710057_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Type of Visit: QrCo=outine
ee Inspection U Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: l Arrival Time: Departure Time: _ `� �} County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: j�kii A S 1-7 -11
Integrator:
Phone:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle C►►specify Pop.
Wean to Finish
La er
DairyCow
Wean to Feeder
er Non -La
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D . Point ,
Ca aci
P■ . ,
Non -Dal
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turke s
I
1l3eefBr­dC-­,
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Ej No ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No ❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No ❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
NA
rN�
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ NA
[:],NE3.
Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes❑
NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili Plumber: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes U rNo ❑ 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): 4
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E]-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 DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ NA
8. Do any of the structures lack adequate markers as required by the permit? Yes [] No ❑ NA rNE
(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 Uf NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ❑ No ❑ NA NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
0
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
LJ E
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
E
18. is there a lack of properly operating waste application equipment?
E] Yes
E] No
❑ NA
[ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [—]No ❑ NA NY
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA E
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. es ❑ 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 '6; NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [:]No ❑ NA
Page 2 of 3 21412015 Continued

Facility Number: it - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No ❑ NA
P-ME_
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No ❑ NA
�E
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ No ❑ NAB
TE
27. Did the facility fail to secure a phosphorus toss assessments (PLAT) certification?
❑ Yes
❑ No Q'NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[] Yes
❑ No ❑ NA
1E
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
1� 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 explain situations..(use additional pages as necessary).
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h rc
eal.�IC
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r �
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Tla 2 rT q1 '1 77.0 Z.1 `
,txl� Jr.j-
Reviewer/Inspector Name: Q wL,t e F' �'� ` Phone: 14 7 1 7jP�
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412015

Google Maps
Page 1 of 1
Imagery 02017 Google, Map data @2017 Google 50 ft
7(-,,5-7
https://www.google.com/maps/@34.4928049,-78.0579821,116m/data—!3m1! lea 7/5/2017

Type of Visit g(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 h Other ❑ Denied Access
Date of Visit: Arrival Time: I /9,'00,a Departure Time: County: %f Region:
Farm Name: J O Owner Email::
Owner Name:— L O/� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Integrator:.Pp�f'�
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Operator Certification Number:
Back-up Certification Number:
Latitude: = c = f = Longitude: = o = d =
di
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
^� []Layer
❑ Non -La ei
Other
❑ Other - - - — - —
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharses & 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)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heife3
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ 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 )� No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
El No
❑NA
❑NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128,104
Continued

Facility Number: — Date of InspectionIG//�Q(G#
Waste Collection & Treatment "
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed
through a waste management or closure plan?
0Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes )INo ❑ NA ❑ NE
❑ Yes VN. ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �'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 ❑ No ❑ NA [� NE
maintenance/improvement?
I t . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA IVNE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or l o Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
IVNE
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
E2'NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
I
gNE
I S. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
ONE
(1"'Plv�aae 7-z-,9 A-'�
Reviewer/Inspector Name I f Y�E Phone:
Reviewer/Inspector Signature: Date: B
12lmw Continued

• Facility Number: Date of inspection 1i;1l
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA] NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA 121NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA yfNE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
VNE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
PNE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
VNE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ❑ No ❑ NA P NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
PrNE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
El No
❑ NA
XNE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
[]NA
�INE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
VNE
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
XNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
FZrNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
FT�G-oa.+/
�ln
1V5A1_ e 7�7eovl 4PC�W7
12128104

Type of Visit f0 Compliance Inspection Q Operation Review O Lagoon Evaluation I
Reason for Visit jo Routine O Complaint O FoRow up O Emergency Notification O Other © Denied Access
Facility Number Date of visit: / T-une:
.. O Not 2Mrational 0 Below Threshold
0Permitted ❑ Certified © Conditionally Certified Q Registered Date- Last Operated r Above Threshold: �.
Farm Name: �� --- R�1�1.5 . County: , .` G� OF�Z
Owner Name:.,......... -Phone No: w��, Ili? _= 5(4242,0„
Mailing Address:..__
Facility Contact: __ _ ._ __... _ + _ _ _ . Title:._... _. _.__ _ _ _ _. Phone _`� Nf( o::
Onsite Representative:. , _ _ Integrator_ �WxU_j4 _ _ ......
Certified Operator:
Location of Farm:
Operator Certification Number:
(Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • Longitude • 9
- Desk Cnrreat Des C_nrrent Destrga ti Current
Swine. r r .iron.€'Pont�3'w ci : Po on Cattle Pn iron
Wean to Feeder]
Layer
Non -Layer
Dairy
Non -Dairy
- _
Feeder to Finish
pd
Farrow to WeanPR
Farrow to Feeder
Tofal Design Caps=ty
Tdtsl �S.SL�V°'• ;a
Farrow to Finish
Gilts
Boars
l�lmnber-1C.8gOtlns w " �.ff "' � &
Mcb=es & 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)
a If discharge is observed, what is the estimated flow in Sallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes WNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ONo
❑ Yes 0 No
❑ Yes 12No
Structure 6
Identifier:
Freeboard (inches):
12112/U3
Continued

` Facility Number: — 517-1
Date of Inspection Zor
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancefimprovement?
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(unprovement?
I I. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Pslnding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
❑ Yes J2 No
❑ Yes ZNo
❑ Yes No
❑ Yes No
❑ Yes 0 No
❑ Yes No
❑ Yes No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 'X No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes )ZI No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Feld Copy ❑ Final Notes
5'lisloz ( f/
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C�L�'-�i0 -- �`��- ��Gap�/��cJF_L 1�/��'QS ��� �R�.r-�T•4Z��gEGo��
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,�w y•J �CC�iOR�C� �Ts� �i�/!�5?� �i3�rJ.4G�.� � T l"Gf��%
ReviewerAkspector Name a
Reviewer/Inspector Signature:
9,
Date:
I2/I2M3 Conanued

