v1
❑ Yes l21 o
❑ Yes
❑ Yes 1c1't�o
❑ Yes la
❑ Yes o
E Yes ❑ No
❑ Yes
❑ Yes ;�O
❑ Yes
❑ Yes
❑ Yes ;��O
❑ Yes [�No
❑ Yes ;No
ElYes:Z�
❑ Yes
ElYes No
❑ Yes o
❑ Yes o
❑ Yes5N�
El Yeso
4J C 4, rf x P-1 Fri e / Q` f/ J i f `t Lek � I &
3/23/99

Facility Number: — j Date of Inspection `�71
Odor Issncs
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?
es ❑ No
❑ Yes
❑ Yes
Yes No
❑ Yes ::'�
ElYes
es ❑ No
ttrona omments'an or;.,.rawtngs:
T

(Type of Visit 0 �Comhce Inspection 0 Operation Review 0 Lagoon EvaluationReason for Visit e 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Foci ' umber Date of Visit: Time:
Not O erational 0 Below Threshold
ermitted [3 Certifie ©Conditionally Certified ©Registered Date Last Operated or Above Threshold:
Farm Name: !Ir County:
Owner Name: Phone No:
Mailing Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Location of Farm:
Title:
Phone No:
Integrator:22
I,I
Operator Certification Number:
❑ Swine ❑ Poultry ❑ cattle ❑Horse Latitude 0 6 .1 Longitude a I
Design Current
Swine - Capacity Population
❑ Wean to Feeder
Design Current
Poultry Ca aci Po` elation Cattle
❑ Layer ❑ Dairy
Resign Current
Ca acr Pii� elation
❑ Feeder to Finish
❑ Non -La er ❑ Non -Dairy I
❑ Farrow to Wean
❑ Farrow to Feeder
❑Other
❑ Farrow to Finish
❑ Gilts
Total Design Capacity
❑ Boars
Total SSLW
Number of Lagoons
Holding Pond's / Solid Tra': Q
- :
❑ Subsurface Drains Present ❑ Lagoon Area
a
JE1 Spray Field Areor
r,
❑ No Liquid Waste Management System
II���� mo "
[:cfJ�&tYaC Y,
Discharges tream l.mh:fete
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 tructure 2 Structure 3 Structure 4 Structure 5
Identifier: f
Freeboard (inches):
r,-
05103101
3�
❑ Yes LTNo
❑ Yes �No
❑ Yes No
❑ Yes P'lglo
ElYes Z No
❑ Yes
❑ Yes ❑ No
Structure 6
Continued

Facility Number:/,I Date of Inspection f
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ 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
W. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over 4pplication? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12, Crop type / A n I ID-)- , S "9<A-, n 5. .%'7 �-1t-
❑ Yes a
❑ Yes ;No
ElYes N
❑ YesjNo
o
El Yes
ElYeso
ElYeso
13. Do the receiving crops differ with those designated inAe Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Reauired Records BAD-aeuments
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes eNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? FNo
�
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes _
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis &soil sample reports) El Yes
20. is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ YesK0_
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes o
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? El Yes i 24. Does facility require a follow-up visit by same agency? ❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes o
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments,,(refer, td questi6i #) OEzplain siiy YES answers and/or,. any recommendations or any'other c'o'riiments:'i r >f
Use drawings f %ellityto Better. ttons use sdd tional pages as necessary) ❑ Field Copy Cl Final Notes
tk �iaP aY vti9r f m:. '.:
H,
Reviewer/Inspector Name f ��-l�k . •l ,<, ;``,'' x '� ', ..w'
Reviewerllnspector Signature: Date:
05103101 Continued

o�Q� W A
b _ d -�
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
April 7, 2004
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Mr. Bobby Gay
P.O. Box 431
Seaboard, North Carolina 27876
Subject: Notice of Violation
Gay Farm
COC AWS660013
Northampton County
Dear Mr. Gay:
Alan W. Klimek, P.E. Director
Colleen H. Sullins, Deputy Director
Division of Water Quality
On April 5, 2004, Mr. Tom Hollowell called Buster Towell of the Raleigh Regional Office to report a
small spill of swine waste that occurred during the weekend prior. Mr. Hollowell reported that between 200
and 300 gallons of wastewater had leaked out of the back of a honey wagon and onto the highway. He
stated that no waste got in to any surface water bodies or ditches.
When asked why the waste was being transported from your facility, Mr. Hollowell stated that he was in
the process of sludge removal from this facility and that the sludge was being applied to a bermuda field
located at the. Hollowell Farm several miles away. Mr. Towell asked Mr. Hollowell if the Waste Utilization
Plan for Facility # 66-13, the Gay Farm, had been amended to reflect any off site fields and his answer was
that it had not.
Please note that any land application site that is to receive waste material from a permitted swine facility
must be included as a part of the Waste Utilization Plan. The WUP is then considered an integral part of
the over-all Permit. Mr. Hollowell told Mr. Towell that he had transported 18 loads at 3600 gallons per load
for a total of 64,000 gallons of sludge from your facility.
The aforementioned activity constitutes a violation of your general permit and as such could be subject to
civil penalties of up to $ 25,000.00 per day, per violation. Please respond to this Notice in writing within
ten days of your receipt. Please include with your response a copy of the waste analysis, soils analysis,
SLR -I, and SLR-2 forms, and a map of the site that received the materials.
If you have any questions regarding this Notice you may call Buster Towel] at [phone],
Sincerely,
Kenneth uste .E.
Regional Water Quality Supervisor
Cc: Northampton Health Department
Northampton Soil & Water Conservation District
Ms. Betsy Gerwig, RRO-DSWC
DWQ Nondischarge Compliance Group
RRO Files
Raleigh Regional Office 1628 Mail Service Center phone [phone] Customer Service
Water Quality Section Raleigh, NC 27699-1628 one facsimile [phone] 1-877-623-6748
No Carolina
aturiall

