660060_PERMIT FILE_20171231

P21( LC --
Type of Visit Compl a Inspectlon Q Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Z Routine O Complaint O Follow up O Referral O Emergency .O Other ❑ Denied Access
Date of Visit: 111.�Arrival Time: .M=1 Departure Time: County:
Farm Name: U A34 kl e WeS __ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
� r
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Region:
Location of Farm: Latitude: = e 0 I =" Longitude: ❑ o = i = «
CDesign
Currentne
HapRIPIMfftio
y
on
Wet Poultry Cty Population
Cattle Capacity
Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
❑ Dairy Heifer
❑ Feeder to Finish
❑ Farrow to Wean
Dray Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
El Beef Feeder
❑ Boars
❑ Pullets
ElBeef Brood Cow
❑ Turke s
Other
❑ Turkey Points
❑ Other
El Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑Yes
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
No ❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[] NA
[I NE
2. Is there evidence of a past discharge from any part of the operation?
ElPN.
El
El NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes❑
NA
❑ NE
other than from a discharge?
Page I of 3
12128104 Continued

z
Facility Number -
Date of Inspection M=
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. 1f yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
❑ Yes No -' NA El
El Yes o ❑ NA ❑ NE
Structure 5 Structure 6
Identifier:
( of app ica a to roo a pit
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): `!
/
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�00,NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
�NoEl NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
thre , 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?
k
N 1' bf1 d d t Al t t k
El Yes
No ❑ NA
❑ NE
s, ry s ac s an or we sac s)
4. Does any part of the waste management system other than the waste structures require ❑ Yes Zo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes "NoNA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ElYes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or i0 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) r'.nf
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ZNo/,NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
A ❑ NE
NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑Yes o El NA El NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Comments {refer to queshonf#); Explain any YES answers and/or ariyrecmmendations or any other comments.
Use drpwmgs of facilityto better explain situations. (use?add�ttanal pages as necessary):
Reviewer/Inspector Name F Phone:
Reviewer/Inspector Signature: 13 /,, -;;7 f70 7 Date: ^I l r 31 1 i
Page 2 of 3 12128104 Continued

l
f
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 appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes No ❑ NA El NE
El Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking
El Crop Yield ❑ 120 Minute Inspections [I Monthly and i" Rain Inspections Bather Code
22. Did the facility fail to install and maintain a rain gauge? El�VE61NA
NA El NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ElYes ❑ NE
24, Did the facilityfail to calibrate waste application equipment as re required b the permit?
ppq Y
❑ Yes
�❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ YesrNo
NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ic/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Add�t�onal Cornmentsandl�pr Drawings,:
a
12/28/04

(Type of Visit: 0 Com ce Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergencv 0 Other 0 Denied Access
Date of Visit: — Arrival Time: p z5 Departure Time: County:
Farm Name: [,10-5 + Yw0it, Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Title:
Phone:
Phone:
Integrator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Region:
Design Current
Design Current Design
Current
Swine Capacity Pop.
Wet Poultry Capacity Pop. Cattle C**specify
Fop,
Wean to Finish
La er DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current Dry Cow
Farrow to Feeder
Dr. P.oult . Ca acit P,o Non -Dairy
Farrow to Finish
[Layers I 113eef Stocker
Non -Lavers Beef Feeder
Pullets Beef Brood Cow
Turkeys
Gilts
Boars
Otherm
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 6 No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
Pal&O ❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
[3Yes
❑ NA
VNNo
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes❑
NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: - u Date of Inspection: •L
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
o ❑ 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
1217No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
�00
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental eat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes N NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Aaalication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes:No
No NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑'No NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
ZONA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes❑
VNoNA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
g�No
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[—]Yes
❑ NA
❑ NE
the appropriate box.
❑ WUP [—]Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: 6 - Date of inspection: - 2
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA 0 NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes gN ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments(refer Ito question #) Explain any YES answers and/or any additional recommendations or any other comments.
Use; drawings3of facility. to better explain situations (use additional pages as necessary).
5141 - ✓e y
1(. -7s
Reviewerfinspector Name:
Phone:
?3I-L/ z0"
Reviewer/Inspector Signature:
Page 3 of 3
jj 4, s 4ow- Date:
21412011

Type of Visit ,0 Com iance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 77 � /- — Arrival Time: � Departure Time: County:
Farm Name: ed Owner Email:
it
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator. 0.
Back-up Operator:
Title:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Location of Farm: Latitude: = e = i = Longitude: ❑ o = 1 0 "
Design Current
Design Current
Design Current
Swine Capacity Population
Wet PoulI -ationi
apacity Population
❑ Wean to Finish
❑ Layer
❑ Dai Cow
❑ Wean to Feeder
I
❑ Non -La er
I I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
Layers
FE03
❑ Non -Dairy
❑ Farrow to Finish
❑ Beef Stocker
❑Gilts
Non -La ersPullets
❑ Beef Feeder
❑ Boars
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Struc#ures:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation'? Yes ❑ No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ther
a. Was the conveyance man-made'? ❑ Yes No A El NE
b. Did the discharge reach waters of -the State? (if yes, notify DWQ) El Yes o ❑ NA El NE
c. What is the estimated volume that reached waters of the State (gallons)'?
d. Does discharge bypass the waste management system? (I f yes, notify DWQ) ❑ Yes o El NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes o A ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters ofthe State ❑ Yes o ❑ NA ❑ NE
other than from a discharge?
Page 1 of 12128104 Continued

�1
Facility Number: 16y
Date of Inspection e'
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural Freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed .Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes �`NoE3NA ❑ NE
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? ❑ YesNA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes NA ❑ NE
maintenance or improvement?
Waste Apl2lication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Z No NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload [I Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 ]bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
Z O NA
NN❑ NA
❑ NA
LLJ No ❑ NA
No ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
ES answers and/or
Comments�(refe� o quest►on *#)� 3E'zplan any Y ;' ` I any; recomm nda ions or any other, comments.
lase drgwings of+I_ac�lity,tojbetter�explam situatlons; (use additrnn_a1 pages as neeessary,):
e,.`;:
Reviewer/[ns ector Name °
p
- � "`
_ , t= Phone: ti/2 t?O
Reviewer/Inspector Signature: :PSG7a,
,�n Date: .0
Page 2 of 3 12128104 Continued

Facility Number: — rj Date of Inspection Owl
Required Records &_Docum_ents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ffNo 0 NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes o ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? 1f yes, check the appropriate box below. ❑ Yes V<o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ eather Code
22. Did the facility fail to install and maintain a rain gauge? [--]Yes No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes N NA ❑ NE
❑ Yes NA ❑ NE
ElYesVXNo,[01
NA El
❑ Yes NA ❑ NE
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
3I. 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
in s. -. ,? +
Add itional'Cornmedts and/or Drawg
14n J s4apfa� ��� t2
'' h 01-1-1--
5 bw\e c-vy-1S � je /W cal v rvu.,-, o C�q
e la C r? J dU S 4 jV rat j_ 0 V- Lv'q54e
a,4 I kl-r- '0�n ,S4- e- 13074 T�
t
Page 3 of 3 12,128104

s° I Division of Water Qualit y
Lrta!1i y NutnbeV 0 Division of Soil and Water Conservation'
0 Other A gene y
T jpe of Visit Cojn > ' ce. Inspection 0 Operation R NieW 0 Structure I-Waluation 0 Technical Assistance
Reason for Visit 91rwtiline 0 Complaint 0 FolloW up 0 Referral 0 I:mergencl 0 Other ❑ Denied Access
Date of Visit: 'I fop J Arrival Time: S Departure Time: County:
Farm Name: �IC�S Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: f
Certified Operator:
Phone:
Title: Phone No:
Integrator:
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Region:
Latitude: = o = = Longitude: E] o =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
Pullets
LJ Turkey Poults
❑ Other
Discharlies & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes o ❑ NA ❑ NE
❑ Yes No NA ElNE
❑ Yes No ❑ NA ❑ NE
❑ Yes �]X
NA ❑ NE
❑ Yes o ❑ NA El NE
❑ Yes ❑ No ❑ NA ❑ NE
12128104 Continued

Facility Number: — �p
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes No NA ❑ NE
ElYes o ElNA ❑ NE
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes :No
o NA El NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental thre , notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes N NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes N 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 �NoED
A El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes o NA El
15. Does the receiving crop and/or land application site need improvement? El Yes No NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes N NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ NA ❑ NE
18. is there a lack of properly operating waste application equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
q
Reviewer/Inspector Name Phone: /
Reviewer/Inspector Signature: Date: D
12128104 Continued

Facility Number: - b Date of Inspection 0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No 'NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ZNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes N El NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes N,0 NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes NA ElNE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes o ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings: i
12128104

I
Gri6ivision of Water Quality
Facility Number _ Q Division of Soil and Water Conservation
0 Other Agency
Type of Visit 4f A;=Utine
me Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 2= Departure Time: County:
Farm Name: d Owner Email:
Owner Name: i/�+�ty,i!I �_!i✓�s-- Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative:
Certified Operator: C2 04
f� le —
Back -up Operator:
Location of Farm:
Swine
10 Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Integrator:
Operator Certification Number:
Region:
Back-up Certification Number:
Latitude: 0 0 , Longitude: = ° 0 d
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ D r
y Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ZNo NA ❑ NE
❑ Yes N ❑ NA ❑ NE
❑ Yes No . ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
C ❑ NA ❑ NE
o ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
12128104 Continued

Facility Number:
Date of Inspection o a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): !c Z 1 t(
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No NA ❑ NE
❑ Yes o ❑ NA ON E
Structure Structure 6
El Yes /N9 El NA ❑NE
❑ Yes No ❑ NA ElNE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental t at, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes N `V ❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes No ❑ NA [I NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes No [I NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes No NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. El No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or t0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) t%_Oblv",,,.) M q i- ,10 /tS
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18, Is there a lack of properly operating waste application equipment? ❑ Yes
Z140 NA
❑ NE
1�'N0 NA
❑ NE
��Y_o�[INA
❑ NE
❑ NE
I A�oNA
EINA
❑NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
i
Reviewer/Inspector Name Phone-
Reviewer/Inspector Signature: / LB� GL� Date: i7
12128104 Continued

❑ Yes No ❑ NA ❑ NE
❑ Yes P-Iq�oEl NA ❑ NE
Facility Number: — Date of InspectionQ
Required Records & Documents l
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
.1C!
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Weather
Rain Inspection��N
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ YesNo
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes❑
NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
� ❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
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
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

ivision of Water. Quality
Facility'Number O Division of Soil and Water Conservation
0 Other Agency.
Type of Visit jaf Co Hance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Vis' Routine 0 Complaint o Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: L? O Arrival Time: ® Departure Time: County: Region:
Farm Name: L _��jajf- 2 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: D7�
Back-up Operator:
Location of Farm:
Title:
Phone:
Phone No:
Integrator: �]GLr�4 5 �r3/crr.✓LS
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ o = 4 Longitude: = ° = 1 "
Design Current
. Swine t �''. Capacity Aopulation."Wet Poultry
❑ Wean to Finish 10 Layer
❑ Wean to Feeder 1 ❑ Non-Layer,
fffeeder to Finish
❑ Farrow to Wean
� ' 'Dry Poultry
❑ Farrow to Feeder
❑ Farrow to Finish I
❑ Gilts
❑ Boars
Other
r 10 Other
Current :" Design Current;
Population Cattle Capacity 1?opulahon
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Daia Heifer
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number'of Structures:.. C
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes ZNo❑ NA ❑ NE
❑ Yes [f ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes el 1 ❑ NA ❑ NE
❑ YesVNN/o,/
❑NA El NE
❑ Yes ❑ NA ❑ NE
12128104 Continued

h . a
Facility Number: p
Date of Inspection Z7 3
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Q �( 04
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes VNo
NA ElNE
[I Yes NA ❑ NE
Structure 5 Structure 6
❑ Yes No NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental thre t, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes o ' 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 �00 NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ElYes ETNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) / 1 ILS
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes o NA El NE
15. Does the receiving crop and/or land application site need improvement? ❑ YesFN9
No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes '❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes No NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question#): Explain any YES answers and/or any recommendations or'any other.comments.
Use.drawings of facility to better explain situations. (use additional pages as necessary):'-
,r
n -ram J 4-o 4-r � 4--z Ili t"-" �
�, ti y p 4 Its 4,) 9 k Ste. e--
lQ.e-tv-C �. 7✓%•T/�C 'Jil",e
t I 1�iY I 'T �G- Atex- ei-a 7 i 4V
7
Reviewer/Inspector Name f A
Phone:
Reviewer/Inspector Signature: Lf
Date: Z D
Page 2 of 3 12128104 Continued

Facility Number: — T11 Date of Inspection Z
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes eNo ❑ 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 El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
Yes
❑ No ❑ NA ❑ NE
aste Analysis El Soil Analysis El Waste Transfers
❑ Waste Application ❑ Weekly Freeboar;11920'
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield Minute Inspections ❑ Monthly and 1 " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No ❑ NA ❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
��No,❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes�aZNo
❑ NA ❑ NE,
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑Yes
❑ No A ❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
o ❑ NA/❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
❑ No LWA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31, Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
I I fJtri�` - f� �
n'I Car- �,1 S �� c��. S� •-ram-e 7 b
Page 3 of 3 12128104

T9, xurl:.i
4 4
y ixc..
Type of Visit CPdompli Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Fa ' ity Number Date of Visit: ime: Printed on: 7/21/2o0(
el I
Not Operational O Below Threshold
ermitted 0 Certified ❑ Conditionally Certified [] Registered ' Date Last Operated or Above Threshold•
Farm Name: ..`i/ l!!-:. f r! Q............"��. . ................................. Count ................
OwnerName:................................._................................._.._...................._........................_.... Phone No: .......... .............................. _...............
FacilityContact: ............................................•---.............................. Title:................................................................. Phone No:
.Flailing Address:.......................................................................................................................................................... .....................
Onsite Representative: ................•........_................................_........__....... Integrator: .... ......... ........................ ......... _................................
Certified Operator:
Location of Farm:.
I ............................................. Operator Certification Number: .....................................
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current
awine
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
!❑ Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity population Cattle Capacity Population
❑ Layer I I ❑Dairy
❑ Non -Layer I I I0 Non -Dairy I Ij
❑ Other I f I
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present j ❑ Lag—, Area lospray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impact-,
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 Ilow in gal/min?
ct Dries discharge bypass a lagoon system'? (if yes, notify DWQ) ❑ Yes
2. Is there evidence of past discharge from any part of the operation? ❑ Yes
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Y ❑
Su-u4lun: I StRidure 2 Structure Structure 4 Structure 5 Structure 6
—%
ldo n ti { IC1 : ..........OL.................. ................�.............. ......................
Frc;choard (inc;heO:

itacttity Nuumber: Date of Inspection t Printed on: 7/21/2000
5. Are themany immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are then: 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 maintenancelimprovement?
9. Do any stuctures lack adequate; gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are these any buffers that need maintenance/improvement?
11. Is there evidence of over application? []Excessive Ponding P PAN [:]Hydraulic Overload
12. Crop type
❑ Yes No
❑ Yes
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes
❑ Yes No
13. Do the receiving craps differ with those designat4 inrthe Certified Animal Waste Management Plan (CAWMP)? ❑ Yes EfNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes
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?
Regpired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
1.8. 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 reviewtinspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. -Were any additional problems noted which cause noncompliance of the Certified AWMP?
10 yiolath)> s;o�r dgficiencies -were poted• dt�rring this'visit' • Yoo will t eeeiye po #'p thin
r6 respondence. about: this visit
❑ Yes
❑ Yes o
❑ Yes
❑ Yes No
❑ Yes No
[I Yes N
❑ Yes
❑ Yes
❑ Yes No
❑ Yes
❑ Yes ZNo
❑ Yes No
❑ Yes ❑ No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Insoector Name
Reviewer/]nspector Signature:
Date:
5100

Type of Visit co lance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Vis' O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 0 G> Arrival Time: Departure Time: County:
Farm Name: a z_� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ W -to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Title:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Region:
Back-up Certification Number:
Latitude: = e = 6 = Longitude: = ° = 6 = „
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laye
_- - - -
❑Non-L
-ayer
Other
❑ Other {
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No❑ NA ❑ NE•:
ty
❑ Yes ;No
'No ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes N 0
NA El NE
❑ Yes;No NA ❑ NE `
❑ Yes o ❑ NA ❑ NE i E
12128104 Continued
_�'i

r I R
Facility Number —
Date of Inspection I it I Y �Ifj
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 7No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in; 41I(
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes I/Nc ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ElYes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental thre ;notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes N ❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No 0 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 El Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift I❑ Application Outside of Area
12. Crop type(s) (ic} "f 1�4SCt, 2 . -'M43"-w ^ , CII be. S
13, Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15, Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination !❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
VNo ❑ NA ❑ NE
ILl N ❑ NA ❑ NE
❑ NA ❑ NE
N ❑ NA ❑ NE
No ❑ NA ❑ NE
�_nne✓'1�•�(]Q�I '5r yflu
�CAJ¢.•`i
7e-�- e Slu��cSt�ru2y
fc4afk t,,;iOq
Nt7 r n: �SS``ejC UC ��
200�
an S�i.art�C Sc�rv�y
��2 ��r
60'f- Zov4.
Reviewer/ins ector Name c y Phone:
P _
Reviewer/inspector Signature & Date:
12128104 Continued

Facility Number: — () Date of Inspection
Required Records & Documents
�
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
El
NA
El
20,
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
;No❑ NA
❑ NE
the appropirate box.
❑ WUP El Checklists El Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Flo ❑ 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'?
[I Yes
NV ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Ng ElNA
ElNE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No ❑ NA
❑ NE
No
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�3 ❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
N [I NA
[I NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
VNo ❑ 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
r
A'dditio`nal�Cornmentsand7or,'Drawli s°�
g
x�. 'a'� -
�� +'� s� "t"t�
�� a,.� �<
12128104

I Z7
(Type of Visit: VCompliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: � Arrival Time: Departure Time: County:
Farm Name: YY\ pi' j C--1 a,((—`f Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: (.)rip Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Other
Latitude:
on -La
Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Phone:
Certification Number:
Certification Number:
Longitude:
Cow
Cy alf
y Heifer
Cow
Beef Stocker
Beef Feeder
Beef Brood Cow
Region:
❑ Yes [7No ❑ NA ❑ NE
❑ Yes �Ko
❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
El Yes] o NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes 2No ❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facili'Numbey: - D Date of Inspection: (j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ff No j . NA ❑ NE
a, If yes, is waste level into the structural freeboard? ❑ Yes o ❑ 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 No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental t at, notify DWQ
7, Do any of the structures need maintenance or improvement? ❑ Yes N ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ` No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑, FAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):r�-
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑Yes
,rN❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
NA
❑ NE
acres determination?
17, Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
INo
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
0140 ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers Weather Code
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No ❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facilirt Number: Date of Ins ection: 11.
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes VNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check El Yes❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes VNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No 'NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ LagoonlStorage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA ❑ NE
❑Yes ❑No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
0 NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ##): Explain any YES answers and/or any additional, recommendations'or any, other, comiiients
Use drawings of facility to better explain situations (use additional pages as necessary):
G- mot.-- r 3 1 t k(� su.-✓.g y
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: YT- f
Date: f N-
2 412011

2- 2l—/
Type of Visit: Compli a Inspection Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: L ( Arrival Time: 4"0 Departure Time: SO County: Region:
Farm Name: _41A y ry t„ f Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
r
Certified Operator:
Title:
Phone:
Phone:
Integrator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Design Current Design Current
Design Current
Swine Capacity Pop. Wet Poulif Capacity Pop.
Cattle Capacity Pop.
Wean to Finish La er
Dairy Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
Dr, PAoultr,, Ca `acit P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qt1Ferjllllllllll
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes No ❑ NA ❑ NE
[:]Yes K"o
❑ NA ❑ NE
❑ Yes [ ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ YesrNo
❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: jDate of Inspection: 2
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
es
❑ No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
VTNo ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 16 r r
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[:]Yes
No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health ar enviro al threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
Yes
❑ No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E3 1'To ❑ 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
L211qo`_ ❑ NA
❑ NE
maintenance or improvement?
Waste Apmlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
f`-' - - ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s): ��! � ►� . 4 t- 14 ACo-11? Ciry'E�
�l
13. Soil Type(s):
,4
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
,r
iff No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
TNo ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[El -'No ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
ENo ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Ko ❑ NA
❑ NE
the appropriate box.
❑ WUP []Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall. ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

IFacility Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check es ❑ No ❑ NA ❑ NE
the �ailure
ro a box(es) below.
to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
❑ No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31, Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[]Yes
❑ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[:]No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[] No
❑ NA
❑ NE
Comments (refer to question #): Explain any.YES. answers and/or any.additional recommendations or, any other comments.
Use drawings of facility to better explain situations (use additional. pages as necessary).A'
! 61 �j IC � 44 � /t �� f _ l ✓l / d n T `� S'Lj� j ri �a�-i ° CGS f M l�p
Jq
t
Reviewer/Inspector Name:
Reviewer/Inspector Signature: �, S-�� 7H, ,e_ l%
Page 3 of 3
Phone::.. �1~ �r2 ar.,
Date: l r a'
21412011

Type of Visit: Q0 Com ce Inspection U Operation Review () Structure Evaluation C.J Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: j 1 Arrival Time: G/ , Departure Time: County: Region:
Farm Name: �y�1,.� „ t,/@ �✓f} �-� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator; (�j tp .g �/7t y (] Y� Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design
Current
, Design Current
Design Current
Swine Capacity
Pop.
Wet Poultry Capacity "Pop. Cattle
C►►apacity Pop.
41
Wean to Finish
La er Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current
DEX Cow
Farrow to Feeder
D,r P�oultr.
Cap .aei P■o P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Othe
ITurkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ NA
Q NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
No ❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
[:]Yes
o ❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[] No ❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3
21412011 Continued