`I Fat ifk Number: rB I Date of Inspection /D
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
27. Did ReviewerAnspector fail to discuss reviewlinspection with on -site representative?
ZYes
❑ No
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
d No
NI MES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 120 Minute inspections ❑ Annual Certification Form
© No violations or deficiencies were noted daring this visit. You will receive no farther correspondence about this visit.
"�� �' � l' �C�Orr»'I,�iJ �v�� /�� �/�G�v.� � os�i - �u � /•� 5
(,l�Dr.�i-4 �,E�JDcJf lf�� �',g�� /,4D� ��JZ�� /O � �7✓-��Ci�.c�
nn
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-2112103 N�
G oOiC AT /Aejyi

9"LIC-d'4 L—
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit _,OF;<outine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit:
©Permitted 0 Ceertified O Conditio"nally Certified 0 Registered
Farm Name: , %1 4 A ' n row + ti� r""- j
Owner Name: In/ ; d t t %zTJ IC ! %_ra
Mailing Address:
Facilih• Contact:
Title:
Onsite Representative: f _
Certified Operator:
Location of Farm:
Time: I / SO
Date Last Operated or Above Threshold:
County: ae8�
Phone No.
Phone No:
Integrator:
Operator Certification No her:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a �� �1• Longitude 0 4 11
Design Current
atvu]e
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 0
.-,:Holding Ponds 1 Solid Traps 0
Design Current Design Current
Poultry Capacity Population Cattle Capacitv Population
❑ Layer I I FoNon-Dairy
Dairy
❑ Non -Layer
❑ Other
Total Design Capacity
Total SSLW
Drains Present
Waste Managen
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gat/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. is there evidence of past discharge from any part of the operation?
Area Spray Field Area �
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
❑ Yes �No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 2TNo
❑ Yes ❑ No
.0Yes ❑ No
Structure 6
05103101 Continued

Facility Number: ?) — oj_j Date of Inspection Btl Z
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ONO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ZNo
(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 )ZrNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ONO
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes JZNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑Yes ',31No
11. Is there evidence of over application? ❑ Excessive Ponding ElPAN ElHydraulic Overload ElYes 2fNo
12. Crop type C0,0 W jNe So be q;i s
B. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes 'MO
b) Does the facility need a wettable acre determination? ❑ Yes ZNO
c) This facility is pended for a wettable acre determination? ❑ Yes JNo,
15. Does the receiving crop need improvement? ❑ Yes _0"No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Required ReLords & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
j2rNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
ONO
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
,Yes
❑ No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
ZYes
❑ No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ONO
24.
Does facility require a follow-up visit by same agency?
ZYes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
ayes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments refer�taquesfion.i#) E%platn atiy YES answersfan or any�recommendahons or�aay<ot�er comments:: I ' ,ate, �� n
zUse drawtngsAoffacility to better ep amain srtuahons (ise ailditlonal pages astnecessary,) w *-
;_ ❑Field Copy ❑Final Notes
�• _�� ;� .,�; �,�. � rr.� � s
q. T17e lq^}oorl v.�d leYel !J' i� ✓��p����o'7. The 1,q9noh /Y v d
level needs fo be lay✓e''e'd ly)la e0'y14'1CP ice, q resfens,'bl e) -/,r-�P/y
ryJannei �� ac�a��ahce w.a� -�l�e Per , , tr✓�s-le ,.y,�nA�e,,.,en �14
�•-td l9L✓f ��'' -�h� Ae F�tL �'/,'f� a �-g des
22. 1Uo
�-4. 6e de-7e , ed)
Reviewer/Inspector NameG�1'1n�� j 1i`�'S'.x r`
Reviewer/Inspector Signature: Date: 0 Z
05103101 Continued

• Facility Number: Date of inspection i 4
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?
I, Additional. Comments and/or Drawings:
❑ Yes ❑ No
Oyes ❑ No
❑ Yes ❑ No
❑ Yes [-]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2'7, `f1, ere qre dPm,4 qrl;-,xet j rc yt a,^.3 o:i 46e side ev' the l-7 yeoN
rlea�s� Ae ho3 house, -7-;� ese aced Io be f ra�erly d, sposed�
r)a� 14 Ae 1Ry�o� . �
25. 717ere q pregrs r view-ig ►I j Ae Leo.-dr -le be oL
qnd -/Av niash recen-f ],de �tv/z
54101 i 1 a��1-, -free board -)-f -&Ien- -rcou✓ i,7c�tes. T4 secs�rs
-]GIP Waste !.f AO/ bein
A]so, sQ76ecths g✓P Gv"'-ey41y i�q 1"5 ez"O cq4►aPl
T1,e wct.s46 r]G►n See s 9 1 ;" qn1 Yeq r -�Ae
wl v.14 be q l-Jc,�,?� evf r' d-*7 41 e -two
is d>7e ��614 q.4 soybegnf o Ae>^ ��, q 9;vc�'t.sr�r�✓�t�r
I9 . Need 4,o use the f rlopar' 11
Ni-�farJ�✓I � �N� G3E�oW4YlLP -,roam -lAe wrf-�e rlq►� Dt'7 `Ae
TR&- zIs .
Also, �h�re %J na w�i.s�e gn �rl� r,'s w:-�J,,'►, (Q dQ ys v
so&7e Ajovem be✓ 2poJ ��j�l�'ca-1,`��, cver��s . L� Lv�s4e
on91
eve`S o n G( .:rvrA �f rt ol� .�,'� ; s �a be Lse
y d
41,po n,'¢ro5eti aptate► the �Tek- z,s .
z 1. Th C1TC is , enne44 W i as i j 1667, w; a —Fv4F y� PJ6
add Tess _
IV �e � �: c�vres rver� �ake� T� /a,9oa1 w19 r>�r, d�aq �iAr�.�e, � Q►���g l P�i�
2-7. �o„fi-> %h ere qre Gd s o W liol e d g a4 170g1 else t,;ge-'e
O5103101 d �'sposev! AP .

