710098_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

11 R. 1q8
Type of Visit 6 Copliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ElDenied Access
Date of Visit: i ly Arrival Time: Odt7 Departure Time: County: f" tA109 Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Phone:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: U�=L, .
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ o = 4 Longitude: ❑ ° ❑
Design
Current
Design Current
Design C>urrent
Swine Capacity
Population
Wet Poultry
Capacity Population Cattle
Capacity Population
❑ Wean to Finish
❑ La er
❑ Da Cow
® Wean to Feeder
g `Z
�u 6
❑Non -La et
❑Dai Calf
❑ Feeder to Finish
❑ DairyHeifer
❑ Farrow to Wean
Dry Poultry
❑ La ers
❑ D Cow
❑ Non -Dairy
'' El Beef Stocker
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Turkeys
❑ Beef Brood Co
ma
Other
❑ Turkey Poults
❑ Other
Nurn er of Structures:
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
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 ld No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
IN
' " ❑ NA
[I NE
El Yes
�No
❑ NA
❑ NE
12128104 Continued

Facility, Number: ! Date of Inspection 9 v
Waste Collection & Treatment
ffNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ 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: LA 6024 i
Spillway?:
Designed Freeboard (in): ?
Observed Freeboard (in): 72d
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
El Yes
,�
U 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 envi7yes.
ental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ No NA ❑ ❑ N
E
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
RNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
2r<o
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[D4
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of
Area
12. Crop type(s) E3E2.n.0 pR CG
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
fNo
❑ NA ❑ NE
-15. Does the receiving crop and/or land application site need improvement?
dYes
❑�No
❑ NA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',
El Yes
0 No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
eNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ff]No
❑ NA ❑ NE
7,y WwR-k::- or-J CodEn C-��ASf �{ �1:1� tfAt t_
1 Qr Cr-ET LA6 ootJ 0(ST6 N
21.) Gt j- c o P�, 7--oc q S,:. L. TFSj
-------------
Reviewer/Inspector Name Phone: ��j►Ql 7�i6 —7�65
Reviewer/Inspector Signature: Date: 7 a
12128104 Continued

❑ Yes �Z 'No ❑ NA ❑ NE
[Yes ❑ No ❑ NA ❑ NE
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
the appropiate box.
❑ WUP El Checklists dDesign ❑Maps El Other
L�
21.
elow.
Does record keeping need improvement? If yes, check the appropriate b?Soil
Yes
❑ No
❑ NA
❑ NE
El Waste Application El Weekly Freeboard El Waste Analysis L 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
ENo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[(No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
NN
,IJ,,
EP6
El NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
,❑,
L o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�o
El NA
El 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
LI 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
ENo
❑ 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
u No
Cl NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[ No
❑ NA
❑ NE
AcldiHoiia! Commenfs;and/or Drawings u
61
12128104

IType of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation ]
IReason for Visit 10 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
F7acility Number Date of Visit: Tune:
JCPNotOperationsal O Below Threshold
Permitted © Certified 13Conditionally Certified 0 Registered Date -Last Operated sh
Above Threold:
Farm Name: _ ,��.t: _ .1_% _ _. _ ...._.... _ W County: �
Owner Name: ,t,�_T�"�%LL _ _ Phone No: _
Mailing Address:
Facility Contact: __ _ _ Title: .... .
Onsite Representative:
Certified Operator:
Location of Farm:
_ Phone No:�fj.
Integrator:
Operator Certification Number:...
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �� �" Longitude
ow,nC --
t;a pro non.
- Wean to Feeder
On
Z
Feeder to Fmish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
To
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 -trade?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes 40 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes INNo
❑ Yes XNo
❑ Yes )" No
Structure b
Identifier:
Freeboard (incites):
12112103 Cominued