Facility Number: & t1c- Date of Inspection: / Z 1 f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier.
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): L 1 2 ! J
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
Zo
�'❑NA ❑NE
❑ NA ❑ NE
Structure 6
❑ Yes ONo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental t eat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes VN
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ 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 2 No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Z/No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload [3Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 0YrJ 1n 5 , 5-M
13. Soil Type(s): /
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
L?1'N NA
[3NE
15. Does the receiving crop and/or land application site need improvement?
[] Yes
N NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[] Yes
VrNo ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
C] Yes
❑ NA
ONo
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No ❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
ElWaste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspectio ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes `❑ No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - V jDateof Inspection: Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �oD
NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes NNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 9 o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑Yes ❑No DNA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑NA ❑NE
❑ NA ❑ NE
❑ NA [] NE
Cornments (refer to question ft Explain any YES answers and/or any additional 'reeomm6fdations'or any other coniinents. '
Use drawings of facility to better explain situations (use additional pages as necessary).
5�h /g< SUir ✓e y
54
Reviewer/inspector Name:
Phone:
Reviewerllnspector Signature:
Page 3 of 3
61 tr 54?1L Cd L✓�L t!�
G
Date: 1 Z { (2- 1
21412011
I

1 V
M
Type of Visit Zoom nce Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time; �� County: Region:
Farm Name: M 01=JFf C� P ( A n. Owner Email:
- Owner Name: `7 L,1C, S Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative::
Certified Operator: S�f� �`�'� (Z=
Back-up Operator:
Location of Farm:
Title:
Phone No:
Integrator: m ......8 s„...,,,'.,.,_._„
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = ' 0 Longitude: ❑ ° a 0 {f
Design Current
Swine C►apacity Population
Design Current
Wet Poultry Capacity Population
III
Design Current
Cattle Capacity Population
❑ Wean to Finish
10 L,a er
❑ Daia Cow
[IWean to Feeder
❑ Non -Layer I
I
El Dairy Calf
ElFeeder to Finish
❑ Dairy Heifer
ElFarrow to Wean
ElFarrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
pry Poultry
❑ Layers
❑ Non -Layers
El Pullets
❑ Turke s
❑ Turkey Points
I 1E1 Other I I
El Dry Cow
ElNon-Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures: E
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State`? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2, Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes ., No ❑ NA
❑ NE' r
e
i;
❑ Yes N NA
ElNE
❑ Yes o ❑ NA
❑NE „ J`
A
❑ Yes/NoE1
❑ NE'
❑ YesNA
❑ NE
❑ YesNA
❑ NE::;
12128104 Continued
� N

Facility Number: —
Date of Inspection I a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1 Z �r
5. Are there any immediate threats to the integrity of any of the structures observed?
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No NA ❑ NE
❑ Yes o ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes �No
A ❑ NE,
El Yes ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental thr , notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes N ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ElYes No ❑ NA ❑ NE
maintenance or improvement?
Waste Aaulication
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 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)` $p n�
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2N ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[] NA
❑ NE•
17. Does the facility lack adequate acreage for land application?
❑ Yes
YEINA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
•Comments/(refer td question:#) Ezplatn any YES;, answers and/or any recommendations or#any other (comments" .
Usedrajvmgsof�facthty�tobe'tterezplamaituahons. (useatidrtrogal pagesasriecessary);
:. _.� . �.;��� ��. 4:�,; e
ReviewerllnspectorName {� _ `.' t�, ��, $_i, �.: �4 Phone: 7��� /�zJ
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: ' — Date of Inspection Z i=
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 7No
El NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Z <""E3 NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
3 I. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑YesVNoEINA
A ❑NE
YesA ❑ NE
❑ YesA ❑ NE
❑ Yes ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Additional Comtnentsand/or Drawings: % ' Ia.�til�,y§� '�
a
Page 3 of 3
I2128104

(Vision of Water Quality
Q Division of Soil and Water Conservation
Q'Other Agency
of Visit (>d-omplianpegnspection O Operation Review O Lagoon Evaluation
Reason for Visit Q06utine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Nunther Date of Visit:� � Three: n Q Printed on: 7/21/2000
Q Not Operational Q Below nreshold
Permitted ©II..Certified 13 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
Farm Name: .[l4hJ ,t?.........V"t'. .I..... - ....................................... Count,: ,!f/d.r .7?`1 .r .. ...............................
OwnerName:........................................................................................................................... Phone No:.......................................................................................
FacilityContact: .....'Title: ................................................. Phone No:............................................................................................................................ ...............
Mailing Address:
Onsite Representative:.......................................................... integrator: .......................................
............................................... T1 �.. --5—...
Certified Operator:....._..C ......�!..G ij......... Operator Certification Number:. .........................................
........................
Location of Farm: L 5' 1
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �° ��� Longitude �• �`
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ W io Feeder ❑ Layer ❑ Dairy
ecder to Finish ❑ Non -Layer ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder 10 Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons I ❑ Subsurface Drains Present 110 Lagolon Area IEISpray Field Area
Holding Ponds / Solid Traps 1 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? [—]Yes �21 O
Discharge ori,;itiatecl at: ❑ Lagoon ❑ Spray Field []Other
a. If discharge is observed, was the conveyance than-madc'? ❑Yes
b. If discharge is observed. did it reach Water of the Stale? (if yes, notify DWQ) ❑Yes td`""
c. if discharge is observed, what is the estimated flow in gal/thin'?
d. Does discharge Bypass a lagoon systeni? (If yes, notify DWQ) ❑ Yes ICI ►� 2. Is there evidence of past discharge from any part of the operation'? El Yes o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [3 Yes o
Waste Collection & 'Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway ❑ Yes eNo
StIcturc l StRLCturc 2 Struc,ture 3 Structure 4 Structure 5 Structure 6
Identifier: ............................................................................,.....................................................................................................................................
Freeboard (inches):
5100 Continued on back

Facility umber: Bate of Inspection / Du Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of 'the structures observed? (ie/ trees, severe erosion, ❑ Yes Z �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 I2'1�o
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require 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 maintenancelimprovement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type �`�" � 49vAk, As'. ( h v 5 � o
❑ Yes 21 O
❑ Yes Ld'No
❑ Yes
❑ Yes No �
❑ Yes �
13. Do the receiving crops differ with those designated in the Certified AAnimal Waste Management Plan (CAWMP)?
ElYes ❑'No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes 0
b) Does the facility need a wettable acre determination?
❑ Yes o
c) This facility is pended for a wettable acre determination?
❑ Yes o
15. Does the receiving crop need improvement?
❑ Yes No
16. Is there a lack of adequate waste application equipment?
❑ Yes 0
Required Records & Documents
17. Fail have Certificate Coverage & General Permit
to of readily available?
❑ Yes No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available'?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
19. Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
El Yes No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes 4t' 0
21. Did the facility fail to have a actively certified operator in charge'?
❑ Yes o
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, Freeboard problems, over application)
❑ Yes o
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes o
24. Does facility r re a follow up visit by same agency'?
❑ Yes ❑ Ije�'
25. We ny additional problems noted which cause noncompliance of the Certified AWMP?
❑Yes I�'No
NO A61bitidiis :or• &flciencie5 were hWo. il&ing •this: visit: • 'Yciix 'Will •r, eceiye •rio further - : • : -
corresp ondence. about: this visit. .
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
.
Al
t�
Reviewer/Inspector Name (�
Reviewer/Inspector Signature: Date: 5100

r. +
Type of Visit Q Co�outie'
Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
ility Number Date of Visit: ,�1? D Time: S3 O
18 Not O erati nal Below Threshold
Permitted [3 Certified [3 Conditii pally Certified [] Registered Date Last Operated or Above Threshold:
Farm Name: `1 11 Q- �.S County:
T !T"
Owner Name:
Mailing Address:
Facility Contact:
Title:
Onsite Representative:
r
Certified Operator: 2
Location of Farm:
Phone No:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry []Cattle ❑Horse Latitude • ` 66 Longitude 00 ram' 0"
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca aci Population Cattle Capacitv Population
❑ n to Feeder ❑ Layer I ❑ Dai --
Feeder to Finish I III ❑ Non -Layer] ❑ Non-Dai
El Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts '
❑ Boars Totai„SkW ,
Number of Lagoons i ❑ Subsurface Drains Present ❑ Le oon Area ❑ 5 ra Field Area I
ti -
g iloldmgzPondsliSohd„Traps, ❑ No Liquid Waste Management System
4
Discharees & Stneam 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
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
r G
Freeboard (inches):
05103101
❑ Yes No -
❑ Yes
❑ YesjNo
❑ Yes DIN
❑ Yes FNo
❑ Yes
El Yes
Structure 6
Continued

4
Y .
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? Oe/ 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 AUplication
I0. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
❑ Yes No Zf
❑ Yes No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
5 N
No
No
No
No
No
❑ No
❑ N
No
lb, is there a lack of adequate waste application equipment? ❑ Yes o
Required RecgrdE 4c Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes o
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 N
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes N
21. Did the facility fail to have a actively certified operator in charge? ElYes No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes
24. Does facility require a follow-up visit by same agency? ❑ Yes
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yesj No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
�c.urawuigs u� xauniy iu uei�er eapiniu auuauvua tine auu��junui pages°as neee��ar ❑ Field Copy Li Final Notes
rr
ReviewerllnspectorName
Reviewer/Inspector Signature: Date: v
05103101 Continued

Type of Visit 0 Czoutine
e-Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Complaint O Follow up O Emergency Notification O 0ther ❑ Denied Access
Facility Number bate of Visit: Time: O
Q Not Operational O Below Threshold
© Permitted [3 Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
FarmName: (� i.�'�1..�7../ `.T!...^ ............................... County:.....................................................................................
OwnerName: ........ lr'` ! ..`{..fit.4e .......1!". :.. ..... ............................................Phone No:..........................................................................
MailingAddress: ..................................................................................................................... ..................................................................................... ..........................
FacilitvContact: .............................................................................. Title:................................................................ Phone No:............................... ....................
Onsite Representative:......................................................................... ..... Integrator: .�p { _
............................. ............................. ..............
Certified Operator:....... ,_s........
' .......................................................... Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 -144 Longitude ' 6 64
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in 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 S
❑ Yes D44O
❑ Yes
❑ Yes o
❑ Yes
❑ Yes VNIo
❑ Yes
❑ Yes No
Structure 6
Identifier: ..........................................................................................................
Freeboard (inches): tt
12112103
Continued

Facility Number: 1,,rl— Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ 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
S. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
o
elevation markings?
Waste Anylication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
io
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type J
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
I5. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
El Yes
� o
Odor Issues
17. 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?
18. Are there any dead animals not disposed of properly within 24 hours? El
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes
Air Quality representative immediately.
.�' ���.,. �:, sm,^h5rr'NLi,.t. E tr,r^ r t. _ , ,n, °:.r, �!:r.!^.. .§�. ;rr:x�ut ..�sre ^^gut s.. ..,�.•i�.s:i, . sr:.'�:i„ r� r �n rr«a.:€..,az:;±iaE?`sj'l �;ar! c�.ni: n.Ei;E!�.r,Eu!t;�-�f,`�'���[,��.,�,��• t r E•�� ;y ��
;'Ca�iunents (refer;to,queshon:#) Explaun any�YFS arnswers and/ar ar�y�recn�amendatrous;ar;anky�othercomments. €;t �,�ei�, ,(E�p��l,p4 „,j,,�
�E4 t..9 7, :::, - �:; � • ..rr � E �'�:i;a ':i:4�t ats€jt�v!li.ra ..E.. 3tW,Ec,c .^,a4-..x ,!°..9�r §"°.14.,4�,:i.c. E,'.: °:�&.1'11;09➢ 7 €,ia. r°»e�:�Y'dG'`a:.a^.:, atYik`.. t IKu.Ytf:.t. - ..t `Y',�r,+..=.:,�::...-��:aw;r,.� w.au..a..:.::..c nw,.tix���iL<,a�xud�lk�Si'.i i; � a � �..�taEEys
Use drawings af�facrhty�ta better�expla�n�situataaus. {use'addat�onal pages asfnecessary):,�s>' #. Field Co V Final Notes �j ,�6,,,�,;.�:;
�i:t a � §E 55 3 � e K ,, a .dd tP ^:r a8ae a€ r ' �x,. (( 99e 66 [+ ti s E aE a " ?FF .E ,t f� ; ❑ pJ ❑ f� t i{i � -
i E B 6i to :1, "�', i3 £", a 3 - 90''•, ti+"' �:i tF .� �Y} i8d e � ,1..,,( • � 3t t . K5a i ai•fd E,E E i E§ 9 �i..g - 3 i,3 d & i
°<: $r;•, �§ �,I, i3r {{? t ` pp6 �>tEti, t f i , �!i &�} : Et 1. ,a . E , @(. E�E � 'i , tx }. .t ��ri°a�ii:' ',3' tr o!" €'i'i 4ag P>
ra; z3E El�, €,,,€._sal. a$,d,.. l.,�t � I � Laa•�r _> x,f� , as€�§e'..z p; { p .,,.<
p5" .I „ k t �� t; �r^• ^ h t E t��i r r§ UtM
Reviewer/Ins ector Name �k , E C �r�r ���,.�
Reviewerampector Signature: Date: e
12112103 Continued

Facility Number: — d Date of inspection /
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(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?
es o
❑ Yes No
❑ Yes o
❑ Yes o
1<
❑ Yes No
❑ Yes �No
ElYes No
❑ Yes Ia 1V o
❑ Yes No
❑ Yes
z'
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 Form [:]Crop Yield Form ❑ Rainfall [:]Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

1 iV1510[l OF Water. Quality
I
��
i ° @
If
Q DlvisioiiE of Soil and Water Conservation
>" p4
[3�! f!33I i
EE E�l,ilE_ ,Si
<
r' tk Ik
P. ther__Agencyr
d Q 6,.-{ [
I
ii 3iii 11
g;,tiEry-i"
iE€ tE,:iF3,
Type of Visit
Com nce Inspection O Operation Review O Lagoon Evaluation
Reason for Visit
O Routine O Complaint O Follow up O Emergency Notification
O Other
❑ Denied Access
-ErFacili y-Number Date of Visit: '? // 0 Time: ® Printed on: 10/26/2000
Q Not Operational Q Below Threshold
ermitted [j Certified © Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
.Farm Name: . ..... (/ll.iC...�...�.................... County: Y: ..............................................................................
Owner Name: ........
Facility Contact:
Mailing Address:
......... Phone No: .....................................
............... Title:................................................................ Phone No: .................
.......................................................................I........................................................................................................... ............................
On.site Representative: Integrator: (?71'
...........I .............................
Certified Operator:.,... .. �� S Operator Certification Number: ...........................
Location of Farm:
�
[]Swine ❑ Poultry []Cattle []Horse Latitude 0 6 �_�- Longitude • 4 "
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ W o Feeder ❑ Layer I 1 ❑ Dairy
gr-Feeder to Finish JZ %:P-V JE1 Non -Layer I I 1E1 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoonsy 10 Subsurface Drains Present �j❑ Lagoon Area I❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
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? ([I'yes, notify DWQ)
c. II'dischargc is observed, what is the estimated flaw in gal/min?
d. Does discharge bypass a lagoon system? (Ifycs, notify DWQ)
2. Is there evidence of past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Slrllc[Ure I it Structure 2 SLrUCtUrc, 3 Structure4 Structure 5
Identifier............................................................................................................
................L.......................................
Freeboard (inches):
5100
❑ Yes
No
❑ Yes
❑ Yes
No
❑ Yes ZN
❑ Yes No
El Yes o
❑ Yes o
Structure
....................................
Continued on back

Facility Number: — Date of inspection E'f=�� Printed on: 1/9/2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes
(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 eN<o-
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes "o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ld'No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes o
IL Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes J� ""
12. Crop type /tai Q�r ,� 2 t t ej- .
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes
14. a) Does the•facility lack adequate acreage for land application? El Yes iw�
b) Does the facility need a wettable acre determination? ElYes o
c) This facility is pended for a wettable acre determination? ❑ Yes
I5. Does the receiving crop need itprovement? ❑ Yes
16. Is there a lack of adequate waste application equipment? ❑ Yes
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes o
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 a'No .
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes I�VO
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes o
22, Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, Freeboard roblems, over application) ❑ Yes Flo
23. Did Reviewer/ins for fall to discuss review/inspection with on -site representative? ❑ Yes
24. Does facil' require a follow-up visit by same agency? ❑ Yes o
25. Wer ny additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes o
yiQla�iQlis:o� d�feienc�e5 wire pgte41 �4Hin9 �hjs:visit; , Y:ojt wiii•te giYe o' Fu>�-thgr'
.. coriesnorideRce:abutit:this'visit:•.•.•:•:::..•:•:•::...•.•:...•.•.•::.•.•.•:•:....:. .

Facility Number: p — d
Date of inspection �O Printed
on: 10/26/2000
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
o�
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
�tsio
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
<No
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
0
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
32.
Do the flush tanks lack a submerged fill or a cover?
❑ Yes
To
pipe permanent/temporary
Additional Comments and/or
Arawrn
_-
J
s/00

(Type of Visit p Compliance Inspection p Operation Review O Lagoon Evaluation I
Reason for Visit p Routine p Complaint p Follow up p Emergency Notification p Other ❑ Denied Access
Facility Number Date of Visit: 4/f4/2Q00 Time: 0 Printed on: 9/22/2000
p Not Uperational p Below Threshold
p Permitted N Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: ........................
Farm Name: WAYU.. 3 j'&t....................................
Owner Name: Wayne .....................
Facility Contact: ......................
............... County: Morthaxuplun.................................. RRO............
.. West............................................................ Phone No: 9.29:53.6 457R..........................................................
Mailing Address: At.1..Roa.33.7..................
........................Title:
Onsite Representative: \?!'.ay. e.wW.Er.ir.. .est.........
Certified Operator:Eric..W..................................... Wesa.................
Location of Farm:
Phone No: ......................................
J.u.ks=NC............................................................ 2I8.45
......., Integrator: Carr.oil's.F.oads..af.YA,.Inc..................
Operator Certification Number: 19.235.............................
N Swine ❑ Poultry p Cattle ❑ Horse Latitude ®o Longitude ©• ©®�
❑ Wean to Feeder
® Feeder to ims
.
❑ Farrow to can
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
1. Is any discharge observed from any part of the operation? p Yes ® No
Discharge originated at: p Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes N No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes 11 No
2. Is there evidence of past discharge from any part of the operation? []Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? []Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: .......... px7ut7 0W.......................131a..
Freeboard(inches): ...............4.6..............................4.6...................................................................................... ...................................
S/nn
[]Yes ® No
Structure 6
.............................
Canlinuod an hark

S�0 Continued on back
Facility Number: 66_60 Date of Inspection ® Printed on: 9/22/2000
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? p 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? p Yes N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid Ievel
elevation markings? ❑ Yes N No
Waste Application
10. Are there any buffers that need maintenance/improvement? []Yes H No
11. Is there evidence of over application? p Excessive Ponding ® PAN ❑ Hydraulic Overload ® Yes p No
12. Crop type Fescue (Hay) Small Grain (Wheat, Barley,
13. Do the receiving crops differ with those des ignate7tiV the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes N 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? p Yes H No
16. Is there a lack of adequate waste application equipment? ❑ Yes Ig No
Keauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ® No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
N No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
[]Yes
Ig No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
p Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
Reviewer/Inspector Name
Reviewer/Insnector SiEnature:
Date:
e inn

Division of Soli end Water Conservation'"'Operation Review �w b°'A 4 .�'A�
.ice
S.vt r
0`Divisi&i of So11 and Water Conservation?- Compliance Inspecuon�
L7hDivision o17Water Quality - Compliance.Anspecaon ' i�•;*x,�!- „ a
r J r9 kaaar f"r <s r is, k/firx� ss
i 0 Other. Agency Operation Review +b ► t; r z t
....°kwc+w.rr �e.+, , e...a.. _rZ,9 .➢r:.- .r._ ..� 'Ht:'
Routine 0 Complaint 0 Follow-ue of DW ins cction 0 Follow -tip of DSWC review 0 Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
0 Permitted 0 Certified [3 Conditionally Certified © Registered 10 Not O erational Date Last Operated:
FarmName: ............................................................................. ...... County:.....................................................................................
OwnerName : ........................... .......................... .................................................................... ..... Phone No:.......................................................................................
FacilityContact:.............................................................................. Title:................................................................ Phone No:.......................................
MailingAddress: ...............,....}.......,......................................................)....,....,.........,........................................................q.................................................................
Onsite Representative:../�!�r.�...lr........... E�1..(.......!%5 O,0---------- Integrator: cL.l..xx�f _L5 4? `�.............................
...............................
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm: .
Latitude Longitude �• �'°'
;:::. ,• w_;: . Design, :,, Current
swine
❑ Wean to Feeder
eeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Boars
ro
Design . Current =' Design:.:' .°Current_
Poultry Capacity' Piiulat on Cattle y Ca" aci ,.Po iulation
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Otherr
Total Design _Capacity...,-_ .; .___ ...__.._..........
Total SSLW
Number of Lagoons' �r ❑Subsurface Drains Present ❑.Lagoon.Area,: ❑ SprayTiEAr
Tr
To
IHolding Ponds /Solid Traps ❑ No Liquid Waste Management System'
" z.
Discharges & Stream Impacts ^
1. Is -any discharge observed from any part of the.operation? _ J ❑ Yes /6 No..
Discharge origimited at: ❑ Lagoon ❑ Spray Field ❑ Other
a.. If discharge is observed, was the conveyance man-made'? ❑ Yes A No
h. If discharge is observed, did it reach Water of the Stale? (If yes, notify DWQ) ❑ Yes /46 No
c. If discharge is observed, what is the estimated flow in gal/min!
d. Does discharge bypass a la goons ~term?? If. es notify DW ❑ Yes zNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3.' Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Svucturc')
Identifier: ;MN— L
Freeboard(inches): .y...................................................................................................... I....................... .................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, [] Yes No
seepage, etc.)
3/23199 Continued back