TO
-JUL-14-1995 15' 26 FROM TEEM WATER QUALITY SECTION
PRO P.02/22
Site Requires Immediate A ttendon- �
Facility No.
j DIVISION OF ENVIRONMENTAL MANAGEMENT E3
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD 1G7 - I&
� V/ DATE: �� ��� , 1995
n r
Time: D�'o
Farm Name/Owner~ 3 v ���
Ma11in g AddreSS: P' _ 0, 'ly x� _ S 6 � -I r C{ I!� C- Z %
County: &0 H ti 6-121cr^
Integrator. 61 01, i n P Phone:
On Site Re -presentative: _rn 11- 64 i _ _ _ Phone: _ / �1�`% s�s s/
Physical Addraess/Locatiorn:
Type of Operation: Swine Poultry Cattle
Design Capacity: _ i Qy Number of Animals on Site, G / o D o
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: " Longitude: Elevation: ------Yeet
Circle Yes. or No
Does the Animal Waste. Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) (61 or No Actual Freeboard: fit. Inches
Was. any seepage observed from. the lagoon(s)? Yes o� Was any erosion observed? Yes of Noy
Is adequate land available for spray? Yes o Is the cover crop adequate. Yy7§ or
Crop(s) being utilized: -50'0f a t4 o J 8S 4h „ �-�e F-' a—
Does the facility meet SCS-minirmum setback criteria? 200 Feet from .DweHings` or -No
100 Feet from Wells? (19 or No
_nc animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes QK0
animal wasteland applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes o Ni 0
T; :animal waste discharged into waters of the state by man-made ditch, flushing syscem, or ether
�imilar man-made. devices'? 'Yes a No If Yes, Please Explain-
�F:cs trlc maintain adequate waste tnatiageinezit Tecords (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments: 14AISl }C :.5 -7;) -/L,qr 6 urn LN(-�ae-r
i ✓) J ?1G04,v p d3 G f1S �, �i 0'/l.
an 't .G_
C:Ik.rY - r 1-z1Cen Lvn-fav'S. CurrM ✓ S.
Js-
cc: Facility Assessment Unit Use Attachments if Needed.
TOTAL P.02

W
4
JUL 37 '95 15:41
943 P02
NORTH CAROLMA DEPARTPUW2 OF ENVLRONMENP, HR&LTH & NATURJLL RESQIIR=
DIVISION OF EI MONMENTAL MANAGEKWf
Fayetteville Regional office
Animal operation Compliance Inspection Form
a4
- /I. 9.s
All, questions answered negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
SECTION I
Animal Operation Type:
Horses, cattle, swine, poultry, or sheep 5&_..'r -C
SECTION II
1. Does the number and type of animal meet or exceed
the (.0217) criteria? [Cattle (100 head),
horses (75), Swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system)]
2. Does this facility meet criteria for
Animal Operation -REGISTRATION?
3. Are animals confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a CERTIFIED ANIMAL
PASTE MANAGEMIE 'P PLAN?
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6_ Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc?

5
r
JUL a? '95 15:42
SECTION III
Field Site Management
1. Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
Map Blue Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ft. of a USGS trap
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application site have a
cover crop in accordance with the
CERTIiICATIPN PLAN-.
5. is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
b. Does the animal waste management at this
farm adhere to'Best Managemen't'Practices
(BMP) of the approved CERTIFICATION?
7. Does animal waste lagoon have sufficient.
freeboard? How much? (Approximately . 3 ( )
S. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SECTION IV
Comments
0 ;,v J VA o r clr� - Cram., [-j
fOW 4faA ) -- �, h 0 t 0 '-'� "�°
e,-� ty - _S
943 P03
i

• S � .-ti. y � �-G�-� .c -alf Q � �' !� 1
i`z,+ / yv-41 s •0 ml d y F 0 1) PO f 9 / ' ()
r
51
ate--
L s-at-&I a atrj
r /-1 " n 9 A o D/ A' 44YI --. S ��`�� -Z