N
Type of Visit 'Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint _,ZrFollow up Q Emergency Notification 0 Other ❑ Denied Access
Facility Number 57
Date of Visit: Z Time: 1 1 S
Not Operational Below Threshold
0 Permitted O Cefrtifif ed © Conditionally Certified ©Registered Date Last Operated or Above Threshold:
Farm Name: W 11 i e Fa ,ram _ County. FE'rl de✓
Owner Name: �i % '` Phone No:
Mailing Address:
Facility Contact: L Title: Phone No:
Onsite Representative: �e P � `� T Integrator: m t/ .e4'�
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ' " Longitude 00 • 0
Design Current Desig>t Current - �Desrgn Carreat
SKtne:. -�
Ca aciri� -,i'o n[adan W�.PouE .. :. Ca hcrty Po ulstkin ... Giattie
❑ Wean to Feeder = ❑ La er m ❑ Da
El Feeder to Finish ❑ Non -La er n ❑Non -Dairy
❑ Farrow to Wean _
_m
Farrow to Feeder �- ❑ Other -
❑ Farrow to Finish = 1=
Total Design Capacity
[] Gilts
❑ BoarsT Total SSLW
=-
IR
l�liimber of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ S ray Field Area
Holding Ponds°/ Soltd'aTraps �1 tag ❑ No Liquid Waste Management Svstem i
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Latroon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
f
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Identifier:
Freeboard (inches): 2 Z
05103101 Continued

Facility Number: 7 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?
(If any of questions 4-6was answered yes, and the situation poses an
El Yes
El No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. 1s facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
❑ No
(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
❑ No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
`CoMm_ in_ ts.(refer-to,ques 6n #) )rxplaut any YES:answers and/or any recommen. tions:or nov other comments:
.Use drawings of.facity-to, lttifiKladditiona beer explain sivaose al paes ges as necsary) � - �❑ Final Notes i
_ il_�❑ Field Conv
4 4Z,P IagQor, lever ; s sv64
4i,c.-e t J z o-­ Zvi o-F -ir eeb o cird; .r) vd9e ► s f v-esen 4- atYlee
1 a�� oY• r�a h be Puvnpeal no )~ems Pwig sl Ud 0 a.
1-jc ¢y7 v;,'Pd AboCe7t Go.s S�taie >Co✓ fat5oay, GleatnvLj} a1"
G i L� 5 v� G9r? Li G-�CD� .S O t+, TU r rt C' ✓ lv , 41, Pe r O(eY 4orc ,7 T .ro r i
� ����� a bard-�L�;s,•-T�so,--, , s �o �Q� Eck ia� �dh ��c� Lyaha,-�v�,d
Reviewer/Inspector Name ,-tel.�i
Reviewer/Inspector Signature: Date: ?i
05103101 Continued

Facility Number: 7 f -59 Date of Inspection D�
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 anv dead animals not disposed of properly within 24 hours?
2& Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt.
roads. building structure, andlor public property)
24. Is the land application spray system intake not located near the liquid surface of the lagoon?
30_ Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments and/or Drawings:
4166,004i'v%Velf) i.J
bou
-1h %s • 15) l s D be earlu Gf Mv v�f lt� -,SYvw ►�
�c a h C6' 7G Ac y nvr,? y
k- able ,� r,^19vfde•
The sleeds ��mv��
�
d prorate✓
),Wes aJ rq%t Or e?"AeY a eleq)iom
dw- cjosvre �l�n .
71,Q Gv>r✓e"4 S)rrve,(5e G{cGvr� r�l��r'or-,
is
✓' , �- f �C r''? S O �-, t�"O ►"1 L'j �G i .n i ✓1 �j � i��%'�df%l')Lt'-�` .YT1J"''G} � e 4l% t'Y/�I C�
ly1 L,e 1 a9P0� . A�a ,'n i eh �d>� ra 9ep�
�l✓. �'%�j!?'.,S�v, -�a
Ilse b� 11, 'OvG i to ble r; gilds 4e AeIr
1^� ct �)'-1 �a ► h t0✓�Y'D�,�'�'�TG'
��'2f°f7vCif!/� k-velf ,. ql fp adv; s eye
TP t►^ �a mil/") j!-f<c)h
v1�' L1�4L1n1-� 2$0� ZG1 1�G�2S jjrlG�cr
Gvr�eri-z� G�✓'Gvnti,S�cfi�GC'S�
L-V11 le s1;1) �o�lo�,.l�5 ��,c aJ�� �t�ti
qnd feer�7:4 .
217- -FL e ale^d .hvjs ortni� 4e k7�ve been 6uv,ed .
05103101