Facility gurnber:bb— 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 Gr) TV /t/
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 a[] components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigations d, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria i�i effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
/Yes ❑ No
❑ Yes /No
❑ Yes EINo
❑ YesIdNo
❑ Yes XinNo
❑ Yes 9No
❑ Yes No
❑ Yes j Na
[:]Yes No
❑ Yes ONO
❑ Yes/P11
0
❑ Yes VNo
❑ Yes A!"No
❑ Yes ej No
[:]Yes Zf No
❑ Yes INO
22. Fail to notify regional DWQ of emergency situations as required by General Permit.
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss reviewhnspection with on -site -representative? ❑ Yes No.
24. Does facility require a follow-up visit by same agency? ❑ Yes No
25. Were any additional problems noted which cause noncompliance df the Certified AWMP? [] Yes No
i�} yiQT�>�igi>js oar dc}eocies v��re pQte�3 dittg this'vist� Yost wii� ye rho #'u;tier
corres�ont�ence. a'both this .visit.. . . ... . ......... . ..... ... w'

Facility Number:tL_j Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes Q'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 JONo
28. Is there any evidence of wind drift during land application? (i.e, residue on neighboring vegetation, asphalt, ❑ Yes INO
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes - No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes VN0
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes YNo
3123/99

QDSWC Animal Feedlot Operation Review
0 DWQ Animal Feedlot Operation Site Inspection
Routine 0 Complaint'. 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
De to of Inspection I 37Y/
Facility Number
µ Tittle of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex;1.25 for I hr IJ min)} Spent on Review
Certified ❑ Permitted or Inspection (includes travel and processing)
Not Operational I Date Last Operated: .................................................................
Farm Name: Count':... l V C}1�1y1.1....:...L.l�.........................
OwnerName: ............................................... ... ......... I .............................................................. Phone No:.......................................................................................
Facility Contact: ........ ..... Title: ... Phone No:
MailingAddress;........................................................ .................................................................................................................................................. ..........................
Onsite Representative
p ....1!.v. �.Rrf ..�............ ..........`.?....1............................ ...,.. Integrat�r:..........t
Certified Operator: ................................ — ............... .............................................................. Operator Certitication Number .........................................
Location of Farm:
=5C
Latitude • 4 49 Longitude • ° :6
T e of O eratton :, ....::..
YP P Destgn "Current . >` Design Current Design' Current
Swine Capacity Populatton - PaulEry Capacity Population Cattle Capacity Population
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Other
Number of La Dons 1 Holden Ponds ❑Subsurface Drains Present ©I,ag ❑ non Area SP Y ra Fiel
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation'?
Dischar`e originated at: ❑ Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is obsen'ed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in oalimin7
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
413 D147 mai n tenanceli mpro ve ment?
Cl Yes ONo
❑ Yes eNo
❑ Yes eNNo
❑ Yes 00
❑ Yes 00
❑ Yes R<
❑ Yes eo
❑ Yes P
o
Continued on back

Facility Number:
S. Are there lagoons or storage ponds on site which need to be properly closed'! ❑ Yes [�?No
Structures _( agoonsLiolding-Ponds . Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? El Yes P4 No
ructure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: 114 107 - 49 -1 .. .......... 5-�C� ...... I_- ........ ........ I .......................... ........... I .......................
............
................................
Freeboard (ft): . ........... 7.... . ......... ....................................
....... I ............................il..
10.
Is seepage observed from any of the structures?
El Yes
0N0
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
E]Yes
gNo
12.
Do any of the structures need maintenance/improvement?
Oyes
[:1 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?
El Yes
1No
Waste Application
14. Is there physical evidence of over application?
rl Yes
6 No
(If in excess of WTvlP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ...... J/, . . ....................................... I....., . ......... I ....... I ...... . ....................... ................................. ....................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
ONo
17.
Does the facility have a lack of adequate acreage for land application?
0 Yes
4N.
18.
Does the receiving crop need improvement?
0 Yes
0 No
19.
Is there a lack of available waste application equipment?
❑ Yes
O'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?
0 Yes
VNO
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
0 Yes
UrNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
0 Yes
No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
�No
No.violations 'ar'de'ricie'nc'ie's'were 'n'ot'ed,d'uiing this'visit.. YO'u',W'ill,r6c'ei've.no-ftiriher,'-
................ .........
OfresOOiidehO About -this'. visit.
/n 6
el' A-1,14 /-71
t-)k JO / /_70,1V'-
P iL 5 E- <�-ev E
a/11 O-e-0 L-Cla-T- )
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signaturev7,,/��� Date:

7N
13 Dimon of Soil and Water Conservation ❑ Other Agency
of Water Quality
Facility Number
Date of Inspection f 3
Time of Inspection E= 24 ha (hh:mm)
0 Registered Certified 0 Applied for Permit 13 Permitted JE3 Not Operational
I Date Last Operated: ,,,,,,,,,,,,,,,,,,,,,,,,,,
Farm Name:lOWFI,¢�LJ ��9�'fe�i' Count /"D/��c�l
................................................. Y:.................................................................................
OwnerName:.... ..%..� i. G..... W. L S _......................................................... Phone No:.... ZS�Z....-..... ; ..... y.s.... .............
Facility Contact: i ✓GS .................. Title:................................................................ Phone No:......................
Mailing Address: .r4l].....I I3 OK 33 . � Ji t 19/C, x J.........................................
...................
Onsite Representative:...
.......
W.� J....l......................................................
Integrator: ..... ....%.v 11 I %.......................................
Certified Operator:..... %...
C..........G
..............................................
Operator Certification Number ........................................
Location of Farm:
0 V (J>q
Latitude 0•t_J,=« Longitude 0'0'0"
Design ' ;CurrentDesign Current
Designs Carreut , ;
a�Sw)ne gh a =Capacity Population',
'Poultry . , Capacity-Populahon -
Cattle m" r''!
Capacity'1?opulation
❑ W rrto Feeder
a
❑ Layer °
❑Dairy
Feeder to Finish
CI l/
❑ Non -Layer
'
❑Non -Dairy
❑ Farrow to Wean
❑� Other
❑;�' Farrow to Feeder
Total Deslgn'Capacttp
r,
❑Farrow to Finish
❑ Gilts
t
❑ Boars
Total
SSLW -
g
,'
NNumber agoo /Holding Ponds ©' ❑ Subsurface Drains Present
❑ Lagoon Area ❑ Spray Field Area
. .: � 10 No Liquid Waste Management System
- �
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 gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes �No
❑ Yes l" "
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No

Facility Number: (4 (�y
8. Are there lagoons "o�r"storage ponds on site which need to be properly closed? ❑ Yes L3'No
Structures (L.aaoons,Holdina Ponds, Flush. Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes o
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...... , ' 1rQ; .?!G. e
............................................................................................................................................
Freeboard ft -� J z
10. is seepage observed from any of the structures? ❑ Yes o
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes o
12. Do any of the structures need maintenance/improvement? ❑ Yes a
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste_Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type f e...S..MQ.r..!` �.r .... 1�' -.,5
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?
I9. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any a tonal problems noted which cause noncompliance of the Certified AWMP?
25. W any additional problems noted which cause noncompliance of the Permit?
❑ Yes No
❑ Yes o
.....................................
❑ Yes �No
❑ Yes �<No�
❑ Yes
❑ Yes;�N�o
❑ YesN
❑ Yes o
❑ Yes �No
❑ Yes
ZNp,1-
0 Yes FNo
❑ Yes
Qj No.violations•or. deficiencies;were.noted.during this:visit: You:will receive•ntiAirtlier•:.
:•corresQoitdehceaboutthis:visat:•:•;:::�: .•�•. :: �:•..•;�.•�:�..•:•:- : :•.::-: .. .�

D ' .on of Soil and Water Conservation [3Other Agency
Division of Water Quality
10 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other J
Facility Number Date of Inspection 7 ,�
Time of Inspection 24 hr. (hh:mm)
[] Registered Certified [3 Applied for Permit © Permitted 10 Not Operational I Date Last Operated:
FarmName:.........I ........................................... County:....L..nAo"...........................
OwncrName: f � `mil sal ' ... ........ Phone No: r.......................:`... ..............
........................................................... ZS...?......... 8<f r/
Facility Contact: ,,,•,, ►�--- f ............................................... Title Phone No: ......
Mailing Address: J � ti//q � 17 -7�J...............I..,................... ..........................
........r..... :i7................._ .... ?.......7.................................................... ............
Onsite Representative: ... J91.1.../. :..`' S .'... ..e2e............................................ Integrator:..�........r.S...........................................
Certified Operator:-..........s _w-- L........... ...... Operator Certification Number; ..................
Location of Farm:
i
.................................................... ...
Latitude Longitude �• �' �"
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
0
��No
2. 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
IJdl`t!o
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
® o
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
ZNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
f
7. Did the facility fail to have a certified operator in responsible charge?
El Yes
7/25/97

Facility Number.
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LaaoonsMoldina Ponds, Flush Pits, etc.)
9. is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
r /
Freeboard (tt): ...........:...•
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13, Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ......... ............. .....--- ..?..��......Acn.....t�:f..l�:....�..... .............................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
IT Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Qnh
23. Does the facility fail to have a copy of the Animal Waste'Management Plan readily available?
24. Were anyad`ditional problems noted which cause noncompliance of the Certified AWMP?
25. )Kre. any additional problems noted which cause noncompliance of the Permit?
❑ Yes iei-No
❑ Yes o
Structure 6
❑ Yes
❑ Yes
• No
o
❑ Yes
a<
JpNo'vio'laifiolns', or. det-icienctes.were-noted,-during_ this,visit.- You.will rcei e'V&n' &fdrth:er-.-
CO about fhis'visit:' ; : : • : .
❑ Yes 2<0
❑ Yes CrNo
.........................
❑ Yes ,E o
❑ Yes No
❑ Yes IQNa
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 0
❑Yes eN
Yes CJ N
❑ Yes No

Facility Number:�-
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date:
Time: D elf
General Information:
Farm Name: Mold Fi e- P6i,4'-tL- County: rv"' �`14/W74"
Owner Name: �[�R'1��_rr 10_�_ Gye S _ Phone No: q Iq 41s'7 )?
On Site Representative: 5qN+ Ir _ _ Integrator: OA4,f-rd ft f
Mailing Address: ;Z± 16 o S 44-f o­ WC -
Physical Address/Location: ! 1W d�q c lU"r�+ �'�, e-
Latitude: 1 1 Longitude: 1 I
Operation Description: (based on design characteristics)
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
0 Sow 10 0 0 ❑ Layer ❑ Dairy
❑ Nursery ❑ Non -Layer ❑ Beef
U Feeder
OtherType of Livestock: Number of Animals:
Number of Lagoons: I (include in the Drawings and Observations the freeboard of each lagoon)
FacilityInspection:
Lagoon
Is lagoon(s) freeboard less than 1 foot + 25 year 24 hour storm storage?: i o '' Yes ll�No ❑
Is seepage observed from the lagoon?: Yes ❑ No U—'-'
Is erosion observed?: Yes ❑ No a ----
Is any discharge observed? Yes ❑ No El"_
❑ Man-made 01' of Man-made
Cover Crop
Does the facility need more acreage for spraying?: Yes ❑ No
Does the cover crop need improvement?: Yes ❑ No
( list the crops which need improvement)
Crop type: Acreage:
Setback Criteria —/
Is a dwelling located within 200 feet of waste application? Yes ❑ No—d`
Is a well located within 100 feet of waste application? Yes ❑ No ld
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream? Yes ❑ No
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? Yes ❑ No
AOI -- January 17,1996

Maintenance
Does the facility maintenance need improvement? YesIT'No a
Is there evidence of past discharge from any part of the operation? Yes 4No
Does record keeping need improvement? Yes U-'No ❑
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes Zr No ❑
Explain any Yes answers:--- 7k Gra-3�2n3 �'�3 ' off* _ F. e� a •�r d . „..
7:'4V4- Z-As eV , c^ "cc 0 F rem �e� w r
S + i IGvA � � n-c1 /�.eo.,,.� /.r,+9-/G � .� S +►`I • c�,t' `�rw.vr K � /�/..:r � T�o•./C .
W le G a ` 4 � ar S of e .9.7 � r a-�s d �u �g-f � �n►-. �5+ 5' �'.Ce
r
Signature: ~ �J Date:
cc: Facility Assessment Unit
Drawings or Observations:
Use Attachments if Needed
AOI -- January 17,1996

[]DS C Animal "FeedlotH operation Review j
W.Q Animal Feedlot:Qperation Site inspection$
-
°''"s�q"�
' Date 'of ;;Inspection ',Time .�of, Inspection:
Fac�Ei#y Numerx r
Use. 24,;hr time
Farm Status: 'S.�?� .••._- .... M ..... Routine [3 Com laint ❑ Follow-u
Farm Name: T �iDl �..X_.L .! ..��. "'...._. ....... County: riDv f�9 v./ "�`.... .............. ........
_
Owner Name: �n/�h._.. c S .._ ........ ... L�1W.r
7 ..... Phone No: ....._.._...........__...._........_...................
Mailing Address: .� DEG._! .. ....p c,�sS .'J``..._....C`. �' _.... ...... _
Onsite representative:` �._ !'��? . .._ ....... _ Integrator: CiYY�� s
Certified Operator Name: W �_.°4...C' �.�.GS ..r_.__..._.....__ ........_ ....._........ ...._ . ...............
Location of Farm: 1rAJ-? /j� 7 ryL �a`3' ii�J�-5 4 0f= 5�.��s0-k-,
Latitude Longitude
❑ Not Operational Date Last Operated: _...._ ...._ . ...... . ............................. .............
Type of Operation and Design Capacity
P, R '& ', d '� 'F-^1 �.,y #.. '+'R"�` SkiRle r. - 'Y 4::•,-:.
?fK ` '� *9�d Bch,'Yy i� a ,s%s. .,Y:. C 4'l F ::i'A 3aoP x,'� _ £'. ^r
f
Stniine.r,,._��_�
.Number_ 4Poultry x Ga
Humber 4.. t.teRV A�f.<..°, umber:..
13 to Fe
s Dairy
;.
Feeder to Finish
er.
Non -Laver, Beef
{�3{
El Farrow to Wean
-.2r.,bA,k1
�M4 K:k�`
`e9
Farrowspa;
to G
10 Farrow to Finish
3t "of N �S 3
.
�" `..Fi.!` ...i :a +�m>.4u.v..hW:t .:R.Me
❑Other Type Livestock
of
03
Ay Y.}S.0 f � .)S.F �. A 4>' ^fi �' i ,:f• �, { : � - {' '� Mf �', S( nP^" '.4yY `�l`.. Y�`X.'�"¢a"1'.3.- .�"'f 9Y^'vs � ,�S£ # - �
+�i
n w
Number�of agoo slHoidingPonds ❑Subsurface Drains Present ;
�v ke fig#� ❑Lagoon Area Spray Field Area Y
-� w= �
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes' kw
Lid
2. Is any discharge observed from any part of the operation? El Yes L� Nw
a. If discharge is observed, was the conveyance man-made? ❑ Yes
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWO) ❑ Yes Pao
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWO) ❑ Yes ,� I�lo _
3. Is there evidence of past discharge from any part of the operation? ❑ Yes Z No
4. Was there ny adverse impacts to the waters of the State other than from a discharge? ❑ Yes LQ Nb
5. Does any p o e waste management system (other than lagoons/holding ponds) require ❑ Yes iJo
maintenance/improvement?
Continued on back

_.
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)? ❑ Yes
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes
r Structures (Lagoons andfor W_ old!nq_ Ponds /
9. Is structural freeboard less than adequate? ElYes 01N
Freeboard (ft): Lago/on ) Lagoon 2 Lagoon 3 Lagoon 4
1 Q. Is seepage observed from any of the structures? ❑ Yes La W
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 maintenancermprovement?
❑ Yes
No
(If any of questions 9-12 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWO)
13.
Do any of the structures lack adquate markers to identify start and stop pumping levels?
❑ Yes
No
Waste Application
i
14.
Is there physical evidence of over application?
❑ Yes
Pilo
(If in excess of WMP, or runoff entering waters of the State, notify DWO) .•
15.
Crop type............. ....... .......... � .... _ .... _..... .
16.
Do the active crops differ with those designated in the Animal Waste Management PI n?
❑ Yes
❑ No
17,
Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the cover crop need improvement?
❑ Yes
2-No .
'No
19.
Is there a lack of available irrigation equipment?
❑ Yes
L
For
Certified Facilities gnly
20.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
21.
Does the facility fail to comply with the Animal Waste Management Plan in any way?
❑ Yes
❑ No
22.
Does record keeping need improvement?
❑ Yes
❑ No
23.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
24.
Did Reviewer/Inspector fail to discuss reviewfinspection with owner or operator in charge?
❑ Yes
❑ No
Reviewer/Inspector Namer/"v
}3eviwer/Ipspectar.;:.Signature:: .. 7i �. ..: ;. ,Date �j..
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 11/14/96

"} DSWC Animal Feedlot Operation Review,, ❑DWQ An>t>ual Feedlot Operation Site Inspection a ,aiY; ,,
s i
Routine O C'otnWaint O 1'011ONV-up of t)4VO insuection O hollmv-uo of DS%VC revie%v O 0thcr
IFacility Number I
Farm Status: [Registered ❑ Applied for Permit
❑ Certified ❑ Permitted
Date of Inspection 1/0 V
'rinse of inspection Lp2jo J 24 hr. (hh:mm)
Total Time fin fraction of hours
(er:1.25 for 1 hr 15 min)) Spent on Reviews T• S
or Inspection {includes travel And processing)
ei Not 0 mratic►naI Date Last Operated: ....................................................................n.....................................................................
FarmName: ............!VM%,! _Nt.......ZN�................. ....................... .............. I........ County:......y�(!d r(f!'. , ..... .......................
Owner Name . ............ Uld.'`t�.. ........w�.s ................................',]:.a:i....�...:.�.... Phone No:.............. .... ....y.-�.7. ................,......
Facility Contact: ...........tlilH.!� ...W.eS..........., i'isle:.................................................................. Phone Nn:...... ?...+c�...... ....................
�
MailingAddress: ............./L.............. .dX......�:3..7 . ........ .i�O. .....Nc...... �`.............,........ ..........................
OnsiteRepresentative :........ ...,........`...-c:-r.T............................................ irrtcgrator:,.........4r..��.. lid//., ......................................
Certified Operator: ............. /��..�.. ............rl......$�.............................................. Operator Certification Number ......�..t.��,.............
Location of Farm:
4jer r T
Imtifiul. [�* ®' FY-7-1u Longitude a c 94
Type of Operation Design Current
Swine Capacity Population
❑ Wean to Feeder
9-1-ceder to Finish
00
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Other
Number of Lagoons / Holding Ponds:
Design Current Design Current".
Poultry Capacity Population Cattle. Capacity Population
❑ Layer _ ❑ Dairy
❑ Non -Layer 1. ILI Non -Dairy
Total Design Capacity
Total SSLW o
Subsurface Drains Present
C:eneral
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?
h. If discharge is observed, (lid 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 yeti, 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?
Area JEJ Spray Field Area 1
❑ Yes VTNo
❑ Yes No
❑'Yes ❑ No
❑ Yes ❑ No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
4/30/97
❑ Yes
❑ No
❑ Yes
ft(No
❑ Yes
�No
❑ Yes
M14o
ton
Continued 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 ArNo
41
8. Are there lagoons or storage ponds on site which need to be properly closed7 ❑ Yes �No
Structures La onn.• antl/or lloldin Ponds
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ❑ No
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
10. Is seepage observed from any of the structures? ❑ Yes RINO
11, Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes f�No
12. Do any of the structures need maintenance improvement? [� Yes ❑ No
(If any of questions 9-12 was answered yes, and [lie situation poses J
an immediate public health or environmental threat,,notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
4
15. Crop type ...........(,.Q11111r y.......
16. Do the receiving crops differ with
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 ReviewerAnspector fail to discuss review/inspection with on -site representative?
For Certified_ 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?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
cc. Division of Water Quality, Water Quality
❑ Yes ArNo
❑ Yes V(No
❑ Yes RNo
❑ Yes e No
❑ Yes 'Po
❑ Yes f�No
❑ Yes _(No
❑ Yes RNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Dale: t�—
Assessment Unit 4/30/97

�Z� -
State of North Carolina
Department of Environment,
Health and Natural Resources
Raleigh Regional Office
James B. Hunt, Jr- Governor
Jonathan B. Howes, Secretary
Al2i
IDEHNR
DIVISION OF WATER QUALITY
November 13,1996
Mr. Wayne West
Mowfield Plantation
Route 1, Box 337
Jackson, North Carolina 27845
Subject: Compliance Evaluation Inspection
Facility # 66-60
Mowfield Plantation
Northampton County
Dear Mr. West:
On October 24, 1996, 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
lagoon had more than 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.
a.
3800 Barrett Drive, Suite 101, FAX 919A71-4718
Raleigh, North Carolina 27609 N%` CAn Equal Opportunity Affirmat€ve Action Employer
Voice 919-571-4700 500% recycled/1,0% post -consumer paper

