820711_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

Type of Visit: Q6Tomphance Inspection O Operation Review p Structure Evaluation (-) Technical Assistance
Reason for Visit: CJRoutine O Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Oa I Departure Time: l7 County: c 5,2V91- Region: (�
0*1
Farm Name: Owner Email:
Owner Name: /jfr Phone:
Mailing Address:
Physical Address:
Facility Contact: zb2m_ Title: Phone:
Onsite Representative: Sg�� Integrator. ,
Certified Operator: r��.vc� Certification Number: -Z 31
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design Current
Design Current
Swine
Capacity P p:
Wet Poultry Capacity`
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
- Non -La er I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
D . P.oult . Ga aci P,o
Layers
Non -Dairy -
Beef Stocker
Farrow to Finish
Gilts
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Beef Feeder
Beef Brood Cow
Boars
it s
Other - 0-
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes - No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes EjlTo
D NA ❑ NE
❑ Yes E<o ❑ NA ❑ NE
Page I of 3 21412015 Continued

` Faci I ity Numher: - / Date of Inspection: r- 7— /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes to ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: I
Designed Freeboard (in): 31
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ErNo ❑ 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 E No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes E O ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [] Yes ICJ o (DNA ❑ 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 E<o ❑ NA ❑ NE
maintenance or improvement?
Waste Avotication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Z No ❑ NA ❑ NE
maintenance or improvement?
11 _ Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu. Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Zey- t Oda /,!�.7dw
13. Soil Type(s): _1(, Jl'y _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EKo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes F,7r�o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [�No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
El No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Q No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[E o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[ No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ErNo ❑ 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 ENo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes dNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection: 7— /
24. Did the facility fail to calibrate waste application equipment as required by the permit?r ❑ Yes El -No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [/] No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to compiete 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 D<o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑NNo
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 [r No
❑ Yes Ej No
❑ Yes []"'No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes [�! No ❑ NA ❑ NE
❑ Yes [i < ❑ NA ❑ NE
❑ Yes [alq�o ❑ 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 exulain situations (use additional Hanes as necessarv).
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone:
Date:��
21412015

`i
'tI
Type of Visit: Q'Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: outine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit:—[� Arrival Time: i : p o Departure Time: j' County:dy,���P_Region:O
Farm Name: Owner Email:
Owner Name: _`c 1 1 %r%I� Phone:
Mailing Address:
Physical Address:
Facility Contact: f / c' �,[�i 1�, v .�-t S Title: Phone: ,/ f/
Onsite Representative: integrator: t j DI/j_44/0
Certified Operator: Certification Number: 17
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design Current o.
Swine Capacity Pop. Wet PoultrJ' Capacity Pop.
Wean to Finish Layer
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish pD j
Dairy Heifer
D Cow
Nan-Dai
Beef Stocker
Farrow to Wean Design Current
Farrow to Feeder C•a aci P,o
Farrow to Finish
Gilts
Beef Feeder
Boars
gNon-Layers
Beef Brood Cow.Other
ts
Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[]Yes O_No [DNA ❑ NE
❑ Yes [j No
Yes [] No
❑ Yes [] No
❑ Yes [KNo
0 Yes [�j No
❑ NA [] NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA C]NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

IFacHity Number: - Date of Inspection: /
Waste Collection & Treatment
r1 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 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
D�[No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
[:]Yes � No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
0 Yes
"No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4fi were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
~
7. Do any of the structures need maintenance or improvement?
Yes
o
❑ 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
fD No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
L&No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes &LNo ❑ 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 [8.,No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes C!� No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes r,';� No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
_Renuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [� No ❑ NA El 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 MNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes MNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes FA
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection: /17
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes Callo ❑ NA ❑ NE
' 25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ff�No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes allo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ZLNo ❑ 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:
❑ Yes [A No ❑ NA ❑ NE
❑ Yes [n No ❑ NA ❑ NE
❑ Yes [&No ❑ NA ❑ NE
❑ Yes F No ❑ ILIA ❑ NE
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
Ca No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
50_No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: _Tn/�-7�7���� Phone: /57
Reviewer/Inspector Signature: r _ Date: 7
Page 3 of 3 21412015

Z., -'Vr("
7/
Type of Visit: IDTompliance Inspection 0 Operation Review 0 Structure Evaluation Q Terbnical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access -�
Date of Visit: Arrival Time: ' £J Departure Time: F77 7.3--M County: Region:
Farm Name: Emir% MV.). , Q/'rku Owner Email:
Owner Name: _ryt �� ,ryJna Phone:
Mailing Address;
Physical Address:
Facility Contact: Zt i2 Title; /%iyr Pbooe:
Onsite Representative: J�rr.�� Integrator:
Certified Operator: Certification Number: 3
Back-up Operator:
Location of Farm;
Certification Number:
Latitude: Longitude:
Design Current Design Current
Swine Capacity Pap. r Wet Poultry Capacity Pop,
Design
Carile Capacity
Dairy Cow
Current
Pop.
Wean to Finish
I 1LayCT
I IN2p:LaLer
Design
Dry l;oult . Ca aci
Layers
rffPullets
Wean to Feeder
Feeder to Finish
U
Current
Dairy Calf
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
Farrow to Finish
P.o
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
3M
Beef Brood Cow
Other
Other
Turkeys
TurkeyPoults
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c, What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ULNo ❑ NA ❑ NE
❑ Yes [] No
❑ Yes [] No
❑ Yes [:]No
❑ Yes 2_No
❑ Yes E3-No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3
21412014 Continued

Facili Number: -711 1 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: _
Designed Freeboard (in): 1.9
Observed Freeboard (in): 3l(
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5
E?3..No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
❑ Yes MNo ❑ NA [] NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes jallo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes CK No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes " No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 2 -No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ®.No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): nr^ - t� "?--
13. Soil Type(s): to,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E�J.No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes jK No ❑ NA ❑ NE
❑ Yes �4 No ❑ NA [] NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E!� 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 [ o
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes J!�No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �o
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
[]NA ❑NE
❑NA ❑NE
Page 2 of 3 21412014 Continued

Facility Number: - / 1 1 jDate of Inspection: i " %
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
�25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E3,No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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)
❑ Yes
2 No
❑ NA
❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes [5 No ❑ NA 0 NE
❑ Yes [0 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ja No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [ No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [�LNo
❑ NA ❑ NE
❑ NA ❑ NE
DNA ❑ NE
❑ NA ❑ NE
Comments (refer to question 4): 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 necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: Y%1�f33 —
3_3�az)
Date: (n
214/2014
Page 3 of 3

iype or visit: w-compnance inspection u Vperation Keview O Structure Evaluation V Yecttnical Assistance I
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
I ,7 6 - / Arrival
Time: D ,`pa
Departure Time: ' c5^
County: Region:
Farm Name:.6Lar
/' Al'oef"r
/,=jz
Owner Email:
Owner Name:
11e;11--7
JE_ Woo e
Phone:
Mailing Address:
Physical Address:
Facility Contact: �(J; ; �z:.s Title: Phone:
Onsite Representative: f _ Integrator: 6zy a/22
Certified Operator: ,�-sr�.�� Certification Number: /'Z3�-3 f
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
If/__70
=015MAIaPop.
urrentDesiNrllol
Wet Poultry @apacity Pop.
Cattle Capacity
Dai Cow
Finish
r
La er
Feeder
Non -La er
Dai Calf
o Finish
a
"� _
Design Current
D , Poulh Ca act P,o
DairyHeifer
Farrow to Wean
Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Gilts
Boars
Other
Layers
Beef Stocker
Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
Turkeys
TurkeyPoults
Other
Other
Dischar es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes MNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ® No
❑ Yes J3 No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412014 Continued

Facili Number: -7 IDate of inspection: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Z No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): �1
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[a 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
�o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental 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
5-d 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
CNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
M-No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
ZLNo
❑ 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): :3e✓`* ,,1,) / ;71 Y-e-
r
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Ej�[ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [a No ❑ NA Q NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [Z No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [A No ❑ NA ❑ NE
❑ Yes ® No [] NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[0 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[ffNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
®No
[:]NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections [:]Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
� No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
C!I-No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

lFacility Number: - f Date of Ins ection: 3— 4 dS
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes MNo NA [] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 5.No [] NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [allo 0 NA Q 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
[allo
❑ 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
[allo
❑ 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
CKNo
DNA
[] 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
[3 NA
[] NE
[] Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
D Yes
[a No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
0 Yes
[ No
[] NA
[] NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
23-No
[] NA
NE
Reviewer/Inspector Name: �f �L� � = Phone: -,
Reviewer/Inspector Signature: Date: 3—
Page 3 of 3 21412011

U-VS' bIHS 111013
Type of Visit: ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ' RrRoutiine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: � Arrival Time: p Departure Time: County:
Farm Name:�('y Hare EQ/M (U-1janc Owner Email:
Owner Name: A 2ArY goap- Phone:
Mailing Address:
Physical Address:
Region: FRO
t
Facility Contact: - Title: �iw_J-0- Phone: _ctq0_1132
Onsite Representative: A) �% W 1111on5 4 kp c1 Integrator: Us � t
` .
Certified Operator: �4r A �Vj I q�,s Certification Number: j-7g3 J
11
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
,�
Design Current
Design CnrrenI Design Current
Swiae
Capacity Pop. WetPoultry
Capacity Pop. Cattle Capacity PPI op.
Wean to Finish
La er
Dai Cow
Dai Calf
Wean to Feeder'
Non -Laver
Feeder to Finish
DairyHeifer
Farrow to Wean-
D sign Current
D , P.oult"`. Ca aci P,o .
D Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
MI
Boars
Pullets
Turkeys
Beef Brood Cow
Other
TurkeyPouets
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Ej No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
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?
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
Z No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

-71 j (Urvs)
Numberr - Date of Inspection: T
Vte
ollection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[:]Yes
[R No
❑ NA
❑ NE
a, If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 r, S�truc Structure 3 Structure 4
Structure 5
Structure 6
Identifier: Akhv-
Spillway?:
Designed Freeboard (in):_
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
N"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 threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[2 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
1 I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [2 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): CQ �y, G ! Sm 1 j _ 'In
13. Soil Type(s): -6
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ®No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [!] No ❑ NA ❑ NE
❑ Yes (2 No [] NA ❑ NE
Reiguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No [] NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ®' No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
NA ❑ NE
Page 2 of 3 21412011 Continued