Type of Visit jo Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit oRoutine O Complaint. O Follow up O Emergency Notification O Outer 1 © Denied Access
Facility Number Date of Visit:1111201,91Time:
Q Not O erational Q Below Threshold
Permitted eCertiiied 13 Conditionally Certified © Registered Date Last Opera"or Above Threshold:
Farm Name: ...W .. ..... County:... l..f!�ll A .. .......... ....... ........ _ ._..
.. _.
.....................................................................
OwnerName:.. . r. ...........11-rez._41,�Qd ............................. Phone No:............................ .................. .......... ...... _............
..
FacilityContact: ............................................................................... Title:................................................................ Phone No:
Mailing Address:.............��A��
............................................................................................... .............................. ............
Onsite Represent ative:............ ,1 f� ...... Integrator:..... .....� X'e �.......... ............... .
CertifiedOperator: ................................................... ............................................................. Operator Certification Number: .......................... ...........
Location of Farm:
,0'Srwine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �4 66 Longitude ' 6 66
- = Desig�T; Current-
, ..�Svvine - ;Ca ci " -Po nlatiiori
to Feeder
IWean
Feeder to Finish
Oil?
to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Nnmberof La-
g6bi 10 Subsurface Drains Present 0 Lagoon Area . ❑ Spray Field Area
W- Holdu>g Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharees & Stream Im act
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in 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 )2rNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Ja No
❑ Yes Y'No
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 0<0
Structure l Structure 2 Structure 3- Structure 4 Structure 5 Structure b
Identifier: ...................................................................................................................... ................ . ................................................................................
Freeboard (inches): 2
5100 Continued on back

Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures obs rued? (ie/ trees, severe erosion,
❑ Yes
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
9-90
(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 maintenancetimprovement?
❑ Yes
0<0
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
PNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
elevation markings?
,01�0
Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes
Rio
11. Is there evidence f over applicatio ? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
12. Crop type (mot/ Q
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
U<0 .
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
2'go
b) Does the facility need a wettable acre determination?
❑ Yes
0�410
c) This facility is pended for a wettable acre determination?
❑ Yes
FKO
15. Does the receiving crop need improvement?
❑ Yes
0<0
16. Is there a lack of adequate waste application equipment?
❑ Yes
Zfqo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Yes
(ie/ WUP, checklists, design, maps, etc.)
❑
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
,0"Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
Of4o
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
21Go
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
O No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
24. Does facility require a follow-up visit by same agency?
❑ Yes
�
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
7No
i9 v0iyyaifft-.66630ee
cori-esporideirce: about this visit.
�) �/��K� `ji/,P,E ffovS�s �f�u�w, f1�s h`iV•�EfI,QF�- p �o� To A.
�rQ�ZG.�7"�Il r G/il �Oi2Tz,o �.2ESSf�li�GZ�✓�
G''t1.✓ L{�.9-S � BEd �v r fi�4r �� Gs�� rr� ,O�.Szc,✓
�J/11rZ�✓L��' Qit/ f "�.l�T
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 129EAV 5100

FaclIity Number. — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge aVor below ❑ Yes No
liquid level of lagoon or storage pond with no agitation?
27_ Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is theme any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ElYes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes a<01
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
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks tack a submerged fill pipe or a permanent/temporary cover? ❑ Yes dNO
Additional -Comments and/or Drawings: - ^:
x9e . lnz�r 6AI71-�e 7-
Af
,41eo
W540,ZA�,-5
;;pro- �5'e
Z� / 'mob Ci�'�/v 1
gm

- - :©
13
Y�iai _L- _
Routine 0 Cam faint Q Follow-up orDWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection-Iq'bfj
Time of Inspection 124hr. (hh:mm)
❑ Permitted A Certified
�� 0 Conditionally Certified ❑ Registered Not Operational I Date Last Operated:
Farm Name �17 `'. ll. ......X-44W.ji......... fi .... ............ County :...................��P111,19-..........................�...1.,..,........
LU
OwnerName: ...... Y..I1..i 1./. .:.......&kik. ].:�.r........ Phone No:.....................................................................................................................
Facility Contact: ...:. � �..%r.......... Rk.KSr'? ... Title: fw Phone No:... f14. 3.: 1�
..........
MailingAddress: ....................�................................................................................................................................................................I-- . .........................,
Onsite Representative:.... L rf f /�. ................... /.�'� l w..................... Integrator:........MY; .................................. .........................
Certified Operator:,,..,,,. ,, / lr ,,,,,,,,,,,,;, „. ........4mes,.e� Operator erator Certification Number.
Location of Farm:
... .................. ................... ........... .......... t
Latitude Longitude
Desi Current Desi Current - - Deli Current
fn gi _ Zul
Swine. -Ca acity Capacity
-;Po ulation Poultry Ca act Po ulation? . Cattle _ ' : -Ca pacit -Po ulati0 ❑ Wean to Feeder JE3 Layer ❑ Dairy
EZFeeder to Finish 1� ❑ Non -Layer ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other =
❑ Farrow to Finish Total Design Cawidq - ,
❑ Gilts
❑ Boars Totai`SSL W {
Number of Lagoons v - I ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holdin Ponds) Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes N0
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? —AI`
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 ANo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [)XNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes kNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): .......................... .................................... ...... ................ ............... - .................. ..................................... ............................
5. Are there any immediate threats to the integrity of any of the structures observed? Oe/ trees, severe erosion, ❑ Yes ®No
seepage, etc.) Y �
3/23/99 Continued on back