Mowfield Plantation
Page 2
The General Assembly recently passed Senate Bill 1217 which will
require all animal waste management systems to designate an
" 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,
Judy E. Garrett
Water Quality Supervisor
cc: Northampton County Health Department
Mr. Tony Short, Northampton County Soil and Water
Conservation District
Mr. John Fitzgerald -Regional Coordinator, DSWC--WARO
DWQ Compliance Group
RRO Files

hm
State of North Carolina
' Department of Environment,
Health and Natural Resources 1 •
Raleigh Regional Office
James B. Hunt, Jr., Governor EDI=HNF;Z
Jonathan B. Howes, Secretary
DIVISION OF WATER QUALITY
November 13,1996
Mr. Wayne West
Mowfield Plantation
Route 1, Box 337
Jackson, North Carolina 27845
Subject: Compliance Evaluation Inspection
Facility # 66-60
Mowfield Plantation
Northampton County
Dear Mr. West:
On October 24, 1996, 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
lagoon had more than 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, Sulte'101, FAX [phone]
Raleigh, North Carolina 27609 Ntwfc An Equal Opportunity Affirmative Action Employer
Voice 919-571-4700 50% recycled/10°h post -consumer paper

Mowfield Plantation
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,
c\6,� i, 4/y��(-
Judy E. Garrett
Water Quality Supervisor
cc: Northampton County Health Department
Mr. Tony Short, Northampton County Soil and Water
Conservation District
Mr. John Fitzgerald -Regional Coordinator, DSWC--WARO
DWQ Compliance Group
RRO Files

• JUL--14-1995 15:26 FROM DEMWATER QUAL17Y SECTION TO Rr:O P.02i02
�
Site Requires fsnmediate Atten�i(­+n
Facility No. GG o
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERA-HONS SITE VISITATION RECORD
DATE: q Z.' ' 1995
Farm Narne/Owner_
Mailing Address: _
County. 1V VA A
Time: L)
L✓@J�
Integrator. _ _0)0-rrU Q _ Phone:
On Site Representative: 1^_JQ%4 1y7 ,t- 1J0J 4_ Phone: 6 7
Physical Add-ess/Location:
Type of Operation: Swine 'e� Poultry � _ Cattle
Design Capacity: 0 01,J S ` po UNumber of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: • Z3 ' J r " Longitude: -7 " V) ' IL" Elevation:.__,___ __,Feet
Circle Yes or No
Does the Anunal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
e
(approximately 1 Foot + 7 inches) or Nb Actuai Freeboard: q__Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray'? &r No Is the cover crop adequate? Yes 01
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria'] 200 Feet from Dwellings?Pe or No
100 Feet from Wells?jg or No
-C animal waste stockpiled within 100 Feet of USGS Blue Line Strcam? Yes oro
animal waste land applied or spray irrigated within 25 Feer of a USGS Map Blue Litre? Yes off
'�. animal waste discharged into waters of the state by man-made ditch, flushing systeua, or other
iimi'a_r man-made cic'�'lces'? Yes 14.1-1 o if �'es. Please Exgl:zin.
the rai:ility waintain adequate waste nkurageracur records (volumes of manure, land applicd-
spray irrigated on spccific acreage
//wirh cover cropf?L e or;No
Additional Comments: _AA5 � S�i/r 0-n&j �9 rA� _ ► -
10 4 Cs au s — i-0t► i 0 a 0 7.0 t? tm
Aa s
�
cc: Facility Assessment Unit
--TB w� -
S ignatune
Use Attachments if Needed
TOTAL F' . 02

ALIT wAk
NCDENR
North Caroiina Department of Environment and Natural Resources
Beverly Eaves Perdue
Govemor
Eddie West
Wayne West Farm
3639 US 158 Hwy
Jackson, NC 27845
Dear Eddie West:
Division of Water Qualit -------- --
r
Coleen H. Sullins D ^';� De Freeman
Director `� Secretary
November 7, 2011
Irr '
",Ipi2h P firo
Subject: Certificate of Coverage No. AWS660060
Wayne West Farm
Swine Waste Collection, Treatment,
Storage and Application System
Northampton County
In accordance with your Notification of Change of Ownership received October 28, 2011, we are hereby
forwarding to you this Certificate of Coverage (COC) issues! to Eddie West, authorizing the operation of
the subject animal waste management system in accordance with General Permit AWG100000.
This approval shall consist of the operation of this system including, but not limited to, the management
and land application of animal waste as specified in the facility's Certified Animal Waste Management
Plan (CAWMP) for the Wayne West Farm, located in Northampton County, with a swine animal capacity
of no greater than the following annual averages:
Wean to Finish: Feeder to Finish-, 1100 Boar/Stud:
Wean to Feeder: Farrow to Wean: Gilts:
Farrow to Finish: Farrow to Feeder: Other:
If this is a Farrow to Wean or Farrow to Feeder operation, there may be one boar for each 15' sows. Where
boars are unnecessary, they may be replaced by an equivalent number of sows. Any of the sows may be
replaced by gilts at a rate of 4 gilts for every 3 sows.
The COC shall be effective from the date of issuance until September 30, 2014, and shall hereby void
Certificate of Coverage Number AWS660060 dated October 1, 2009. Pursuant to this COC, you are
authorized and required to operate the system in conformity with the conditions and limitations as
specified in the General Permit, the facility's CAWMP, and this COC. An adequate system for collecting
and maintaining the required monitoring data and operational information must be established for this
facility. Any increase in waste production greater than the certified design capacity or increase in number
of animals authorized by this COC (as provided above) will require a modification to the CAWMP and
this ('OC and must be completed prior to actual increase in either wastewater flow or number of animals.
Ple,; .Q carefully ead this COC and the enclosed Staitc General Permit. Please pay careful attention to the
reeprd �eeriing and monitoring conditions in this p,_cinit. Record keepin forms.are unchanged with this
Gei :r•al Permit. Plertse coritiitl a to use the same re, )rd keeping forms.
1636 Mail Service Center, Ralegh, North Carolina 27699-1636
Location: 2728 Capital Blvd., Raleigh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer awally

If your Waste Utilization Plan (WUP) has been developed based on site -specific information, careful
evaluation of future samples is necessary. Should your records show that the current WUP is inaccurate
you will need to have a new WUP developed.
The issuance of this COC does not excuse the Permittee from the obligation to comply with all applicable
laws, rules, standards, and ordinances (local, state, and federal), nor does issuance of a COC to operate
under this permit convey any property rights in either real or personal property.
Per 15A NCAC 2T .0105(h) a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary. Per NRCS standards a 100-foot separation
shall be maintained between water supply wells and any lagoon, storage pond, or any wetted area of a
spray field.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive relief.
If you wish to continue the activity permitted under the General Permit after the expiration date of the
General Permit, then an application for renewal must be filed at least 180 days prior to expiration.
This COC is not automatically transferable. A name/ownership change application must be submitted to
the Division prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an individual permit by contacting the Animal Feeding Operations Unit for information on this
process. Unless such a request is made within 30 days, this COC shall be final and binding.
In accordance with Condition 11.22 of the General Permit, waste application shall cease within four (4)
hours of the time that the National Weather Service issues a Hurricane Warning, Tropical Storm Warning,
or a Flood Watch associated with a tropical system for the county in which the facility is located. You
may find detailed watch/warning information for your county by calling the Wakefield, VA National
Weather Service office at (757) 8994200, or by visiting their website at: www.erh.noaa.p-ov/er/akq/
This facility is located in a county covered by our Raleigh Regional Office. The Regional Office Aquifer
Protection Staff may be reached at (919) 7914200. If you need additional information concerning this
COC or the General Permit, please contact the Animal Feeding Operations Unit staff at [phone].
Sincerely,
for Coleen H. Sullins
Enclosure (General Perniit AWG100000)
cc. (Certificate of Coverage only for a]I cc,,)
Raleigh Region iI Office, Aquifer Protection Section
Northampton C( ,unty Health Department
Northampton C(;unty Soil and Water Conservation District
APS Central File s (Permit No. AWS660060)
AFO Notebook
Murphy-Brotivn. 1.LC

0
MCDENR
NOR7H CAPIDUNA DI:PARTMEMI- OF
ENVIRON-mLN'r AND N,;-Ui3AL RESG:-=E-"
NEW I TAILING ADDRESS:
Rolelgh Regional Office
[Deportment of Environment
and Natural Resources
1628 Mail Service Center
Raleigh, NG 2760-0-1628
PHYSICAL LOG,-",70N (rot o
moiling address)
3800 Borreit Drive, P-m 101
Rdelgh, NC- 2700-9
Voice: 010/571-41700
FAX: 9)1�/57-4718
PLEA5E NOTE OUR NEW
r
-_." : I I "ALING ADEDRE31:7nIll
TO:
FRO M:
SUBJECT: D ��fl�zh���/ D,ATY:4/O Z__
2--Poges including crwa- s} oat
i-IE55AGE' i
tir

4; X2
fi..........

'4�
PLEASE NOTE OUR,' NEW
MAILING AOLDRE-33111
NEW M,4,,IL-INC7 AL)DRE55:
'Cleig} R-e-g&76 Office
Department cf Environment
and Natural Resource-9
rr 1628 MoK Service Center
Raleigh, NIG 2700-9-1628
PHYSICAL LOCATION (n2t
moiling address)
3800 Borre��j Drive, Rm 101
Raleigh, NG 27G-03
Voice: 01-9/571-4700
FAX: -910/5Ti-z--718
TO:
FAx: qLj ­7B - 133
DATE:
—2?--poges HcLdrg cover S}7eet
b4z L- - -5
0 T6-1 6 (,f
-(3
Ww"AWAMYNIMMI

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.•1:.
6

dab �-o
Natural Resources Conservation Service
P.O. Box 218
9495 NC 305 HWY
Jun, NC 27845
252-534 2591
FAX [phone]
facsirole transmittal.
u s �6 t-11 d 61 e. � 1 Fax:
Re: e .3o dao A- 8:

PLAN OF ACTION (PoA) FOR HIGH FREEBOARD AT ANIMAL FACILITIES
AWS 660060 County, Northampton
Facility Number: - ty
Facility Name: Wayne West Farm
Certified Operator Name: Gregory Taylor Operator # 993843
-1. Current liquid level(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 Structure 6
Lagoon Name/identifier (ID)- 1
Spillway (Yes or No): yea
Level (inches):
6" i
2. Check all applicable items
Liquid level is within the designed structural free board'elevations of one & more structures. Five
and 30 day Plans of Action are attached. Hydraulic and agronomic balances are within
acceptable ranges."
Ligriid' level is within the 25 year 24 hour storm elevations for one or more structures, A 30 day
Pian 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 ill 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 odg[ 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
3. Earliest possible date to begin land application of waste: 1-25--2013 Depending on weather.
I hereby certify that I have reviewed the Information listed above and included within the attached Plan
of Action, and to the beat of my knowledge and ability, the information is accurate and correct.
Phone: Z5 7 9
Date:
PoA Cover Page 2121100

PLAN OF ACTION (PoA) FOR HIGH FREEBOARD AT ANIMAL FACILITIES
FIVE (5) DAY DRAW DOWN PERIOD
I. TOTAL VOLUME TO BE LAND APPLIED PER WASTE STRUCTURE
1, Structure Name/Identifier (ID):
2. Current liquid volume In structural freeboard
a. current liquid level according to marker
b. designed structural freeboard zone
(Normally 12 inches or greater)
c. line b - line a (Inches within structural freeboard) _
d. top of dike surface area according to design
(area at below structural freeboard elevation)
e. line c x line d x 7.48��
. 12 ft
inches
inches
L.,
inches
fe
gallons
3. Projected volume of waste liquid produced during draw down period
f. temporary storage period according to structural design days
g., volume of waste produced according to structural design ft3
h. actual waste produced curL@nt her x line g =
certified herd #
I. volume of wash water according to structural design
j. excess rainfall over evaporation according to design
k. (lines h + i + j) x 7.48 x 5 days =
Ilne f
4. Total volume of waste to be land applied during 5 day draw down
ft3
ft3
3
gallons
I. total volume to be land applied line e + line k gallons
REPEAT SECTION I FOR EACH WASTE STRUCTURE ON SITE WITH A LIQUID LEVEL WITHIN
THE STRUCTURAL FREEBOARD ELEVATIONS
li. TOTAL VOLUME OF WASTE STORED WITHIN STRUCTURAL FREEBOARD ELEVATIONS
FOR ALL WASTE STRUCTURES FOR FACILITY
PoA (5 Day) 2/21100 1

1.
structure ID:
line I =
gallons
2.
structure ID:
line I =
gallons
3.
structure ID:-
line I =
gallons
4.
structure ID.-
line I =
� gallons
5.
structure ID:
line I a
gallons
B_
structure ID:
line I =
gallons
n. lines 1 -11� 2 + 3 + 4 + 5 + 6 = gallons
o. 'ne = acre -inches
27,164
III. TOTAL ACRES AVAILABLE TO RECEIVE WASTE DURING 5 DAY DRAW DOWN PERIOD''
t While this section deals with hydraulic loading capacities, applications cannot exceed
agronomic rate for receiving crop according to its certified waste plan
Y Fields with no remaining PAN balance, no receiving crop, and/or completely saturated are
not considered available to receive waste
tract #fq� r. soil a a. crop t. aCr88 u, remaining V. maximum w, maximum
i p type �
IRR-2 PAN appNcation application
balance rate (In/hr) amount
x. total acres available during 5 day draw down (sum of column Q = acres
IV. FACILITY'S PoA OVERALL HYDRAULIC LOAD TO BE LAND APPLIED PER ACRE
Y. line o inches per acre to be applied within b days
line x
PoA (5 Day) 2J21100 2

If unable to land apply hydraulic load listed in line y, list course of action here including pump
and haul, depopulation, herd reduction, etc. For pump & haul and hard reduction options,
recalculate new hydraulic load based on new Information.
Plan to land apply hydraulic load:
1. Describe moisture conditions of fields? (e.g./ Is there water standing in field; does irrigation
equipment mar down In field; °trafficability" across sails; will soils absorb application without runoff ,
etc.)
2. Date and amount of last rainfall event?
3. Dates of last waste application event per field
4. Given optimum soil and weather conditions, is irrigation equipment capable of applying the
volume in line "n" at appropriate seasonal (i.e. winter) application rates within five days?
5. irrigation schedule for next 5 days - include daily schedule; proposed application rates and
amounts per irrigation event; changes made in gun sizes, nozzles, "o" rings, operating time, travel
speed, etc. to meet proposed changes In application rates and amounts; and any other information
for consideration
PoA (s Day) 2121100 3

PLAN OF ACTION (PoA) FOR HIGH FREEBOARD AT ANIMAL FACILITIES
THIRTY (30) DAY DRAW DOWN PERIOD
I, TOTAL PAN TO BE LAND APPLIED PER WASTE STRUCTURE
1. Structure Namelldentifier (ID): Wayne west Lagoon 1
2, Current liquid volume in 25 yr.124 hr. storm storage & structural freeboard
a. current liquid level according to marker
b. designed 25 yr./24 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. i1ag g x line d x 7,48-gallons =
12 ft
16
inches
.12
inches
411
inches
30,576
ft2
76,236gallons
3_ Projected volume of waste liquid produced during draw down period
f. temporary storage period according to structural design 120 days days
g. volume of waste produced according to structural design 40588 _ ft3
h. actual waste produced 4 current herd # x line g 40588 ft3
certified herd #
i. volume of wash water according to structural design 0 ft3
J. excess rainfall over evaporation according to design 15468.2 — ft3
k. (lines h + i +i) x 7.48 x 30 day, - 14,764 gallons
line f
4. Total PAN to be land applied during draw down period
I., current waste analysis dated 10/30/12 86 Ib/1000 gal.
m. lin + x line 1 - 78.26 lb PAN
1000
REPEAT SECTION 1 FOR EACH WASTE STRUCTURE ON SITE
II. TOTAL POUNDS OF PAN STORED WITHIN STRUCTURAL FREEBOARD AND/OR 25 YRJ24
HR. STORM STORAGE ELEVATIONS IN ALL WASTE STRUCTURES FOR FACILITY
PoA (30 nay) 2121100 1

1. structure ID: Loon 1
2. structure ID:
3. structure ID:
4. structure ID:
5. structure ID:
6. structure ID:
line m = 78=26 — Ib PAN
line rn =
line m=
lb PAN
Ib PAN
line m = _ 1b PAN
line m = lb PAN
line rn =
lb PAN
n. Ilnes'I+2+3+4+5+6 _lb PAN
Ill. TOTAL PAN BALANCE REMAINING FOR AVAILABLE CROPS DURING 30 DAYDRAW DOWN
PERIM n0 NOT LIST FIELDS TO WHICH PAN CAN NOT RE APPLIES DURING THIS 30 DAY PERIOD.
o. tract #
p. field #
q. crop
r. acres
s. remaining
IRR-2 PAN
balance
ft/acre)
t. TOTAL PAN
BALANCE
FOR FIELD
(Ibs.)
column r x s
u.
application
window'
1688
5
small grain
15.9
50
795
5ept.1-Apr:.15
cover crop
'State current crop ending application date or next crop application beginning date for available receiving
crops during 30 day drawn down period
v. Total PAN available for all flelds (sum of column t) 0 795 Ib. PAN
IV. FACILITY'$ PoA OVERALL PAN BALANCE
POA (30 Day) 2121100 2

w. Total PAN to be land applied (line n from section Il) = 78.26 lb. PAN
x. Crop's remaining PAN balance (line v 'from section 111) .795. lb. PAN
y. Overall PAN balance (w - x) =-716.74 lb. PAN
Line y must show as a deficit. 1f line y does not show as a deficit, list course of action here
including pump and haul, depopulation, herd reduction, etc. For pump & haul and herd
reduction options, recalculate new PAN based on -new information. If new fields are to be
included as an option for lowering lagoon level, add these fields to the PAN balance table and
recalculate the overall PAN balance. If animal waste is to be hauled to another permitted
facility provide Information regarding the herd population and lagoon freeboard levels at the
receiving facility.
NARRATIVE:
PoA (30 Day) 2121100 3

State of North Carolina
Department of Environment,
Health and Natural Resources
James B, Hunt, Jr., Governor
Jonathan B, Howes, Secretary
November 13, 1996
Wayne West
Mowfield Plantation
Rt I Box 337
Jackson NC 27845
SUBJECT: Operator In Charge•Designation
Facility: Mowfield Plantation
Facility ID#: 66-60
Northampton County
Dear Mr. West:
A a rikL� ��
[DEHNR
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 919n33-0026.
Sincerel ,
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
Enclosure
cc: Raleigh Regional Office
Water Quality Files
P.O. Box 27687, W 4
Raleigh, North Carolina 27611-7687 aC An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 ,�. 50% recycled/10% post -consumer paper

State of North Carolina
Department of Environment - • •
and Natural Resources^ 14'
Division of Water Quality
,lames B. Hunt, Jr., Governor SEP i
s NCDENR
Bill Holman, Secretary 71
NORTH CAROLINA DEPARTMENT OF
Kerr T. Stevens, DICECtOr ry R RILEIGN �G'IOo_"ENVIRONMENT AND NATURAL RESOURCES
September 12, 2000
WAYNE WEST
WAYNE WEST FARM
RT 1 BOX 337
JACKSON NC 27845
Subject: Certificate of Coverage No. AWS660060
Wayne West Farm
Swine Waste Collection, Treatment,
Storage and Application System
Northampton County
Dear Wayne West:
In accordance with your application received on July 31, 2000, we are forwarding this Certificate of
Coverage (COC) issued to Wayne West, authorizing the operation of the. subject animal waste
collection, treatment, storage and land application system in accordance with General Permit
AWG100000. This approval shall consist of the operation of this system including, but not limited to,
the management of animal waste from the Wayne West Farm, located in Northampton County, with an
animal capacity of no greater than 1100 Feeder to Finish and the application to land as specified in the
Certified Animal Waste Management Plan (CAWMP).
The COC shall be effective from the date of issuance until September 30, 2003. Pursuant to this COC,
you are authorized and required to operate the system in conformity with the conditions and limitations
as specified in the General Permit, the facility's CAWMP, and this COC, with no discharge of wastes to
surface waters. An adequate system for collecting and maintaining the required monitoring data and
operational information must be established for this farm. Any increase in waste production greater than
the certified design capacity or increase in number of stocked animals above the number authorized by
this COC will require a modification to the CAWMP and this COC and shall be completed prior to
actual increase in either wastewater flow or number of animals.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive relief.
Upon notification by the Division of this COC's expiration, you shall apply for its renewal. This request
shall be made within 30 days of notification by the Division.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