4r. 0 Division -Soil and'Water,,Conservatron 'Operation Review' y 3 t ""' '
i
0 D' on of Soil avid Water Conservation Comphance� _ pectii6hr Y i r , ' t
tyision of Water Quality. 'Compliance Inspection 3 >w� ` '' SI r?? -"'S tj
,. Other Agency •,Operatr Review' ,� M ,
f
4a
Routine 0 Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review O Other
Facility Number. � Date of Inspection
Time of Inspection E= 24 hr. (hh:mm)
E3 Permitted Certi Pied © Conditionally Certified © Registered 10 Not Opera Date Last Operated:
Farm Name: ... ..(L�.�✓. ...��. ......I �Zf4� County ......{ ! ir-t�/.................. I .... .......................
Owner Name:.........!!'. . ................... Phone No:..�... ......................
....................................................... z........ �'r'j.f
Facility Contact: 74.. ...r:h?h�. ,!.�-.�..� ..............Title:................................................................ Phone No: ...................................................
MailingAddress: ... ..Q....� .. l...�r..1.1....... 3 �7.. .�`...`!......! .....-........ .......................................................................... ..,. ..........................
Onsite Representative:.. ! � ...11?.<. /p �..... .... [ntegrator:C. _ �J:r� f�L..S.. �..............................................
4! a�
Certified Operator:........... w L ........ I......... . Operator Certification Number:
..ocation of Farm: L
...................................................................................................................................................................................................................................................................
Latitude Longitude C�• �° 0°°
Design Current ' �1.;De'sign Curre
,
Swine 1 l3id it€� Ca achy Population.,,,,,,�' Poultry ''E "'iCa ac>ity, Po' ul'a1
❑ W an to Feeder
•
El Layer
eeder to Finish`s
❑Non -Layer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
TOtal Desijj
4
❑ Giltsr
❑ Boars
(Number 6!L' agoons ©; ❑ Subsurface Drains Present
Holding Ponds / Solid Traps ,5 ; ❑ No Liquid Waste Manager
Design Current
Cattle �' -Capacity Po `elation
❑ Dairy
❑ Non -Dairy
;n Capacity
otal SSLW
] ❑ Lagoon Area ❑ Spray Field Area .,
lent 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 rcach 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'? ([f yes, notity 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 StrUCWrc 5
Identifier: ryry rr
Freeboard (inches): ti h.l7.. ..........................................................
"t...................................................................
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 2(No
El Yes �tv0
❑ Yes GkNo
i
ElYes o
[IYes
Cc] Yes o
❑ Yes No
Structure 6
...............................
❑ Yes o
Continued on back

1^
Facility Number: �� Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes eNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
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 A1212lication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
I
13. Do the receiving crops kfer 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) "Phis facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21, Did the facility fail to have a actively certified operator in charge?
22, Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
24. Does Xlity require a follow-up visit by same agency?
25. W/re any additional problems noted which cause noncompliance of the Certified AWMP?
P:.'10 VRAatidris :or• deficiencies •mere noted• during tliis:visit. - Y;oi.t will •re0iye Rio Ifukther - : • : -
cor'resporidtence: about this visit.::: ... ...:::..: : :::.::::....::: ......
❑ Yes
❑ Yes eN.
❑ Yes eXNo
❑ Yes � ""
[:)Yes o
❑ Yes [ No
❑ Yes N
❑ Yes N
❑ Yes N
❑ Yes N
❑ Yes No
❑ Yes No
f
❑ Yes N
❑ Yes N
❑ Yes
❑ Yes No
❑ Yes o
❑ Yes o
❑ Yes o
❑ Yes No
1.
Reviewer/Inspector Names_l:�! F �, I
s t xS . Pl 2 k'13: EP•!E�. nH.
Reviewer/Inspector Signature: A/"Z/ Date:
3/23/99

r
Facility Number: -� Date nl' I.espection
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?
Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes Na
❑ Yes N
El Yes o
❑ Yes No
At
3/23/99

Revised January 22, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
VA rir,�r 77 eta►►�h�'►
Facility Number w - Operlion is flagged for a wettable
Farm Name:___�rr�-_ r^'1 acre determination due to failure of
On -Site Representative: Part !1 eligibility item(s) F1 F2 F3 F4
Inspector/Reviewer's Name:
Date of site visit: 71 �rl �I dI
Date of most recent WUP: t1((`1-1( 11 -)
Operation not required to secure WA
determination at this time based on
exemption E1 E2 E3 E4
7 4 0
Annual farm PAN deficit: 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 wlportable pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system w/portable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part II, overrides Part I exemption.)
E1 Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D21D3 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 111. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part 11. Complete eligibility
checklist, Part II - F1 F2 F3, before completing computational table in Part 111).
PART 11. 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
field(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
buffer/setback 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 III.