F
i Number: `6A - Date of ins ection:
id the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [M No ❑ NA ❑ NE
the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ® NN�o) ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [—]Yes �]�N6 NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [—]Yes [R 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
M 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
O 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
In No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question ff): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations fuse additional pages as necessary).
YvQa� rrGr��a 1` cal -6e1ji j ood ne.10 '1
Reviewer/Inspector Name
Revi ewer/] nspector Signature:
Page 3 of 3
Da Sr hftp i4- _
Phone: Sid-V3�-.J
Date: lyyV �_S,rJn13
21412011

Facility No, Farm Name Date
Permit ' COC OIC_ NPDES (Rainbreaker PLAT Annual Cert Daily Pipe )
Lagoon Name, S forspillway
1
2
3
4
5
6
7
Design Freeboard 1 Last Recorded in
Observed freeboard
Sludge Survey Date
Sludge Depth ft
Liquid Trt. Zone ft
Ratio Sludge to Treatment Volume if> 0.45
Date out of compliance/ POA?
Sj -eye o, -va* aot3
Design .. m)��------
rlzmp low
�DpJI�� ir1B, air �+5
Soil Test Date
Crop Yield
Transfer Sheets
PH Fields
Wettable Acres
RAIN GAUGE
Lime Needed
WUP ✓
Dead box or incinerator
Lime Applied
Weekly Freeboard,/
Mortality Records
Cu-I Zn-I
1 in Inspections ✓
Check Lists
Needs S (S-1<25)
120 min Insp.
Storm Water
Needs P
Weather rooes
Pull/Field
Soil
Crop
Acres
PAN
Window
Max Rate
Max Amt
j3TCOA
9,
yO
3
r
�`-
Verify PHONE NUMBERS and affiliations s i�Sty_
Date last WUP FRO 5�. FRO or Farm Records
Date last WUP at farm Lagoon # rola 4) g4YAp
App. Hardware 0) Top Dike 1P0, 'I -
Stop Pump 45u,
Start Pump SIN;
1 +� t`7
Conversion- Cu-I 3000= 108 lblac; Zn-I 30 00= 13 ib/ac

ype Ui visit. ! %...ompnanee inspection %.j uperatiotl iceview U structure evaivanon lJ i ecuntcat assistance
Reason for Visit: 9 Routine Q Complaint Q Follow -op Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: io z_ Arrival Time: Departure Time: 7 County: Region:
Farm Name: &r^ �el�'+ Owner Email:
Owner Name: j)re Phone:
Mailing Address:
Physical Address.
Facility Contact: 41(e�o Title:
Onsite Representative:
Certified Operator: k
Back-up Operator:
Location of Farm:
Latitude.
Phone:Integrator-
Certification Number: 62 3 1
Certification Number:
Longitude:
[]Yes
[-]No
DestgtiCiirrent Design Current Design Current
r.
Swine CapacttyPop�. 1�'et Poultry @apa�ty�'Pop: Cattle Capacity Pop.
La er DairyCow
Non -La er DairyCalf
rh= DairyHeifer
Designl,Crrent D Cow
t.4=f,z
DryPoultry Ca aci ' Non -Dairy
Layers Beef Stocker
BOars `'_ Non -Layers Beef Feeder
4v
Pullets Beef Brood Co
urke s
ew
Turke Poults
T.
Othr ��
Other Other
h,
Finish
Wean to
Wean to Feeder
Feeder to Finish QfJ
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Discharges and Stream Impacts
1- is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure ❑Application Field ❑Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
C. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management System? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3- Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes I'M No ❑ NA ❑ NE
[] Yes ❑ No
❑ Yes ❑ No
❑ Yes [�LNo
[:]Yes [ No
[g
� NA ❑ NE
NA ❑ NE
NA ❑ NE
❑ NA [] NE
❑ NA ❑ NE
Page 1 of 3 2/4/1011 Continued
j
Discharges and Stream Impacts
1- is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure ❑Application Field ❑Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
C. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management System? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3- Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes I'M No ❑ NA ❑ NE
[] Yes ❑ No
❑ Yes ❑ No
❑ Yes [�LNo
[:]Yes [ No
[g
� NA ❑ NE
NA ❑ NE
NA ❑ NE
❑ NA [] NE
❑ NA ❑ NE
Page 1 of 3 2/4/1011 Continued
j

Facility Number: D7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
® No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[y] 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
N] No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
S. Do any of the structures tack adequate markers as required by the permit?
[:]Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind
%Drift ❑ Application Outside of Approved Area
12. Crop Type(s): G5 ",t 5 �►+ a ll+rN (��JfJc+
13. Soil Type(s): tn1g ,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ®No ❑ NA ❑ NE
acres determination?
IT Does the facility lack adequate acreage for land application?
❑ Yes
[54 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available`?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
® No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facili Number: Date of Ins ection: l0 7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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?
D Yes
[] No
❑ NA
❑ NE
[:]Yes
No
❑ NA
❑ NE
❑ Yes
© No
❑ NA
❑ NE
❑ Yes [N No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
Me No
❑ NA
❑ NE
❑ Yes
[j] No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES -answers and/or any additional recommendations or any otber comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: r�� 33^UCa
Date: I o J 2
21412011

type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Season for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Q Departure Time: ounty: �j� Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
-1I1`404-S Title:
Onsite Representative: N
Certified Operator:
Back-up Operator:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design
C►urrent
Design
Current
Design Current
Swine Capacity
Pop. Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
,I
INon-Layer
I
Dairy Calf
Feeder to Finish�rtr�
'`
`"
Dairy Heifer
Farrow to Wean
xt
Design
Current "
Dry Cow
Farrow to Feeder
*Dry
Poultry
Capacity
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
113eef Brood Cow
Turkeys
Qther
Turkey Pouets
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)
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?
❑ Yes � No ❑ NA ❑ NE
[:]Yes [:]No
[:]Yes [::]No
[:]Yes [—]No
❑ Yes No
❑ Yes No
®NA ❑NE
NA ❑ NE
NA ❑ NE
❑NA ❑NE
❑NA ❑NE
L
Page I of 3
21412011 Continued

FacilitN tuber: - Date of Inspection: I/
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 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: —�
41 No ❑ NA [] NE
❑No �NA ❑NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate t reats to the integrity of any of the structures observed?
❑ Yes
Pg 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
K] No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify 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
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes
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 W 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
�Or"
Window
❑ Evidence ofLWind Drifts ❑] Application
,,,Outside oof Approved Area
12. Crop Type(s): 1.__ _W "S (YQS-T+'►' J� �'+f�-�O�►"� 7 f rl� G�
13. Soil Type(s):
14. Do the receiving crops Viffer from those designated in the CAWMP?
❑ Yes
No
❑ NA
[] NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
I8. Is there a lack of properly operating waste application equipment'?
❑ Yes
® No
❑ NA
❑ NE
Ree uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Vj No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
P No
❑ NA]
NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ny No
T
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

acili ' Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No (DNA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [] Yes M No ❑ NA ❑ NE
LPM
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [] Yes �0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ 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
414 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 5+ No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes EpNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes `to No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Im 413-3,qz
Date: /1 it
21412011

t
i ype oT vtsrt 9 Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit S Routine O Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
. I
Date of Virit: A,rrival I Time: 09: Departure Time: ! i s 600 kti County: �rv�t{s PA-) Region: -
Farm Name: I'' �yI f-ivm Owner Email:
Owner Name: —f eh ry � e Phone:
;Nailing Address:
Physical Address:
Facility Contact: A41kk WWI,5 'Title:
Onsite Representative: K
u
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Operator Certification Number
Back-up Certification Number:
Latitude: o ❑ 1 0 Longitude:
17131
Swine
Design .,, Current Design Current
Capacity ..Population Wet Poultry Capacity Population
❑ La er
❑Non -La er
Cattle
Design Current
Capacity Population
o Finish
❑
Da Cow
to Feeder
❑
Da Calf
to Finish
FFF
QO
w%. t
l?iy Poultry ,.z
�' "`'
❑ Layers
❑Dai
Heifer
❑
El
D Cow
Non -Dairy
❑
Beef Stucker
❑ Non -Layers
❑Beef
Feeder
❑ Pullets
❑
Beef Brood Co
❑ Turkeys
Turke y Poults
r
Number of'Struetures:
❑ Other
to Wean
to Feeder
to Finish
Discharges &Stream Impacts
!. Is any discharge observed from any part of the operation?
❑Yes
❑ No
❑ NA
❑ NE
Discharge originated at: ❑Structure ❑Application Field El Other
a. Was the conveyance man-made?
❑Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State'? ([Eyes, notify DWQ)
El 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)
El Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
❑ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
❑ No
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12/28/04
Continued

Facility Number: �— Date of Inspectionz�/y0 I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 55 N
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ 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 fi� No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 1bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window!! [I Evidence
'of Wind Drift El Application Outside of Area
12. Crop type(s) Ce'a 5 V � iTwSS �-id/�t ). _�- - Ca, L., , 6M'n t��ti-✓�r -�" �
13. Soil type(s) j,Jarf-rLri►
`J
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[9 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[)I No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
J0 No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment'?
❑ Yes
[ANo
❑ 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 10-43-3­ 3 339
ctio-,�2qq_ {o I
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

FaeirityNumber: S�L`711 j Date of tnspection 15T"'t"r
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 appropriate box.
❑ WUP El Checklists ❑Design El Maps ❑Outer
21. Does record keeping need improvement? If yes, check the appropriate box below, ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soi] Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
P 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
EgNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26,
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27,
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[VNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWN P?
❑ Yes
FZ No
❑ NA
❑ N F
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E0 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
IP 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
fflNo
ElNA
ElNr
33.
Does facility require a follow-up visit by same agency?
ElYes
th No
❑ NA
❑ NE
AddihonalComments and/or Drawings:+`
•
Page 3 of 3 12128104

j
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: !If! _l1_VU Arrival Time: Departure Time: County: S&4 Region: W
Farm Name:
Owner Email:
HeOwner Name: r�, �. G2L Phone:
Mailing Address:•
Physical Address:
Facility Contact: Att�i ' Q Title: Phone No:
Onsite Representative: y Integrator: 6)6e(�p114AA5 .7
Certified Operator: N Operator Certification Number: I r
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = d [� Longitude: 0 0 =1 = it
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[P NA
❑ NE
b. Did the discharge reach waters of the State? (I f 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
❑ No
rye
Lll NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
M No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Ei No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes Wo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
[;9NA
❑ NE
5 cture i Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
14
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes [y$ No
❑ NA
ElN E
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes '�l No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes [ yNo
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes P No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑Yes P'Vo
El NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below,
❑ Yes N No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window❑ Evid e of Win Drift ❑ Application Outside of
Area
��
12. Crop type(s)wtLl l3 a57G �LI �h P r y. 4
/
C 4rt L:.�
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[59 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 acre determination ?
❑ Yes
No
❑ 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
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use. additional pages as necessary):
Reviewer/Inspector Name Phone: 9 33_33co
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? ❑ Yes Q%No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Wo ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes J§No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29_ Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
❑ Yes
. [RNo
❑ NA
❑ NE
El Yes
@No
[I NA
❑NE
El Yes
50No
El NA
El NE
❑Yes
NNo
❑NA
El NE
❑ Yes
R No
❑ NA
❑ NE
[I Yes
P] No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
(y� No
❑ NA
❑ NE
❑ Yes
1P No
❑ NA
❑ NE
1.2128104

� ozoF w a rFyQG
� r
o -c
Curtis Barwick
Coharie Farms
300 Westover Road
Clinton, North Carolina 28328
Dear Mr. Barwick:
Michael F. Easley, Govemor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
RECEUI p
January 28, 2008 Fra 11 2$
-FA"llf RI:pO OFRCF
Subject. Sludge Survey Testing Dates
Coharie Farms
Animal Waste Management System
The Division of Water Quality (Division) received your sludge surveys information on January 16, 2008.
With your results, you requested that the numerous lagoons be exempt from further sludge surveys for the
life of the current permits. Due to the amounts of treatment volume available, the Division agrees
that a sludge survey is not needed until 2009 for the lagoons that are listed on the attached table.
For these lagoons, the results of the 2009 sludge survey are to be submitted by March 1, 2010.
Thank you for your attention to this matter. if you have any questions, please call me at (919)
7l 5-6937.
Sincerely,
Miressa D. Garoma
Animal Feeding Operations Unit
CC' Wilmington Regional Office, Aquifer Protection Section
Raleigh Regional Office, Aquifer Protection Section
Fay,etteville Regiona� 1e, Aquife�_Prntection Seetiori
Washington Regional Office, Aquifer Protection Section
Central Files
Aquifer Protection Section 1636 Mail Service Center
Internet: www,newaterqualitv.org Location: 2728 Capital Boulevard
An Equal opportunitylAfimtative Action Employer- 50% Recyded/10% Post Consumer Paper
No Carolina
Naturally
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

� � I
COHARIE FARMS SLUDGE SURVEY EXEMPTIONS APPROVAL
January 28, 2008
FARM NO.
FARM NAME
Owner Name
COUNTY
REGIONAL
OFFICE
LAGOON ID
EXTENSION
APPROVAL TO 2009
1
AWS820183
Coharie C-10
D M Faircloth
Sampson
lFayetteville
L#3 only_
Yes
2
AWS820237
Coharie Farms C-1
Coharie hog farm
Sampson
Fayetteville
I
Yes
3
AWS820667
Hall Farm
Coharic hog farm
Sampson
Fayetteville
1
I Yes
4
AWS820081
Coharie Farms C-12
Coharie hog farm
Sampson
Fayetteville
L#2 only
Yes
5�AWS820098
F & B Farms
Graham Freddie
Sampson (Fayetteville
1
Yes
6
AWS820132
Sam Hope farm
Samuel Hope
Sampson
Fayetteville
1
Yes
7
AWS820377
ADJ Nursery #2
ADJ Farms Inc
Sampson
Fayetteville
1
Yes
8
AWS820053 IF
& B Farms
F & W Farms
Sampson
Fayetteville
1
Yes
9
AWS820188 IF
& B Farms
James Faircloth
Sampson
Fayetteville
1
Yes
10 IAWS820061
Knotty Pine Farm IMichael
Herring
Sampson
Fayetteville
L#1 & L#2
Yes
11 �AWS820090
Quarter Farms
Quarter D Farms
Sampson IFayetteville
L#1 & L#2
Yes
12
AWS820229
P & J Farms
Nelson Porter (Sampson
IFayetteville
L#2 only
Yes
13 IAWS820392
Running Branch #2
Joel Parker
Sampson JFayetteville
1 �I
Yes
14
Goshen Farms
Nelson Waters
Sampson
Fayetteville
L31, L#2, & L#31
Yes
JAWS820606
15
AWS820042
John Royal #1-8
John Royal
Sampson
Fayetteville
L31, L#2, & L#31
Yes
16
AWS510028
J & M HogFarm I
J & M Hog Farm
Johnston
Raleigh
1
Yes
17
AWS310162
Glade Ridge 'Charles
Edwards
Duplin
Wilmington
L#1 & L#2
Yes
18
AWS710052
M & D Sow Farm
Mike Hope IPender
Wilmington
1
Yes
19
JAWS960028
Bennie Barwick Farm
Bennie Barwick
lWayne
Washington
1
Yes
20
JAWS260059
Collier Farms
David Collier
lCumberland
Fayetteville
1
Yes
21
AW5820711
Henry Moore Farm
Henry Moore
I Sampson
Fayetteville
1
Yes
22
23
IAWS310655
JAWS510041
Sloan Brothers
Spring Meadow Farms
Troy Sloan
I Whitley Stephenson
IDuplin
Johnston
Wilmington
Raleigh
1
1
Yes
Yes
1/29/2008 mdg

F,�2^ 711
January 28, 2008
Curtis Barwick
Coharie Farms
300 Westover Road
Clinton, North Carolina 28328
Michael F. Easley,_ Governor
William G. Ross Jr, Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
F +tc D
FEB 2CO8
° a. F REGIONat_ oFf4cE
Subject: Sludge Survey Testing Dates
Coharie Farms
Animal Waste Management System
Dear Mr. Barwick:
The Division of Water Quality (Division) received your sludge surveys information on January 16, 2008.
With your results, you requested that the numerous lagoons be exempt from further sludge surveys for the
life of the current permits. Due to the amounts of treatment volume available, the Division agrees
that a sludge survey is not needed until 2009 for the lagoons that are listed on the attached table.
For these lagoons, the results of the 2009 sludge survey are to be submitted by March 1, 2010.
Thank you for your attention to this matter. If you have any questions, please call me at (919)
715-6937.
Sincerely,
Miressa D. Garoma
Animal Feeding Operations Unit
cc: Wilmington Regional Office, Aquifer Protection Section
Raleigh Regional Office, Aquifer Protection Section
Fayetteville Regional Office, Aquifer Protection Section
Washington Regional Office, Aquifer Protection Section
Central Files
Aquifer Protection Section 1636 Mail Service Center
Internet: N%ww.ncwaterquahL- .ore Location, 2 728 Capital Boulevard
An Equal opportmily/Aifinnative Acton Employer- 50% Recycledl10% Post Consumer Paper
NoartYtcarolina
Naturally
Raleigh, NC 27699.1636 Telephone: (9t9) 733-3221
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

COHARIE FARMS SLUDGE SURVEY EXEMPTIONS APPROVAL
January28, 2008
FARM NO,
FARM NAME
Owner Name
COUNTY
REGIONAL
OFFICE
LAGOON ID
EXTENSION
APPROVAL TO 2009
1
AWS820183
Coharie C-10
D M Faircloth
Sampson
Fayetteville
L#3 only
Yes
2
AWS820237
Coharie Farms C-1
Coharie hog farm
Sampson
Fayetteville
1
_
Yes
3
AWS820667
Hall Farm
Coharie hog farm
Sampson
Fayetteville
1
Yes
4
AWS820081
Coharie Farms C-12
Coharie hog farm
Sampson
Fayetteville
L#2 only
Yes
5
AWS820098
F & B Farms
Graham Freddie
Sampson
Fayetteville
I
Yes
6
AWS820132
Sam Hope farm
Samuel Hope
Sampson
Fayetteville
1
Yes
7
AWS820377
ADJ Nursery #2
ADJ Farms Inc
Sampson
Fayetteville
1
Yes
8
AWS820053
F & B Farms
F & W Farms
Sampson
Fayetteville
1
Yes
9
AWS820188
F & B Farms
James Faircloth
Sampson
Fayetteville
1
Yes
10
AWS820061
Knotty Pine Farm
Michael Herring
Sampson
Fayetteville
L#1 & L#2
Yes
11
AWS820090
Quarter D Farms
Quarter D Farms
Sampson
Fayetteville
L#1 & L#2
Yes
12
AWS820229
P & J Farms
Nelson Porter
Sampson
Fayetteville
L#2 only
Yes
13
AWS820392
Running Branch #2
Joel Parker
Sampson
Fayetteville
I
Yes
14
AWS820606
Goshen Farms
Nelson Waters
Sampson
Fayetteville
L31, L#2, & L#3
Yes
15
AWS820042
John Royal #1-8
John Royal
Sampson
Fayetteville
L31, L#2, & L#3
Yes
16
AWS510028
J & M Hog Farm
J & M Hog Farm
Johnston
Raleigh
1
Yes
17
AWS310162
Glade Ridge
Charles Edwards
Duplin
Wilmin to pes t
L#1 & L#2
Yes
18
AWS710052
M & D Sow Farm
Mike Hope
Fender
Wilmington
1
Yes
19 JAWS960028
Bernie Barwick Farm
Bennie Barwick
Wayne
Washington
1
Yes
20
AWS260059
Collier Farms
David Collier
Cumberland
Fayetteville
1
Yes
21
AWS820711
Henry Moore Farm
Henry Moore
Sampson
Fayetteville
1
Yes
22
AWS310655
Sloan Brothers
'Croy Sloan
Duplin
Wilmington
1
Yes
23
AWS510041
I Spring Meadow Farms
Whitley Stephenson
Johnston
Raleigh
I
Yes
1/29/2008 mdg