6 it
Certificate of Coverage AWS660060
Wayne West Farm
Page 2
+ This COC is not automatically transferable. A name/ownership change application must be submitted to
the DWQ prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an individual non -discharge permit by contacting the engineer listed below for information on
this process. Unless such a request is made within 30 days, this COC shall be final and binding.
The subject farm is located in the Raleigh Regional Office. The Regional Office Water Quality Staff
may be reached at [phone]. If you need additional information concerning this COC or the
General Permit, please contact Stephanie Milam at [phone] ext. 544.
cc: (Certificate of Coverage only for all cc's)
Northampton County Health Department
R-aleighAegional:office, Water Quality:�ection
Northampton County Soil and Water Conservation District
Permit File
NDPU Files

tx
i
State of North Carolina RECEIVED
_ r
Department of Environment and Natural Resources JUL T 1 2000
Division of Water Quality ,
- �P,Lr 1 r St`C-Ir.N
Non-Diseharge Permit Application Form ,- ,...
(THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL)
General Permit - Existing Animal Waste Operations
The following.questions have been completed utilizing information on file with the Division. Please
review the information for completeness and make any corrections that are appropriate. If a
question has not been completed by the Division, please complete as best as possible. Do not leave
any question unanswered.
1. GENERAL INFORMATION:
Ll Facility Name: Wayne West
1.2 Print Land Owner's name: Wavne W,
1.3 Mailing address: Rt 1 Box 337
City, State: Jackson NC Zip:
Telephone Number (include area code): 919-536-4578
1.4 County where facility is located: Northampton ^^
1.5 Facility Location (Directions from nearest major highway. Please include SR numbers for state roads. Please include a copy
of a county road map with the location of the farm identified): Farm location: 3 mi. west of Jackson NC on Route 158
1.6 Print Farm Manager's name (if different from Land Owner):
1.7 Lessee's / Integrator's name (if applicable; please circle which type is listed): Carroll's Foods of VA, Inc.
1.8 Date Facility Originally Began Operation: 1/1/1981 ✓
1.9 Date(s) of Facility Expansion(s) (if applicable):
2. OPERATION INFORMATION:
2.1 Facility No.: ---{6 (county number); 60 (facility number).
2.2 Operation Description: Swine operation
Feeder to Finish
1 I00- Certified D ign Capacity
Is the above information correct? yes; no. If no, correct below using the design capacity of the facility
The "No. of Animals" should be the maximum number for which the waste management structures were designed.
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
0 Wean to Feeder 0 Layer 0 Dairy
0 Feeder to Finish 0 Non -Layer 0 Beef
0 Farrow to Wean (# sow) 0 Turkey
0 Farrow to Feeder (# sow)
0 Farrow to Finish (# sow)
Other Type of Livestock on the farm: No. of Animals:
FORM: AWO-G-E 5/28/98
Page I of 4 66 - 60

11
s
2.3 Acreage cleared and available for application (excluding all required buffers ar}d
✓
✓;
areas not covered by the -application
system): 200 Required Acreage (as listed in the AWMP): 20
2.4 Number of lagoons/ storage ponds (circle which is applicable): �✓
2.5 Are subsurface drains present within 100' of any of the application fields?
(please circle one)
YES o900
2.6 Are subsurface drains present in the vicinity or under the lagoon(s)?
YES o(please circle one)
2.7 Does this facility meet all applicable siting requirements? (Swine Farm Siting Act,
NRC tandards, etc.) (Swine Only)
ES or NO (please circle one)
What was the date that this facility's swine houses and lagoon were sited?
�Q0
What was the date that this facility's land application areas were sited? 1
7 _ 7 T
3. REQUIRED ITEMS CHECKLIST
Please indicate that you have included the following required items by signing your initials in the space provided next to each
item.
Applicants Initials
3.1 One completed and signed original and one copy of the application for General Permit - Animal
Waste Operations;
3.2 Two copies of a general location map indicating the location of the animal waste facilities and
field locations where animal waste is land applied;
3.3 'I" wo copies of vic entire Certified Animal Waste Management Plan (CAWMP). If the facility
does not have a CAWMP, it must be completed prior to submittal of a general permit application
for animal waste operations.
The CAWMP must include the following components. Some of these components may not
have been required at the time the facility was certified but should be added to the
CAWMP for permitting purposes:
3.3.1 The Waste Utilization Plan (WUP) must include the amount of Plant Available
Nitrogen (PAN) produced and utilized by the facility.
3.3.2 The method by which waste is applied to the disposal fields (e.g. irrigation,
injection, etc.)
3.3.3 A map of every field used for land application.
3.3.4 The soil series present on every land application field.
3.3.5 The crops grown on every land application field.
3.3.6 The Realistic Yield Expectation (RYE) for every crop shown in the WUP.
3.3.7 The PAN applied to every land application field.
3.3.8 The waste application windows for every crop utilized in the WUP.
3.3.9 The required NRCS Standard specifications.
3.3.10 A site schematic.
3.3.11 Emergency Action Plan.
3.3.12 Insect Control Checklist with chosen best management practices noted.
3.3.13 Odor Control Checklist with chosen best management practices noted.
3.3.14 Mortality Control Checklist with the selected method noted.
3.3.15 Lagoon/storage pond capacity documentation (design, calculations, etc.). Please be
sure to include any site evaluations, wetland determinations, or hazard classifications
that may be applicable to your facility.
3.3.16.Operation and Maintenance Plan.
If your CAWMP includes any components not shown on this list, please include the
additional components with your submittal.
FORM: AWO-G-E 5/28/98 Page 2 of 4 66 - 60

i.
1
A
Facility Number: 66 - 60
Facility Name: Wayne West
4. APPLICANT'S CE TIFICA
TIM
1, ci
(Land Owner's name listed in question•-1;:�)4Lgg that
this application for _ -_ (Facility name listed in questidn,Z
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included, this application package
will be returned to me as incomplete.%
Signature
Date . ,;Z'r- q, -• 0� C) O 0
5. MANAGER'S CERTIFICATION: (complete only if different from the Land Owner)
1, (Manager's name listed in question 1.6), attest that this
application for (Facility name listed in question 1.1)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included, this application package
will be returned as incomplete.
Signature
Date
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND MATERIALS,
SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF WATER QUALITY
WATER QUALITY SECTION
NON -DISCHARGE PERMITTING UNIT
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
FAX NUMBER: [phone]
FORM: AWO-G-E 5128/98
Page 3 of 4 66 - 60

DIYI5ION OF WATER QUALITY REGIONAL OFFICES (LO98)
Asheville Regional WQ Supervisor
59 woodfin Place
Asheville, NC 28801
(szg) 251-6208
Fax (egg) 251-6452
Avery -
Macon _
Buncombe
Madison
Burke
McDowell
Caldwell
Mitchell
Cherokee
folk
Clay
Rutherford .
Graham
Swain
Haywood
. Transylvania .
Hradexson
Yancey
Jackson
Fayetteville Regional WQ Supervisor
Wachovia Building, Suite 714
Fayemvilie, NC 29301
(910) 49& 1541
Fax [phone]
Anson Moors
Braden Richmond
Cumberland Robeson
Harnett Sampson
Hoke Scotland
Montgomery
Winston-Salem Regional WQ Supervisor
585 waughtown Street
Winston-Salem, NC 27107
03Q 77146D0,
Fax Gj3 ) 771-4631
Aiamance Rockingham
Alkeghany Randolph
Asbe Stokes
Caswell Surry
Davidson Watauga
Davie Wain=
FarA Yadkin
Gailfcrd
Washington Regional WQ-Supervisor
943 Washington Square Mall
Washington, NC 27B89
(.2S) 946-5481
Fax (; 975-3716
Beaufort Jobes
Bertie Lenoir
Camden Martin
Gowan Pamlico
Craven Pasquortank
Ca rituck. Perquimaas
Dare Pitt
Gates Tyrell
Greene Washing=
Hertford Wayne
Hyde
Mooresville Regional WQ Supervisor
919 Nortb Main Street
Mooresville. NC 28115
[phone]
Fax [phone]
Alexander Lincoln
Cabarrus Meekienburg
Catawba Rowan
Cleveland Sternly
Gaston Union
l:xdrll
T?"= .
Raleigh Regional WQ SWervism
3800 Baasst Dr.
Raleigh, NC X7611
[phone]
Fix [phone]
Chatham Nash.
Durham - Northampton
Edgecombe Orange
Franklin Person
Granville Vance
Halifax Wake
Johasm Ww=
Lee Wilsca
Wilmington Region. WQ Supervisor
127 Cardinal Drive Extension
Wilmington, NC 28405-3645
[phone]
Fax [phone]
Brunswick New Hanover
Carteret Onskow
Columbus' Pender
Duplin
FORM: AWO-G-E 5128198
Page 4 of 4

w�R RAH
r o u w r r

Producer: Wayne West
The purpose of this plan is to provide guidelines for carrying out
the routine operation and maintenance work needed to keep this swine
waste management system functioning as planned. Routine maintenance
is considered to be normal good care of the system. Good
maintenance adds to beauty, usefulness, and permanence.
A. Maintenance
The routine maintenance of the lagoon involves the following:
1. Maintenance of a vegetative cover on the embankment top and
side slopes: Fescue and common Bermuda has been established`
on these areas. Beginning in 199G and each year thereafter,
the embankment should be fertilized with 800 pounds of 10-
10-10 per acre to maintain a vigorous stand.
2. Control of brush and trees on the embankment. This may be
done by mowing, spraying, or chopping, or a combination of
all three. This will need to be done at least once each
year and possibly twice in years favorable to heavy growth
of vegetation.
Maintenance inspections of the lagoon should be made during the
initial filling of the lagoon and at least annually. Items to
be checked should include, as a minimum, the following:
1. Waste Inlet Pipes, Overflow Pipes
a. condition of pipes
(1) separation of joints
(2) cracks or -breaks
2. Pool Area
a. undesirable vegetative growth
b. floating or lodged debris
3. Embankment
a. settlement, cracking or "jug" holes
b. side slope stability - slumps or bulges
C. erosion and rodent damage
4. Transfer Pump (not applicable)
1

:,J
0
INT.ma
B. Operation
Your animal waste management facility was designed for a total
of 1100 sows/animals (topping). The lagoon contains both
permanent and temporary storage. The permanent storage is not
to be pumped in order to ensure that anaerobic action will
occur. The design includes permanent storage of one cubic foot
per pound of steady state live weight.
The temporary storage portion of the lagoon includes capacity
for the volume of waste produced over 90 days, the amount of
rainfall in a 25 year 24 hour storm event, and rainfall in
excess of evaporation. Your facility is designed for 90 days of
temporary storage; therefore, it will need to be pumped every
three months. Begin pump -out of the lagoon when fluid level
reaches elevation 93.6 as marked by permanent markers. Stop
pump -out when the fluid level reaches elevation'92.0.
The attached waste management plan should be followed. This
plan recommends sampling and testing of waste (see Attachment B)
before land application. The waste material should be analyzed
before each application cycle to determine its nutrient content.
A soil test of the area of application should be made annually
to insure the waste is applied as reasonably and practically
possible to recommended rates.
It is strongly recommended that the treatment lagoon be pre -
charged to 1/2 its capacity to prevent excessive odors during
start-up. Pre -charging reduces the concentration of the initial
waste entering the lagoon thereby reducing odors. Solids should
be covered with effluent at all times.
The Clean Water Act of 1977 prohibits the discharge of
pollutants into waters of the United States. The Department of
Environment, Health, and Natural Resources, Division of
Environmental Management, has the responsibility for enforcing
this law.
K

i
Animal Waste Management flan Certification
(Please type or print all information that does not require a signature)
Name of F
Owner(s) Name: WtNry
Mailing Address:
R9
ty No: - �o
No:�G_ :S'7
Fartn Location: Fourteen Digit Hydrologic U'nit: _ d a p po o
Olt
Latitude and Longitude: Z3 f�/ � / 77° 2-- � 3o County:
Please attach a copy of a county road trap with location identified and describe below (Be specific: road
names, directions, milepost, etc.): CE[_ G(5� 3 rt�� At _
Operalign^Descri pticgn:
Type of Swine No. of Animals
❑ Wean to Feeder
*eeder to Finish 00
0 Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Type of Poultry
❑ Layer.
❑ Pullets
No. of Animals
Type of Cattle
0 Dairy
❑ Beef
No. of Animals
Other Type of Livestock. Number of Animals:
Acreage Available for Application: 7-00+ Required Acreage: 9--w
Number of Lagoons / Storage Ponds: . Total Capacity: �-2-�. I �l Cubic Feet (ft3)
Are subsurface drains present on the farm: YES or NO (please circle one)
Owner / Manager Agreement
I (we) verify that all the above information is correct and will be updated upon changing. I (we) understand the operation and
maintenance procedures established in the approved animal waste management plan for the farm named above and will
implement these procedures. I (we) know that any expansion to the existing design capacity of the waste treatment and
storage system or construction of new facilities will require a new certification to be submitted to the Division of
Environmental Management before the new animals are stocked. I (we) understand that there must be no discharge of animal
waste from die storage or application system to surface waters of the state either directly through a man-made conveyance or
from a storm event less severe than the 25-year, 24-hour storm and there must not be run-off from the application of animal
waste. I (we) understand that run-off of pollutants from lounging and heavy use areas must be minimized using technical
standards developed by the Natural Resources Conservation Service. The approved plan will be filed at the farm and at the
office of the local Soil and Water Conservation District. I (we) know that any modification must be approved by a technical
specialist and submitted to the Soil and Water Conservation District prior to implementation. A change in land ownership
requires written notification to DEM or a new certification (if the approved plan is changed) within 60 days of a title transfer.
Name of Land
Signature:,.
Name of Mana
different from owner):
Signature: Date:
AWC -- April 24, 1996 1

r
I'Ieclinical Specialist Certification
As a technical specialist designated by the North Carolina Soil and Water Conservation Commission
pursuant to 15A NCAC 6F .0005, I certify that the animal waste management system for the farm
named above has an animal waste management plan that meets or exceeds standards and specifications
of the Division of Environmental Management (DEM) as specified in 15A NCAC 2H.0217 and the
USDA -Natural Resources Conservation Service (NRCS) and/or the North Carolina Soil and Water
Conservation Commission pursuant to 15A NCAC 2H.0217 and 15A NCAC 6F .O001-.0005. The
following elements are included in the plan as applicable. While each category designates a technical
specialist who may sign each certification (SD, SI, WUP, RC, I), the technical specialist should only
certify parts for which they are technically competent.
II. Certification of Design
A) Collection. Storage. Treatnignt ►SUtein
Chec he appropriate box
Gk Existing facility without retrofit (SD or WUP)
Storage volume is adequate for operation capacity; storage capability consistent with
waste utilization requirements.
Cl dew. expanded or retrofttted__facility (SD)
Animal waste storage and treatment structures, such as but not limited to collection systems,
lagoons and ponds, have been designed to meet or exceed the minimum standards and
specifications.
Natne of Technical Specialist (Please Print):
Affiliation:_
Address (Agency). YOO & OX gi�It/L hone No.:
Signature: Date: 9/Vs; 7
B) Land Ayolica(ign Site (WUP)
The plan provides for minimum separations (buffers); adequate amount of land for waste
utilization; chosen crop is suitable for waste management; hydraulic and nutrient loading rates.
Name of Technical Specialist (Please Print): AoIV
Affiliation: -
Address (Agency):O t? t 2dYff hone No.:.S'3 V—Z ff /
Signature: ate:__ Z — / — 'V 7
C) Runoff Controls fr'
Check the appropriate box
Facility without exterior lots (SD or WUP or RC)
This facility does not contain any exterior lots.
❑ Facility with exterior lots (RC)
Methods to minimize the run off of pollutants from lounging and heavy use areas have been
designed in accordance with technical standards developed by NRCS.
Name of Technical Specialist (Please Print):_! !_✓_ !l S�%rt f
Af :l' UGC
t ration.
Address(Agency):_
Signature:
AWC -- April 24, 1996
No.: 373 5Z rT/

Application and Handlingy Equipment
:heck the appropriate box
Existing acility with existing waste application equilment (WUP or 1)
Animal waste application equipment specified in the .plan has been either field calibrated or
evaluated in accordance with existing design charts and tables and is able to apply waste as
necessary to accommodate the waste management plan: (existing application equipment can
cover the area required by the plan at rates not to exceed either the specified hydraulic or
nutrient loading rates, a schedule for timing of applications has been established; required
buffers can be maintained and calibration and adjustment guidance are contained as part of the
plan).
0 New or expanded facility; or existing -facility without existing waste application equipment (I)
Animal waste application equipment specified in the plan has been designed to apply waste as
necessary to accommodate the waste management plan; (proposed application equipment can
cover the area required by the plan at rates not to exceed either the specified hydraulic or
nutrient loading rates; a schedule for timing of applications has been established; required
buffers can be maintained; calibration and adjustment guidance are contained as part of the
plan).
Naive of Technical Specialist (Please Print): William A. Stalls
Affiliation: Revelle Agri -Products. Inc.
Address(A
III. Certification of Installation
A) Col1cglis}nSt ragg,.Reatiment ftistallation
No.: 919-398-3116
9-.22, - ?7
New, expanded or retrofitted facility (S1)
Animal waste storage and treatment structures, such as but not limited to lagoons and ponds,
have been installed in accordance with the approved plan to meet or exceed the minimum
standards and specifications.
For existing facilities without retrofits, no certification is necessary.
Naive of Technical Specialist (Please Print):
Affiliation.
Address(Agency):_ phone No.:
Signature: - __ Date:
AWC -- April 24, 1996

B) Land Allp]icg 'on Site (WUP)
Check the appropriate box
The cropping system is in place on all land as specified in the animal waste management plan.
W
Conditional Approval: all required land as specified in the plan is cleared for planting; the
cropping system as specified in the waste utilization plan has not been established and the
owner has committed to establish the vegetation as specified in the plan by
(month/day/year); the proposed cover crop is appropriate for compliance with the waste
utilization plan.
❑ Also check this box if appropriate
if the cropping system as specified in the plan can not be established on newly cleared
land within 30 days of this certification, the owner has committed to establish an interim
crop for erosion control;
Name of Technical Specialist (Please Print): S &hf
Affiliation: ttI12.0 _
Address(Agency): A0 man a. I�IC Z hone No.: ?!K — 24-f/
Signature: ��711�,, - - - - Date: _ - / - 9 -7
This following signature block is only to be used when the box for conditional approval in U1. B
above has been checked.
I (we) certify that I (we) have committed to establish the cropping system as specified in my (our) waste
utilization plan, and if appropriate to establish the interim crop for erosion control, and will submit to
DEM a verification of completion from a Technical Specialist within 15 calendar days following the date
specified in the conditional certification. I (we) realize that failure to submit this verification is a
violation of the waste management plan and will subject me (us) to an enforcement action from DEM.
Name of Land Owner:
Signature: Date:
Name of Manager(if different from owner):
Signature: Date:
C) Runoff Controls from Exterior Lola (RC)
Facili y wit�i exterior lats
Methods to minimize the run off of pollutants from lounging and heavy use areas have been
installed as specified in the plan.
For facilities without exterior lots, no cert(rication is necessary.
Name of Technical Specialist (Please Print):_
Affiliation:
Addre ss (Agency): Phone No.: _
Signature: Date:
AWC -- April 24, 199b

M
�f • • ' .. �� � fit....
D) Aijnlication and I-landling Equ'lltnent Installation (WUP or I)
Check the appropriate block
Animal waste application and handling equipment specified in the plan is on site and ready
for use; calibration and adjustment materials have been provided to the owners and are
contained as part of the plan. .
❑ Animal waste application and handling equipment specified in the plan has not been
installed but the owner has proposed leasing or third party application and has provided a
signed contract; equipment specified in the contract agrees with the requirements of the
plan; required buffers can be maintained; calibration and adjustment guidance have been
provided to the owners and are contained as part of the plan.
❑ Conditional approval: Animal waste application and handling equipment specified in the
plan has been purchased and will be on site and installed by
(month/day/year); there is adequate storage to hold tire waste until the equipment is installo
and until the waste can be land applied in accordance with the cropping system contained
in the plan; and calibration and adjustment guidance have been provided to the owners and
are contained as part of the plan.
Name of Technical Specialist (Please Print):
Affiliation: Pewcele- a r. v.• bra afar e
Address(Agency):cI rfi^c Phane No.: ���=-�/��
Signature:-��- �-, f ate:
The following signature block is only to be used when the box for conditional approval in III D
above has been checked.
I (we) certify that I (we) have committed to purchase the animal waste application and handling
equipment as specified in my (our) waste management plan and will submit to DEM a verification of
delivery and installation from a Technical Specialist within 15 calendar days following the date specified
in the conditional certification. I (we) realize that failure to submit this verification is a violation of the
waste management plan and will subject me (us) to an enforcement action from DEM.
Name of Land Owner :
Signature: Date:
Name of Manager(if different from owner):
Signature: _ Date:
Please return the completed form to the Division of Environmental Management at the
following address:
Department of Environment, Health, and Natural Resources
Division Of Environmental Management
Water Quality Section, Compliance Croup
P.O. Box 29535
Raleigh, NC 27626-0535
Please also remember to submit a copy of this forth along with the complete Animal Waste
Management Plan to the local Soil and Water Conservation District Office and to keep a copy in
�- your files with your Animal Waste Management Plan.
AWC -- April 24, I996

I II 1 MIMI Y D10 a
r Z . Manning
ADDRESS: a- i i pad-Streeti, 68
Murfi7eesboro, \
C 27855
TELEPHONE: (M)398-3116 s •
TECHMCAL SPEC( I) William A- Stalls d
COMPANY
FARM #.
ADDRESS:
PHONE:
COUNTY Nfr1.•.111 fl
►/ 1 25, 1297
The following parameters, as laid out by our design group, must be followed when spraying waste- water on Wayne West's Farm . Any deviation
from this waste water irrigation plan could result in runoff or reckless discharge of waste water_ Refer to the Waste Utilization Plan, provided for
information on Nitrogen loads and population information. The designer has taken the NRCS Guidelines regarding waste water irrigation into
consideration and has applied them to the following design. Calculations and computations have been run to back up all information in the design,
and specifications on all equipment are supplied with this design_ A copy of this plan must be made readily available to anyone, that is responsible
for the operation of irrigation equipment.
The following information and computations must accompany all irrigation designs.
1) A scale drawing of the proposed irrigation system, which includes hydrant locations, travel lanes, pipeline routes, thrust block locations, and
buffer areas where applicable
Z-) Specifications for the irrigation pump, traveler, and sprinklers
3) Computations used to determine all mainline and lateral pipe sizes
4) Total Dynamic Head Computations and Horse Power requirements
S) Sources and or calculations used to determine application rates
6) Computations used to determine the size of thrust blocks
7) Manufacture's specifications for the irrigation pipe -and USDA - NRCS Specifications