Facility Number: 1 f — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan_?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
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?
(iel 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?
0: N4.violaf icjris:ojr &fici6ndL-5 -mere pQtet3• Oof ifi this:visit; • Y;oi>f will•recehree Rio further
corresparidehce: ahout thLNisIt............................. .
❑ Yes %No
P(Yes ❑ No
�Yes ❑ No
❑ Yes ;KNo
❑ Yes KNo
❑ Yes RAlo
❑ Yes [KNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
AYes ❑ No
❑ Yes $ No
❑ Yes ONo
❑ Yes KNo
XYes ❑ No
❑ Yes [1No
❑ Yes KNo
❑ Yes KNo
❑ Yes quo
9Yes ❑ No
❑ Yes XNo
Comments (refer to'q_ .- 9n #)`=Explarnany YES answers ail ortany,.recommendations or:any other comments < 4
Use drawing/s of facilrety[to bette�p}r explamsit[u(ations (use:a%�ddi`hGonalLpages as necessary}
jVi�J�r't! � lab � W-A, G�%jl1M N' T AS& J6// � �%�au{� PJ&Sk- iC #' �L6tS �t�iLi �
f 5j 6,t4msire, w� o es •fv h-t. dprt4 A �P�a /'Z44, . 6�A s1�� h� 6ks�- cp[
t"r� �RRt as Sawti- RS we4iKw.- arv� �'`�Gl Coy-rdif i�J �er.�i� Sot 5 Sys
L �Oiel-. -Pd,& as 56 4y. 6rcwcr da�r.S-�
p� Say4[�nS arisad In.7— / zo /
/�s.s She:,f�L kL{�>!h—
T
IReviewer/Inspector Name -� I
Reviewer/Inspector Signature:�T VIA? 1 ,`/ti Date: J_��/Q � d/D

Facility Number: 7 — S Date of .Inspection
Odor Issues
26. Does thedischarge 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? ❑ Yes �(No
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 land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes j 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 MNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?-'tel�o
Additional', omments a
_.._. n or
�r Y ✓� 5!S O� �v�r77i �O GLL�LI,/I/
r � e � J
W-a'firt e6w'rz i" � on Si l-e� w ✓�cvrD�s,
'/Yt� W1�
fiplldw-uP will h-t' Anz h rerle' p—) oC &V6�46ws .
3/23/99

Re-Viscd January 22. 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number - S _ Operation is flagged for a wettable
Farm Name: Wt acre determination due to failure of
On -Site Representative: ti �hli 1-�, Part 11 eligibility item(s) F1 F2 F3 F4
InspectorlReviewer's Name:
Date of site visit:
Date of most recent WUP: 3
Operation not required to secure WA
determination at this time based on
exemption El (0 E3 E4
Annual farm PAN deficit: �9 I 19- pounds
Irrigation System(s) - circle #: 1. hard -hose traveler, 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system w/permanent pipe; 5. stationary sprinkler system w/portable pipe;
B. stationary gun system w/permanent pipe; 7. stationary gun system w/portable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part II, overrides Part I exemption.)
E1 Adequate irrigation design, including map depicting wettable acres js complete
and signed by an I or PE.
E2 Adequate D, and D21D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter. sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ill. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part ll. Complete eligibility
checklist, Part If - F1 F2 F3, before completing computational table in Part III).
PART If. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Deter minat_ion required because operation fails one of the eligibility
requirements listed below:
F1 Lack of acreage which resulted in over application of wastewater (PAN) on spray
field(s) according to farm's last two years of irrigation records.
F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations (numerous ditches; failure to deduct required
buffer/setback acreage; or 25% of total acreage identified in CAWMP includes
small, irregularly shaped fields - fields less than 5 acres for travelers or less than
2 acres for stationary sprinklers).
F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part III.

44
Revisal January 77, ] 9:
Facility Number
Part Ill. Field by Field Determination of 75% Exemption Rule for WA Determination
L_iLLLJ P4UlVl LJ=jt - IIYU192JIL, gull, Lul+ul VI IJulllL I IUIJIO=10!i iOY ua U..�V Is ul IIG lu IIUL u.Fulb uCPG71U I] ly uli l,Plvvwlr
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption if possible; otherwise operation will be subject to WA
determination.
YIELD NUMBER' - must be clearly delineated on map.
COMMENTS3 - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less than 50%
of its annual PAN as documented in the farm's previous two years' (1997 & 1998) of irrigation records, cannot serve as the
sole basis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessible
by irrigation system.

✓J Revised January 22, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Numb -
Farm Name -
On -Site Representative: C7wZ1
Inspector/Reviewer's Name: �1
Date of site visit:
Date of most recent WUP: txbo ` r)
�./ Operation is flagged for a wettable
acre determination due to failure of
Part 11 eligibility items) F1 F2 F3 F4
Operation not required to secure WA
determination at this time based on
exemption E1 E2 E3 E4
Y• � �f a
Annual farm PAN deficit: 73W�pounds
Irrigation System(s) - circle #:Qhard-nose traveler, 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system w/permanent pipe; 5. stationary sprinkler system w/portable pipe;
fi. stationary gun system w/permanent pipe; 7. stationary gun system w/portable pipe
PART 1. WA Determination Exemptions (Eligibility failure, Part 11, overrides Part I exemption.)
E1 Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D21D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part ill. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part 11. Complete eligibility
checklist, Part If - F1 F2 F3, before'completing computational table in Part 111).
PART If. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Determination required because operation fails one of the eligibility
requirements listed below:
F_1 Lack of acreage which resulted in over application of wastewater (PAN) on spray
field(s) according to farm's last two years of irrigation records.
F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations (numerous ditches; failure to deduct required
buffer/setback acreage; or 25% of total acreage identified in CAWMP includes
small, irregularly shaped fields - fields less than 5 acres for travelers or less than
/ 2 acres for stationary sprinklers).
✓ F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part III.