l Division of Soil and Water Conservation- Operation Review
d Dtviston,of Soil and Water Conservation.- Compliance Inspection ; 3
13 Division of Water Quality - Compliance Inspection
Other t�gencyOperation Review
Qf Routine Q Complaint Q Follow-up of DIVQ inspection Q Follow -tip of DSWC review Q Other
Facility Number Date of likspCction
Time of Inspection 24 hr. (hh:mm)
[3 Permitted [3 Certified E3Conditionally Certified ['] Registered IDNot O perationa! Date Last Operated:
Farm Name: ...Xt !.� . l�..I..... v County:............
OwnerName:........................................................................................................................... Phone No: ................................................................... ....................
Facility Contact: .................................................. ... Title:.......................... .......... Phone No: .............
FlailingAddress: ......................................... ............................................................................
1 _
Onsite Representative:.�.:F� .."rhLGw.z�.L.._.................... lntq;rator:..................... ...........................................................
......
Certified Operator: ................................................... .... ........................................................ Operator Certification Number:..........................................
Location of Farm:
Latitude 0 1 Longitude 9
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer JE1 Dairy
EEITeeder to Finish J❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ soars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ l �aguon Area 10 Spray Field Area
Holding Ponds / Solid 'Traps ❑ No Liquid Waste Management System
Discharges & Stream tntuacts
1. Is any discharge observed from any part of the operation'?
❑ Yes
'5�No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the conveyance span -made".
[:]Yes
1�No
h. If discharge is ohservcd, did it reach W�jter O the State') (II'yes, notify DWQ)
❑ Yes
WfNo
c. If discharge is observed, what is the estim:ued flow in galhnin'r
tl. Does discharge bypass a lagoon sysmil'? (II'yes, notify DWQ)
❑ Yes
0 No
2. Is there evidence of past discharge from any part of the operation'?
❑ Yes
P No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
[XNo
Waste Culicetion & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
❑ado
Structure I Structure ? Structure 3 Structure 4 Structure 5
Structure b /
ldcntificr:
Freeboard(inches):
....r................................ ....... ......... .................................... ........................ ..............................................
...................................
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion,
❑Yes
o
seepage, etc.)
3123199
Co�rtrirricr nir hock

t,Iility Number: — Late of Inspection 7
6. Are there structures on -site which are not properly addressee] and/or managed through a waste management or
closure plan? El Yes No
(If any of questions 4-6 was answered yes, and the situation poses an ✓
immediate public health or environmental threat, notify DWQ)
7, Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑iNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level _
elevation markings? ❑ Yes 7N0
Waste ADolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes Q(No
11. Is there evidence of over application? ❑ Excessive Prmding ❑ PAN [:]Yes ErNo
12. Crop type �_,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [�No
14. a) Does the facility lack adequate acreage for land application'? y ❑ Yes (�No
b) Does the facility need a wettable acre determination'? ❑ Yes 9No
No
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement? ❑ Yes plNo
16. Is there a lack of adequate waste application equipment'? ❑ Yes [�K0
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes [fNo
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/ Lrrigation• freeboard, waste analysis & soil sample reports) ❑ Yes P No
` 1011 tv414dz,1 ,t
20. Is facility not in compliance with any applicable setback criteria in_�?fcct at the time of design? ❑ Yes UNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑'flo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ;YNo
24. Does facility require a follow-up visit by same agency? ❑ Yes VNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes O No
Rio yiol'atigns:or deficiencies vtAere noted +during �ttis:visit; Yoi} will eeeiye fib furt. f. ; ;
: corres'pondenke:;bouts this visit.. • .::::. .......:.. ' .............. .
shun #1) Ekplain'ariy YES answers and/or any re
:to better�expla�n'situations: (use additional page
,Y
4 *s .•v e-v e-e
d
/Z
� "ra
+'Y
comments. t, ,,
y
Reviewer/Inspector Name
viewer/Inspector Signature: ` Date:
3/23/99

0 Div:: of Soil and Water Conservation ❑ Other Agency
tvision of Water Quality
O Routine O Complaint O Follow-u of DW2 inspection O Follow-up of DSWC review O Other
Date of Inspection
Facility Number
.2ETime of Inspection d 24 hr. (hh:mm)
© Registered Certified 13Applied for Permit' © Permitted 113Not Operational Date Last Operated: ........................•.
Farm Name: ...................................................
OwnerName:.. .i�. .4,/.... . g.................................. Phone No ................................................ f . �L.....................
Facility Contact: ..��.A.......... ..l.R. G .... Title• Thone No: ...................................................
Mailing Address: ....Y................ ?..✓C„ li1�L �7�
........................ ........
OnsiteRepresentative:....L...l7h- •�•�/:�..�/ ..... Integrator: ......................................
��Certified Operator:............:.1.//.�Q,,.� ..l ... /.-.� v ....... ............................ Operator Certification Number,.................... ..........
[vocation of Farm: 2 i3z
...... .. ..... .....
Latitude•, �«
"'Design ; Current;
Swine , Capacity Population
❑ We to Feeder
QIle-eder to Finish B-J
❑ Farrow. to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
' ❑ Gilts
"` ❑ Boars
Longitude �• �' �'°
Design Current k'
Poultry, �, Capacity I?opulatenn Cattle
❑ Non -Lay
T ❑Other
Tata
r �nDesign Current -.
Capacity:,Population
❑ Dairy
❑ Non-Dairy
esign "pa
y Total SSl
Number Lagoo 044 ponds
'k
❑ Subsurface Drains Present 110
Lagoon Area
10 Spray Field Area
❑ No Liquid Waste Management System
"
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes No
2. Is any discharge observed from any part of the operation?
❑ Yes No,
Discharge originated at: Cl Lagoon' ❑ Spray Field ❑ Other
�
a. If discharge is observed, was the conveyance man-made?
❑ Yes 0
kNo
b. If discharge is observed, did it reach Surface Water? (if yes, notify DWQ)
❑ Yes
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes E NNoo
El GKO
3. Is there evidence of past discharge from any part of the operation?
Yes
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes No
5. Does any part of the waste management system (other than lagoons/holding: ponds) require
❑ Yes (�1 o
maintenance/improvement?
b. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
7. Did the facility fail to have a certified operator in responsible charge?
❑Yes No
7/25/97
Continued on back