IRRIGATION SYSTEM DESIGN PARAMETERS
Landowner/Operator Name:
Address:
Telephone:
TABLE I - Field Specifications ' -
County:
Date:
Feld
Number2
Approximate
Maximum
Useable Size
of FMW3
(acres)
son Type
Slope
(%)
cmp(s)
maximum
Appiraatim
Rate 4
ram+)
Maximum
Applicadn
per'"kptlon
cycle
Cinch—)
comments
Z/
3-
I Cris✓w,
-e-/ Ve
1 C-.o 770-77
I a• 3 31
2. Y
I
I
f
I
I
I
f
f
•
I i
f
f
I
-
f
'Table to be completed in its entirety by Feld Office personnel and forwarded to the irrigation system designer.
2See attached map provided by the Feld Office far field locadon(s). ,i 3 5�11
sTotai field acreage minus required buffer areas.
`Refer to N. C. Irrigation Guide, Feld Office Technical Guide, Section If G. Annual application must not exceed the agronomic rates for the sod and crop used
Iftlation Paraffietem .
October IBM pa439.1

TABLE 2: Traveler Irrigation Gun Settings
Irrigation E ui ment
Make:
Hobbs
Model:
1030G5 Hard Hose Traveler 965' of 3" Hose w! Nelson SR 150
Type:
Gas Driven
Fld #
�Hyd #
Trvler Speed
Rate
Effect. Wdth
Effect. L th
Wttd Diam.
Nzzl Diam.
PSI Gun
PSI Reel
Arc Pattern
Ac Cvrd
ftlmin
inlhr
ft
ft
ft
in
psi
psi
dea
ac
4
1
4.3
0.35
224
1040
320
1.08
80
123.8
320
5.3
5
2
4.3
0.35
224
1040
320
1.08
80
123.8
320
5.3
5
3
4.3
0.35
224
880
320
1.08
80
123.8
320
4.5
5
4
4.3
0.35
224
880
320
1.08
80
123.8
320
4.5
15
2a
4.3
0.35
224
1040
320
1.08
80
123.8
320
5.3
15
3b
4.3
0.35
224
1040
320
1.08
80
123.8
320
5.3
15
4c
4.3
0.35
224
1040
320
1.08
80
123.8
320
5_.3
16
5
4.3
0.35
224
1040
320
1.08
'80
123.8
320
5.3
21
6
4.3
0.35
224
1040
320
1.08
80
123.8
320
5.3
21
7
4.3
0.35
224
1040
320
1.08
80
123.8
320
5.3
7
8
3.76
0.4
224
680
320
1.08
80
123.8
280
3.4
OTAL
54.8

TABLE 4: Irrigation System Specifications
raveling Inigation Own!
Solid SeLSy3tem
Center Picot
Flow Rate of.S rinkler m
210
0 eratin .Pressure at Pump (psi)
a
�pplication Rate Utilization Plan
.35 , .40
Hose Length
965
xxxxx
Type Of Speed Compensation
Mechanical
xxxxx
Pump Type En , PTO, Elc
PTO
Pump Power Requirement
35 h
Location
90 deg bend
na
Dead End Tee
na
Other
na

Narrative of Irrigation System operation
' r
Describe the operation of the system in•the space provided
below or on, a similar sheet most convenient to the
designer/supplier.
Include procedures such as start-up, shut -down, winterization
and regular maintenance of all equipment.
This - irrigtor is designed to apply . W -L4 of water at specified -
ratings. Pump should. be primed and started and 1030
traveling hose should be extended to specified destinations
in accordance with map. The reel should be started -in manner
that is given in owner's manual that accompanies the machine.
The machine is equipped. with shutoff system,. so there is
no harm done to the machine itself. The irrigator should
only be ran in accordance with the waste management plans
and to the specifications of this design.
Winterization should be done when the machine will be shut
down for more than a month at a time, during the winter
season. All water should be drained and machine should
be greased and oiled.
Regular checks should be made on the reel, hose, and all
mechanical equipment on the machine itself.

T
k o't
U. S. DEPARTMENT OF AGRICULTURE
SOIL CONSERVATION SERVICE
SOIL INVESTIGATION TO DETERMINE SUITABILYP IT'OF 00P ....:.......a._ '� . .. ... ., .0$ED .POND SITE -
1 ' i l !J'�?11.a • it
I
WATERSHED AREA MEASUREMENTS
�CROPLAND
WOODLAND -ACRES TOTAL ---- �� ACRES
�SKETCH OF,.PROPOSED POND SHOWING WHERE BORINGS WERE MADE
L Locate refirence point on ce",ter line of dam and identify an sketch.
MEN
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BORWG NUMBER AND PROFILE
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, 20K.-

CLIENTS
COUNTY
TODAYS
SITING
NUMBER
NUMBER
NUMBER
NUMBER
NUMBER
NUMBER
NUMBER
NUMBER
THIS DESIGN IS FOR A,SINGLE STAGE SWINE LAGOON
NAME
DATE
LAW DISTANCES OKAY (YES OR NO) =>
OF PIGS WEANLING TO FEEDER
OF PIGS FEEDER TO FINISH =======>
OF SOWS FARROW TO WEANLING
OF SOWS FARROW TO FEEDER
OF SOWS FARROW TO FINISH
OF DEVELOPING GILTS
OF STUD BOARS OR GESTATING SOWS >
OF YEARS OF SLUDGE ACCUMULATION >
(5 year minimum unless retrofit)
Wayne West
Northampton
7/23/97
Yes
0
1100
0
0
0
0
0
0
TOP LENGTH AT NORMAL WATER LEVEL
TOP WIDTH AT NORMAL WATER LEVEL
NORMAL WATER LEVEL ELEVATION
SEASONAL HIGH WATER TABLE ELEVATION =__>
LAGOON BOTTOM ELEVATION
Depth of Permanent Water 8.3
(minimum depth including sludge = 6 feet)
(maximum depth of sludge = 2-feet)
SIDE SLOPES
Permanent Volume Required 148500.0
Permanent Volume Provided 150201.6
ADDITIONAL DA W/O EVAP. (VEGETATED)
ADDITIONAL DA W/O EVAP. (NON-VEGET.) =_>
(i.e. feedlot & non -diverted area)
ADDITIONAL D. A. WITH EVAPORATION
(i.e. pumpout pond)
LENGTH OF PUMPING CYCLE
GALLONS OF FRESH WATER ADDED DAILY
NORMAL RAINFALL.FOR PUMPING CYCLE -_=>
PERCENT RUNOFF ON VEGETATED AREAS
PERCENT -RUNOFF ON NON -VEGETATED -AREAS =>
NORMAL EVAPORATION FOR PUMPING CYCLE
25YR/24HR STORM RAINFALL
RUNOFF DEPTH FROM VEGETATED AREAS
RUNOFF DEPTH FROM NON -VEGETATED AREAS =>
INCLUDE HEAVY RAIN (YES=1, NO=O)
FREEBOARD
280.0
FEET
90.0
FEET
92.0
FEET
90.0
FEET
83.7
FEET
feet
2.5:1
cubic feet
cubic feet
0 SQUARE FEET
0 SQUARE FEET
0 SQUARE
120 D S
ALLONS
.1 INCHES
30 PERCENT
65 PERCENT
7.3 INCHES
6.7 INCHES
0.0 INCHES
0.0 INCHES
0 (NUMBER
1.0 FEET
ESTIMATED TOP OF DAM ELEVATION =---====> 95.8 FEET
Temporary Storage Volume Needed 77253.1 cubic feet
Temporary Storage Volume Provided 77994.9 cubic feet
Top of Dam Elevation =
Inside Dimensions of Lagoon at
Length = 299.0 feet Width =
ESTIMATED DEPTH TO PUMP =
Volume To Be Pumped =
Volume for Estimated Depth =
Begin Pumping Elevation =
Stop Pumping Elevation =
FEET
i L�
ONLY)
95.8 feet
Top of Dam 98 �-
109.0 feet
2.1 FEET
59056 cubic feet
57076 cubic feet
94 :1 feet
92.0 feet•
I r I . _.I I

1. STEADY STATE LIVE WEIGHT'
0
head weanling to feeder x 30 lbs. -
0
1bs
1100
head feeder to finishing x 135 lbs. -
148500
lbs
0
sows farrow to weanling x 433 lbs. =
0
lbs
0
sows farrow to feeder x 522 lbs. -
0
lbs
0
sows farrow to finish x 1417 lbs. =
0
lbs
0
developing gilts x 150 lbs. -
0-lbs
0
stud boars or gestating sows =
0
TOTAL STEADY STATE LIVE WEIGHT (SSLW) -
148500
lbs
2. SLUDGE ACCUMULATION
Sludge accumulates at varying rates.
0
pounds weanling to feeder x 0.25 -
0
cu.
ft.
148500
pounds feeder to finishing x 0.25 =
37125
cu.
ft.
0
pounds farrow to weanling x 0.17 -
0
cu.
ft.
0
pounds farrow to feeder x 0.17 -
0
cu.
ft.
0
pounds farrow to finish x 0.25 =
0
cu.
ft.
0
pounds of developing gilts x 0.25 =
0
cu.
ft.
0
lbs. of boar studs or gest. sows * 0.125=
0
cu.
ft.
TOTAL SLUDGE ACCUMULATION - 0 cu. ft.
3. REQUIRED LIQUID VOLUME OF LAGOON
Design Treatment Volume varies by animal type.
0
pounds
weanling to feeder x 1.0 =
0
cu.
ft.
148500
pounds
feeder to finishing x 1.0 =
148500
cu.
ft.
0
pounds .farrow
to weanling x 0.67 =
0
cu'.
ft.
0
pounds
farrow to feeder x 0.67 =
0
cu.
ft.
0
pounds
farrow to finish x 1.0 -
0
cu.
ft.
0
pounds
of developing gilts x 1.0 =
0
cu.
ft.
0
lbs. of
boar studs or gest. sows * 1 -
0
cu.
ft.
TOTAL LIQUID VOLUME REQUIRED FOR LAGOON - 148500 cu. ft.
TOTAL VOLUME FOR TREATMENT AND SLUDGE - 148500 Cu. ft.
4. NORMAL LAGOON LIQUID LEVEL
Maintain normal lagoon liquid level at elevation 92.0 feet
Construct lagoon bottom elevation 83.7 feet
Lagoon size for normal lagoon liquid volume using prismodial formula
SS/END1 SS/END2 SS/SIDE1 SS/SIDE2 DEPTH
2.5 2.5 2.5 2.5 8.3
AREA OF TOP
LENGTH *WIDTH =
280.0 90'.0 25200.0 (AREA OF TOP)

5. DAM
AREA OF BOTTOM
Lb * Wb -
238.5 48.5
AREA OF MIDSECTION
(Lm * Wm) _
259.2 69.2
11567.2 (AREA OF BOTTOM)
17953'.1 (AREA OF MIDSECTION)
CU. YD. = [AREA TOP + (4*AREA MIDSECTION) + AREA BOTTOM] * DEPTH/6
25200.0 71812.2 11567.2 1.383
VOLUME OF LAGOON AT NORMAL LAGOON LIQUID LEVEL=50201.6 CU. FT.
VOLUME NEEDED = 1.48500.0 CU. FT.
THE SURFACE DIMENSIONS OF THE LAGOON AT NORMAL LIQUID LEVEL
ARE 280.0 FEET LONG BY 90.0 FEET WIDE.
Place spoil as a continuous dam to elevation .95.8 feet.
6. TEMPORARY STORAGE REQUIRED
DRAINAGE AREA:
Lagoon (top of dam)
Length * Width =
299.0 109.0 32591 square feet
Additional Drainage Area Without Evaporation'
Vegetated 0 square feet
Non -Vegetated 0 square feet
Additional Drainage Area With Evaporation
0 square feet
TOTAL DA 32591 square feet
Pumping cycle to be 120 days.
6A. Volume of waste produced
0
head weanling
to feeder x 0.5 gals/day =
0
gals/day_
1100
head feeder to
finishing x 2.3 gals/day =
2530
gals/day
0
sows farrow to
weanling x 7.2 gals/day -
0
gals/day
0
sows farrow to
feeder x 8.0 gals/day -
A
gale/day
0
sows farrow to
finish. x 23.0 gals/day =
0
gals/day
0
developing gilts
x 2.5 gals/day =
0
gals/day
0-stud
boars or
gest. sows x 6.7 gals/day =
0
gals/day
TOTAL VOLUME OF
WASTE =
2530
gals/day
Volume =
2530 gals/day * 120
days in the
pumping
cycle
divided by 7.48 gallons per
cu. ft.
Volume =
40588.2 cubic feet

6B. Volume of rainfall in excess of evaporation
Use period of time when rainfall exceeds evaporation by largest
amount.
Excess rainfall (difference) =
6.6 inches
Volume = Volume from lagoon + volume from feedlots, etc + volume from
Volume = .18468.2 cubic feet
6C. Volume of fresh water added
This is the amount of fresh water used for washing floors or
volume of fresh water used for a flush system. Flush systems
that recycle the lagoon water are accounted for in 6A.
Volume = 0 gallons/day * 120 days in pumping
cycle divided by 7.48 gallons per cu. ft.
Volume =
0 cubic feet
6D. Volume of 25 year - 24 hour storm
Volume = Volume from lagoon + volume from feedlots, etc + volume from
Volume = 18196.6 cubic feet
6E. Volume of "Heavy Rain"
Volume = Volume from lagoon + volume from feedlots, etc,+ volume from
Volume =
0.0 cubic feet
TOTAL REQUIRED TEMPORARY STORAGE
6A.
40588.2
cubic
feet
of
waste
6B.
18468.2
cubic
feet
of
excess rainfall
6C.
0.0
cubic
feet
of
fresh wash water.
6D.
18196.6
cubic
feet
of
25yr-24hr.storm wate
6E.
0.0
cubic
feet
of
heavy rainfall
TOTAL TEMPORARY STORAGE 77253.1 cubic feet
7. DEPTH OF STORAGE REQUIRED (ABOVE NORMAL LIQUID ELEVATION OF LAGOON)
VOLUME OF TEMPORARY
STORAGE WHEN TOP OF
DAM IS 95.8 FEET ELEV.
AREA OF BOTTOM =
25200.0
sq.
ft.
AREA OF TOP =
30576.0
sq.
ft.
AREA OF MID -SECTION
27839.0
sq.
ft.
VOLUME PROVIDED =
77994.9
cubic
feet
THE DIMENSIONS OF THE INSIDE EDGE OF THE DAM AT.ELEVATION ' 95.8 FT,

ARE. 299.0
SET BEGIN•PUMPING ELEVATION
PUMPED STORAGE VOLUME
6A.
6B.
'6C.
TOTAL PUMPED VOLUME =
FEET BY 109.0 FEET
40588.2 cubic feet of waste
18468.2 cubic feet of excess rainfall
0.0 cubic feet of fresh wash water
59056.5 cubic feet
VOLUME AT ESTIMATED PUMPING DEPTH
AREA OF BOTTOM = 25200.0 sq. ft.
AREA OF TOP = 29195.2 sq. ft.
AREA OF MID -SECTION = 27170.1 sq. ft.
VOLUME PROVIDED = 57076.4 cubic feet
DESIGNED BY: APPROVED BY:
DATE: 7 (L� DATE: 7 zi

Swine Farm Waste Management Odor Control Checklist
Source Cause BMPs to Minimize.Odoe Site Specific Practices
Farmstead • Swine production Vegetative or wooded buffers;
Recommended best management practices; .
Good judgment and common sense
Animal body. surfaces • Dirty manure -covered animals 0 Dry floors
Floor surfaces • Wet manure -covered floors Slotted floors;
Waterers located over slotted floors;
0 Feeders at high end of solid floors;
O Scrape manure buildup from floors;
Underfloor vendlation,for drying
Manure collection pits • Urine; A Frequent manure removal by flush, pit recharge,
• Partial microbial decomposition or scrape;
Underfloor ventilation
Ventilation exhaust fans • Volatile gases; Fan maintenance;
Dust Efficient air movement
Indoor surfaces • Dust Washdown between groups of animals;
Feed additives;
0 Feeder covers;
.Feed delivery downspout extenders to feeder
covers
Flush tanks • Agitation of recycled lagoon 0 Flush tank covers;
liquid while tanks are filling X Extend fill lines to near bottom of tanks with
anti -siphon vents
Flush alleys • Agitation during wastewater Underfloor flush with underfloor ventilation
conveyance .. i
Pit recharge points • Agitation of recycled lagoon 0 Extend recharge lines to near bottom of pits
liquid while pits are filling with anti -siphon vents
Lift stations • Agitation during sump tank ❑ Sump tank covers
filling and drawdown
Outside drain collection • Agitation during wastewater Box covers
orjunction boxes conveyance
AMOC ,vember it, 1996, Page 3

Source
End of drainpipes at +
lagoon.
Cause
conveyance
BMPs to Minimize Oddr
wastewater= Extend discharge point of pipes underneath
lagoon liquid level ;
• Volatile gas emissions;
• Biological mixing;
• Agitation
K Proper lagoon liquid capacity;
Correct lagoon startup procedures;
f Minimum surface area -to -volume ratio;
C
Minimum agitatioa when.pumping;
Mechanical aeration; .
Proven biological additives
P"H irrc
Irrigation sprinkler
•
High pressure agitation;
Irrigate on dry days with littic or no wind; .
nozzles
•
Wind drift
Minimum recommended operating pressure;
Pump intake near lagoon liquid surface;
,M
Pump from second -stage lagoon DUB
Storage tank or basin
•
Partial microbial decomposition;
0
Bottom or midlevel loading;
surface
•
Mixing while filling;
0
Tank covers;
+
Agitation when emptying
0
Basin surface mats of solids;
0
Proven biological additives or oxidants
Settling basin surface
•
•
Partial microbial decomposition;
Mixing while filling;
0
Extend drainpipe outlets underneath liquid
level;
:, "'
•
Agitation when emptying
0
Remove settled solids regularly
Manure, slurry or sludge
•
Agitation when spreading;
❑
Soil injection of slurry/sludges;
spreader outlets .
+
Volatile gas emissions
0
Wash residual manure from spreader after use;
1
0
Proven biological additives or oxidants
Uncovered manure, + Volatile gas emissions while 0 Soil injection of slurry/sludges
slurry or sludge on field drying ❑ Soil incorporation within 48 lus.;
surfaces
Spread in thin uniform layers for rapid drying;
0 Proven biological additives or oxidants
Dead animals • Carcass decomposition Proper disposition of carcasses
ueaa ancmai uisposat
• %,aFU= ucwinpUsiccwc
Li
uompiete covering or carcasses in ouriai pits;
pits
0
Proper location/construction of disposal pits
Incinerators
• Incomplete combustion
0
Secondary stack burners
* ��
Ar"r1r ' ovesnber 11, 1996, Page 4 t

Source Cause , . BMPs to Minimize Odor Site Specific Practices
Standing water around 0 Improper drainage; - Grade and landscape such that water drains
-
facilities . Microbial decomposition of away from facilities
- - -
organic matter
Manure tracked onto • Poorly maintained access roads Farm access road maintenance -
-- -
public roads from farm
access
Additional Information:
Available From:
Swine Manure Management; 0200 Rule/BMP Packet
NCSU, County Extension Center .
Swine Production Farm Potential Odor Sources and Remedies ; EBAE Fact Sheet
NCSU - BAE
Swine Production Facility Manure Management: Pit Recharge'- Lagoon Treatment; EBAE 128-88
NCSU - BAE
Swine Production Facility Manure Management: Underfloor Flush - Lagoon Treatment.; EBAE 129-88
NCSU - BAE
Lagoon Design and Management for Livestock Manure Treatment and Storage; EBAE 103-83
NCSU - BAE
Calibration of Manure and Wastewater Application Equipment ; EBAE Fact Sheet
NCSU - BAE
Controlling Odors from Swine Buildings; PIH-33
NCSU - Swine Extension
Environmental Assurance Program ; NPPC Manual
NC Pork Producers Assoc
Options for Managing Odor; a report from the Swine Odor Task Force
NCSU Agri Communications
Nuisance Concerns in Animal Manure Management: Odors and Flies; PRO107, 1995 Conference Proceedings
Florida Cooperative Extension
X -November 11, 1996, Page 5
l

Insect Control Checklist for Animal Operations
Source Cause BMPs to Control Insects Site Specific Practices
Flush Gutters •
Accumulation of solids E+ Flush system is designed and operated
sufficiently to remove accumulated solids from
gutters as designed.
Remove bridging of accumulated solids at
Lagoons and Pits Crusted Solids Maintain lagoons, settling basins and pits where
pest breeding is apparent to minimize the .
crusting of solids to a depth of no more than 6 -
8 inches over more than 30% of surface.
Excessive Vegetative . Decaying vegetation Maintain vegetative control along banks of
Growth lagoons and other impoundments to prevent
accumulation of decaying vegetative matter -
along waters edge on impoundment's perimeter.
Dry Systems
Feeders • Feed Spillage 0 Design. operate and maintain feed systems (e.g., :
bunkers and troughs) to minimize the
accumulation of decaying wastage.
Cl Clean, up spillage on a routine basis (e.g., 7 - 10
day interval during summer, 15-30 day interval
during winter).
Feed Storage • Accumulations of feed residues 0 Reduce moisture accumulation within and
around immediate perimeter of feed storage
areas by insuring drainage away from site
and/or providing adequate containment (e.g.,
covered bin for brewer's grain and similar high
moisture grain products).
0 Inspect for and remove or break up accumulated
solids in filter strips around feed storage as
needed.
AA"" '-)vember It, 1996, Page 1