Revised January 22, 1999
Facility Number
Part lil. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBEW-2
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS)
`Z, 0
r]S .`-f
I
- �
E
FIELD NUMBER' - hydrant, pull, zone, or point numbers may be used in place of field numbers depending on CAWMP
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption if possible; otherwise operation will be subject to WA
determination.
FIELD NUMBER - must be clearly delineated on map.
COMMENTS' - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less than 50%
of its annual PAN as documented in the farm's previous two years' (1997 & 1998) of irrigation records, cannot serve as the
sole basis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessible
by irrigation system.

'4 ..
©Diviscon of Soil and Water Conservation Operat►on
�U Division of Soil and Water Conservation -Compliance Inspection
IN-Division_of Water Quality Compliance'lnspection -
- 0 Qther-Agency -Operation Review v
Routine 0 Complaint 0 Follow -tip of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date ofinspection
"Dime of Inspection aG0 24 hr. (hh:mm)
0 Permitted (Certified E3 Conditionally Certified © Registered 113Not Operational Date Last Operated:
Farm Name: W`1\1` i j\mil County:............................-........-..........................
................. �...................��!�...---..---.................................................
Owner Name: Phone No:
FacilityContact: .... ...................................................................... :... Title:---............---............--..---...--.---.---.............. Phone No: .......................................... I........
MailingAddress:..................................................................................................................... .....................................................................................
Onsite Representative:.. ..(i................................................................ Intetiratnr:..... .....
Certified Operator:.....-y...•„th2cr.... Operator Certification Number:......G... 'i.....................
I catio of F rm
S�yyrr.....
qL
/� .... i
.. ............. 5�7�1. ........... ............. ......... .. ......:...... .... .... ... ......................................................-. ....:::.)..-...... ...... !.-... ..
Latitude 0 6 Longitude • ° 44
Swine Capacity Population
❑ Wean to Feeder
DR[Feeder to Finish
GV
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I I❑ Dairy
❑ Non -Layer I I ❑ Non -Dairy I I�
❑ Other I I I
Total Design Capacity
Total SSLW
Number of Lagoons JE1 Subsurface Drains PresenE ❑Lagoon Area Ili 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 (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made:'
b. 11-discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the State
c, if discharge is observed. what is the estimated flow in galhnin?
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any 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?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: n�-(
Freeboard (inches):...........�`...1........................................................................
❑ Yes Z No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [WNo
❑ Yes j1'No
❑ Yes &(No
Structure h
1/6/99 Continued on back

-F
. Facility Number: — J/ Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pact of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required top of dike,.maximum and minimum
liquid level elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
0
❑ Yes tS�No
❑ Yes 5(No
L'Yes ❑ No
❑ Yes 9No
❑ Yes FYNo
❑ Yes XNo
11. Is there evidence of over applicatio '7 ❑ Pondim, ❑ Nitro,,en ❑ Yes ff No
12. Crop type ..................................................................................................................... .... .............. ..........
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. Does the facility lack wettable acreage for land application`? (footprint)
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, e(c.)
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 certified operator in responsible 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?
0- KO 61a'tionS:6r. dehc' ienries .were noted. during .t}iis.visit:. You wvi*JfreCeive ncr further .:.
e6rresp6ridehce; about: this visit.: ; ; :. ....: :.. : . : .:. : .:.:.:. : .
Yes ❑ No
❑ Yes C'No
❑ Yes KNo
❑ Yes J�' No
❑ Yes WNo
❑ Yes KNo
9Yes ❑ No
❑ Yes ff No
❑ Yes tKNo
❑ Yes [ANo
❑ Yes M No
❑ Yes [allo
Comments.(refei to question#): Explain any YES answers and/or an-recomtiiendations or any other comments.
Use drawings of facilityto better explain situations. (use additional pages as necessary) „ - _
V­e;z Its
ic)
!nr 1--5 c� ,�i�.� ` � �i►--�cc...s listed l �-. ��� o�\ {�
}� ,` - ems _ rer� t� ve � -� �� s "a �t(q�
Kip,-
c :►r r 4s l ti � rcr p_ 1QC� tiey+. -- dL �+_6
Reviewer/Inspector Name
Reviewer/inspector Signature: Date: 3 l C(5 11/6/99

❑ Division of Soil and Water Conservation ❑ Other Agency,
Wivision of Water Quality
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-uE of DSWC review 0 Other
Date of Inspection -2 3
Facility Number Time of Inspection J Z : 5 24 hr. (hh:mm)
M Registered Certified © Applied for Permit 13 Permitted ID Not Operational Date Last Operated:
Farm Name: �.?r k; wgvti 1�cv h County:_.. ..................................`�?... ...
..........................................................................................I.............................
Owner Name: ............�.i .. e ...k: K lson ........... Phone No:..........r�.�.GQ...:.?. g..�7....�:�.���................�.
FacilityContact:.............................................................................. Title:................................................................ Phone No:..............................
Mailing Address: ... ....1..6..:5.. � i' ..Son R- , Cv r r . e ./Y .......2 T L 3'S� .............................. ..........................
.........................................'......................---...................--- ...... . /..........--- 1
Onsite Representative: ............................................. Integrator: ...!w.l..sl .
Certified Operator ......... LK:t:"_j .....J�. !x.l'!........................................... Operator Certification Number:...................-
Location of Farm:
Latitude • 11' " Longitude • 0' 0'f
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5_ Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes )�No
❑ Yes PrNo
❑ Yes gNo
❑ Yes XNO
❑ Yes
00
❑ Yes
❑ No
❑ Yes
No
❑ Yes
❑ No
❑ Yes (dNo
❑ Yes 'q�lo