.a
Facility Number: -- 3
8. Are there lagoons or storage ponds on site which need to be properly closed'! ❑ Yes 2<10
Structures (Lagoon Holding Ponds, Flush Pits, etc.l
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ZNo
S ructure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
....... .....
Freeboard (tt):........................ :...
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'! ElYes \`
12. Do any of the structures need maintenance/improvement? ❑ Yes ""O'
(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 1 'o
Waste Application
14. Is there physical evidence of over application? ❑ Yes /No
(If in excess of WMP, or runoff entering waters of the State. notify DWQ)
�t
15. Crop type [,•D .... dr.1.............................................................................................................................................. ..
..... ... . ............ ........
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWIMIT ❑ 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 No
19, Is there a lack of available waste application equipment? ❑ Yes [_Z N
20. Does facility require a follow-up visit by same agency? ❑ Yes N0
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative'! ❑ Yes (Z Kl�
22. Does record kee in need improvement? ❑ YesrX
p g P
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes ffNo
24. Wer any additional problems noted which cause noncompliance of the Certified AWMP? EllYes J�o
25. ere any additional problems noted which cause noncompliance of the Permit? ❑ Yes No
No.vio'lations or def<ciencies.were noted duringthis. visit.:Yoii.will receive no f'urttier
' correspondence ai4out this.visit. ;
IColt ments'`(tefer'to.questeonz#) <Explain anyffYES answers and/or anf recorriiricn�datrons or any other comments 2
Use:drawings tif.facthty: to;bettcr`explatn sttuahons (usE additional pages- as. necessa rv)..
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: /ram—f�7 Date:
.../� ...

i,.
i
u -, �• rw rcr;
DSWC Animal Feedlot Operation Review t '
.,y DWQ Animal Feedlot Operation Site Inspection FR
W.
�'�< .. "`%'�Y�.,`T ..i ....r<'x •:i.f "r '. .., w. ..2 .car-:;"h,4 .,r:x b ���"t .
Io Routine A Complaint Q Follow-up of MN'Q insLection 0 Uollow-tip o1'DSX1`C review Q Other - -
Date of Inspection
Facility Number
Tillie of Inspection E!Ealn24 hr. (hh-.mm)
Total T'irne (in fraction of hours
Farm Status: Registered C] Applied for Permit iex. 1.24 far '1 hr 15 min)) Spent oil Review
0 Certiiied ❑ Permitted or Inspection r,includes travel and processing)
C] NN,ottO perational Date Last Operated.................................................................................................................................................
FarmName:..,.%!` .y.. ....fir,-.'/4.7.. .....F YW— County:................................................................... ...I.........
OwnerName: ................................................... ........................................................................ Phone No:......................,........,..............,........................................
l �
Facility Contact1 dG+i F- r Phone No:................................................................+�......,7?L�?.,...,.. ... ..............��:...... Title ......fir................,. .........
MailingAddress:.........................................................
OnsiteRepresentative:........................................................................................................... Integrator:......................................................,...............................
Certified Operator: .................................................. ...... Operator Certification Number:...............
Location of Farm:
......................... .. . .. ..
Latitude Longitude ��• ���«
Type of Operation Desi1. gn m
Swine Capacity ,P
a<'
❑ Wean to feeder
"Feeder to Finish36-0
❑ Farrow to Wean
❑ Farrow to Feeder,
❑ Farrow to Finish
❑ Other
Destgtf Current I
Poultry : "? Capacity Population- _� Cattle C
❑ Layer ❑ Hairy
C] Non -Layer I ❑ Non -Dairy
Total Design Capacity
Nun ber�of agoons / Holding Pondsj L f ❑ Subsurface Drains Present 10 Lagoon Area !❑ Spray Field Area � r
f. .
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes PNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes (RfNo
b. It' discharge is observed, did it reach Sm-face Water? (If yes, notify DWQ) ❑ Yes A No
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) El Yes P'No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes 7(No
4• Were there any adverse impacts to the waters of the State other than from a discharge? [] Yes 0 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require Yes
maintenance/improvement.)
Continued on back

Facility Number
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes [ No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes 1P No
8. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes U1 No
Structures (Lagoons and/or Bolding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes VNo
Freeboard (ft); Structure f Structure Structure 3 Structure 4 Structure 5 Structure 6
....................!...............I..................3 ....................................................... .................................. ..... ..................... ................. ............................
...,
I0. 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 a6y 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? XYes ❑ No
Waste Application
14. Is there physical evidence of over application? ❑ Yes No
(If in excess of WMP, or run�of)f entering waters of the State, notify DWQ) /
15 Crop type (.® U✓"
16.
.......................................... _.......... ..................... ................................................................................................. ....................................................
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
El Yes
I�No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the receiving crop need improvement?
❑ Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
ONo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
21.
Did Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑ Yes
9No
For Certified Facilities Onl
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
24. Does record keeping need improvement? ❑ Yes ❑ No
4 "J-VS _F 5 7H' rF_P S 7V Cle-1.W_G-- --- 14 A- .5 P70T I�,O
mUW v 6, e-e T g VO t1 Ta Pc-lz- Al c r l: ,�s �! Vt 5 v1f'�
yL3s
1 G� Pod r �� r� I&V­(5 # vi5_C--C T_ -rl a J CW
&=. 5 f Wet 6
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: to.
cc: Division of Water Quality, Water QualitylBection, Facility Assessment Unit 4/30/97