Source Cause BMPs to Control Insects, Site Specific Practices
Animal Holding Areas • Accumulations of animal wastes Q
and feed wastage
17
r
Dry Manure Handling • Accumulations of animal wastes CQ
systems
O
O
Eliminate low areas that trap moisture along
fences and other locations where waste
accumulaies and disturbance by animals is
minimal.
Maintain fence rows and filter strips around +�V
animal holding areas to minimize
accumulations of wastes (Le., inspect for and
remove or breakup accumulated solids as
needed).
Remove spillage on a routine basis (e.g., 7 -.10
day interval during summer 15-30 day interval r v u 1
during winter) where manure is loaded for land
application or disposal.
Provide for adequate drainage around manure
stockpiles.
Inspect for and remove or break up accumulated
wastes in filter strips around stockpiles and
manure handling areas as needed.
For more information contact the Cooperative Extension Service, Department of Entomology, Box 7613, North Carolina State University,
Raleigh, NC, 27695-7613.
AMIC - Y umber 11, 1996, Page 2
Oq

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

EMERGENCY ACTION PLAN
PHONE NUMBERS
DWQ o0
EMERGENCY MANAGEMENT YST M
S WCD N -Z.S_j
NRCS ! W— Z /�
This plan will be implemented in the event that wastes from your operation are leaking,
overflowing, or running off site. You should not wait until wastes reach surface waters or
leave your property to consider that you have a problem. You should make every effort to
ensure that this does not happen. This plan should be posted in an accessible location for
all employees at the facility. The following are some action items you should take.
1. Stop the release of wastes. Depending on the situation, this may or may not be �.
possible. Suggested responses to some possible problems are listed below.
A. Lagoon overflow possible solutions are:
a. Add soil to berm to increase elevation of dam.
b. Pump wastes to fields at an acceptable.rate.
c. Stop all flows to the lagoon immediately.
d. Call a pumping contractor.
e. Make sure no surface water is entering lagoon.
B: Runoff from waste application field -actions include:
a. Immediately stop waste application.
b. Create a temporary diversion to contain waste.
c. Incorporate waste to reduce runoff.
d. Evaluate and eliminate the reason(s) that caused the runoff.
e. Evaluate the application rates for the fields where runoff occurred.
- C:--Leakage from the waste pipes and sprinklers -action include:..----___.___..
a. Stop recycle pump.
b. Stop irrigation pump.
c.. Close valves to elinnate further discharge. .
d. Repair all leaks prior to restarting pumps.
D: Leakage from flush systems, houses, solid separators -action' include:
a. Stop recycle pump.
b. Stop irrigation pump.
c. Make sure no siphon occurs.
d. Stop all flows in the house, flush systems, or solid separators..
1 December 18, 1996

R
F
e. Repair all leaks prior to restarting pumps.
E: Leakage from base or sidewall of lagoon. Often this is seepage as opposed to
flowing leaks- possible action:
a. Dig a small sump or ditch away from the embankment to catch all seepage,
put in a submersible pump, and pump back to lagoon.'
b. If holes are caused by burrowing animals, trap or remove animals and fill
holes and compact with a clay type soil.
c. Have a professional evaluate the condition of the side walls and lagoon
bottom as soon as possible.
2. Assess the extent of the spill and note any obvious damages.
a. Did the waste reach any surface waters?
b. Approximately how much was released and for what duration?
c. Any damage noted, such as employee injury, fish kills, or property damage?
d. Did the spill leave the property?
e. Does the spill have the potential to reach surface waters?
f. Could a future rain event cause the spill to reach surface waters?
g. Are potable water wells in danger (either on or off of the property)?
h. How much reached surface waters?
3: Contact appropriate agencies.
a. During normal business hours, call your DWQ (Division of Water Quality)
regional office; Phone - - . After hours, emergency numbe`"r:' 919-733-3942.
Your phone call should include: your name, facility, telephone number, the details
of the incident from item 2 above, the exact location of the facility, the location or
direction of movement of the spill, weather and wind conditions. The -corrective..
measures that have been under taken, and the seriousness of the situation.
b. If spill leaves property or enters surface waters, call local EMS Phone number -
c. Instruct EMS to contact local Health Department. '
d. Contact CES, phone number" '= '. - . , local SWCD office phe number
and local NRCS office for advice/technical assistance phone" number-' -. -
4: If none of the above works call 911 or the Sherifrs Department and explain your
problem to them and ask that person to contact the proper agencies for you.
5: Contact the contractor of your choice to begin repair of problem to minimize off -site
damage.
a. Contractors Name:
b. Contractors Address:
c. Contractors Phone:
2
December 19, 1996

v
6: Contact the technical specialist who certified the lagoon {NRCS, Consulting
Engineer, etc.}
a. Name: loAliv
b. Phone: Z F2 - SI �Z
7: Implement procedures as advised by DWQ and technical assistance agencies to
rectify the damage, repair the system, and reassess the waste management plan to
keep problems with release of wastes from happening again.
e
3 December 18, 1996

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RECEIVED
WASTE UTILIZATION PLAN SEP 1 '2 ?Uuu
ti;'47PR QUALITY SECTIM
The waste from your animal facility must be land applied at a specified rate to
prevent pollution of surface and/or ground water. The plant nutrients in the
animal waste should be used to reduce the amount of commercial fertilizer
required for the crops on the fields where the waste is to be applied. This
waste utilization plan uses nitrogen as the limiting nutrient. Waste should be
analyzed before each application cycle. Annual soil tests are strongly
encouraged so that all plant nutrients can be balanced for realistic yields of
the crop to be grown.
Several factors are important in implementing your waste utilization plan in
order to maximize the fertilizer value of the waste and to ensure that it is
applied in an environmentally safe manner. Always apply waste based on the
needs of the crop to be grown and the nutrient content of the waste. Do not
apply more nitrogen than the crop can utilize. Soil types are.important as they
have different infiltration rates, leaching potentials, cation exchange
capacities, and available water holding capacities. Normally waste shall not be
applied to land eroding at greater than 5 tons per acre per year. With special
precautions, waste may be applied to land eroding at up to 10 tons per acre per
year. Do not,appiy waste on saturated soils or on land when the surface is
frozen. Either of these conditions may result in runoff to surface waters.
Either of these conditions may result in runoff to surface waters which is not
allowed under DEM regulations. Wind conditions should also -be considered to
avoid drift and downwind odor problems. To maximize the value of nutrients for
crop production and to reduce the potential for pollution, the waste should be
applied to a growing crop or applied to bare ground not more than 30 days'prior
to planting. Injecting the waste or disking will conserve nutrients and reduce.
odor problems.
The estimated acres needed to apply the animal waste is based on typical
nutrient content for this type of facility. Acreage requirements should be
based on the waste analysis report from your waste management facility.
Attached you will find information on proper sampling techniques, preparation,
and tiansfer of waste samples to the lab for analysis.
This waste utilization plan, if -carried out, meets the requirements for
compliance with 15A NCAC 2H A217 adopted by the Environmental Management
Commission.

Amount of Waste Produced Per Year(gallons, tons,etc.)
1250 animals X 751 gal. waste/animal/year = 938,750 gals. waste/year.
Amount of Plant Available Nitrogen (PAN) Produced Per Year
1250* animals X 2.3 lbs. PAN/animal/year =2875 lbs. PAN/year. (PAN from N. C.
Tech. Guide Std. 633)
* (actual amount would be closer to 1100 topping, will use 1250 for planning
purposes)
Applying the above amount of waste is a big job. You should plan time and have
appropriate equipment to apply the waste in a timely manner.
The following acreage will be needed for waste application based on the crop to
be grown and surface application:
Table 1: ACRES OWNED BY PRODUCER
Tract Field Soil Crop Lbs. N Acres Lbs. N Month of
# No. Type Per Ac.* Utilized Application
1688
21
CrA
Cotton
600 x.1
33.9
2034
Mar -Aug
16
CrA
Cotton
600 x.l
9.2
552
Mar -Aug
5
CaA
Sm grain
1.7 x55
15.9
1486
Oct -Mar
15
CrA
Sm grain
1.7 x55
28.3
2646,
Oct -Mar
4
CaA
Peanuts
Option
10.1
Opt
August
7
GoA
Peanuts
Option
5.1
Opt
Au ust
A
GoA
Fescue
hay
4.3 x
50
1
215
Sept -Nov
Feb -May
2
TsA
Cotton
600 x.l
44
2640
Mar -Aug
Total
1147.5
9573
Table 1 I I 9573 )
Total I I 9573 I
Amount of N Produced I 2875
Surplus or Deficit I -6698 I
* This N is from animal waste only. If nutrients from other sources such as
commercial fertilizer are applied, they must be accounted for. N must be based
on realistic yield expectation.

131
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ICA

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ON
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al
NLA��J M im

NOTE: The applicator is cautioned that P and K may be over applied while
meeting the N requirements. This plan only addresses Nitrogen.
NOTE: The Waste Utilization Plan must contain provisions for periodic land
application of sludge at agronomic rates. The sludge will be nutrient rich and
will :.-equire precautionary measures to prevent over application of nutrients or
other elements.
Application of Waste By Irrigation
Field No.
Soil Type
Crop
Application
Rate (In/Hr)
Application
Amount (In.)
21
Craven
Cotton
0.35
1.0
16
Craven
Cotton
0.35
1.0
5
Caroline
Small grain
0.35
1.0
15
Craven
Small grain
0.35
1.0
4
Caroline
Peanuts
0.35
1.0
7
Goldsboro
Peanuts
0.4
1.0
A
Goldsboro
Fescue
0.4
1.0
Total Acres are wettable acres not irrigated acres.
Your facility is designed for 120 days of temporary storage and the temporary
storage must be removed on the average of once every 4 months.
In no instance should the volume of waste being stored in your structure exceed
1.7 ' from the top of dike.
Call the local Natural Resources Conservation -Service (,formerly Soil
Conservation Service) or Soil and Water Conservation District office after you
receive the waste analysis report for assistance in determining the amount per
acre to apply and the proper application rate prior to applying the waste.
Narrative of operation:
Waste will be applied to cotton, some peanuts, small grain, and fescue.

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

10. Waste nutrients shall not be applied in fall or winter for spring
planted crops on soils with a high potential for leaching. Waste
nutrient loading rates on these soils should be held to a minimum and
a suitable winter cover crop planted to take up released nutrients.
Waste shall not be applied more than 30 days prior to planting of a
crop or forages breaking dormancy.
11. Any new swine facility sited on or after October 1, 1995 shall comply
with the following: The outer perimeter of the land area onto which
waste is applied from a lagoon that is a component of a swine farm
shall be at least 50 feet from any residential property boundary and
any perennial stream or river other than an irrigation ditch or canal.
Animal waste other than swine waste from facilities sited on or after
October 1, 1995, shall not be applied closer than 25 feet to surface
water. This distance may be reduced for waters that are not perennial
provided adequate vegetative filter strips are present (See Standard
393-Filter Strips).
12. Mimal waste shall not be applied closer than 100 feet from
wells.
13. Animal waste shall not be applied closer than 200 feet of dwellings
other than those owned by the landowner.
14. Waste shall be applied in a'manner not to reach other property and
public right-of-ways.
15. Animal waste shall not be discharged into surface waters, drainageways
or wetlands by a discharge or by overspraying. Animal waste may be
applied to prior converted cropland provided it has been approved
as a land applications site by a "technical specialist". Animal waste
applied on grassed waterways shall be at agronomic rates and in a
manner that causes no runoff or drift from the site.
16. Domestic and industrial waste from washdown facilities, showers,
toilets, sinks, etc., shall not be discharged into the animal waste
management system.
17. A protective cover of appropriate vegetation will be established on
all•.disturbed areas (lagoon embankments, berms, pipe runs, etc.). Areas
shall be fenced, as necessary, to protect the vegetation. Vegetation
such as trees, shrubs, and other woody species, etc. are limited to
areas where considered appropriate. Lagoon areas should be kept mowed
and accessible. Lagoon berms and structures should be inspected
regularly for evidence of erosion, leakage, or discharge.
18. If animal production at the facility is to be or terminated,
the owner is responsible for obtaining and implementing a "closure
plan" which will eliminate the possibility of an illegal discharge,
pollution and erosion.
19. Waste handling structures, piping, pumps, reels,.etc., should be
inspected on a regular basis to prevent breakdowns, leaks, and spills,
A regular maintenance checklist should be kept on site.

20. Animal waste can be used in a rotation that includes vegetables and
other crops for direct human consumption. However, if animal waste is
used on crops for direct human consumption it should only be applied
preplant with no further applications of animal waste during the crop
season.
21. Highly visible permanent markers shall be installed to mark the top and
bottom elevations of the temporary storage (pumping volume) of all
waste treatment lagoons. Pumping shall be managed to maintain the
liquid level between the markers. A marker will be required to mark
the maximum storage volume for waste storage ponds.
22. Soil tests shall be made every two years and a liquid waste analysis
be taken at least twice each year consistent with waste utilization
plan: Poultry litter shall be tested prior to application. Soil
and waste analysis records shall be kept for five years.
23. Dead animals will be disposed of in a manner that meets NC regulations.
r

WASTE UTILIZATION PLAN AGREEMENT
Name of Farm: Wayne West
Owner/Manager Agreement
I (we) understand and will follow and implement the specification and the
operation and maintenance procedures established in the approved animal waste
utilization plan for the farm named above. I (we) know that any expansion to
the existing design capacity of the waste treatment and storage system or
construction of new facilities will require a new certification to be submitted
to the Division of Environmental Management (DEM) before the new animals are
stocked. I (we) also understand that there must be no discharge of animal waste
from this system to surface waters of the state from a storm event less severe ,
than the 25-year, 24-hour storm. The approved plan will be filed on -site at the
farm office and at the office of the local Soil and Water Conservation District
and will be available for review by DEM upon request.
Name of Facility Owner: Wayne West
Signature: Z I Date: r Q
Technical Representative: Tony Short
Affiliation: Natural Resources Conservation Service
Address Agency: P.O. Box 218
Jackson N.C. 27845
252-534-25
Signature: bate: /

4L
y
Producer: Wayne West
Location: 3 miles west of Jackson on US 158
Telephone:
Type Operation T
Number of Animal Units?\ 625 from 35 to 110 lbs an"25 from 110 to 220 lbs
The waste from your anim4 facility must be land applied at a specified
rate to prevent pollution �,of surface and/ r ground water. The plant
nutrients in the animal waste should be used to reduce the amount of
commercial fertilizer requirea� for the cr s on the fields where the waste
is to be applied. This waste utiliz tion plan uses nitrogen as the
limiting nutrient. Waste should be anal zed before each application cycle.
Annual soil tests are strongly engoura ed so that all plant nutrients can
be balanced for realistic yields of,\th crop to be grown.
Several factors are important in im ementing your waste utilization plan
in order to maximize the fertilize value of the waste and to ensure that
it is applied in an environmentall saf\ manner. Always.apply waste based
on the needs of the crop to be gr wn and e nutrient content of the waste.
Do not apply more nitrogen tha the crop can utilize. Soil types are
important as they have differe infiltrati rates, leaching potentials,
cation exchange capacities, nd available water holding capacities..
Normally waste shall not be a lied to land er ding at greater than 5 tons
per acre per year. With spe ial precautions, waste may be applied -to land
eroding at up to 10 tons er acre per year. \\Do not apply waste on
saturated soils or on land when the surface is frozen. Either of these
conditions may result in runoff to surface water Either of these
conditions may result in runoff to surface waters ich is not allowed
under DEM regulations. .1 conditions should also be onsidered to avoid
drift and downwind odor problems. To maximize the valu� of nutrients for
crop production and t reduce the potential for pollution, the waste
should be applied to agrowing crop or applied to bare ground not more than
30 days prior to planting. injecting the waste or disking will conserve
nutrients and reduce odor problems.
The estimated acre needed to apply the animal waste is based on typical
nutrient content or this type of facility. Acreage requirements should be
based on the wa to analysis report from your waste management facility.
Attached .you ill find information on proper sampling techniques,
preparation, and transfer of waste samples to the lab for analysis.
This waste utilization plan, if carried out, meets the 'requirements for
compliance with 15A NCAC 2H.0217 adopted by the Environmental Management
Commission

Amount of Waste Produced Per Year(gallons, tons,etc.)
animals X gal. waste/animal/year gals. waste/year.
Amount of Plant Available Nitroaen (PAN) Produced Per Year
1250* animals X_,,, 2.3 lbs. PAN/animal/year =2875 lbs. PAN/year. (PAN from
N. C. Tech. Guide Std. 633)
* actual amount would be closer to 1100 topping, will use 1250 for planning
purposes
Applying the above amount of waste is a big job. You should plan time and
have appropriate equipment to apply the waste in a timely manner.
The following acreage will be needed for waste application based on the
crop to be grown and surface application:
Table I: ACRES OWNED BY PRODUCER
Tract Field Soil Crop Lbs. N Acres Lbs. N Month of
# No. Type Per Ac.* Utilized Application
E=I
�. 32',
• li 77
I
�WTTVW
! -
* This N is from animal waste only.' if nut rientsJfroln other
as commercial fertilizer are applied, they must be accounted
be based on based on realistic yield expectation expectation.
7y'-3 8T,, 3 jq6
Izly lie
sour es su�hy/��
for. N must
NOTE: The applicator is cautioned that P and K may be over applied while
meeting the N requirements. This plan only addresses Nitrogen.

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WASTE UTILIZATION PLAN ,
Table 2: ACRES WITH AGREEMENT OR LONG TERM LEASE
(Agreement with adjacent landowner must be attached)
(Required only if operator does not own
adequate land [see Required Specification 21)
Tract Field Soil Crop Lbs. N Acres Lbs. N Month of
## Type Per Ac.* Utilized Application
*See footnote for Table 1.
Totals from above Tables
Acres Lbs. N
Utilized
Table 1
Table 2
Total I TT r �
Amount of N Produced 2 1 S
Surplus or Deficit e
NOTE: The Waste Utilization Plan must contain provisions for periodic land
application of sludge at agronomic rates. The sludge will be nutrient rich
and will require precautionary measures to prevent over application of
nutrients -or other elements.
See attached map showing the fields to be used for the utilization of waste
water.

WAS........... .. ...........
TE UTILIZATION PLAN '
Application of Waste by Irrigation
Field
No.
Soil Type
Crop
Application
Rate(In/Hr)
Application
Amount(In.)
C-0
CM
Sr
� O-� O f I
�ihr�,11.,.r1�
� • S�
d , C�
J I
114 ylq
This table It hot needed It waste is nat bebtg applied by irogation, however a simllar table wlloe PYeded for dry litter or sludge.
lie eRu
Your facility is designed for days of temporary storage and the
temporary storage must be removelfWri the average of once every months.
In no instance should the volume of waste being stored in your suture
exceed 1.7 t from the top of dike.
Call the local Natural Resources Conservation Service (formerly Soil
Conservation Service) or Soil and Water Conservation District office after
you receive the waste analysis report for assistance in determining the
amount per acre to apply and the proper application rate prior to applying
the waste.
Narrative of Operation:
Waste will be applied to cotton, some peanuts, small grain, and some
fescue.

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

a+ w
10. Waste nutrients shall not be applied in fall or winter for spring
p;.anted crops on soils with a high potential for leaching. Waste
nutrient loading rates on these soils should be held to a minimum and
a suitable winter cover crop planted to take up released nutrients.
Waste shall not be applied more than 30 days prior to planting of a
crop or forages breaking dormancy.
11. Any new swine facility sited on or after October 1, 1995 shall comply
with the following: The outer perimeter of the land area onto which
waste is applied from a lagoon that is a component of a swine farm
shall be at least 50 feet from any residential property boundary and
any perennial stream or river other than an irrigation ditch or canal.
Animal waste other than swine waste from facilities sited on or after
October 1, 1995, shall not be applied closer than 25 feet to surface
water. This distance may be reduced for waters that are not perennial
provided adequate vegetative filter strips are present (See Standard
393-Filter Strips).
12. Animal waste shall not be applied closer than 100 feet from
wells.
13. Animal waste shall not be applied closer than 200 feet of dwellings
other than those owned by the landowner.
14. Waste shall be applied in a manner not to reach other property and
public right-of-ways.
15. Animal waste shall not be discharged into surface waters, drainageways
or wetlands by a discharge or by overspraying. Animal waste may be
applied to prior converted cropland provided it has been approved
as a land applications site by a "technical specialist". Animal waste
applied on grassed waterways shall be at agronomic rates and in a
manner that causes no runoff or drift from the site.
16. Domestic and industrial waste from washdown facilities, showers,
toilets, sinks, etc., shall not be discharged into the animal waste
management system.
17. A protective cover of appropriate vegetation will be established on
a,.l disturbed areas (lagoon embankments, berms, pipe runs, etc.). Areas
shall be fenced, as necessary, to protect the vegetation. Vegetation
such as trees, shrubs, and other woody species, etc. are limited to
areas where considered appropriate. Lagoon areas should be kept mowed
and accessible. Lagoon berms and structures should be inspected
regularly for evidence of erosion, leakage, or discharge.
18. If animal production at the facility is to be or terminated,
the owner is responsible for obtaining and implementing a "closure
plan" which will eliminate the possibility of an illegal discharge,
pollution and erosion.
19. Waste handling structures, piping, pumps, reels•, etc., should be
inspected on a regular basis to prevent breakdowns, leaks, and spills,
A regular maintenance checklist should be kept on site.