11acilityNumber:
• 8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
t No
Structures (Lagoonsj][olding Ponds Flush Pits etc.)KNO'
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
Structure i Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: l
Freeboard (ft):...........Z.1....l..............
10.
Is seepage observed from any of the structures?
❑ Yes
VNo
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
VNo
12.
Do any of the structures need maintenance/improvement?
t/Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
VNo
Waste Application
14. Is there physical evidence of over application?
❑ Yes
tWNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type Sri .." `I. i................................................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
OR"No
IT
Does the facility have a lack of adequate acreage for Iand application?
❑ Yes
N No
18.
Does the receiving crop need improvement?
j$ Yes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
WNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
O No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
P3-No
22.
Does record keeping need improvement?
XYes
❑ No
For Certified or Permitted Facilities Only
WNo
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
ErYes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
)�(No
0, No:vio'lationsor deficiencies.were-noted-duritig this -visit'.- You :will receive•no•fdrth:er
correspoi►dence about..
1 Z � e Ile- 5t¢a �i ba �G a �� c -, a :1 -6/ o ` � � 5 oc�vl Q. spz
Covey Gro� !�%lxd .fo Ice5�1:5�► Cc,c.c/�r��_
-Z ecip r,-e_4 b—/-d ► e-et,r�s
Zi1r 1_ k a .pc ��.� c Ctavy rfa� . (Nor,;)
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: �1t c.17 C;,-" Date: 9 .2 3

Routine O Complaint O Follow-up of DNVQ inspection O Follow-up of DSNN'C review O Other
Facility Number
Farm Status:.:..L�..__ ..` _ .... �.—...... i�...
Farm Dame: P 1 _....................
l�.I L.....t���5.47r1.._.I~�Yt'+a......._..............—. County:........ �'�]CKX:............
Owner tiame:....!�+�i�—A��ii�5�n----._. _...._ �.... Phone
Mailing.ddress:. J..Q1._Rc�. W ---- �---L..._._.................
Onsite Representative: — Al
p l�ln�.......f�!..LC156n.............. ........ --..... --•-•--••---.... Integrator:... Mu7c*1�......
.............
........._..........�.___.._...........
p�—. ...._ Operator Certificatilon Dumber: �.t.Zd1.Q1...._..T......
Certified O erator: _...�s� ... ��...................-------------....---- P ..
Location of Farm:
JAit ... ....._( ....v�: _ 4
..... _................
Latitude ®' ° u Longitude ®' 03 ' j'
113 Not U erational Date Last Operated:
< rype of Operation and Design Capacity
z„s,'iyy.-
J � � . �
wines `MNumtierm?� Poulfry; \umr _Cattle Number,
be
Yy
•y
❑Wean to Feeder Big K ILJLaver El Dairy
h
Feeder to Finish 60 ❑ Non -Laver El Beef Yew
Farrow to W can •.
e.s
Farrow to Feedere�'
R Farrow to Finish f ' ❑ Other Type of Livestock
ry�+..
.£:i?�� .�. »w.H.n�'�W�l�3a' �: :vm'..:#. .:+. M.'y ...&•e°'^ x •.t,....::<i� ii.`.'.rSew'% ";'>��R�.'¢:�:� n:.
Number. ofLagaons ! oldutg=Ponds;10 Subsurface Drains Present
Pilln
n Area pray Field Area
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes JZ No,
2. Is any discharge observed from any part of the operation? ❑ Yes ® No
a. If discharge is observed, was the conveyance man-made? ❑ Yes [Oo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes N No
c. If discharge is observed, what is the estimated flow in gal/min? Al
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 121No
.},�. Is there evidence of past discharge from any part of the operation? _ • ❑ Yes 5ANo
4. Was there any adverse impacts to the waters of the State other than from a discharge? ElYes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ®Yes ❑ No
maintenance/improvement'?
Continued an back

6. Is facility not in compliance with any applicable setback criteria? Yes 15 No
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1l1/97)?= -_-----.14Yes [$No
8. Are there Iagoons or storage ponds on site which need to be properly closed? Yes Cz No
Structures (Lagoons and/or HoidinA Ponds)
9. Is structural freeboard less than adequate? [] Yes ® No
Freeboard (h): Lagoon 1 Lagoon 2 Lagoon 3 Lagoon 4
—26
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenancelimprovement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
S��aste Ayplicatian
14. Is there physical evidence of over application?M (If in excess of N P, or runoff entering waters of the State, notify DWQ)
J2
15. Crop type -• .. �..-................_......_�.....—.�.phil._.......:....------..__..__...... ......
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the cover crop need improverri,ent?
19. Is there a lack of available irrigation equipment?
For Certified Facilities 631v-
20. Does the facility fail to have -a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal. Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes jo NTo
❑ Yes R] No
❑ Yes CA No
❑ Yes W No
0 Yes ®No:
❑ Yes ® No
❑ Yes
® No
[j Yes
® No
® Yes-
El No
❑ Yes
® No
❑ Yes
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1;l'se;-drawtngs of fac�tty�fo bettere, lain, sttt>rahons tt�e.adaftonal �ages£as necessa:l� �,� «.�.�. ,��' �, � � ���
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Reviewer/Inspector Name
Reviwer/Inspector Signature: Date:
Division of Water Ouality, Water Quality Section, Facility Assessment Unit 11/14/96