State of North Carolina
Department of Environment,
Health and Natural Resources
Raleigh Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
e��
EDI=HNF;Z
DIVISION OF WATER QUALITY
July 16, 1997
Mr. Bobby Gay
P.O. Box 431
Seaboard, North Carolina 27876
Subject:Compliance Evaluation Inspection
Facility # 66-13
Bobby Gay Swine Farm
Northampton County
Dear Mr. Gay:
On July 8, 1997, Mr. Buster Towell from the Raleigh Regional Office
conducted a compliance inspection of the subject animal facility.
This inspection is part of the Division's efforts to determine
compliance with the State's animal waste nondischarge rules.
The inspection determined that your animal operation was not
discharging wastewater into waters of the State and that the
waste lagoon had the required amount of freeboard. As a result of
the inspection the facility was found to be in compliance with the
State's animal nondischarge regulations.
This office would also like to take this opportunity to remind you
that you are required to have an approved animal waste management
plan by December 31, 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 office.
The Raleigh Regional Office appreciates your cooperation in this
matter. If you have any questions regarding this inspection please
call Mr. Buster Towell at [phone].
Sincerely,
tJy Garrett
Water Quality Section Supervisor
cc: Northampton County Health Department
Mr. Tony Short, Northampton Soil and Water
Conservation District
Ms. Margaret O'Keefe, DSWC --- RRO
DWQ Compliance Group
RRO Files
3800 Barrett Drive, Suite 101, *_ FAX [phone]
Raleigh, North Carolina 27609 N%q fC An Equal Opportunity Affirmative Action Employer
Voice 919-571-4700 50% recycled/10% post -consumer paper

Facility Number -- —�'
Farm Status: Registered ❑ Applied for Permit
❑ Certified ❑ Permitted
Other
Date of Inspection
Time of Inspection
24 hr. (hh:mm)
Total Time (in fraction of hours
(ex:1.25 for 1 hr 15 min)) Spent on Review��
or Inspection (includes travel and orocessinpl
❑ Not Operational Date Last Operated:......_.......................... _........................................................... _............... _.......... _............... _......
Farm Name: ..... a.v46,1/... ._..............__. .......... .County:
.. .... .......................
Land Owner Name: .... .6`........ ............................ Phone No:/..!...._.............._._................ r........................ Facility Conctact:....C!.!x ..�IPN. G!/.................. Title: f? .rl.^._p�G.:."'................ Phone No: „7/ 4..� S
Mailing Address:...P_ ..._6.P..,2�..7.
// /.....................�� AV-�:i? -? `6
....... .__....... _................................
........................... ..........................
Onsite Representative: ... k..�. - (l...aW .1........................................ Integrator:..... f/ s...................................
Certified Operator: ....._...S ^L�............. ................................. _............ Operator Certification Number:.................................
Location of Farm:
Latitude =*=` =" Longitude 0. 0, 0«
.General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes �UKO C� ❑ Yes 'No
❑ Yes 05C
❑ Yes No
❑ Yes No
❑ Yes ®/�
❑ Yes
❑ Yes No
Continued on back

Faciti LyNumber: ,.(d.(... —...,( .....
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?
StructurC5 fLaeoons and/pr Ijoldine Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (fl): Structure I Structure 2 Structure 3
......... `�� :.. .... ....... ...... q........ ............................
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
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?
❑ Yes 2'No
❑ Yes
❑ Yes Id'No
❑ Yes
Structure 5 Structure 6
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 �Nflp.'? sf^?.'!.� 1�'/.irs.............................................................................................................
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 Cerdfigd Facilities 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 <o
❑ Yes 2 No
❑ Yes
Vel �es❑ No
❑ Yes 2'No
❑ Yes
No
,❑,,
❑ Yes
Idivo
❑
Yes
No
❑ Yes
L'j N
❑ Yes
❑ Yes
CJ N `
No
[:]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
ReviewerAnspector Name
Reviewer/Inspector Signature: �- Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

State of North Carolina
Department of Environment,
Health and Natural Resources
Raleigh Regional Office
James B. Hunt, Jr„ Governor
Jonathan B. Howes, Secretary
MIA
EDEHNR
DIVISION OF WATER QUALITY
.February 10, 1997
Mr. Bobby Gay
P.O. Box 431
Seaboard, North Carolina 27876
Subject: Compliance Evaluation Inspection
Facility # 66-13
Bobby Gay Swine Farm
Northampton County
Dear Mr. Gay:
On February 6, 1997, Mr. Buster Towell from the Raleigh Regional
Office conducted a compliance inspection of the subject animal
facility. This inspection is part of the Division's efforts to
determine compliance with the State's animal waste nondischarge
rules.
The inspection determined that the Swine operation was not
discharging wastewater into waters of the State and that the
waste lagoons had the required amount of freeboard. 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 stewardship 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. Accordingly, illegal discharges of wastewater to surface
waters of the State are subject to the assessment of civil
penalties and may also result in the loss of deemed permitted
status, requiring immediate submission of a waste management plan.
This office would also like to take this opportunity to remind you
that you are required to have an approved animal waste management
plan by December 31, 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 office.
3800 Barrett Drive, Suite 101, FAX [phone]
Raleigh, North Carolina 27609 NO C An Equal Opportunity Affirmative Action Employer
Voice 919-571-4700 500k recycled/10% post -consumer paper

Bobby Gay
Page 2
The General Assembly recently passed Senate Bill 1217 which will
require all animal waste management systems to designate an
to Operator in Charge". It shall be the responsibility of this
individual to oversee the operation and maintenance of the animal
waste management system and to have control over waste application
activities. Currently classes are being held for operators of swine
facilities and training is being developed specifically to address
dairy and liquid poultry operations. For more information please
call either your local Soil and Water Conservation District or
Cooperative Extension Service Office.
The Raleigh Regional Office appreciates your cooperation in this
matter. If you have any questions regarding this inspection please
call Mr. Buster Towell at [phone].
Sincerely,
oe641zy-
Judy Garrett
Water Quality Section Supervisor
cc: Northampton County Health Department
Mr. Tony Short, Northampton Soil and Water
Conservation District
Ms. Pat Hooper, Environmental Engineer,DSWC--WARO
DWQ Compliance Group
RRO Files

State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt, Jr„ Governor
Jonathan B. Howes, Secretary
November 13, 1996
Robert Gay Jr
Gay Farm
PO Box 431
Seaboard NC 27876
SUBJECT: Operator In Charge Designation
Facility: Gay Farm
Facility ID#: 66-13
Northampton County
Dear Mr. Gay Jr:
rw"
®F—::HMF:Z
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 919/733-0026.
cey,
Sincerely, Howard, J ., , Director
Division of Water Quality
Enclosure
cc: Raleigh Regional Office
Water Quality Files
P.O. Box 276e7, N�W�CRaleigh, North Carolina 27611-7687 An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 50% recycled/ 10% post -consumer paper

JLJL-14-1995 15:26 FROM DEM WATER QUALITY SECTION TO
RRO P.a?•a?
Site Requires Immediate Anenfjrr
Facility No. - GC-4.3
DrVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
(I �� DATE.: ?- // - , 1995
Time: OSo 0
Farm Name/Owner: 3 0 b � u &A ,f -
Matting Address: P 0. G6L/ _ S 6Z;) A r c( rt/ L Z 7
County:. I'U o r `(f q+►-
Integrator. V,-r6, n R de- c4 _ Phone:
On Site Representative: on t G Phone: i11 63 - � s751 /
Physical Address/Locaaon:
Type of Operation: Swine Poultry Cattle
Design Capacity:: _ i � o o Number of Animals on Site:. G / v o o -- -
DEM Certification Number:' ACE DEM Certification Number: ACNEW
Latitude: Longitude: Elevation:
Circle Yes. or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately I Foot -+- 7 inches) (6� or No Actual Freeboard: Inches
Was any seepage observed from the lagoon(s)? Yes of& Was any erosion observed? Yes o<�
Is adequate land available for spray? Yes is the cover crop adequate. es or
Crop(s) being utilized. SPA 4 , ^f D %Q J S 14 n Ji GrG[
Does the facility meet SCS minimum setback criteria'? 200 Feet from Dwellings or No
100 Feet from Wells? (G or No
•: _hc animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or,
animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Lute? Yes ors
animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar than -made devices? Yes o No If Yes. Please Explain.
�-_S Itic facility maintain adequate waste mmagemcnt records (volumes of manure, land applied.
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments:
" Pq j 1 n/ e-,4 W D J c,S P r e. G-"AJ fe_, ; s, 4-11r
It-n �-yG RTC /
/
Ci .
116r-, !-tlx ty r , Q td 1 D J 'h o 4� secs-
�/ 1 k /Y ` k / r e
Signature
cc- Faciliry Assessment Unit Use Attachments if Needed.
TOTAL F-a2

4�A, llivisiun u#' Suil and Water Conservation ❑ Uther Agency ,
a Dt� tston o#'Water Quality
0 Routine O Complaint Q Follow-up ol'DWQ inspection CYFollow-up of DSWC review Q Other
Date of Inspection
Facility Number
Time of Inspection 24 hr. (hh:mm)
❑ Registered ©Certified © Applied for Permit © Permitted O Not O erationalId
Date Last Operated:
Faun Name: ............... .. i� ...1. Counh•.P i �i ........I..............
OwnerName: ................................................... ........................................................................ Phone No:..............................,......,.,...................................
FacilityContact: .............................................................................. Title:...................,............................................ Phone No:........................................
MailingAddress: ......................................................................
Onsite Rep resentative:K.l�....1. Ut ! 1..................
CertifiedOperator;..............................................................................................
Location of Farm:
................................................................................ ..........................
Integrator:...1..h..........................................
........ Operator Certification Number.... ......................................
c
Latitude ° 0 Longitude I J• 6
Design ..
_swine . .. ,Capacity P
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ soars
Number of I a ii, �l Holding Pc
r
Design
Poultry. Capacity
V • I —I I aver
rrent
ilation'„ Cattle_,-
,
❑ Dairy
❑ Non-Dairy
s<l Design Capacity .L
Total SSLW C
Subsurface Drains Present ❑ Lagoon Area
No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
b No
2. Is any discharge observed from any part of the operation?
❑ Yes
r
No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
[/No
b. Il'discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
7No
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (lf yes, notify DWQ)
❑ Yes
[/No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge`?
❑ Yes
No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No

F � �
Facility Number: —
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes LM No
Structures (L12oons,11olding Ponds, Flush Pits, etc.)
9. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes P(No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
�........... ..............
Freeboard (ft): ...........d'......... I........
t0. 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 ❑ No
Waste application
14. Is there physical evidence of over application? ❑ Yes ❑ No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type...........................................................................................................................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ❑ No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes ❑ No
18.
Does the receiving crop need improvement?
❑ Yes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
❑ No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
21,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
22.
Does record keeping need improvement?
❑ Yes�No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
[] No. viol Ations-or. deficiencies: were, noted daring this'visit. You'wiII i e'cei've,n6 fu:rthen
correspbndence about this'visit.
!�IOIR o
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: ���� �` �� `'�" ' �—. Date:

F-IIAIAIA 6
4 DSWC Animal Feedlot Operation Review
❑ DWQ Animal Feedlot Operation Site Inspection
1,0 Routine 0 Complaint O Follow -tip of MV ) ins ection O Follow-up of USNVC review O Other
r... » . Date of Inspection
Facility Number
Time of Inspection 24 hr. (hh:mm)
Total Time fin traction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (es: 1.25 for I hr 15 min;:) Spent oil Review
❑ Certified ❑ Permitted or Inspection (includes travel and processing)
10 Not O erational I Date Last Operated :......................................................................r.........................................n................................
Farm Name:........ . . ,(......... ...&:.............�t9....�.................................. County:...,,/U,G. ..j. f'�.C.."1 ....................,..
OwnerName: ................................................... ........................................................................ Phone No.......................................................................................
Facility Contact:..............................................................................'I itle.:............ Phone No:
AtkilingAddre. s:...........................--.......................................................... ................. ...........,................. .................. ..........................
Onsiie Representative:... t �.. ... integrator:...,C .......
..�............................................
Certified Operator:................................................................................................................ Operator C'erti(teation Number:.........................................
Location of Farm.
................................ ....... ..... .. . .. ..... ...... .... .. .
Latitude
Type of Operation r Destgn Curren
wine Capacity I'opulaO
❑ Wean to Feeder
7 Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Other
�Numher of Lagoiins l Holding>Pottds Subsurface Drains PresentIJ �Lagoon area JU Spray Field Area ,
t�netal
1. Are there any buffers that need maintenance/improvement'? s d\'o
2. Is any discharge observed from any part of the operation? EjWes ❑ No
Discltarge originated at: ❑ Lagoon ❑Spray Field �Qther
a. If dischar�-e is observed, was the conveyance man-made" El Yes 16 No
b, Ifdischarge is observed, slid it reach Surface Water? flf yes, notify DWQ) ❑ Yes XNo
c. If discharge. is observed. what is the estimated flow in eal/min`?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ZNo
3. Is there evidence of past discharge from any part of the operation? IvYes ❑ N
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yeti / I
5. Does any part of the waste managetnent system (other than lagoons/holding ponds) require Yes ❑
maintenance/improvement'?
4/3l}/97
Cunliuuerl
1

Fdcility Number: —
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
. /No
Structures (Lagoons.Holding Ponds Flush Pits etc.-
9. Is storagercapacity,(freeboard plus storm storage) less than adequate?
es...
❑ No .,
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: 6 a4AVO ...................................
...............................................................
I......
....... ...I......................................................... ......... ................ ...........
Freeboard (ft):........i..�!..l.............. ....... l..l.......C............... ..•.•.........................................................................................................
.................................
10. Is seepage observed from any of the structures?
❑ Yes
Po
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
iNo
12. Do any of the structures need maintenance/improvement?
[(Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
No
Waste Application
14. Is there physical evidence of over application?
❑ Yes
No
(If in excess of WNW, 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).
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19, Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified rr or Penitted Facilities_Otly
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
ti
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
? ❑ Yes ?NO
❑ Yes P No
0 Yes ❑ No
❑ Yes VNo
❑ Yes YN0
❑ Yes No
❑ Yes No
0 No violations or dediciehdei s were 'no' ted-during this" visit. Yo'64411 'k've�no further,
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❑ Yes �] No
❑ Yes No
❑ Yes No
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❑ Yes �] No
❑ Yes No
❑ Yes No
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