-- Faer7,'ty Number' Date of Inspection !�T
5. Are there any immediate threats to the integrity of any of the structures observed? (iee// trees, severe erosion, ❑ Yes PrNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
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 No
8. Does any part of the waste management system other than waste structures require maintenanceolimprovement? ❑ Yes No
9. Do any strictures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenanc ermprovement? ❑ Yes No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes No
❑ Excessive Ponding ❑ PAN _ ❑ Hydrai;4 Overload ❑ Frozen Ground ELCopper and/oZ Zinc
12. Crop type ,OF /
13. Do the receiving crops differ with those designated m the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes PYNo
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 O No
16. Is there a lack of adequate waste application equipment? ❑ Yes 0 No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes k] No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes P No
Air Quality representative immediately -
Field Cozy ❑ Final Notes
)_ �U.Q �n G 5jl��d�7�y 2 ��5 s �OtIF/ lJrs/ 04QF / TI�EA5- �)N
L,4,-,,,,,l 14�ra-,
e rN,0,62 8 yoG FAT /7/4-s A C,q�k Lh��-
S�f I( arZA I>F��o��►� iva I-ws C6c 7-ZP r�
f j'.
/l��T�� �/r/�/1A-c� ��LM--ter-✓ C1-o0� Sf�I��F_ .
Reviewer/Inspector Name
Reviewerlinspector Signature:
Date:
I7✓IZJU3 [:onanuea

'Fatdlity Number: — Date of Inspection i
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 PrNo
❑ 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 10 No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes ONO
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
27. Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative? ❑ Yes No
28. Does facility require a follow-up visit by same agency? ❑ Yes 51 No
29. Were any additional problems noted which causc noncompliance of the Certified AWMP? ❑ Yes m No
NPDES Permitted Facilities /
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes XNo
3I. 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 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

IType of Visit j0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit A Routine 0 Complaint Q Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit:
Permitted 0 Certified [3 Con itionally Certified 0 Registered
Farm Name: z 6
Ay
Owner Name:
Mailing Address:
Facility Contact: /)') Title:
lOnsite Representative: �f�l,<nl _ e19,<0
Certified Operator:
Location of Farm:
Time:
Date Last Operatefr-Above Threshold:
County: / L/U0E&
Phone No:
� y]Phone No:
1 �1!
Integrator: /RP4
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ' u Longitude 0 ' u
wine
xD gn turret Design Current WDOign" Current
Ca aci P,o ulation Poultry Ca aci Population LattleAa aci P,o ulation
❑ Layer ❑ airy
Feeder
Finish
VEIFaerrow
❑Non -La er
❑Non -Doi ry
IU7
o Wean'
Total Design Total SSLW
Feeder Finish
Number of Lagoons ❑ Subsurface Drains Present 110 Lagoon Area JEJ spray Field W
Holding Ponds ! S5Gd 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 discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes JZNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
ONo
Cl Yes
VNo
❑ Yes
FfNo
Structure 6
Continued

Faei;lity Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes P�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 0 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 V(No
8- Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes J�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 )dNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [XNo
I.
lz. crop type I/�,4 1�A-s7�,�.� J�nA�� 1.��4Zn� l�✓Fes o
13. Do the receiving crops'differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
EfNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
P(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
FfNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
P(No
Required Records _& Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes XJ 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 [dNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes VNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes PNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes O(No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes R�No
23. Did Reviewcr/inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes XNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes P'No
0 ylQiatpnls;ekoresencie rare noted 00609 Ns;vist; Yoh wd� r. ee�iye lrko ful t gr
corres deuce. ahout this :visit: .. . • • • .. • • •
e
Cotrtments (refer to questtott #) .Explatnaay YES answers anil/ar any recommendations or,any other comametets. T� r
- W_ - - x T
Use dra _mgsVof fai ty_to fetter eaplait =situations.s use a _ tronal pages assnecessary}
�Qr�l� �i✓�� �a �02r, Di✓ �i=.T7�N� �� -i�� �2,�-s s
Reviewer/Inspector Name L
Reviewer/Inspector Signature:
�LlD
[ - _ Date:
5100

„'Facility Number: Date of .Inspection / n
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atfor 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
0 No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
FfNo
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
XNo
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
/[21No
VNo
Additional Commentsan or” rawings: _ -
1�drFl V.I* 4 ---

r Divas[on of Water Quality, w
s
_ r�„
_ Q Division of Sail and Water & ii—vation z . >•
Agency
(Type of Visit ppCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 69Routine O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number '11 Date- of Visit: lb a Time: � Printed on: 7/21/2000
Nat (Operational Q Below Threshold
Permitted © Certified ❑ �C`onditionally Certified ❑ Registered Date Last Operated or Above Threshold: ........................
Farm Name: ..........K --- ...t�.lu Sf v's ........ ............................................ County: ¢ .......................
Owner Name: `Y
tt o Phone No:
Mlca...]l.lti... L0................... k.................................. 1......................................................................
FacilityContact: ..............................................................................Title:.................................................. ......... Phone No:
-Mailing Address: ....QW4 ......SAQ. lkin----.T?!:ii.f ....................... ..... N Z)
1 u ................�....................................... .. ..............
Onsite Representative: ....... �L?Y�v1..... ._1! 4G' '............._-------------- ........ _.......... Integrator :.......
!``i�.*ul.........................................................
Certified Operator :....................... A0 6— ' .............. .......... tv..................................... Operator Certification Number: ..... ZZ�........................
Location of Farm:
p h nw'M'�s\ S tr o S� i l00 t a� �rf7 I• S m i. 5 o f """Z 53/ I l �'
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 ° ;4 Longitude • ° 69
Design Current
Swine CaDacity Pouulation
® Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑Dairy
❑ Non -Layer I JE1 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lag,lnn Area 10 Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System .
Discharges & Stream Impacts
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 convcyancc Oman -made?
❑ Yes
No
b. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ)
❑Yes
No
c. II" dischar.=e is observed. what is the estimated slow in gal/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
❑ Yes f
® No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
Q No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
(}P No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
No
SIMCIUre I Structure 2 Structure Structure 4 Structure 5
Structure 6
Identifier:........................................................................."."...."........_..........._....................................
Freeboard (inches):Z
5100 Continued on back

Facility,,Number: "�_CI$ Date of Inspection 1 zoo Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, 0 Yes fA 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 jj 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?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN P Hydraulic Overload
12. Crop type
W Yes ❑ No
PQ Yes ill No
❑ Yes 04 No
❑ Yes ® No
Dd Yes ❑ No
J ` 3
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAW -MP)? ❑ Yes (jNo
14. a) Does the facility lack adequate acreage for land application? El Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
e) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
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?
0: �4� •yiofations;oi- di ficiencies �iere nbtea• dtWing this:visit'. • Y;ou Will -receive iio further
Torres- Tidence'abai ut: this ::::::: :
❑ Yes M No
❑ Yes [8 No
❑ Yes 'n No
❑ Yes EbNo
to Yes ❑ No
❑ Yes [RNo
❑ Yes lP No
❑ Yes P No
❑ Yes QNo
❑ Yes 1p No
❑ Yes 1p 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):
14 00M Of (f- L�l bt �rnow�. ��� Wfr `cz) ors l60Am orctts on %'tt W�11, •
Mi r�or �voS►�^ or- oAr tAJO.II S4 %(t be a1 l
$. Loth w �� e La s�u1d b� �i LLl r� c1nS,eedc� • �+^���� opt -,ems 4 ��ge a� Fi`e i d
s6tkU 6 ((CC�� a�'t'etl
1t- pe CO �,17i L%�AOtO C- 1UG01 OY� Stha�� l'^��
1R.`v- cawv-� M Al ir\ Wto S�o�(� 6(_ �(t C[� at- 5VYVI rLt0VCL CtAl Gt.t6 n' .s 01'
V-, dA . %W 1 s6a O 1v- tefw(Acr4. Oaskt s. a,A b-. �&, , •
Reviewer/inspector Name
Reviewer/Inspector Signature: Date: t0ho n) 5/00

Facility Number: 7 -- $ Date of Inspection (Q dd Printed on: 7/21/2000
Oder Issues
26. Does the discharge pipe from the confinement building to the storage pond or Iagoon fail to discharge attor hielow 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 there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 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 PNo
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 peTmanent/temporary cover? ❑ Yes No
5100

Q Division of Soil and Water.'Copse vatton _,Operation -Review
:[3 Division of Soil and Water Conservation_- Compliance Inspection
Division of W�later
rr
J p p Y
13 Outer Agency O eratiion Review Lance Ins ec t _
Routine O Com laint O Follow-up ofDWQ inspection O Follow-u of DSWC review O Other
Facility Number Date of InspectionI . . j �3
Time of Inspection =24 hr. (hh:mm)
Permitted 0 Certified Conditionally Certified Registered © Not Operatiionall Date Last Operated:
FarmName:.......#,.�....................................................................................................... [aunty:.--._..!.........._.......?......................_. 1.1Z..........
Owner Name:...... �..C?.!........... r�..1.'`.'.....!..r... ............... Phone No:...................._.........
FacilityContact: .......................................... ................................... Title: ................................................................ Phone No: ....................... ..........
MailingAddress:.............................................................................................
Onsite Representative: ....... J..(Q h r1 M v V .. Integrator L �' '...................................................................
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- I J
......................................................................................................................................................................................................................................................
Latitude �' �� �•� Longitude
Swine
Design Current = '
Capacity Population Roultry
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Non -Layer
=Design- Current ` Design
Capacity- Population Cattle Ca acit
❑ Dairy
❑ Non -Dairy
Current.
opuration =
�..
❑ Other I__ . -.._..
Total_Desgn, Capacity
Total SSLW
�Number-of Lagoons.: ❑ Subsurface Drains Present ❑ Lagoon Area
0
-Holdiing.Ponds / Solid Traps " ` - ❑ No Liquid Waste Management System
111 Spray Field Area
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
j 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? (IE' ves, 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 storm storage) less than adequate? ❑ Spillway
❑ Yes
KN 0
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
d
Freeboard(inches): ..........................................................................................................
...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
#fN0
seepage, etc.)
3/23/99
Continued on buck

Facility plumber: - — Date of Inspection ( Z
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 ,1
immediate public health or environmental threat, notify DWQ)
7_ Do any of the structures need maintenance/improvement? ❑ Yes J�rNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes 4Tio
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes V_No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes eNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes XNo
12. Crop type L] rw✓ �A 1�1 Py e,
13. Do the receiving crops differ with t ob se designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
�No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
Wo
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
A No
16. Is there a lack of adequate waste application equipment?
[-]Yes
VNo
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
^gNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Yes
ArNo
(ie/ WUP, checklists, design, maps, etc.)
❑
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
XYes
/�❑Yes
[I No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
KNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
gNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
-No
(iet discharge, freeboard problems, over application)
❑ Yes
or
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
FNo
((W`
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
.N..-6 -viblafidhs:or deficiencies were ngted• during thi5'visit' • Yo4 Wiii-ceb6ir6 Rio fukther ;
corresporideRce: ab' f this visit : ::::: •
'oimments ( >refer to uesfton #) 'Explatnany Y.ES ansyvers andlor anyrecomn�endaiiansor�any other comments r
-_ 4
Jseadrawings of facility to;l;etter explain-situatinns (iise additioiial pages as=necessary) w
��1.- ,�/ecels eu�N.,,fi `U{s-�t /i-►-G><ys�5
' ,�ct,;� S�` lrr, 9a+: art ✓�GGu rc�S +v rG �- (��' �� s � Y+cG� f+/c s � A-h a�Lj�iS
Reviewer/Inspector Name _
_
Reviewer/Inspector Signature �? „Date. 1 f — Z
AL
3/23/99

Facillty'Number: = Date of Inspection 's
odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
�No
28.
is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yesr
0
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
1
_
31.
Do the animals feed storage bins fail to have appropriate cover?
ElYes
KNO
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
N(No
onaommentan Drawings:,,
Al
3/23199

Rtvis--d Ap:i1 20, 1999
JUS-11W1CATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number 21 - ,2;T Operation is flagged for a wettable
Farm Name: ;. ��.� ✓ �- c acre determination due to failure of
Un-Site ';''epresentati ' : D �It ��-� Pa ll eligibility item(s) F1 F2 F3 F4
lnspcctor,"Reviewer's dame: , s�,�l Operation not required to secure WA
determinatithis time based on
SIXIZZ2 exemption F? E2 E3 E4
Datfi car �m _} Y1;: �'' �:' r _ Operation pended for wettable acre
determination based on P1 P2 P3
Anrm?! ?l --- —0 "76 pounds
�pe
. }yard -hose -traveler, 2. center -pivot system; 3. linear
move system;
4. stationary sprinkler system pipe; 5. stationary sprinkler system w/portable pipe;
6. stGr_io;,a., ju j ,:;tern: r�.,/p rmanent pipe; 7. stationary gun system w/portable pipe
(Eligibiiityfailure, Part 11, overrides Part I exemption.)
Adequate irrigation design, including map depicting wettable acres, is complete
by an I or PE.
rl Arj urite, n, and D21D3 irrigation operating parameter sheets, including map
s=enable acres, is complete and signed by an I or PE.
E3 Adeq-!.ate D, irrigation operating parameter sheet, including map depicting
complete and signed by a WUP.
w F 7_5% rul exemption as verified in Part 111. {NOTE-75 % exemption cannot be
2 pppsjec io ia; ms that fail the eiigibiiity checklist in Part 11. Complete eligibility
7 rt 11 - Fi F2 F3, before completing computational table in Part 111}.
Checklist.and .Documentation of :WA Determination
Requirements.. WA Determination .required -because-operation fails -one of the .eligibility
aga-which Tesulteddn-overappiication:DfLwastewater_(PAN) on:spray-
sc;d' ;_acc;c;rding:toiarm'slastfwoyearS:Df-irrigationTecords_-
' .inc1. - --, t-l"ble,-or lack of informationlmap.-
n :.7r r�-` �'a imitaiions:(numerousxiitcnes,aaitura a�dedLct:r red= _�-- -
bufferlsetback:acreage;=or25%_offotal:acreage-identinedlri--CAWNIP-.--includes
small-irreaularly-shaped fields = fields_lessitzan-5tacres-for mvvelers-Dr-less#han -:
-es-fa -stationary sprinklers):
F4 WA determination required because CAWMP.creditsfreld(s)'s acreage -in excess
r)f 75% of the respective field's total acreage as noted in table in Part 111.

Revised April 20, 1999
Facility Number -
Part III. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT FIELD TYPE OF TOTAL CAWMP FIELD COMMENTS3
NUMBER NUMBER',2 IRRIGATION ACRES ACRES
SYSTEM
I
I � 1
I
i � f
i
1
I
l
FIELDNUMBER' - hydrant-pull,zone.--or:pointnumbers-may be used.in place of field numbers depending on CAWMP
and type of irrigation system.-:lf-pulls, etc. cross inore'than -one field,-inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption; -otherwise operation will be subject to WA determination.
FIELD_NUMSER2 - must be clearly -delineated ion -map.
COMMENTS'. -back-up fields with CAWMP.acreage�exceeding75% of its total:acresand -havin&eceived less than 50%
of its annualPAN as:documented Lin the-farm's-previousdwo:years' (1997.& '1998) of_iniaationTecords,-:cannot-serve-asfhe
sole basisfiorrequiring a WA'Determination:;Back-up:fields-nust berated'in:the-commentzection�nd-mustbe accessible
by irrigation system.
Part IV. Pending WA -Determinations -
P1 Plan ]a cks Jollowing information:
P2 _ Plan Tevision-may_satisfy-.75% -rule-based .on-adequate.overall -PAN deficit sand -by
adjusting allfeldacreagedo:below.75% use Tate
P3 Other (ie/in process of installing new irrigation system):.

r ❑ ❑ Other Agency
Division of Sail and Water Conservation ,
t"Division of Water Quality
r
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection
' Facility Number
Time of Inspection % s O 24 hr. (hh:mm)
0 Registered Certified 0 Applied for Permit Permitted 10 Not O erational Date Last Operated
Farm Name: ,C?" ../t' LrSer ............... ................ County:...........`'�.......................�.1.....................
... ........... . l?�
OwnerName:....... ..°. '. ............. .Q!r................................. ........ Phone No........................... ......... ........................... ....................................................
Facility Contact.... ........................... .................. ... Title:
Mailing Address:........-- 4. ...... ......
Onsite Representative:.......- � j... / der e_
...............................
Certified Operator................:........L!.�..5k.R.:.l'.%....................
Location of Farm:
................................................. Phone No:...................................................
.......... .��:` ,. G........ZIA.0 .................................
Integrator: ...... ..✓�_/ ........
.........................................
.......... Operator Certification Number; .........................................
Latitude Longitude
IJestgn Current Design CurrenE Design :`Cure `
toot__
Swine" Capactty' ,.Papulabon - Poultry Capacity Popplatran', Caftle a Capactty, PoPulahotti
Wean to Feeder yp
,< a ❑ Layer Y Z. ❑ Dairy
k. ❑ Feeder to Finish ❑ Non -Layer ❑Non -Dairy
ZI ❑ Farrow to Wean
" ❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity Q
❑ Gilts
a
❑Boars sf Total SSLW
r Nnmber of Lagoons! Holdmg Pi►nds Q ❑ Subsurface Drains Present ❑Lagoon Area ❑ Spay Field Area
z....... ... ... ....
x t D No Liquid Waste Management System
General
L Are there any buffers that need maintenance/improvement? ❑ Yes �I_No
2. Is any discharge observed from any part of the operation? ❑ YesEl-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 Surface Water? (If yes, notify DWQ) ❑ Yes
o
c. If discharge is observed, what is the estimated flow in gai/min? ✓ f/ /
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes
V<o
3. Is there evidence of past discharge from any part of the operation? ❑ Yes Ila&0
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes o
5. Does any part of the waste management system (other than lagoons/holding ponds) require ElYes TNO
maintenance/improvement?
G. 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 O(No
7/25/97

Ifaiffty Number:2=
-18. Are there lagoons or storage ponds on site which need to he properly closed? 0 Yes (b—NO
Structures (Lagoons.Holding Ponds., Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? OYes LCNo
Struc Structure 2 Structure 3 Structure 4 Structure 5
.
Structure 6
Identifier: ................. lure
•......... ................................... .................................... ................................... ...................................
.................
.............
Freeboard(ft): ................ ................... .................................... ................................... .................................... ....................................
...................
................
10.
Is seepage observed from any of the structures?
El Yes
�N0
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
0 Yes
O—No
12.
Do any of the structures need maintenance/improvement?
)j"Yes
-OrNO
(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?
0 Yes
�No
Waste Application
14.
Is there physical evidence of over application?
0 Yes
No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
e_
Crop type .?..v .............................. i ................................................................. ..........................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
�d No
17.
Does the facility have a lack of adequate acreage for land application?
0 Yes
��To
18.
Does the receiving crop need improvement?
0 Yes
R&O
19.
Is there a lack of available waste application equipment?
El Yes
VRO
20.
Does facility require a follow-up visit by same agency?
0 Yes
�,(N 0
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
0 Yes
VNO
22.
Does record keeping need improvement?
0 Yes
VN 0
For Certified or Permitted FacUities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
0 Yes
�No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
0 Yes
No
25.
Were any additional problems noted which cause noncompliance of the Permit?
0 Yes
No
0- No-vio'lations'or'dericie-nc'ie's'were, noted during this. -visit. You mill receive, n'o'Airi1ier','-
..................
,-.-cofre**debto
I /_ ge,,e_ ¢ref 4,,,
t. qoe�\ L-,­11.
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: "I'41161116--_1 Date:

M�❑ DSWC Animal Feedlot Operation ReviewMts
';•
DWQ Animal Feedlot Operation Site Inspection
® Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DMVC review 0 Other
FacilityNumber
Date of Inspection y
�{
Time of Inspection 24 hr. (hh:mm)
g 13 Not Operational Date Last Operated: © Registered Certified ©Applied for Permit ld Permitted
Farm Name: ki.- Q.T...... �4v.S-.S... ..:�:...I...... . #. Z1. .. .... County:.... ...` . ...........................
Owner Name:... .a1 .�....1�).:.. ...1k . %i t.Ajo.4..r..t..................... Phone `o:.L�' g
Facility Contact: .......................
............. Title :................................................................ Phone No:
Mailing Address:_..y.._�.�.�........ .�._D..�..�.�,.....r...�,;.a........................
OnsiteRepresentative:_�,T.fl.K-,%.... 9_q.T��... v,. �,.. :
Certified Operator
Location of Farm:
...Y i..+.....?.C...r......................�t.�.l.
Integrator,—M..u.y �a. ......I .....................
Operator Certification Number, .........................................
!ax>....x,o.K.�?-�.#.rAS.:...Sx.tl.e.....c ... �.ii.t.A.R.. a. �,ra.Kc.�►!�a f �. yus.e..j.�s......Se.'1,.l.a.t.�.......i.
........................... ...................................... ..................... ---..--.---.--.---..-_...---.--...........................................
Latitude a 1 44 . Longitude • =' 11
Design Current
Design Current
Design;,-: Current.
Swine Capacity Population
Poultry "
Capacity Population Cattle
Capacity: Population ".
Wean to Feeder S Z¢b
JE1 Layer
❑ Dairy
❑ Feeder to Finish
I0 Non -Layer
I 1 ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
10 Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
l5
Number of Lagoons / Holding Ponds 10 Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area 11,
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin"
cl. 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 Iagoons/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
MNo
❑ Yes
9 No
❑ Yes
IQ No
❑ Yes
B No
01.4
❑ Yes
8 No
❑ Yes
19 No
❑ Yes
JRNo
❑ Yes
® No
❑ Yes
91 No
❑ Yes
M No
Continued on back

Facility Number: —
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes $R No
Structures (L.agoons,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes 0 No
Structure 1 Structure 2 Structure =3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft):............. S................... .................................... ................................... .................................... .................................... ....................................
10. Is seepage observed from any of the structures? ❑ Yes ® No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ® Yes ❑ No
12. Do any of the structures need maintenance/improvement? MYes ❑ No
(If any of questions 9-12 was answered ves, 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 9 No
Waste Application
14. Is there physical evidence of over application? ❑ Yes JRrNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .....................-..S.uu-a.) .�.r�a .i.rx.....----......--..................... .......... ....-.............-..
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes 91 No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes ® No
18. Does the receiving crop need improvement? ❑ Yes & No
19. Is there a lack of available waste application equipment? ❑ Yes No
20. Does facility require a follow-up visit by same agency? ❑ Yes No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes RNo
22. Does record keeping need improvement? ❑ Yes KNo
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes ® No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes k No
No.violations or deficiencies. were noted during this.v_ isit. Nou4ill receive no fur[her
correspandence about this:visit:
Use¢i swings of facility ta'betier explain -situations (tile additionat,pages as necessary} m41
Z., S o, t P" t t v �, w t- i
o b S e_ _v gal- o-.-t i,
I o o I- to a t I J w I-,' t- k ,+-e a dd Ear 1-f—
ti a.4j_% 1� o �. t
1 C- Q C vt w n. t I
V-LI.0 .j t�
y.¢- C a" .
ik i'a IUD
�..]..
a Vi 0 "t. t v f-&� la..e
1 a --A-. c� �-o
t,w L•-ws
w. { o�
e�.-� e t
7/25/97
Reviewer/Inspector Name�� �t fin' f�tr-
Reviewer/Inspector Signature: Ci �L� . I �h 'A 0 11.�_, _ Date: 1 2 -7 i✓ g -I