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Site Renuires Immediate Attention:
Facility No. 'Z/- 5-
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATI NS ITE VISITATION RECORD
DATE: 1995
Time:
Farm Name/Owner: %Z,�®� • /�7
Mailing Address: u
County: ✓
Integrator 4Trt ✓ Phone: F 373
On Site Representative: Pho e:
Physical Address/Loca ' n:
Type of Operation: Swine T;etfl-, _ ou Cry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE ' DEM Certification Number: ACNEW
Latitude: �' ' �" Longitude: Elevation: Feet
Circle Yes or No
Does 'the Animal Waste Lagoon have suff cient and of 1 Foot + 25 year 4 hour storm event
(approximately 1 Foot + 7 inches) es o Actual Freeboard: Ft. Inches
Was any seepage observed from th a oon(s) . Yes or o� Tas any erosion observed? Yes or re
Is adequate land available for s ray? a or No Is the cover crop adequate? Yes or( CJ
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings?l5 or No
100 Feet from Wells? &or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes 00
Is animal waste discharged into waters of the state by'man-made ditch, flushing system, or other
similar man-made devices? Yes or i o If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with co er crop} Y s o 0
Additional Comments: _ -sorL
cc: Facility Assessment Unit
- Use Attachments if Needed.

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Owner -
County:
Site Requires Iiamediate Attention
SITE VISITATION RECORD
DATE: June 18 . 1995
Willie & Gene AtkinSO4 Farm Naive:
Facility Number. -7 /
Atkinson Farms
Agent Visiting Site: Kenneth Cook amender SWCD Phone:(910)Z59-4305.
Operator. Willie Atkinson „w __. Phone: [phone]
On Site Representative; Gene Atkinson Phone:
Physical Address: SW of the intersection of US 421 and SR 1119. 0 ation is
Atkinsonbehild Farm Supply.
Mailing Address:
Currie, NC 28435
Type of Operation: .Swine X
Design Capacity: unknoyn
Latitude: c »
Type of Inspection: Ground X
Poultry Cattle
Number of Animals on Site: 600 finishing
Longitude:
Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Oe or No Actual, Freeboard: 2- Feet 9_. -Inches
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from the lagoon(s)? Yes oc N Was there erosion of the darn?: Yes o No
Is adequate land available for land application? (& or No Is the cover crop adequate? Yes co
Additional Comments; Lagoon banks need to be mowed.
r
Fax to [phone] Signature of Agent

JU1 0 '95 1 P.14/1,-:
Site = '1ifCS _rmine'31ace Aaeudou
•
F: ,;ffitti 1�'urnbcr:
sl'T*—;z v,,Sl i ATI0N KECO D
DATE: 'June 18 , 1995
[huller: Willie & Gene Atk rISOrl. Farm N-u-ne: Atki.naoi, Farms
Counry- _ PNnd"-
Agernt Visiting Site: =!9111 c2nK,�- - pt ; ��rC� Fhaac: (9; 59- sat 5
Operaror: � ' �,.t�. - - - phone:
On Site RepmsentaCvt- Crerte Atkinnon _. --- - P1:aae:
Physical Address: .25 mills SW of 11,1�_ intersection of US 421 and SR iii9. aeration
behind Arr.KLn"Zi Farm S1. pply.
Mailing Address:
Currie, Nc 278435
Type of Operation: 'Swine x Poulcry _ Cat*.ie
Design Capacity!: _ womown Number of Aalmgls on Site: 600 finislAng
Type of Insttectioa: Ground _ Aerial
0
CircleWs or No
Dogs the Animal Was:e Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hva: stony event
(approximately 1 Foot + 7 inches) (A or No Actual Freeboard: ; Feet _�— Inches
For with more than one lagoon, please ad&ess the other lagoocs' freeboard unlc. the
coII`+.iz1Cv.C5 SCrrtln[]_ .
Was any secgage QbSI--, t:kl from Llie luguun(s)? Yes Or i Was ".Izezc crosit�n of the gym?: 'Yes o N.N,
9
r `P;
Is adequace land available for land applic,2don? , or NoIs the cover crop adequate'. Yes c
Additional Cvrzutients: La oon t'Anks need tO tw-F,
Fax ro [phone] SiZzaturr of Apat

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Site Requires Immediate Attention: /mob
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: l , 1995
Time: V SRO
Farm Name/Owner:
Mailing Address:
County:
Integrator: MAy_
On Site Representative: _
Physical Address/Location:
Phone:
i Wso
T
Type of Operation: . Swine --J/— - Poultry Cattle
Design Capacity: 677_0F Number of Animals on Site:
DEM Certification Number: ACE - DEM Certification Number: ACNEW
Latitude: Longitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches Yes r No Actual Freeboards . Ft. � 'Inches
Was any seepage observed from the agoon(s)? Yes or No Was any erosion observed? Yes r No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes r N
Crop(s) being utilized: M S 4L I S
T
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? e -No
100 Feet from Wells?/ Yeskr No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No 1
Additional omments: QL/_) a L' l Ll Z G7 — M f s -501/Ql A62KAEi J
�fiij S i !l .fl�� �✓'r 51�1 i.+1P� C�Af�P�,e- 11lJ���
eS C:9l/n/ �&(? u
e)d h/1 S i D� Q� L,A-60VIII - 601,& A A/,0 7— e i*4
Inspector Name
Si
A/
cc: Facility Assessment Unit
Use Attachments if Needed.