Sz - 7/ /
i
Curtis Barwick k .�
From: Keith Larick [keith.larick c@ncmail_net]
Sent. Friday, August 05, 2005 9:08 AM t <
To: Curtis Barwick
Subject: Re: Sludge Survey Exemptions
Curtis,
I have added the due date of the next sludge survey to the spreadsheet. Let me know if you have any questions.
Thanks,
Keith
Curtis Barwick wrote:
Thank you Keith. I look forward to hearing from you.
CURTIS
-----Original Message -----
From: Keith Larick[mailto:[e-mail] I
Sent: Wednesday, July 27, 2005 5:35 PM T
To: Curtis Barwick
Subject: Re: Sludge Survey Exemptions
Curtis,
I got the mailing, and should get to it soon.
Keith
Cur•Lis Barwick wrote:
Keith,
Please see the attached list of farms that I am asking for exemptions from
the annual sludge survey. I am sending via USPS the information sheets for
each indiv.idua). farm. I am emailinq this list so that you can reply back
after you have finished, with the due date for the next survey (if granted
an extension). This should save you having to send a letter to me about it.
Hopefully this will make it easier for you.
I look forward to hearing from you.
Thanks, CURTIS.
N
Div n»nn.�

SLUDGE SURVEY EXEMPTION LIST
CURTIS BARWICK
910 590-6314
Counter Facility # Farm Name
First Name
Last Name
I
County
Tvae Next Survey
Due
26
59 David Collier Farm
David
Collier
Cumberland
Finish
200'
51
28 J & M Hog Farm
J & M Hog Farm
Johnston
Finish
200'
AGOON 1 & 3 51
41 Spring Meadow Farm Unit 1
Whitley
Stephenson
Johnston
Sow
200+
51
46 Sandy Ridge Pork
Whitley
Stephenson
Johnston
Sow
200
4GOON #24�fr ,3 82
42 John O Royal: #1-8
Johil
Royal ]
Sampson
Finish
200'
82
53 F & W Farms I B -T Farm
F & W Farms
Sampson
Finish
200'
82
74 Linoard Howard & Son (New Farm Linoard
Howard i
Sampson
Finish
200
82
98 F&B Farms
Harold Frederick & Freddi
Butler
Sampson
Finish
200
82
132 Sam Hope Farms
Samuel J.
Hope
Sampson
Finish
200
82
188 F&W Farms
James
Faircloth
Sampson
Finish
200
82
190 Billy Lockamy Farm
Billy
Lockamy
Sampson
Finish
200
B2
202 Simmons Hog Farm
Ray
Simmons
Sampson
Finish
200
82
215 T&T Farms
Frederick
Thornton
Sampson
Finish
200
82
606 Goshen Farms
W. Nelson
Waters Jr
Sampson
Finish
200
�82...._:.
-866 :fohriny:Hope.Farrns.=..: : -
; .John A ,.. ;Hope.
y
` .;;-..
_
SarI ipson .` __
1=iri9sh .'
200
82
667 Hall Farm
Coharie Hog Farm
I
Sampson
Finish
200
82
725 C-7
Coharie Hog Farm
Sampson
Finish
200
B2
61 Knotty Pine Farm
Mike
Herring
Sampson
Finish
200
AGOON #2 0r 82
315 Bobcat Farms
Henry
Moore
Sampson
Sow
200
82
711 Henry Moore Finisher/Bad Branch Henry
Moore
Sampson
Finish
20C
82
71.4 SHW Sow Farm LLC
SHW Sow Farm LLC
Sampson
Sow
20C
96
28 Bennie Barwick Finishing
Bennie
Barwick
Wayne
Finish
20(

Decembcr 1, 2006
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Henry E Moore
Henry Moore Farm
PO Box 766
Clinton, NC 28328
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Dcpament of Environment and Natural Resowrm
Subject: Application for Renewal of Coverage for Expiring NPDES General Permit
Dear Petmittee:
Alan W. Klimek, P.E. Director
Division of Water Quality
RECEIVED
DEC 06 =
DW FAYE lr Uf IW0xq omCE
Your facility is currently approved for operation under one of the Animal Waste Operation NPDES General Permits, which expire on
July 1, 2007_ Due to changes in federal rules, facilities that do not discharge nor propose to discharge may choose whether or not to
retain coverage under an NPDES General Permit. Copies of the draft animal waste operation NPDES general permits and the State
Non -Discharge General Permits are available at httpa/h2o.enr.state.nc.uslaps/afouldowntoads.htm or by writing or calling:
NCDENR — DWQ Animal Feeding Operations Unit
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Telephone number: [phone]
In order to assure your continued cover -ale under one of these two types of uneralpermits__you must submit an application for permit
coverage to the Division. Enclosed you will find a, `Request for Certificate of Coverage Facility Currently, Covered by an Expiring
NPDES General Permit.' The application form must be completed and returned by January 2, 2007. Please note, you must include_
two (2) copies of your most recent Waste Utilization Plan with the application form.
Failure to request renewal of your coverage under a general permit within the time period specified may result in a civil penalty,
Operation of your facility without coverage under a valid general permit would constitute a violation of NCGS 143-215.1 and could
result in assessments of civil penalties of up to $25,000 per day.
If you have any questions about the draft general permits, the enclosed application, or any related matter please feel free to contact the
Animal Feeding Operations Unit staff at 919-733-3221.
Sincerely,
Ted L. Bush, Jr., Chief
Aquifer Protection Section
Enclosures
cc (w/o enclosures): Sampson County Soil and Water Conservation District
Fayetteville Regional Office, Aquifer Protection Section
AFO Unit Central Files - 820711
Coastal Plains
Aquifer Protection Section 1636 Mail Service Center
Internet: www,newaterquality.org Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Action Empbyer— 50% RecyclW0016 Post Consumer Paper
Rakigh, NC 27699-1636 Telephone:
Raleigh, NC 27604 Fax 1:
Fax 2:
Customer Service:
Njo�Carolina
N(919)' "a&!'Q&1J
[phone]
[phone]
[phone]

type of visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 1 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit. Arrival Time: Departure Time: I t)' 3 County: ,9AmRg
Farm Name: rv
Mmine �/j m Owner Email:
Owner Name:.. �� � • r " `coI'� Phone:
Mailing Address:
Physical Address:
Region l
Facility Contact: —& C' Title: Phone No: -
Onsite Representative: j Integrator: C6c drd P Wn S
Certified Operator:'Tb�'�ap^S Operator Certification Number: I 7�'3�
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o u Longitude:
Design Current Design Current; °Design Current
e Ca., .
Swin ciFty population Wet Poultry Cap�acsty Popul hon Cattl •Capacity Population
❑ Wean to Finish 10 Layer ❑Dairy Cow
❑ Wean to Feeder 10 Non -Layer I airy Calf
= .:__
Feeder to Finish ��`�T� --� El Dairy Heifer
Farrow to Wean .h ❑ Dry Cow
'"-DryiPoultry� -
❑ Farrow to Feeder ❑ Non -Dairy
❑ Farrow to Finish El Layers ❑ Beef Stocker
Gilts ❑Non -La Non -Layers
j D +� ❑Beef Feeder
❑ Boars ❑ Pullets ❑Beef Brood Cow
vx : ❑ Turkeys
Other vl^�
❑ Turkey Po
ults
❑ Other
❑Other Number}of Structures:Lij
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
P 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
❑ No
E� NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
f]No
ElNA
ElNE
3. Were there anv adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
tt No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes
�] No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes
❑ No 'P NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
MNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
VI No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
1p No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
�No ❑ NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Are�a►�,
12. Crop type(s) �-I &Xw ul � 644 � r _CC2yn,, _ �&c LN'G
�,M
W�A
r t n - v,
13. Soil type(s)q�q [M
14. Do the receiving differ from those designated in the CAWMP?
❑ Yes
[INo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
01 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
�3)No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Vg�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P 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):
Gwd +`^,
Cell � feC@,45'
f� r
Reviewer/Inspector Name � Phone: 3�
ReviewertInspector Signature: Date: f�
Page 2 of 3 12a8/04 Continued

y
Facility Number: — [ Date of Inspection L0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ONo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 01 No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P1 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
jj No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
@No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
�JNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
;_cj 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
t@ 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
P3 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
R 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
�fl No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
Page 3 of 3 12128104

0 Division of Water Quality
Facility Number Q Division of Soil and Water Conservation
O Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: �r~�a Departure Time: �Q� County: �
Farm Name: �1-+rMCorp rti _ Owner Email:
Owner Name: HfA O Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: 1et""r tA0OrV Title: Phone No:
Onsite Representative: t/ � l 11 l„�!�►' C _ _-„ Integrator:. ��s� ��^ s P"-S
Certified Operator: Operator Certification Number -
Back -up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: ❑0 =L = Longitude: El ❑I ❑ u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ i
nyei
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkevs
❑ 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'?
b. Did the discharge reach waters of the State? (I f yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dai Calf
❑ Dairy Heife)
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: �.
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2, is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes Q4 No ❑ NA [INE
❑ Yes
❑ No
1PNA
❑ NE
❑ Yes
❑ No
R NA
❑ NE
❑ Yes
❑ No
q� NA
❑ NE
❑ Yes
qPNo
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE:
12128104 Continued

<:acility Number: — �� Date of Inspection l �t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes "lo
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes ❑ No
O NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: i
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes pa No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 5ONo
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes IS No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [§No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks. or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
I. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes 1� 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 op Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) War
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes (� No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes *LI No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18_ Is there a lack of properly operating waste application equipment?
❑ Yes ® No
❑ Yes ® No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Dame
Reviewer/Inspector Signature:
Phonell-1,T)
Date: f
12128104
❑ NA ❑ NE
❑NA ❑NE
Continued

Facility Number: pt-- Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes r No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes [A 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 0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ER No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25_ Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
F No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification`'
❑ Yes
E No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
f3 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
KJ 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
JQ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss reviewlinspection 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

4 Division of Water Quality'
=aF"iNvtnber _ �� -7/ Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit ® Compliance Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up Q Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: -/ - trt7 Arrival Time: Departure Time: 1� County: .�� Region:
Farm Name: _Js.� _�l/�al r...� _cAV�t�Owner Email:
Owner Name: _ Me-m- r trpa' Phone: 421PJ
Mailing Address:
Physical Address:
(Facility Contact:--,l�s��—_Nv_Q_-e _ _ Title: ��tJn1� t/ Phone No,
Onsite Representative: _ Integrator: �(✓�g����f Ia�NS
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Operator Certification Number:
Back-up Certification Number:
Latitude: = O 0 , = $4 Longitude: ❑ o ❑ ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Non -La er
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
1100
4, 5*,90
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkev Poults
❑ Other
Discharges & Stream Impacts
pacts
i - Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
b. Did the discharge reach waters of the State? (ifyes, notify DWQ)
c. What is the estimated volutne that reached waters of the State gallons??
Number of Structures:
d. Dovs discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes &No ❑ NA ❑ NE
❑ Yes
[XNo
❑ NA
❑ NE
❑ Yes
CYNo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
�No
❑ Yes
R1 No
❑ NA
❑ NE
❑ Yes
On No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes IM No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes W No ❑ NA ❑ NE
Structure 1 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
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
P No
❑ NA ❑ NE
S. Do any of the smctures lack adequate markers as required by the permit?
❑ Yes
[0 No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
P� No
❑ NA ❑ N E
maintenance or improvement?
Waste Application
14. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ No
❑ NA ❑ NE
maintenance/improvement?
H. 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 1D 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) .6eriuuala-GvaA -e 1x!k- Lw/ C Di n! Rt.r
2-
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[�No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
[�j No
❑ 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 #): Explaiin any YES answers and/or any recotnmendatfons or any other comments.
Use drawings of facility to better explain situations. (_use additional pages•as necessary): n
Reviewer/Inspector Name iG ` Phone:
Reviewer/Inspector Signature: Date:
/Z/Ld/U4 uonunuea

t
[Facility Number: Date of inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [ANo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes] No ❑ NA ❑ NE
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement'? If yes, check the appropriate box below_ ❑ Yes [ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[A No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
NJ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
r"4 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
`$ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
QdNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
rV No
LOW
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[� No
❑ NA
El 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
1� 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
[0 No
❑ NA
❑ NE
General Permit? (le/ 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
f No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

W A
pF 9
OG
Michael F_ Easley, Governor
C01
a)
WilliamG. Ross Jr., Secretary
North Carolina Department of Environment and natural Resources
7 -u-
0
Alan W. Klimek, P.E. Director
Division of Water Quality
August 23, 2005
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
RECEIPT # 7002 2410 0003 0272 8606
Henry Moore
Henry Moore Farrn
PO Box 766
Clinton, NC 28328
RE: Sludge Survey Testing Dates
Facility # 82-711
Sampson County
Dear Henry Moore:
RU'r-ti�i�+
AUG 24 2-7 a
DER-FAYEMILtEREGIO.�t'RESCE
The Division of Water Quality (DWQ) received your sludge survey information on July
27, 2005. With your survey results, you requested that the sludge survey for the Henry Moore
Farm not be required until 2007. Due to the amount of treatment volume available, DWQ agrees
that a sludge survey is not needed until 2007. The results of the 2007 sludge surveys are to be
submitted with the Annual Certification Form that will be due on March 1, 2008.
Thank you for your attention to this hatter. If you have any questions, please call me at
[phone].
Sincerely,
Keith Larick
Animal Feeding Operations Unit
cc: File# 82-711
Fayetteville Regional Office
j
Aquifer Protection Section 1636 Mail Service Center Raleigh,.NC 27699-1636 Phone [phone] CUSIOTner Service
Internet: http://h2o.enr.Mle.nc,us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax (919) 715-W48
An Equal Opportunity/AffirmaWe Anion Employer— 50°% Regded/10% Post Consumer Paper

Date of Visit: / v� Time: /%�
Facility Number $e't 1
a Not —Operational 0 Below Threshold
Mfermitted Certified [3 Conditionally Certified1 0 Registered Date Last Operated or Above Threshold: _..__ .....__.._ ..
Farm Name: .... � ... N!! ....__ .. n+'_c�`J -- - �...._....... County:----..-�?Sax..�. ......._. ................ .
Owner Name: ----......... ''!'' ._ •.._,.......Mo!+!? _.... �...»,...------ Phone No: .,_»..... S3,2 _'f 33 g.., . . �.. _...... - ...- ..... .
o. S�K Gc Cl•
Mailing Address. ........�......._.�... `�".s�.t��..�...a...— 0�30�.�..w..
Facility Contact: . _ _..... ...__ ..........._-_-_-Title: ... .... . . ....... . . . .. . .................... Phone No: _..._. � ---•..........
Onsite Representative:........_ -- ? DO/?f _ :..... _......... Integrator:.. '! !�w.`F, / Svc. ...............................
Certified Operator: ........... ����.� _._....__.. bv�'N�4..,5 ._....___.........._ Operator Certification Number: ........
Location of Farm: J
13116�wine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ' " Longitude • ° cc
Design
CurrenDesign
Current
-]Design C
uerlraetniotn
1.Swine
Ca aci 'Po
Ilation PoutryCapacity
PopulationCittli
Capacity Po
ed
El Wean to Feder
- Layer
❑Dairy
RIfeeder to Finish ptoo
11<6 JE3 Non -Layer
❑ Non -Dairy
Farrow to Wean
Farrow to Feeder
Other
:
Farrow to Finish
Total D CB 26l
S$40
El Gilts
El Boars
Total SSLW ,
Number of Dons
17nldnalli�I� 1 CwC� Trams
'
9
r
_
Dischar7ges 8 Stream lmRaets
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ 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 stores storage) less than adequate? ❑ SpilIway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...............I.......-....-.._... .. ......... ........... ...... .... ... .................... ............ -------------- -_-........ ,...._-..,.-_------------. --...... ............... ...........
Freeboard (inches):
12112103 Continued

t
Date of Visit: ime:
i
Facility Number _Q
rQ Not O erational Q Below Threshold
ermitted [3 Ce 'tied 0 Conditionally Certified R istered a Last Operated or Above Threshold:
/lFar�\m Name: % c County: __
Owner Name: 04 f'e Phone No: G
Mailing Address: �<� ��L l �n Gt /LIC
Facility Contact:
/� *� Title: Phone No:
nr
Onsite Representative: t .116-a rY=, J /'_ integrator: (2g Q��S
Certified Operator. e> 4 S �� t ( �, 5 Operator Certification Number:
Location of Farm:
[]Swine []Poultry []Cattle ❑Horse Latitude a �� �" Longitude ° OK
Design Current
Design Current Design,,--
Current
Swine "'tipacitv Population
Poultry CapacitV Population Cattle Ca act
Po ulation
❑ Wean to Feeder I
JE1 Layer I I Dairy I
Feeder to Finish I
JEJ Non -Layer I ❑ Non -Da'
Farrow to Wean
❑ Farrow to Feeder
❑ Other
- ,
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW '
Number of Lagoons,
❑ Subsurface Drains Present ❑ Lagoon Area
❑ Spray
Field Area
t:
Hol�dmg`Ponds I Solid Traps
- - --- - - _.
❑ No Li uid V1'aste I14ana ement Sys#em
_.
rr ti � ; ' } ,
DischarM & Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: [] LaQoon ❑ 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. noes 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
Identifier:
Freeboard (inches):
05103101
Structure 5
❑ Yes 0No
❑ Yes No
❑ Yes I�No
[:]Yes E�No
❑ Yes KNo
❑ Yes [ 110
❑ Yes jlrJ) No
Structure 6
Continued

3
Facility Number. Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
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
5NO
(U 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
S. Does any pan of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
PNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
[�No
Wastg Application
l Q. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of ver application? ❑ Exrye§sive Wing ❑/PrAN El Hydraulic Overload
❑ Y s
No
12. Crop type rVet ce
13. Do the receiving crops differ with those designated ' Certified Animal Waste Management Plan (CAWM
❑ Yes
No
14, a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
El Yes
No
Required Records & Dogpments
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
$1No
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
qfNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
Cl Yes
ONo
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
IPNo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
qT110
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
Tla
(ie/ discharge, Freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
9No
24. Does facility require a follow-up visit by same agency?
❑ Yes
KNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑Yes
r
No violations or deficiencies were noted during this visit. You will receive no further correspondence 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):- ❑ Field Copv ❑ Final Notes
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: ' �L
0510310I /
Continued

Facility Numher:92__ — 70 bate 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
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32_ Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
AdditioAa nmme�tsanif/oi,Drawuugs .� <s ;Ar.,,
❑ Yes ❑ No
❑ Yes No
❑ Yes o
❑ Yes To
❑ Yes M0—
o❑ Ycs
❑ Yes ❑ No
05103101

. _ s 6. f'.
Date ofVisit "9 a51ol Time: /%;qC)
Facility Number r111
Q Not Operational Below Threshold
IN Permitted C�C)ertified [3 Conditionally Certified Q Registered Date Last Operated or Above Threshold: ........... �.
Farm Name: .....P...?�] f �K: �tr x .......................... .I......................... County:......... MP C� .... ........ ....
Owner Name: ......... .........,G�!'L.....� ...a .._�....._ .. ........ Phone No: .......r�.�.? .. ._.._ .. _ . _ ..
Facility Contact: ......... 9.?r..........MdS!!.:�.......................Title:........................................ Phone No: .................. .............. ._ ...._
Mailing Address: ...... ��Ci .kc. .. ._..............W... ...... ....- ......-C-Ja n,?%a ,..N.C................
_
Onsite Representative: _-/A . L : � �'� � ............ » » �.�_._...... Integrator = Cyr c? �.s ........
Certified Operator:.........-S...,... ...... L.J� l.L��M� T- �_ ......_.. Operator Certification
Location of Farm:
065wine ❑ Poultry ❑ Cattle ❑ Horse Latitude a t 64 Longitude �' �d "
Design Current Design Current Ueagry - Carr;eat
_MSwlne; . C, ipaciti Po ulation Poultry , ' ' .Ca ci .. PO ulatiou Cattle Ca : -Po d v°
Ej Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish V $00 10 Non -Layer 1 10 Non -Dairy
❑ Farrow to Wean
❑ Other;_
El Farrow to Feeder - -
Farr4w to Finish Total Design Capacity
Gilts
Boars Total SSLW
-°-Nrimbck:ol i:agoo� - Subsurface Drains Present JFOLagoanArea JOSprayField Area _
' Holduig Ponds / Solid Traps,;; ❑ No Liquid Waste Management Sys7 7tem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes OfNo
Discharge originated at: ❑Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ)
❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes [XNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [X•No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway [:]Yes M No
Structure I Structure 2 Structure 3 Structure 4 Structure 3 Structure 5
Identilier: ..........._................... . ................
Freeboard (inches): 55
5100 Continued on hack

Facility Number: g1 — 7!+ Date of Inspection
5. Ate There any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
' No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
[�Io
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
62'1�0
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
ETTo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
["No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes
Q No
l I . Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
�lo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
/
12. Crop type�G; S,ma�� 4I1c�i in /Ih ;ITC+
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAVVMP)?
❑ Yes
[1lo
14, a) Does the facility lack adequate acreage for land application?
❑ Yes
Pf4o
b) Does the facility need a wettable acre determination?
❑ Yes
01�0
c) This facility is pended for a wettable acre determination?
❑ Yes
[flo
15. Does the receiving crop need improvement?
❑ Yes
B*�o
16. Is there a lack of adequate waste application equipment?
❑ Yes
Bio
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes [a'lvo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes MIC
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 [ o
Air Quality representative immediately.
teCeSSaFj
lye` ooe "'-C-c' W;4-In
N0 (4fL's r.KJ
Reviewer/Inspector Names
Y17ield Copy ❑ Final Notes
Reviewer/Inspector Signature:
12112103
Date: tit o
Continued

Facility Number: gp Date of Inspection
Re uired 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?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections. ❑ Annual Certification Form
❑ Yes [2No
❑ Yes YNo
❑ Yes 0'No
❑ Yes [!'No
❑ Yes [31No
❑ Yes QNo
❑ Yes Q No
❑ Yes [�No
❑ Yes []rNo
Giles ❑ No
❑ Yes [ErNo
❑ Yes Q'No
❑ Yes ErNo
❑ Yes ErNo
❑ Yes ['No
12112103

Facility Number: gaZ — t"f j Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [�No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ 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? j Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes UNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes %No
Waste Application
10. Are there any buffers that need maintenancetimprovement? ❑ Yes 0 No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes PrNo
12. Crop type a tsts..r corn,-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes P0 No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes Mj No
b) Does the facility need a wettable acre determination? ❑ Yes t@ No
c) This facility is pended for a wettable acre determination? ❑ Yes 0 No
15. Does the receiving crop need improvement? ❑ Yes %No
16. Is there a lack of adequate waste application equipment? ❑ Yes J� No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
(XNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
0 No
(ie/ WUP, checklists, design, maps, etc.)
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
[1 No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
allo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
OrNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
J�fNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONo
�Vo yiolatiQris o#- dgficiendpe •mere itQte during t�js.vl[s�t; Yop wi#I �eeeiye Rio u tper
comes deuce alwu this visit .. .
aveis aai
Not'_" L�L' s�p�e5 Ctr'_ q'j %U cis W 60d�5
r]- � on qec c ,'u c Gxi� pn inset. d' ' ,.Jjs, Gr a b
�
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: O J 5100

Facility Number: a -- +' `f Date of Inspection Et7 �7bjl
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes V 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 SNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes kNo
roads, building structure, and/or public property)
29. Is the Iand application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 0 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 No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes �] No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
JAdditionW"Vomments andfor rawings-:
,&1
5/00

Y _ jgDrvistoa of Wateiiahty
Q;Divtsion of Soil and Water Conservation
Q Other A etacy-
_
- -x
lType of Visit
Compliance Inspection Q Operation Review Q Lagoon Evatuation
ReasonforVisit
O(Routine Q Complaint O Follow up Q Emergency Notification O Other
❑ Denied Access
Facility Number Z Date of Visit: /Z /z Time: Printed on: 10/26/2000
Q Not Operational Below Threshold
XPermitted © Certified 0 Conditionally Certified © Registered Da a Last Operated or Above Threshold
Farm Name; r i.:i...�.`!.!�M... %<urK� County:........... .1` �_..............................
OwnerName:...-! 4./ ..N.aM4r .......................................... Phone No:.... • .............................3...��...........................
Facility Contact: .............. t.J....._ Title• Phone No:
//��........................
Mailing Address: ..... i°d.. ... ..0 .... .... .lr.ri �. ' .. L.........-- ........1 ..........................
Onsite Representative: Integrator.Ca.rYQ"/.,,�f
..........
Certified Operator . Do (A010 L4Ji Operator Certification Number:
Location of Farm:
_ I-
❑ Swine E] Poultry ❑ Cattle ❑ horse Latitude �� �� �� Longitude �� �� �44
Design Current
. nauv
❑ Wean to Feeder
Fcederto Finish
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer �^I I JEI Dairy
❑ Non -Layer I I I[] Non -Dairy
❑ Other 1 J
Total Design Capacity
Total SSUW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ 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'? (If yes, notify DWQ)
c. if discharec is observed. what is the esihnated flow in gaUmin?
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
❑ Yes AJ(No
❑ Yes No
❑ Yes o
❑ Yes 4-
No
❑ Yes o
❑ Yes t
o
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes fijr�o
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6�
Identifier: ....................................
Freeboard (inches): ��
5100 Continued on back

+ ]Pacility Number: g2,— 1 Date of Inspection Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures obs r d? (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? ❑Yes 4'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 lNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes )]�No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 10No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes XNo
11. Is there evidence of over application? ❑E essive Ponding 2 PAN Hydraulic Overload ❑ Yes 4�(No
Gr4z�J'
12. Crop type pr a - xi , ara I, r ye�' rrL
13. Do the receiving crops differ with those de i nated in the Certil- Animal Wast Management Plan (CAWMP)? ❑ Yes XNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes 3'No
15. Does the receiving crop need improvement? ❑ Yes KNo
16. Is there a lack of adequate waste application equipment? ❑ Yes Mo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes j�No
\\
18" Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes o
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ YesfNo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yeso
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
discharge,
❑ Yes
(ie/ freeboard problems, over application)
(No
.M`
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes o
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
yiolaiitlris:or dtfciendie5 -*60h6led during �his:visit' - Yott will -teceiye fio utj th�r
;cories' oiideitce: abaut this visit:
Comments (refer to question #): Explain any -YES answers and/or any recommendations or any other comments.-s
Use drawn .of facility to.better explain situations. (nse additional pages as necessary):
CernS c' Y,91 `cl Z er Aa.r/E C?_ddreSSP
G000�
T
Reviewer/Inspector Name
Reviewer/Inspector Signature:

Facility Number: Z — ;7 Date of Inspection Z— Z- 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 )XNo
liquid level of lagoon or storage pond with no agitation? +
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes
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 No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ' No
Additional omments and/or Drawigs:
.&I
5100

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
Henry Moore
Henry Moore Farm
PO Box 766
Clinton NC 28328
Dear Henry Moore:
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RE50URCES
December 30, 1999
— ;J
r;�► � 1! tViLLE
FIe G. OFFICU
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 82-711
Sampson County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. IRR1, IR.R2, 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.
Sincere]
Kerr T. Stevens, Director
Division of Water Quality
cc: Fayetteville Regional Office
Sampson County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Henry Moore
Henry Moore Farm
PO Box 766
Clinton NC 28328
Dear Henry Moore:
5"Ir
/ 0 •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
December 8, 1999
RECEIVED?/
DEC 1 v 1999
FAYMEVILLE
REC. OFFICE
Subject: Conditional Approval
Animal Waste Management System
Facility Number 82-711
Sampson County
Our records indicate that your facility was conditionally certified in order to fulfill the requirements of
completion of your Certified Animal Waste, Management Plan Certification. This letter is to inform you of your
unresolved conditional approval status. Any facility receiving a conditional approval must notify Division of Water
Quality (DWQ) in writing within 15 days after the date that the work needed to resolve the conditional certification
has been completed. Any failure to notify DWQ as required, subjects the owner to an enforcement action. As of
December 7, 1999, we have no record of any information from you, advising us of the status of your conditional
approval. Therefore, please fill out the attached form and have your technical specialist and landowner sign the form
in the appropriate areas.
The completed form must be submitted to this office on or before 45 days of receipt of this letter. Please be
advised that nothing in this letter should be taken as removing from you the responsibility or liability for failure to
provide DWQ with proper notification of your conditional certification status or possible failure to comply with the
requirement to develop and implement a certified animal waste management plan by December 31, 1997.
If you have any questions regarding this letter, please do not hesitate to contact me at [phone]
extension 571.
Sincerely,
Sonya L. Avant
Environmental Engineer
cc: Fayetteville Regional Office
Sampson Count}, Soil and Water Conservation District
Facility File
1617 A1ail Service Center, Raleigh, north Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled110% post -consumer paper

Division of Soil and WaterConseri+ation - Operation Review -
0 Division of Soil and Water Conservation -Compliance Inspection Y
Division of Water Quality -, Compliance Inspection - "�
Other Agency_-;Operation13 -Review
ip Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number p'1, Date of inspection
Time of Inspection 24 hr. (hh:mm)
Permitted Certified Q Conditionally Certified 0 Registered No[ O erational Date Last Operateed/d�t: .................._.._..
Farm Name: Ui�cN2.(/( County: .......... ....._`..P........._................
.....................IY:'""'�L...............................�.../..�.................................................
Owner Name: ..............___ rv3 I IGO f Phone No: 9/0 - 5 3.1 — q % 9-7
....R................�../%.....- -�---......................................................--.--............................................................................
Facility Contact: ............. 4.n.(np....l."..4�u.L.`./.e......... Title: ............ ....................................................
, Phone No:...................................................
MailingAddress: P•o. BO b .............` 1"✓...!".j,r........4...�.r.................... ..a.8.3aS
�........................................k...........%y................._..................................... l' i
Onsite Representative: .I"i'✓rI Ir(06ric _._ Integrator: G(5 oof•�,'y,•_ ,�_.
.......................�.................................................................... ....................... ....
Certified Operator:........... 04q 14. .......................�1%! �.` i ................... Operator Certification Number:..........................................
Location of Farm: .J
Latitude Longitude =• =` =14
Design
Current -'.:
...:Design Current Design
-Swine:.;_.Capacity
Population -Poultry -
Capacity Population Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Capacity $ 00
J[j Boars
Total SSLW
' Number of Lagoons
_.
❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
❑ No Liquid Waste Management System
Holding�Ponds / SoGd.Traps
" Wean to Feeder
'
=
❑Layer
Feeder to Finish
BSQQ
❑Non -Layer
Farrow to Wean
-
-� Farrow to Feeder
_
❑Other
Farrow to Finish
Total
Discharges & Stream Impacts t
1. Is any discharge observed from any part of the operation? ❑ Yes IN No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other 7777iiiS
a. If discharge is observed, was the conveyance man-made? ❑ Yes df No
b. If discharge is observed, did it reach Water of the State'? (if yes, notify DWQ) []Yes //�rN7o
c. If discharge is observed, what is the estimated flow in gaUmin? 4 �t#
d. Dues discharge bypass a lagoon system'? (if yes, notify DWQ) ❑ Yes KNo
2. Is there evidence of past discharge from any part of the operation'? ❑ Yes WNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 0 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [WNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
5 'f
Freeboard(inches):----..........�..::..........:...-......:....................__.........._.............................................
..................:.................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
3/23/99 Continued on back

Facility Number: Date o1' 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?
S. 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
12. Crop type
r-1 "A Ai
13. Do the receiving crops differ with those designated in the -Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15_ Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
o yiolaticiris or &ficienc>ies were noted• d&irig (his_visit: • Yoi>t WHI-receive fio further
. correspondence. about this visit. . • . . .. . . .. . . . . .... . . . . ... .
❑ Yes VNo
Yes ❑ No
❑ Yes ['No
❑ Yes 0 No
❑ Yes Of No -
x�
❑ Yes ® No
❑ Yes *No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes OrNo
❑ Yes Wo
❑ Yes � No
❑ Yes [YNo
❑ Yes 19No
❑ Yes X No
❑ Yes [XNo
❑ Yes [� No
❑ Yes ��` No
❑ Yes R No
XYes ❑ No
Comments {refer to,questton #) :Explain any YES answers and/or anyrecommendat�ons or ny other comments �w.
t
Use drawings of facility to bitte zplai s tuations (use additional a es as necessa .) '
P r-t J CVL{ `2 tro S ! 4✓1 N Gam( {ti Can GTo S i �e-L L't 5 rw., r' e
aS, _AQ CP(WMP OLes no- (44 Qccu/xi.4 as -� cmfs arc to
.Qqr-A 'ttt't'fq, CWNP cwe,, ✓ 1'c{W 4 �errf
Reviewer/Inspector Name
Reviewer/Inspector Signature: fir, Date: j?
3/23199

Facility Number: $a— ` Date of Inspection Odor Issues
Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes AINo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes E)�o
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 [ N0
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc_) Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a perinanentltemporary cover? ❑ Yes XNO
tionali Comments -an7.or rawmis:__ H_.�
A.
FA
3/23/99

Division of Soil and Water Conservation ❑ Other Agency
JX Division of Water Quality
Etoutine 0 Complaint, 0 Follow-up cif DNV2 ins ection 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number Time of Inspection 14 t cX3 24 hr. (hh:mm)
13 Registered 13 Certified 13 Applied for Permit A Permitted [3 Not O eratinnai Date Last Operated: ..........................
Farm Name: Urn Y Moo oo M t � ��- County:............ J.�r3,(yt � ?f�.�..............
..........tj......----. ............................. ........
OwnerName. �AU3 �f..0.............................I......... Phone No:................L........ ��3�i..Y....T ����............ ...................................................
Facility Contact: ......-....!...`..�'�. l llu'�P � Title: ...... Phone No: ............................
Q pp
Mailing Address:
......p'.....8� !�Adl l f........r....... .cr�.0.3.
�c....2...........................................................................�f. ........................
Onsite Representative :......... ...n�.......... moo .f......... �f•
............................... Intlgrator ........fl....,Sy......,cz-------
Certified Operator: .............................................. Operator Certification Number:........................
Location of Farm:
Latitude Longitude
; Current,
v Ponulation ` -1
..........................
❑ Wean to Feeder
.
Feeder to Finish
yam:
❑ Farrow to Wean
_
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Soars
Design"--, Current
rapacity: Population .
y ❑ Non -Layer I ❑ N
-� ❑ Other
w Total Design Cad
K .r .,.,Total S
Subsurface Drains Present
No Liquid Waste Management S
0
"o
V "
Area 10 Spray Field Area
General
I. Are there any buffers that need maintenance/improvement? ❑ Yes KNo
2. Is any discharge observed from any part of the operation? ❑ Yes IXNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 19 No
b. If discharge is obsen--ed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes (XNo
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ((No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes VkNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes 1�No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes [ No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes 1KNo
7/25/97
Continued on back

Facility Number: —
8. Are there lagoons cr storage ponds on site which need to be properly closed? ❑Yeti ilG
Structures (Lagoolls.11olding Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure J Structure 6
Identifier:
Freeboard (tt): ....
10. Is seepage observed from any of the strictures? ❑ Ye,, No
IL Is erosion. or any other threats to the integrity- of any of the structures observed? ❑ Yes No
12.. Do any of the structures need maintenance/improvement? ❑ Yes 1VNo
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
t
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes P4 No
WasteApplication
14. Is there physical evidence of over application? r ❑ Yes No
(If in excess of WMP, or runoff entering waters of the State. notify DWQ)
15, Crop tYPa ................... ............................................................. ...................•---...................--.--..........................---..........---..............•..---.---.---.---.....-...........................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW VIP)?
❑ Yes
No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
Cj No
18. Does the receiving crop need improvement?
❑ Yes
No
19, Is there a lack of available waste application equipment?
❑ Yes
No
20, Does facility require a follow-up visit by same agency?
❑ Yes
No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative"
❑ Yes
� ,No
22. Does record keeping need improvement? f
❑ Yes
No
For Certified or Permitted Facilities Only
,
23. Does the facility fail to have a copy of the Animal Waste :Management Plan readily available?
❑ Yes
P No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
25. Were any additional problems noted which cause noncompliance of the Permit''
❑ Yeti
No
0 No violations or deficiencies were noted during this visit. You will receive no f'tirther
correspondence ab.ottt this visit. ;
Cbm4nents (refer; to, question#): Explain any YIDS answers and/or any recommendations or any other.comments
Use>d'rawings of facility to better explain situations. (use additional pages as neeessary): °. ` me,'µ , .40�
So ct llau 7 a-V vy ¢ at
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: % - 3D

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Henry Moore
Henry Moore Farm
PO Box 766
Clinton NC 28328
Dear Henry Moore:
REC-
EAVEDurie 26, 1998
itil 2 3 1993
FAYETTEVI L E
17MC. () = ,(;E
,Tk?WA
NCDENR
NORTH CARouNA DEPARTMENT OF
ENVIRONMENT AND NI;ruRAL RESOURCES
Subject: Reissuance of Certificate of Coverage
No.AWS820711
Henry Moore Farm
Swine Waste Collection, Treatment, Storage and
Application System
Sampson County
The Division of Water Quality modified the Swine Waste Operation General Permit originally issued to
this facility on August 4, 1997. 1n accordance with the issuance of the revised General Permit, we are
forwarding this Certificate of Coverage (COC) to Henry Moore, authorizing the operation of the subject
animal waste collection, treatment, storage and land application system in accordance with General
Permit AWG 100000. This approval shall consist of the operation of this system including, but not
limited to, the management of animal waste from the Henry Moore Farm, located in Sampson County,
with an animal capacity of no greater than 8800 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 April 30, 2003, and shall hereby void
COC No AWS820711 dated August 4, 1997. The COC shall hereby incorporate by reference any
specific conditions of the previous COC issued to this facility. The purpose of this COC is to allow
coverage under the revised General Permit. Please review the revised General Permit (enclosed) and pay
particular attention to Condition 1I.10 regarding tree removal from lagoon embankments, Condition IH.1
regarding inspection frequency of the waste treatment, storage and collection system and Condition I11.6
regarding notification requirements for system failures, spills and emergencies. 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.
P.D. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Certificate of Coverage AWS820711
Henry Moore Farm
Page 2
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.
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 Fayetteville 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 J. R. Joshi at [phone] ext. 363.
Sincerely,
w
for A. Preston Howard, Jr., P.E.
cc: (Certificate of Coverage only for all cc's)
Sampson County Health Department
Fayetteville Regional Office, Water Quality Section
Sampson County Soil and Water Conservation District
Permit File

COPY
CARROLL'S FOODS, INC.
P. O. Drawer 856
WARSAW, NORTH CAROLINA 28398
June .23, 1998
Mr. Kim H. Colson
Non -Discharge Permitting Unit.
NCDENR
PO Box 29535
Raleigh, NC 27626-0535
Subject: Henry Moore Farm COC No. AWS820711, Sampson County
Dear Mr. Colson,
In response to your letter dated June 17, 1998, 1 made a field
visit to the subject farm yesterday. At this point, the land has
been cleared and buildings laid out. I located the property line
and used a measuring wheel to determine the closest distance to the
building and lagoon. As shown on the attached topographical map,
the distance to the outside toe of the lagoon is 580 feet and the
distance to the building is 710 feet.
Please let me know if additional information is needed.
Sincerely,
Howard L. Hobson, Technical Specialist
Carroll's Foods, Inc.
cc: Don Butler
Henry Moore
Fayetteville Regional Office Water Quality Section

t State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Mr. Don Butler
Real Estate Manager
Carroll's Foods Inc.
PO Drawer 856
Warsaw, NC 28398
Dear Mr. Butler,
1 � •
NCDENR
NORTH CAROUNA DEPARTMEKT OF
ENVIRONMENT ANo NATURAL RESOURCES
June 17,1998 RECEIVED
JUN 2 5 1998
FAYETTEVILLE
REG. OFFICE
Subject: Henry Moore Farm
COC No. AWS820711
Sampson County
The Division of Water Quality has received your letter dated June 9, 1998 regarding the siting of
the Henry Moore Farm in Sampson County. Maps that were submitted with this facility's permit
application show that this facility, as designed, would not meet the setback requirements
established in House Bill 515 as noted by the 408 feet distance to the property line. It is our
understanding that this facility had not started construction by August 27, 1997 and therefore
must meet the setbacks that were ratified in House Bill 515.
Please provide this office with further documentation to show that the subject facility meets the
new siting requirements. Construction not in compliance with the Siting Act is a violation of
State Statutes and could result in revocation of the permit.
If you have any questions or comments concerning this matter, please contact Sue Homewood at
919-733-5083 extension 502 or me at extension 540.
Sincerel
/f
Kim H. Colson, P.E., Supervisor
Non -Discharge Permitting Unit
Cc: Faydttdville Regional Office, WatEF Quality Sectioa
Henry Moore
Permit File
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycied110% post -consumer paper

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
June 1, 1998
CERTIFIED MAIL
T EIPT REQUESTED
Henry Moore
Henry Moore Farm
P.O. Box 766
Clinton. NC 28328
Dear Henry Moore:
RECEIVED"I
JUN 0 4 1998
FAYETTEVILLE
REG. OFFICE
Subject. Henry Moore Farm
COC No. AWS820711
Sampson County, NC
The subject facility was issued a Certificate of Coverage (COC) on August 4, 1997 authorizing
the construction and operation of a new swine waste management system. You were sent a letter
(attached) on October 17, 1997 regarding changes in the Swine Farm Siting Act (Siting Act) and advised
to make changes to the Certified Animal Waste Management Plan to reflect these changes and submit
for approval. You have since advised the Division that the construction of the subject facility had not
started by August 27, 1997 but meets the new siting requirements.
Please provide this office with further documentation (a map showing the new setbacks and a
revised waste utilization plan, if necessary) by July 1, 1998 to show that the subject facility meets the
new siting requirements. Construction not in compliance with the Siting Act is a violation of State
Statutes and could result in revocation of permit.
If you have any questions or comments concerning this matter, 0ease contact Sue Homewood at
[phone] extension 502 or me at extension 540. 9
Sinjere ,
Kim H. Colson, P.E.: Supervisor
Non -Discharge Permitting Unit
cc: Fayetteville Regional Office, Water Quality Section
Permit File
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]i9
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
Groundwater Section
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Mr. Ted Moore
Ted Moore Farm
P O Box 46'
Harrells, NC 28444
Dear Mr. Moore:
DIVISION OF WATER QUALITY
October 24, 1997
Subject: NOTICE OF VIOLATION
Failure to Conform With Conditions and
Limitations of Certified Animal Waste
Management Plan
Ted Moore Swine Farm (Fac. # 82-267)
Sampson County
this letter transmits a Notice of Violationfor failure to conform with the conditions
and limitations of your Certified Animal Waste Management Plan (CAWMP) as required
by North Carolina General Statute 143-215.10.
On 10/10/97,staff from the Fayetteville Regional Office of the Division of Water
Quality inspected the Ted Moore Swine Farm and discovered that waste from the Thomas
Hudson Swine Farm was being transferred to your lagoon(s) and subsequently applied on
your spray fields. This is a violation of your CAWMP as the plan is based only on a 3350
feeder to finish operation and does not address how any additional waste from the Hudson
facility will be treated or managed In addition, it was also noted that all of the lagoon
embankments needed to be cleared of weeds / bushes and established with a permanent
grass cover.
Therefore, you are asked to either cease transferring waste from Mr. Hudson'sfarm
to your lagoon(s) or have a technical specialist revise the CAWMP to include the
additional waste in the plan if there is enough lagoon storage capacity and spray acreage
available. You are further requested to establish a permanent grass cover on all of your
lagoon embankments.
225 Green Street, Suite 714 FAX [phone]
Fayetteville, North Carolina 2MI-SO43 An Equal Opportunity Affirmative Action Employer
Telephone [phone]S41 50% rerycled110% post -consumer paper

Page 2
Mr. Moore
l0 /24 [97
Failure to comply with these conditions, may result in the revocation of your
deemed permitted status, assessment of civil penalties, or other actions deemed necessary
by the Division of Water Quality.
Please notify this office in writing by no later than November 27, 1997 at the
address located on the bottom of the previous page as to the actions taken or proposed to
be taken to resolve these violation and deficiencies.
Nothing in this letter should be taken as absolving this facility of the responsibility
and liability of any violations that have resulted or may result from these violations and
deficiencies. if you have any questions concerning this matter, please feel free to contact
either myself or Mr. Ed Buchan, Environmental Engineer, at [phone].
Sincer ly,
Q
Kerr T. Stevens
Regional Supervisor
cc: Sue Homewood- Facility Compliance
Central Files - Raleigh
Audrey Oxendine - DSW Fayetteville
Wilson Spencer - NRCS Sampson County

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
October 17, 1997
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Henry Moore
PO Box 766
Clinton NC 28328
LF
4••
[DEHNF=
C;{ 2 21991
,PA E
Subject: Henry-Moore:Farm
COC No. AWS820711
Sampson County
Dear Henry Moore:
The subject facility was issued a Certificate of Coverage (COG) on 8/4/97 authorizing the operation
of the animal waste collection, treatment, storage, and land application system in accordance with General
Permit No. AWG100000. On Aug. 27, 1997 Governor Hunt signed into law the Clean Water
Responsibility Act. The Clean Water Responsibility Act included. several changes to the Swine Farm-:
Siting Act (Siting Act) including the requirement that all set back distances be met for any swine Iagoon -or.,
swine house for which construction commences on or after - the effective date of the Clean Water
Responsibility Act (Aug. 27, 1997). Before the Siting Act was amended, it required the set back distances:
be met at the time the swine house or lagoon washed. The change in siting requirements may apply to
your farm since construction may not have commenced by the effective °.date of the Clean Water
Responsibility Act.
Your farm was permitted prior to the effective date of the Clean Water Responsibility Act;.
therefore, you meet one of the exceptions to the moratorium. However, the 'farm must be re-evaluated
and, if necessary, re -designed to meet the new requirements of the Siting Act to remain covered under the
General Permit. Within 15 clays of the date of this letter, you are requested to submit, notification to the
Division of Water Quality whether the farm was under construction on or before Aug. 27, 1997.
If the farm was not under construction on or before Aug. 27, 1997, then a revised Certified Animal
Waste Management Plan must be submitted to reflect the new siting requirements. Construction. not in
compliance with the Siting Act is a violation of State Statutes and the General Permit.
If you have any questions or comments concerning this matter, please contact me at (919) 733-
5083 extension 540.
Sincerely
Kim H. Co son, P.E., Supervisor
Non -discharge Permitting Unit
cc: Fayetteville Regional Office, Water Quality Section
Permit File
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Govemor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Henry Moore
Henry Moore Farm
PO Box 766
Clinton NC 28328
Dear Henry Moore:
RECE1V��
August 4, 1997
AUG 0 6 1991
FAYETTI
REG. OFFICE
Subject: Certificate of Coverage No. AWS820711
Henry Moore Farm
Swine Waste Collection, Treatment, Storage
and Application System
Sampson County
In accordance with your application received on July 9, 1997, we are forwarding this Certificate of
Coverage (COC) to Farm No. 82-711, authorizing the operation of an animal waste collection, treatment,
storage and land application system in accordance with the State's General Permit (attached). This
approval shall consist of the operation of this system including, but not limited to, the management of
animal waste from the Henry Moore Farm, located in Sampson County, with an animal capacity of no
greater than 8800 Feeder to Finish and the application to a minimum of 68 acres of land as specified in the
Certified Animal Waste Management Plan (CAWMP).
The COC shall be effective from the date of issuance until December 31, 2001. 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.
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.
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.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% posi-consumer paper

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 Fayetteville 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 Mike Lewandowski at [phone] ext. 362.
Sincerely,
/ . Preston Howard, Jr., P.E.
cc: (Certificate of Coverage only for all cc's)
Sampson County Health Department
Fayetteville = Regional -Office, Water-Quality_Secti0_n _-3
Sampson County Soil and Water Conservation District
Permit File

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Henry Moore
Henry Moore Farm
P.O. Box 766
Clinton, NC 28328
Dear Henry Moore:
AgmAr4i •
, lllll
C)CF,
I
July 15, 1997
.1 R 18 1997
FAYi T iE V LSE
REG. OFFICE
Subject: Application No. 82-711
Additional Information Request
Henry Moore Farm
Animal Waste Operation
Sampson County
The Permits and Engineering 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 August 14, 1997:
1) The Waste Utilization Plan included with your permit application was developed for the
Bobcat Finishing Farm. Please submit the Waste Utilization Plan developed for the Henry
Moore Farm.
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 August 14, 1997, 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 362.
Sincerely,
Michael T. Lewandowski
Environmental Engineer
State Engineering Review Group
cc: Fayetteville Regional Office, Water Quality
Pen -nit File
P.O. Box 29535, Raleigh, worth Carolina 27626-0535 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
Wayne McDevitt, Secretary
Steve W. Tedder, Chairman
Henry Moore
Henry Moore Farm
PO Box 766
Clinton NC 28328
Dear Mr. Moore:
i 1997
FAY iTEVUE
REC. OFFICE
Subject: Classification of Animal Waste Management Systems
Facility: Henry Moore Farm
Facility ID #: 82-711
County: Sampson
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study Commission. on
Agricultural Waste, was enacted by the North Carolina General Assembly on June 21, 1996. This bill
requires that a certified operator be designated as the operator in Charge (OIC) by January 1, 1997, for each
animal waste management system that serves 250 or more swine, 100 or more confined cattle, 75 or more
horses, 1,000 or more sheep, or 30,000 or more confined poultry with a liquid animal waste management
system. Our records indicate that your facility is registered with the Division of Water Quality and meets
the requirements for designating an OIC.
A training and certification program is available for animal waste management system operators. For
information on the training programs please contact your local Cooperative Extension Agent. Operator
certifications are issued by the Water Pollution Control Systems Operators Certification Commission
(WPCSOCC). For information on the certification process, please contact the Technical Assistance and
Certification Unit at [phone]. The type of training and certification required for the operator of each
system is based on the nature of the wastes to be treated and the treatment process(es) primarily used to treat
the animal waste_ There are two types of animal waste management systems, type A and type B. Type A
animal waste management systems are generally used to treat waste generated by monogastric animals
which produce a low -fiber waste. Type B animal waste management systems are generally used to treat
waste generated by ruminants and other animals which produce a high -fiber waste. The type of training and
certification an operator receives should correspond with the type of systems? they intend to operate. For
more information on the classification of your system please contact the Technical Assistance and
Certification Unit.
As the owner of an animal operation with an animal waste management system, you must designate an
Operator in Charge and must submit the enclosed designation form to the WPCSOCC. If you do not
intend to operate your animal waste management system yourself, you must designate an employee or
engage a contract operator to be the Operator in Charge. The person designated as the Operator in Charge,
whether yourself or another person, must possess a currently valid certificate of the appropriate type.
Sincerely,
Joseph B. McMinn, Supervisor
Technical Assistance and Certification Unit
cd/AW OIC Designation
Enclosure
cc: Fayetteville Regional Office
Water Quality Files
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] Fax [phone]
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