20. Animal waste can be used in a rotation that includes vegetables and
other crops for direct human consumption. However, if animal waste is
used on crops for direct human consumption it should only be applied
preplant with no further applications of animal waste during the crop
season.
21. Highly visible permanent markers shall be installed to mark the top and
bottom elevations of the temporary storage (pumping volume) of all
waste treatment lagoons. Pumping shall be managed to maintain the
1_quid level between the markers. A marker will be required to mark
the maximum storage volume for waste storage ponds.
22. Soil tests shall be made every two years and a liquid waste analysis
be taken at least twice each year consistent with waste utilization
plan. Poultry litter shall be tested prior to application. Soil
and waste analysis records shall be kept for five years.
23. Dead animals will be disposed of in a manner that meets NC regulations.

• .,
WASTE UTILIZATION PLAN AGREEMENT
Name of Farm: wes/
Owner/Manager Agreement
I (we) understand and will follow and implement the specification and the
operation and maintenance procedures established in the approved animal
waste utilization plan for the farm named above. I (we) know that any
expansion to the existing design capacity of the waste treatment and
storage system or construction of new facilities will require a new
certification to be submitted to the Division of Environmental Management
(DEM) before the new animals. are stocked. I (we) also understand that
there must be no discharge of animal waste from this system to surface
waters of the state from a storm event less severe than the 25-year, 24--
hour storm. The approved plan will be filed on -site at the farm office and
at the office of the local Soil and Water Conservation District and will be
available for review by DEM upon request.
Name of Facility Owner: (Please print)
Signature - -- __ —Date: -2•
Name of Manager (If different from owner:
Signature: Date:
Technical Representative: Tony Short
Affiliation: Natural Resources Conservation Service
Address (Agency:
Signature:
P.O. Box 218
Jackson N.C. 27845
919-534-
Date:.,3—Z r__-! �7

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
July H, 2000
CERTIFIED MAIL .
RETURN RECEIPT REQUESTED
Wayne West
Wayne West
Rt 1 Box 337
Jackson NC 27845
Farm Number: 66.60
Dear Wayne West:
4 •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
You are hereby notified that Wayne West, in accordance with G.S. 143-215.10C, must apply for coverage under an
Animal Waste Operation General Permit. Upon receipt of this letter, your farm has sixty (60) days to submit the attached
application and all supporting documentation. In accordance with Chapter 626 of 1995 Session Laws (Regular Session
1996), Section 19(c)(2), any owner or operator who fails to submit an application by the date specified by the
Department SHALL NOT OPERATE the animal waste system after the specified date. Your application must be
returned within sixty (60) days of receipt of this letter. Failure to submit the application as required may also subject your
facility to a civil penalty and other enforcement actions for each day the facility is operated following the due date of the
application.
The attached application has been partially completed using information listed in your Animal Waste Management
Plan Certification Form. If any of the general or operation information listed is incorrect please make corrections as noted on
the application before returning the application package. The signed original application, one copy of the signed application,
two copies of a general location map, and two copies of the Certified Animal Waste Management Plan must be returned to
complete the application package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
If you have any questions concerning this letter, please call Sue Homewood at [phone] extension 502 or
Charles Alvarez with the Raleigh Regional Office at [phone].
Sincerely,
c
for Kerr T. Stevens
cc: Permit File (w/o encl.)
Raleigh Regional Office (w/o encl.)
1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
August 31, 2000
W AYNE WEST
RT 1 BOX 337
JACKSON NC 27845
ILT?W,A
IT 0 0
A&41;
NCDENR,
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURcE5
Subject: Application No. AWS660060
Additional Information Request
Wayne West
Animal Waste Operation
Northampton County
Dear Wayne West:
The Non -Discharge Permitting Unit has completed a preliminary engineering review of the subject application. Additional
information is required before we can continue our review. Please address the following by September 30, 2000:
The WUP received July 31, 2000 includes several revisions only signed and dated by the technical
specialist. Please send a copy of the WUP with each revision signed and dated by both the owner and
the technical specialist.
Please reference the subject permit application number when providing the requested information. All information should be
signed, sealed, and submitted in duplicate to my attention at the address below. The information requested by this letter must
be submitted on or before September 30, 2000 or the Division will return your application as incomplete in accordance with
15A N.C.A.C. 2H .0200 and your facility will be considered to be operating without a permit.
Please be advised that operation of the subject animal waste management system without a valid permit is a violation of North
Carolina General Statute 143-215.1 and will subject you to the enforcement authority of the Environmental Management
Commission.
If you have any questions regarding this request, please call me at [phone], extension 544.
cc: Raleigh Regional Office, Water Quality
Tony Short, Natural Resources Conservation Service
Permit File
Sincerely,
Stephanie Milam
Environmental Engineer
Non -Discharge Permitting Unit
SEP 7 MW
i OFuNR RALEIGH REGIONAL OFFICE
4
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

WASTE UTILIZATION PLAN
Producer: Wayne West
Location: 3 miles west of Jackson on US 158
Telephone: [phone]
Type Operation: Topping
Number of Animal Units: 625 from 35 to 110 lbs. and 625 from 110 to 220 Ibs
The waste from your animal facility must be land applied at a specified rate to prevent pollution of surface
and/or ground water. The plant nutrients in the animal waste should be used to reduce the amount of
commercial fertilizer required for the crops on the fields where the waste is to be applied. This waste
utilization plan uses nitrogen as the limiting nutrient. Waste should be analyzed before each application
cycle. Annual soil tests are strongly encouraged so that all plant nutrients can be balanced for realistic
yields of the crop to be grown.
Several factors are important in implementing your waste utilization plan in order to maximize the fertilizer
value of the waste and to ensure that it is applied in an environmentally safe manner. Always apply waste
based on the needs of the crop to be grown and the nutrient content of the waste. Do not apply more
nitrogen than the crop can utilize. Soil types are important as they have different infiltration rates, leaching
potentials, cation exchange capacities, and available water holding capacities. Normally waste shall not be
applied to land eroding at greater than 5 tons per acre per year. With special precautions, waste may be
applied to land eroding at up to 10 tons per acre per year. Do not apply waste on saturated soils or on land
when the surface is frozen. Either of these conditions may result in runoff to surface waters. Either of these
conditions may result in runoff to surface waters which is not allowed under DEM regulations. Wind
conditions should also be considered to avoid drift and downwind odor problems. To maximize the value of
nutrients for crop production and to reduce the potential for pollution, the waste should be applied to a
growing crop or applied to bare ground not more than 30 days prior to planting. Injecting the waste or
disking will conserve nutrients and reduce odor problems.
The estimated acres needed to apply the animal waste is based on typical nutrient content for this type of
facility. Acreage requirements should be based on the waste analysis report from your waste management
facility. Attached you will find information on proper sampling techniques, preparation, and transfer of waste
samples to the lab for analysis.
This waste utilization plan, if carried out, meets the requirements for compliance with 15A NCAC 21-1.0217
adopted by the Environmental Management Commission.
RECEIVED/ DENR I !?VV
AQUIF:FR'ARnTFf TIn�� f' Il1 r
MAR 1$ ���

Amount of Waste Produced Per Year (gallons, tons,etc.)
1250 animals X 751 gal. wastelanimallyear = 938,750 gals. wastelyear.
Amount of Plant Available Nitrogen (PAN) Produced Per Year
1250* animals X 2.3 lbs. PANlanimallyear =2875 lbs. PAN/year. (PAN from N. C. Tech. Guide Std.
633)
(actual amount would be closer to 1100 topping, will use 1250 for planning purposes)
Applying the above amount of waste is a big job. You should plan time and have appropriate equipment to
apply the waste in a timely manner.
The following acreage will be needed for waste application based on the crop to be grown and surface
application:
Table 1: ACRES OWNED BY PRODUCER
Tract Field Soil Crop Lbs. N Acres Lbs. N Month of
# No. Type Per Ac.* Utilized Application
1688
21
CrA
Cotton
600 x.1
33.9
2034
Mar 15 - Aug 1
21
CrA
wheat
50
33.9
1695
Sept 1-Apr 30
5
CaA
Cotton
600x .1
15.9
954
Mar 15 - Aug 1
5
CaA
wheat
50
15.9
795
Sept 1- Apr 15
4
GoA
Fescue hay
4.3x 50
1
215
Aug 1- Jul 31
6
CaA
Cotton
600x .1
1.4
84
Mar 15 - Aug 1
6
CaA
wheat
50
1.4
70
Sept 1-Apr 30
16
CrA
Cotton
600 x.1
9.2
552
Mar 15 - Aug 1
16
CrA
wheat
50
9.2
460
Sept 1-Apr 30
15
CrA
cotton
600 x.1
28.3
1698
Mar 15 - Aug 1
15
CrA
wheat
50
28.3
1415
Sept 1-Apr 30
7
GoA
cotton
600 x.1
5.1
306
Mar 15 - Aug 1
7
GoA
wheat
50
5.1
255
Sept 1-Apr 30
Total
94.8
10533

Table 2: ACRES OWNED BY PRODUCER showing rates for small grain and wheat or
Triticale placed in the rotation instead of cotton.
Tract Field Soil Crop Lbs. N Acres Lbs. N Month of
# No. Type Per Ac.* Utilized Application
1688
21
CrA
Sm grain/
soybeans
1.7 x
55
33 x 4
33.9
33.9
3169
+
4474
Sept 1-Apr 30
Apr 1-Sept 30
16
CrA
Sm grain/
soybeans
1.7 x
55
33 x 4
9.2
9.2
860
1214
Sept 1-Apr 30
Apr 1-Sept 30
5
CaA
Sm grain/
soybeans
1.7 x
55
33 x 4
15.9
15.9
1486
2099
Sept 1-Apr 30
Apr 1-Sept 30
15
CrA
Sm grain/
soybeans
1.7 x
55
33 x 4
28.3
28.3
2646
3735
Sept 1-Apr 30
Apr 1-Sept 30
6
CaA
Sm grain/
soybeans
1.7 x
55
33 x 4
1.4
1.4
131
184
Sept 1-Apr 30
Apr 1-Sept 30
7
GoA
Sm grain/
soybeans
1.7 x
55
33 x 4
5.1
5.1
476
673
Sept 1-Apr 30
Apr 1-Sept 30
4
GoA
Fescue
hay
4.3 x
50
1
215
Aug 1- July 31
Total
94.8
21362
Table I 1 1 10533 1
Total 1 1 10533 1
Amount of N Produced 1 2875 1
Surplus or Deficit 1 -7658 1
Table 2 1 1 21362 1
Total 1 21362 I
Amount of N Produced 1 2875 I
Surplus or Deficit 1 -18487 1
This plan will allow small grains such as wheat, rye or triticale to be used as
a winter cover that waste water can be applied on from September through April
at a maximum of 50 pounds of nitrogen per acre. The applied nitrogen will be
subtracted off of the allowed nitrogen for the next crop.
" This N is from animal waste only. If nutrients from other sources such as commercial fertilizer are applied,
they must be accounted for. N must be based on realistic yield expectation.
NOTE: The applicator is cautioned that P and K may be over applied while meeting the N requirements.
This plan only addresses Nitrogen.

NOTE: The Waste Utilization Plan must contain provisions for periodic land application of sludge at
agronomic rates. The sludge will be nutrient rich and will require precautionary measures to prevent over
application of nutrients or other elements. The operator is advised not to apply sludge on normal spray
application fields. A separate application plan can be devised prior to sludge application events which will
not occur annually.
Application of Waste By Irrigation
Field No.
Soil Type
Crop
Application
Rate (In/Hr)
Application
Amount (In.)
21
Craven
Cotton
0.35
1.0
16
Craven
Cotton
0.35
1.0
5
Caroline
Small grain
0.35
1.0
15
Craven
Small. grain
0.35
1.0
4
Caroline
Peanuts
0.35
1.0
7
Goldsboro
Peanuts
0.4
1.0
4
Goldsboro
Fescue
0.4
1.0
Total Acres are wettable acres not irrigated acres.
Your facility is designed for 120 days of temporary storage and the temporary storage must be removed on
the average of once every 4 months. In no instance should the volume of waste being stored in your
structure exceed 1.7' (19 inches) from the top of dike. NOTE: in 2001 the lagoon sludge was removed,
therefore the total storage has increased, so the temporary storage will be higher than 120 days.
Call the local Natural Resources Conservation Service office after you receive the waste analysis report for
assistance in determining the amount per acre to apply and the proper application rate prior to applying the
waste.
Narrative of Operation:
Waste will be applied to cotton, wheat, soybeans and fescue. Soybean rates have been reduced by 7
bushels per acre when double cropped. Crops planted after the soybeans (i.e. cotton) must deduct 20 lbs.
of N per acre as a result of residual carryover.

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

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

18. If animal production at the facility is to be or terminated,
the owner is responsible for obtaining and implementing a "closure
plan" which will eliminate the possibility of an illegal discharge,
pollution and erosion.
19. Waste handling structures, piping, pumps, reels, etc., should be
inspected on a regular basis to prevent breakdowns, leaks, and spills,
A regular maintenance checklist should be kept on site.
20. Animal waste can be used in a rotation that includes vegetables and
other crops for direct human consumption. However, if animal waste is
used on crops for direct human consumption it should only be applied
preplant with no further applications of animal waste during the crop
season.
21. Highly visible permanent markers shall be installed to mark the top and
bottom elevations of the temporary storage (pumping volume) of all
waste treatment lagoons. Pumping shall be managed to maintain the
liquid level between the markers. A marker will be required to mark
the maximum storage volume for waste storage ponds.
22. Soil tests shall be made every two years and a liquid waste analysis
be taken at least twice each year consistent with waste utilization
plan. Poultry litter shall be tested prior to application. Soil
and waste analysis records shall be kept for five years.
23. Dead animals will be disposed of in a manner that meets NC regulations.

WASTE UTILIZATION PLAN AGREEMENT
Name of Farm: Wayne West
Owner/Manager Agreement
I (we) understand and will follow and implement the specification and the operation and maintenance
procedures established in the approved animal waste utilization plan for the farm named above. I (we) know
that any expansion to the existing design capacity of the waste treatment and storage system or
construction of new facilities will require a new certification to be submitted to the Division of Environmental
Management (DEM) before the new animals are stocked. I (we) also understand that there must be no
discharge of animal waste from this system to surface waters of the state from a storm event less severe
than the 25-year, 24-hour storm. The approved plan will be filed on -site at the farm office and at the office of
the local Soil and Water Conservation District and will be available for review by DEM upon request.
By signing below I certify the above management plan is correct regarding the correct fields, crop and
animal populations and that the plan is being operate as per the plan.
Name of Facility ]Owner: Wayne West
Signature:1AA_e Date: 1�JP- 4D 9
Technical Representative: William P. Boone
Affiliation: Natural Resources Conservation Service
Address Agency: P.O. Box 218
Jackson N.C.27845
252-534-2591
Signature: ZoW-10- Date: 3 aC.?

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!MDEERR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Eddie West
Wayne West Farm
3639 US 158 Hwy
Jackson, NC 27845
Dear Eddie West:
John E, Skvarla, III
93
August 19, 2014
AUG 2 0 20%
INC DENR Raleigh Regional Office
Subject: Application for renewal of General Permit/Waste Utilization Plan
Wayne West Farm
Certificate of Coverage No. AWS660060
Animal Waste Management System
Northampton County
The Division of Water Resources (Division) received your application for the renewal of coverage for
expiring State general pen -nit. However, you did not include a copy of your most recent waste utilization plan
with the application form as requested by the Division by a letter dated March 3, 2014, The Division
considers your application as incomplete as long as all the required documents are not included in your
application. Please submit one copy of your most recent waste utilization plan within fifteen (15) days to the
following address:
Miressa D. Garoma
Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
If you have any questions, please do not hesitate to contact me at [phone].
Sincerely,
Miressa D. Garoma
Animal Feeding Operations Branch
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
cc: Raleigh Regional Office, Water Quality Regional Operations Section
Central Files
1636 Mail Service Center, Raleigh, North Carolina 27699.1636
Phone: 919M7-64641 Internet: www.ncdenr.gov
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State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Wayne West
Wayne West -
Rt 1 Box 337
Jackson NC 27845
Dear Wayne West:
— 7iLA� �
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
December 30, 1999 j' `-- 1, /� l
AAA
wr,�( OFF'
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 66--60
Northampton -.County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. ERRI, IRR2, DRY], DRY2, DRY3, SLURI, SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone].ext. 571.
Sincerely,
Kerr T. Stevens, Director
Division of Water Quality
cc: Raleigh Regional Office
Northampton County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
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m
PLAN OF ACTION (POA) FOR HIGH FREE D AT ANIMAL FACILITIES
Facility Number: _ � � ;- J�Cou /110
Facility G e
Name: r V 5--r
Certified Operator Name: I D r ` 1• ,�'v' o Z- !
I. Current liquid levei(s) In inches as measured from th current liquid level in the lagoon to th
lowest point on the top of the dam for lagoons without sp"16ays; and from the current liquid lev,
in the lagoon to the bottom of the spillway for lagoons with spillways.
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Lagoon Name/Identifier (ID):�
Spillway (Yes or No):
Level (inches):
2. Check all applicable items
Liquid level is'within the designed structural freeboard elevations of one or more structures. FIvf
and 30 day Plans of Action are attached. Hydraulic and agronomic balances are within
acceptable ranges.
l/ 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 t�
pumped and hauled is reflected in section III tables. Included within this plan is a list of th,
proposed sites with related facility number(s), number acres and receiving crop informatior,
Contact and secure approval, from the Division of Water Quality gdgr1nfransfer of wash
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
- 4 animals are to be moved to another permitted facility, provide facility number, lagoon
freeboard levels and herd population for the receiving facility
3. Earliest possible date to begin land application of waste: Z 3 D
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.
Phone: 2_5 Z_ 5 5-5 / Y d
PaA Cover Page 2/21/00

PLAN OF ACTION (PoA) FOR HIGH FREEBOARD AT ANIMAL FACILITIES
THIRTY (30) DAY DRAW DOWN PERIOD
I. TOTAL PAN TO DE LAND APPLIPED PER WASTE STRUCTURE
1. Structure Name/Identifier (lD): , t 2
2. Current liquid volume in 25 yr./24 hr, storm storage & structural freeboard
a, current liquid level according to marker
b. designed 25 yr./24 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. tines x lime d x 7.48 gWlans
12 ft
3. Projected volume of waste liquid produced during draw down period
inches
1 q inches
inches
ft2
gallons
f. temporary storage period according to structural design days
g. volume of waste produced according to structural design f
h. actual waste produced = " ent herd # x line g
certified herd #
i. volume of wash water according to structural design _ fta
j. excess rainfall over evaporation according to design ft3
k. (lines h + i +i) x 7.48 x 3Q days = gallons
line f
4. Total PAN to be land applied during draw down period ,
14t'9 sa ►++Pl+� gctl � *9
I. current waste analysis dated 1r a 3, o lb/1000 gal,
m. (lies e + N) x line I - lb PAN
1000 _
REREAT SECTION l FOR EACH WASTE STRUCTURE ON SITE
PoA (30 pay) 2121100 1

SEP-21-2004 TUE 03:33 PM DERR RRO
FAX N0, 19195714718 P, 04
IL TOTAL POUNDS OF PAN STORED WITHIN STRUCTURAL FREEBOARD ANDIOR 25 YR.124
HR. STORM STORAGE ELEVATIONS IN ALL WASTE STRUCTURES FOR FACILITY
1. structure ID:
2. structure ID:
3. structure ID:
4. structure ID:
5. structure ID:
6. structure ID:
n. lines 7 +2+3+4+5+6 =
line m = lb PAN
line m = lb PAN
line m = lb PAN
line m = lb PAN
line m = lb PAN
line m = lb PAN
lb PAN
Ili. TOTAL PAN BALANCE REMAINING FOR AVAILABLE CROPS DURING 30 DAYDRAW DOWN
PERIOD. DO
NOT LIST FIELDS TO WHICH PAN CAN NOT BE APPLIES DUFFING
THIS 30 DAY YEKIUD.
o. tract #
p. field #
q. crop
r, acres
s. remaining
IRR-2 PAN
balance
(Iblacre}
t. TOTAL PAN
BALANCE
FOR FIELD
COfliii'IJi C z 8
cofur
u.
application
window'
zo o 5�
4
`state current crop ending application date or next crop application beginning date for available receiving
crops during 30 day drawn down period
Py
v. Total PAN avallable for all fields (sum of column t) � Zo 9 4 lb. PAN

FAX NO, 19195714718 P, 05
IV. FACILITY'S PoA OVERALL PAN BALANCE
w. Total PAN to be land applied (line n from section 11) = — . 1b. PAN
x. Crop's remaining PAN balance (line v from section Ill) = _ 7 lb. PAN
y. Overall PAN balance (w - x) = I b. PAN
Line y must show as a .deficit. If line y does not show as a deficit, list course of action here
including pump and haul, depopulation, herd reduction, etc. For pump $ haul and herd
reduction options, recalculate new PAN based on new information. if new fields are to be
included as an option for lowering lagoon level, add these fields to the PAN balance table and
recalculate the overall PAN balance. If animal waste is to be hauled to another permitted
facility provide information regarding the herd population and lagoon freeboard levels at the
receiving facility.
NARRATIVE: