760003_INSPECTIONS_20171231

t-
Division of Water Resource
Facilit► Number - ❑ Division of Soil and Water eservation
0 Other Agency � ' ��� 11�
f► pe of Visit: Compliance Inspection 0 Operation Re► ie►+ 0 Structure Evaluation 0 Technical Misistancc
season for Visit: Routine a Complaint p Follo►►-up 0 Referral 0 Emergenc► a Other 0 Denied Access
Date of Visit: Arrival Time: M-parlare Time: [•ounty: Region: L05R
I-arni Name: w Ip Ee F ld Far m Oh%ncr inail:
�'h111P
O%%ncr Namv: � Fa Q Ct, e- Phone:
r
Mailing Address:
NC- 97
Physieal Address: 4
Facility Contact: h, , p P�bin C61 ?Rq`a75$1
�O, uCg_ e- Title: Phone:
Onsite Represenlafive: V 11 Ctyr"-re-SS u Q 2L Integrator: P� l � L► i_5
Certified Operator: Q� ► 1t Ed L) C,e Certification Number: eet �[his b
l�
Back-up Operator: Certification Number: �1 l/.2alg
Location of Farm: Latitude: 3 S_ a 33 1 S ,Longitude-. 7 rj ° _ 6
Hwy S Asht Veer tc��e_ � 1 fr��y � � � Z mt � Sri
e �'4 ,
Swine
Design Current Msign Current
Capacity Pop. 11 ct Poultry Capacit► Pup.
N��rl-La►er
Wcan to Finish
Wean to Feeder
F cedcr it) Finish
r .
' D
Farrow to Wean
Farrow ill feeder
1'arnn% to finish
Gilts
13oat%
Other
F—JoLhe,
Design ( urrent
ih*' i'lini I-N l a Yacll► roll.
Layers
Non -Layers
Pullet~
Turkevs
i urkev Poults
(7ther
Discharges and Stream Impacts
1. Is any discharge ohservcd from an) part of the operation"
Discharge originated at: ❑ Sinicture ❑ Application Field ❑ Other:
a. Was the conveyance man-made.'
h. Did the discharge reach waters ofthe State'' (II'ves. notil} LWR i
c. What is the estimated volume that reached waters of the Slate (gallons)?
d. floes the discharge hypass the waste management system? 1If yes. notify ❑W R I
2. is there evidence of a past discharge from any part of the operation?
3. Were there any obser►able adverse impacts or potential adverse impacts to the waters
of the State tither than from a discharge'?
Design Unrrcnt
Cattle Capacit► Pop.
Lair} ( cm
I)airy UaIf
13siry Ilci1er
Dry (,ow
N[111-Lai
13eef Stocker
Beef Feeder
Recf F3rood Uow•
❑ Yeti ❑ NA ❑ tie
❑Yes ❑No DNA ONE
❑Yeti ❑No ❑NA ❑NF.
❑ S•r,,
❑ No
❑ NA
❑ NE
❑ Yes
J2�N
❑ NA
❑ NF:
❑ Yes
.No
❑ NA
❑ NE.
Page 1 of 3
21412015 Continued

Facility Number: -7- Date of Ins ection: $ 7.v 7 p -7
,v ante Collection & I reatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
r+ a. If ycs, is waste level into the structural freeboard?
m6r -? Mori Structure I Stricture 2 Structure 3 Structure 4
' 15 Identifier: .fit" LU
_ r May[, —� htiin. =3 ee+ 1,-`to
Spillway'.: 7"[+�` r� r! ,ti 7 �nr hP5
[7es �i Frechn srd [in]: } hr s��vrn _ (� " o-
rc-r�
Observed freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed'?
(i.e., large trees, severe erosion, seepage, etc.)
G. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
El Yes No ❑ NA ❑ Nf?
❑ Yes X No ❑ NA ❑ NE
if any of questions 4-6 were answered ►•es, and the situation poses an immediate puhlie health or en►ironmcntit I threat, notify UW R
7. Do any of the structures need maintenance or improvement? ❑ Yes &No ❑ NA ❑ NI:
8, Do any of the structures lack adequate markers as required by the permit? ❑ Yes W<o ❑ 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 [] Yeti N`n ❑ NA ❑ N1;
maintenance or improvement?
Waste Application
10. Are there any required hutfers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application'? If yes, check the appropriate hoax below. ❑ Yes Wo ❑ NA ❑ NE,
❑ Excessive Ponding ❑ Ifydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (CU. Zn, etc:.]
❑ I'AN ❑ PAN > 10-/'0 or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence ol'Wind Drift ❑ Application Outside of Approved Area
12. Crop'I'ype[s): C orr� , W*,go_4-,-Pe5e—ue-- (� h a-'!)
13. Soil '1rype(s):
14. Do the receiving crops ditrcr from those designated in the CAWMP? ❑ Yes NJIN"u ❑ NA ❑ NE
15. Does the receiving crop ancilor land application site need improvement? ❑ Yes No ❑ NA ❑ NI;
16, Did the facility tail to secure and/or operate per the irrigation design or wettable ❑ Yes 6_Nll ❑ NA ❑ NI;
acres determination'?
17. Does the laciIity lack adequate acreage for land application? ❑ Yes pNo ❑ NA ❑ NE
18. Is there a lack of'properiy operating waste application equipment? �es TT❑��'' No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility tail to have the Certificate of Coverage & Permit readily av,ailable? ❑ Yes [ D NA ❑ NI?
20. Does the facility fail to have all components of the CAWM1'readily available'? If'yes. check ❑Yes tin ❑ NA ❑ NI;
the appropriate box.
❑WUI' ❑Checklists [] Design ❑ Maps ❑ Lease Agreements El Other:
W
oes record keeping ngediroventent'? Ifyes, check t appropriate box below ❑ Yes Ptin ❑ NA ❑ NC
�rite Applicationekly Freeboard '4Vatite Analysis Soil analysis ❑ 11'eather Code
aintali Stocking Crop Yield 6i120 Minute Inspections EJ701ithly and i" Rain ftil Inspectiuns L udgc Survey
22. Did the facility tail to install and maintain a rain gauge:' ❑ Yes 2fNo ❑ NA ❑ NE
23. 1f'selected, did the Facility trail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No g;�' VA ❑ NE`
Palle 2 u/'3 21412015 Crir'rtinued

Facility lumber: - I* Date of Inspection
fa :
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes XNo ❑ NA ❑ NI;
25. is the i'Mility out ofcompIiance with permit conditions related to sludge? if yes, check ❑ Yes o ❑ NA ❑ NE
the appropriate box(es) below. 01
❑ 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 f irst survey indicating; non-corpliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the laciiity fail to secure a phosphorus loss assessments (PLAT) certification?
Other issues
28. Did the facility fail to properly dispose ofdead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the: tirne of the inspection did the facility pose an odor or air quality concern`.'
1t'ves, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional 0flicc of emergency situations as required by the
permit'! (i.e.. discharge, freeboard problems, over -application)
31. Do subsurt'ace the drains exist at the facility? Ifyes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage. Pond ❑ Other:
❑ Yes �No ❑ NA ❑ NI:
❑ Yes �90 ❑ NA [] NE
❑ Yes �o❑ NA ❑ NI:
❑Yes Wo ❑NA ❑NL'
❑ Yes
WNo
❑ NA
❑ NE
i] Yes
�kNo
❑ NA
❑ NK
32. Were any additional problems noted which cause non-compliance of the permit or CAWNIP? ❑ Yes [a No ❑ NA ❑ NE
r
33. Did the Reviewer/Inspector fail it) discuss review/inspection with an on -site representative? ❑ Yes j5U"No ❑ NA ❑ NE
34. Does the facility require a t'ollow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question 4): Exptain any YES answers and/or any additional recommendations or any other comments.
Use rawings of facility to better explain situations (use additional pager as necessary).
`?. ve x--�-ib►� o� u �{�' a ao+� ��-t l �5 he Tr f� le -5 soh
g- 56k 15 eak+te-fed �a14. �' �' r� ,�d(� . �uL t V ,Z000
.��r r i� '1 -pre�U�,P�ey 1 rA,QrbVe- �A ,
Ca-iI h ra_41o►� due. ;,2,Q l� �1a5-I corubleViAGa adI S� s Ctaa>�p1��eC� U� �Gl6 ctiV, �
M&Ole tee 11/�rs '� ���aE��u��X
SPAS ® n pu Yq5 c .t`e- 5 a w t r1 L ] 0-0-Y' 12,4`0.0 11-5 , Pu Vltp Qt 1f` rem u 1 r`
con sf a-vN-� M&-- i V\`��,\&-n ce, �- ►r i y� l re-9 � a.c .!1
e- Q-m e-
Cv3 Su
I r i (-P-I (tr(A 5tq) P U tv fl 1r tr 1 5 a.6 a n ,f] ex_ S
� l'
i S il Ot_ mac. c-.e s s , v e f-
`� t e- %yt a 6W lY) C r 5 t ►) N o tin �CA-5+ a.n GLI S 4 5
rain S run`T�
'S
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
Phone: 7 7 to -
Datc: a
21412015

7-/
umber "7 -
411sit; U Conipliarice Inspection U Operation Review U btructure Evaluation
.Son for Visit: Coufine ❑ Complaint O Follow-up Q Referral 0 Emergency
i
Date of Visit.
rmn ision of Water Resources
vision of soil and Water. Resources
a Other Agency
f s 0 Q l-Al
(J •Technical Assistance
Q Other Q I)enied access
Arrival Time: ; Departure Time: County: po4t-k Region: W3 RO
Farm lame: ML_CftLLd f AR►\_ _ — _ Owner Email:
Owner Name; ? iAILL-t P Phone:
1a i\&X11DS,4T R f� , BRaw►a �uN.,y.r�,_ ��_ �7 � 1� �_
}'hysiral Address: _ �� I 1C_! f 5►C1 l �—, �,� �' t-'� , ■ �-+ (2, 73 i
Facility Cuntaet: 7'itic: Phone: 4 -
R��
Onsite Representative: klf"C6syj . i�_S�ct P integrator: PulkV15 i
Certified Operator: PH It_tp fhUe-0rr*
Back-up Operator:
Certification Number:
Certification Numher; H6URS
Location of Farm: Latitude: I.rrngitude:
Discharges and Stre;Irt_ t�lrueacis
1. Is any discharge observed from nny part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes. notify DWR)
❑ Yes 9<o ❑ NA ❑ NE"
❑ Yes .lo ❑ NE
❑ Yes ❑ No [31'ri 0 N'i;
c• What is the estinvwed volurne that reached waters o1 the State (gallons)?
d. Does the discharge bypass the waste management systeni? (lt'yes, notify MIZ) ❑ Yes ❑ No NA ❑ Ni l:
?. 1s there evidence of n past discharge from any pan of the operation? ❑ Yes No [] CIA ❑ NE
3. Were there uny observable adverse impacts or potential adverso impacts to the watery Yeti Itio ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 uf'3 21412115 Continued

Facility Number: „ - �[Date of Inspection:
Waste Collection & Treatment
4• Is storage capacity {structural plus stornt storage plus heavy rainfall} less than adequate? ❑ Yes O No E] NA [] NE
a. If yes, is w sste level into the structural freeboard? ❑ Yes 0 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Stnucture 6
Identifier:
Spillway'?:
Designed Freeboard (in):
�► , n
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? Yes No ❑ N'," NEE
(i.e., large trees, se,,•cre erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a El Yes No E] NA ❑ N1E
waste management or closure plan?
If any of questions 4-6 were ansisered yes, and the situation pores an immediate public health ar environmental threat, notify DWR
7. Do any offfic structures need maintenance or improvement? Tryes ❑ No ❑ NA [] NE
8, Do any of the structures lack adequate markers as required by the permit? E] Yes ' No Ej NA E] NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any pan of the waste management system other than the waste structures require E3 Yes E1111110 F-1 NA ❑ NE
maintenance or improvement?
Waste Application
10.
Are there any required bufters, setbacks, or compliance alternalivcs that need
Yes
No
NA
NE
maintenance or improvement?
1 f.
Is there evidence o1 incorrect lane! application? If yes, check the appropriate box Mow,
Yes
No
NA
NE
d
s. El 1
h^^ie ''ndnw• �����#-�u.d_i]rift
12.
Crop'['ypc[s]: Gil Ll41 (VW CL6lj4ml_,L'URI•Z- - -
-
13.
Soil Type(s):
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NI"
15.
Does the recei%•ing crop and/or land application site need improvement?
Yes
�No
[] NA
0 NEE
16,
Did the facility fail to secure and/or operate per the irrigation design or wettable
[] Yes
�N'o
[] NA
ONL
acres determination?
17.
Does the facility lack adequate: acreage for land application?
[] Yes
No
NA
Ej NEE
18.
is there a lack of'properly operating waste application equipment:'
Yes
No
NA
[] NE
Reuuired Records & Ducumems
19.
Did the facility fail to have the Certificate of Coverage & Permit readily available?
Y�.S'
[5*Nt
Ej NA
Ej NE
20.
Does the facility fail to have a]I components ofthe C:AWMP readily available? it-ycs, check
Yes
No
0 NA
[] NE
the appropriate b
G1'l]P Checklists Design 1•taps-Other:
t
21.
Does record keeping need improvement? I Ives, check the appropriate box below.
NO
E] NA
[:] NE
of na yst
]44m4rRPH- ❑ Stocking mute Inspections
s
22.
Did the lacility fail to install and maintain a rain gauge?
❑ Yes
���Nojo
NA
❑ NI-
23.
lfselected, did the facility fail to instail and maintain rainhreakers on irrigation equipment?
❑ Yes
❑ No
'A
[] NIE
Page 2 r? f 3
21412015 Comimie d

Facility Number: Date of Inspection: q17*,�d
qW
24, bid the facility fail to calibrate waste appli3lion equipment as required by the permit?
❑ Yes
El"No
❑ NA [] NE
25, is the facility out of compliance with permit conditions related to sludge'? if yes, check
❑ Yes
[31,No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structures) and date of first survey indicating non-compliance:
26. Did the fiscility fail provide documentation of an actively certified operator in charge?
❑ Yes
tR4)
[] NA ❑ NE
27. Did the fiscility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
C "o
❑ NA ❑ NI
2S. 1)id /lie facility fail to properly dispose ofdcad animals with 24 hours and/or document
U Yes L�j No
[ ] NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the fiscility pose an odor or air quality concern?
❑ Yes ��Io
❑ NA ❑ NE
lfyes, 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 [g<
❑ NA ❑ NE
permit'? over -application]
31. Do subsurface tile drains exist at the facility'? If yes, check the appropriate box below.
❑ Yes [R<lo
❑ NA ❑ NE
❑ Application field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWN1P?
❑ YesEr-No
❑ NA ❑ Nli
33. Did the Reviewer/Inspector fail to discuss review/inspection•v�ith an on -site representative`?
❑ Yes ��'l�o
❑ NA ❑ Nl:
34, Does the facility require a follow-up visit by the same agency?. ,
❑ Yes Ca<
❑ NA ❑ Nl;
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),
al•� ?OtS Sot L_ Ir-5 6 'COA►,PV-_V6a DUE
OCr_O JGf- POP
1
yc , p\16
as.� Lp�oc s �t:�NwEf, our - fj.► o - S6PTc �lC3s� a�[
aal[� -ra f3E
13
} ?-UhTZ IwNOG Td PDO C-
al kM6p,�t tcw W1,VRav64D QdjNes0 •-era 19901 ALL i~Or-
Nua�
qAr TW6-
S� 6Luflce 5LR,VejS eVAQLG_*o ok3 l][ KA LOWOK
LA4WQ S 11 41 I5
l PuC,,ASE RLQA N\,&)R -M Mk_-t, L i''
al } .kjP6-T-6 4�4"SiS I}OJ C 313,
]� 4Aty, 6ANp n�cts., i a upR3� L [�� cr�u D v SE
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f
i-O t.-M. Ai5 = i, Slb+�l r ic�aa t • uPp6r- k-,It6t 1 b M 1006
Reviewer/]nspector Name; �' Phone:
Reviewerllnspector SignaturUhA d�&, Date: Z? I �L3
Puke 3 of 3 21412015

P 213 a:_ /1)d, jaw oZa 5. &.6� eu r a2 7 3I la
ue o Division of Water Resource
Facility Nurether ®- Di►isian of Sail and Water Cot�ser►ation ' t
p Other Agency
Type of Visit: Compliance Inspection Operation Review ❑ Structure Evaluation 0'1'cchnical Assistance
17
Reason for Visit: Routine Q Complaint Q Follow-up Q Referral 0 Emergency Q Other d Denied Access s
Date of Visit: ArrivalTime: © Departure'rime: County: ARegion: 4 j"
Farm Name: ;]if, .��Q,�d Qr Owner Email:
Owner ,Name: ] Phone:
Mailing Address: —1 -7 �, �r I �vi5 k t 4 f`-�u i [- ] 1�ry_& _)ngiJlr, ma + � � 1� z 7 ;-1 T
Phvsical Address:
Facilit►' Contact: Title: Phone:
v
Onsite Representative: vI t417!,-ef4- rP,SjL211 Integrator: u rird 5
Certified Operator: 12 11 D ta M?= Certification Number -
Back -up Operator: Certification Number:
Location of Farm:
Swine
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry, Capacity Pop.
Layer
Non -La er
Wean to Finish
Wean to Feeder
Fccder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Dther
Design Current
Dr►• Poultry C anneity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey 11oults
Other
Discharees and Stream Impacts
1 • is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. "'as the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWR)
c. What is the estimated volutne that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Daia Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 2 No ❑ NA ❑ NI-1-
Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA [] N1:
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No
2. is there evidence of a past discharge from any part of the operation? ❑ Yes PeNo
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 'o
of the State other than from a discharge?
Page 1 ryf'3 �T�
❑NA ❑NEI
❑ NA ❑ Nli
❑NA ❑NE
21412014 Continued

]Facility Number: 1 - J Date of —Inspection;
Waste Collection Irk Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Na
❑ NA
❑ NE
a. If yes, is waste: level into the structural freeboard?
❑ Yes
[D No
[] NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
I
Structure 5
Structure 6
ter:
�`
Spixfway?: T1�
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�'o
❑ NA
NE
(i.c., 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 an of questions 4-6 were answered ves, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
&rNo
❑ NA
❑ NE
R. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
allo
❑ 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
CeYes
[]No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improverncnt?
❑ Yes C�No ❑ NA ❑ NE
l 1, 1s there evidence of incorrect land application? Ifyes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ I?xcessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Ileavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > I0% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
,rOutside of eptabie , 'i dow ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
� '-t"-)1X 1
12. Crop Type(s); l..�.�
13. Soil Type(s):
14. Do the receiving crops dif er from those designated in the CAWMP? 0 Yes NNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes CRItilo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA ❑ NE
acres determination?
17. Dees the facility Iack adequate acreage for land application? ❑ Yes M No ❑ NA ❑ NE
LVMV
19. Is there a lack of properly operating waste application equipment? Yes ❑ No [] NA ❑ NE
Required Recurds & Documents
19. Did the facility fail to have the Certificate ofCoverabe & Pe.-mit readily available`? ❑ Yes �5r-No ❑ NA ❑ NE
20, Does the facility tail to have all components of the CAWMP readily available? If yes, check ❑ Yes Dj�No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
W
oes record keeping need i 'rovement. caw. ❑ Yes No ❑ NA ❑ NE
aste Application Weekly Freeboard Waste Analysis oil Analysis ❑Weather Code
�infall Stocking cop Yield ❑ 120 Niiriutc Inspections onthly and 1" Rainfall Inspections Wudge Survey
22. Did the facility flail to install and maintain a rain gauge? ❑ Yes CgrNo ❑ NA ❑ NE
23. If selected. did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No jjal?�A ❑ NE
1'uge 2 of 3 21412014 Conti►tirerl

Facility Number: - Date of Inspection: d
I low
24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes O No ❑ NA ❑ NE
25. Is the facility out of com fiance with permit conditions related to sludge? If yes, check ❑ Yes CR'No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes J�R`No ❑ NA ❑ NE
2T aid the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No 5�NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ly'No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes [yNo ❑ NA ❑ NE
It'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 PgNo ❑ NA ❑ M;
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below. ❑ Yes A`No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [� No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes trio ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes N No ❑ NA ❑ NE
Coniniezits (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of facilitv to better exulain situations fuse additional naees as necessarv).
� u �■ +il i � � + i I j l � � u
r
169
11
a
� V 776 96q`j
Reviewer/]nspec[or Namc: ii' Phone: —
Reviewedlnspcctor Signature: Dale:
Page 3 of 3 j P

Division of Water Qualit
Facility Number . , - = Division of Soil and Wate nservation
AA 04-C&L4 e, , ❑ Otller Agency
JoAg II -
(Type of Visit: Q Compliance 15sp efiori TD Operatibn Review ❑ Structure Evaluation ❑'['ethnical Assistance
Reason far Visit: [ Routine a Complaint ❑ Follow-up ❑ Referral ❑ Emergency- ❑ Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time:® County: - iFtegion: ���
Farm Dame; + �P �� �_���m Owner Email:
Owner Name: 1 FO 0 Ce e-- Phone:
� .
Mailing Address: ��?� 1�CCi�y Ejl t P4 rn wi'1S Lt Num t -- ? ;)- I
Physical Address: L C" tj' 1 _ [ 1r I [�l L' + _ ��M U -7 3
Facility Contact: �; �� ��,� 'Title: Phone: - J, _ y- IS I
VinC_re{mot- Te5 VFLCE, -
Onsite Representative: Integrator: L: E Q L
Certified Operator: Q,_ U C_�'}- e_
Back-up Operator:
Location of Farm:
Certification Number:
Certification Number:
Latitude. -1 "7 / S Longitude:
9 3 & 5S
w q g .S .nrL S �� ��o ral
Swine
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
l.a er
Non -Layer
Wean to Finish
Wean to Feeder
eederto Finish
0
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Qther
Design Current
Dry Poultry Canacibv Pon.
Layers
Non -La ers
Pullets
'1'urke s
Turkey Potslts
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d, floes the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of 3
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
IIeef'Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 2No ❑ NA ❑ NE
❑Yes
❑N❑
DNA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
214I2011 Continp

(facility Number: —7to IDate of Ins ertion:
Waste Callection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0�',o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NF
Structure 1 Structure 2 Structure 3 Structure 4 5tnicturc S Structure 6
Identifier: I I n_ _ �_ p_4
Spillway?:
Designed Freeboard (in).
Observed Freeboard (in): a- 0
5_ Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0"N o ❑ NA ❑ NE
(i.e., large tret-s, severe erosion, seepage. etc.)
6. Are there: structures on -site which are not properly addressed and/or managed through a 0 Yeti nNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an Iimmediate public health ur env iriinmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? bdYes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate: markers as required by the penuit? ❑ Yeti �o ❑ NA [] NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any pan of the waste management system other than the waste structures require ❑ Yes C No ❑ NA ❑ NE
maintenance or improvement?
Waste Ilcatinn
A10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [�(No ❑ NA ❑ NE
maintenance or improvement'?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below, ❑ Yes JNo ❑ NA ❑ NE
❑ H.xcessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, !n, etc,)
❑ I -AN ❑ PAN > If . or 1p lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside ul' Acceptable Crop Window ❑ evidence of Wind Drill ❑ Application Outside of Approved Area
12. Crop Type(s): '�_N A VLa (-- LL-1 Yl •--- �- �1 ; r
13. Soil Type(s): r d
14. Do the receiving crops differ from those designated in the CAWMI"? ❑ Yes 14 No ❑ NA 0 NI_
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 0 No ❑ NA ❑ NE
lf. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes r� No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Ye., 0`10 ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Required Records & Documents T`
19. Did the facility sail to have the Certit;cate of Coverage & Permit readily available? El )'es n No ❑ NA ❑ Nl:
20. Doer the facility fail to have all components of the CAWM11 readily available'? If yes, check 0 Yew CN/No ❑ NA ❑ NI
the appropriate box.
❑WUI' ❑Checklists ❑ Design ❑ Maps ❑ Lcaw Agreements ❑[:ether:
21. oes record keeping need i provement? ❑ Yes QdNo ❑ NA ONE
YastC Applicc ivn ['Weekly E�reebourd [Waste Analysis Soil Analysis �€-T+a 4crs- ❑ Weather Code
R,,ainfaII [ Stocking [►Crop Yield EJ' 20 Minute Inspections Monthly and V Rainfall Inspections �Iudge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes � No ❑ NA ❑ NE
23, If selected, did the facility fail to install and maintain rainhreakers on irrigation equipment? ❑ Yes ❑ No 21"NA ❑ Ni"'
Page 2 0f.3 21412011 Continued

Facility Number: - Date of Inspection: 'u l
- t
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. [s the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structurc(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation oFan actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time oFthe inspection did the facility pose an odor or ;sir quality concern?
If yes, contact a regional Air Quality representative immediately.
30. 1)id the the iIity tiiiI to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon./Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33, Did the Revi ewer/[ nspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a fo]low-up visit by the same agency?
❑ Yes [S�No ❑ NA ❑ NE
❑ Yes D No ❑ NA ❑ NE
❑ Yes P7--,1'No D NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes �y o ❑ NA ❑ NE
❑ Yes ;No
o ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use - wings of facility to better explain situations (use additional pages as necessary).
u e P � ...� c� r� n e. e� S v�t✓ � L-��-�, o +r, a � � � � o � d�a�- - �'Cd �,
as Sl oCt Q- r "POT kA dui ► n 201 .
Reviewer/[nspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
e
1 r) P A) rD
do
Phone: '77 1 — 5 ,a ' J —
Date: q1) `1' [ 'Z c. f21412011

_ ,KDivision of Water eSc�Uf
Facility Number ©- 3 D Division of Soil and Wate onservation
Q Other Agency
`Type of Visit: Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
(Reason for Visit: Routine Q Complaint Q Follow-up Q Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: r{ Z ��, Departure Time: a.,, County: �A� Region: KWR_Q
Farm Name: Aade- Pt fm Owner Email:
Owner Name: _ �►11 [ � p rr, 4-,-g4 a Phone: SkQ -
Mailing Address: f]r] 2.5-- E `rr�d s jg kd ,, Ffzit.j . N G _ 2-7214 -
Physical Address: � �� Jr► f` e,- S tyc[p JC ' f �q e4le i r, N C'
Cc Z47-31y2-
F acility Contact: P10 11 i'l COX Title: Phone: rj � Z41
Of V, Alt-+ Tellt4r - 8 7? 6 5VO (F7qrM)
Onsite Representative: Integrator., TuT V1 f
Certified Operator: ;k�;p ik ttE, Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: '350 37 0'15 r/ Longitude: '7q "_.36 �'J7�r /,
H W y L/ Z -S, 'Tl l7M N w"ra/ R R ive rJ ge Pa ., '6.., .v t t Z m i, on i .01-'T
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Z p
1 219
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
Layer
]Non -Layer
Non-L
Pullets
Poults
Design Current
Discharges
and Stream Impacts
Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did (tie discharge reach waters of the State? (If yes, notify DWQ
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow -
❑Yes 1�0No ❑NA 0N1
❑ Yes ❑ No ❑ NA ❑ NE
❑Yes ❑No ❑NA ❑NE
❑ Yes [:]No
❑ Yes No
❑ Yes A
No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number. r% 1. Date of Inspection-
Waste Collection & 'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: V
Spillway?: 1 E
Designed Freeboard (in):
Observed Freeboard (in): 30 2-2-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes �No ❑ NA n 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, notifv I?WQ
7. Do any of the structures need maintenance or improvement? ❑ Yes j{ No ❑ NA ❑ NE
S. Do any of the structures lack adequate markers as required by the permit? ❑ Yes JJJ"X"'CCC No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? Ix
11. is there evidence of incorrect land application? Ifyes, check the appropriate box below. ❑ Yes XNa ❑ NA ❑ NE
�] Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ l;vidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):—Ez"t.-1 11k (�'er4 ! jfloiA .
13. Soil Typc(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑Yes
1
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
o
❑ NA
❑ NE
lS. Is there a lack of properly operating waste application equipment?
❑ Yes
rNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificutc of Coverage & Permit readily available?
❑ Yes
o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available`? If yes, cheek
❑ Yes
o
tN
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes No
ElWaste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste T ns ers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
21412011 Conlrnued

Faeilit Number:(� - 3 hate of Ins ecdow
24. Did the facility fail to calibrate waste application equipment as required by the permit'! ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge'? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagtvjn
List structurc(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application?
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application field ❑ Lagoon./Storage Pond ❑ Other;
Yes 'v o
❑ Yes No
❑ Yes pJ No
❑ Yes 9No
❑ Yes No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
C] NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
32. Were any additional problems noted which cause non-compliance of the permit orCAWMP? Q 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 folluw•up visit by the same agency? ❑ Yes i N,) ❑ NA ❑ NE
Comments (refer to question ti): Explain any 1'E5 answers and/or any additional rceornmendations or any other cantments.
Use drawings of facility to better explain situations (use additional pages as necessary),
�4;
tj L�.� It}r2IZ��7� i
1 �"'Li n`r t'rf� •L1 V�-- �I�A� 1 �^fL1 �, LWQ""^ !*�1`L
�''
K)6 kv� nn LD..W 1,,- �" L" �'�accci
5+Ij tr�'� ^° f ski Cx► � j J+"'
F- Pe- +{,-A,� IZ'fI
%(srS
gI7-$1Z
1l /mot z = Vfr r - 2 • zz L�jr - 2.7-3
`�'1nt 3 —
Reviewer/]nspector Name: u}- rGK I r I 1 4At•G
Reviewer/Inspector Signature:
Page 3 of 3
Phone: (33 L) I r%1-5-2 6
Date:
21412011

' Division of Water [duality 11
Facility Number ®- 9Division of Soil and Water nservat ion 10 A M
Q Other Agency
Type of Visit: ft Compliance Inspection 0 Operation Review Q Structure Evaluation Q'I'echnical Assistance
Reason for Visit: Routine n Complaint Q Follow-up Q Referral Q Emergency Q Other QQ Denied Access
Date of Visit: rival 'Time: _ to 7 Departure Time: County��'RC> C' n Region:
Farm Name: p p Q 1'TI old Fa r n Owner Email:
Owner Name: Ph Phone: S ihc) P 6S6 7, q
Mailing Address: -7 ir` h- r -6 L)M ivi'l IV 7a
Physical Address: 4/,S-j!j g 1 v ,0-r5 e— (2. r � 7,
fjA�(0
Facility Contact: [w h C d x 'Title: Phone: 7
o r q - la SM Fa r M
Onsite Representative: Integrator: Ljru
Certified Operator: Tj{ r 1` aV [etfe_
Back-up Operator:
Location of Farm:
Certification ,Number•�+�,
;;_e_rr
Certification Numhe La V
Latitude:3S ,3 _1 1 S Longitude: -7 1 3 4� 5 S~
G 1j Lu q x ,5 From As h t to©ro . ►e ► ht 4� 2+` ve sr-
Fo_r M S ! - d- M; ley c r► j Q-F +
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Teeder to Finish
Furrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design
Current
Wet Poultry
Capacity
Pop.
La er
JI
jNon-Layer
rJ
Design
Current
Dry Poultry
Capacity
Pan.
La ers
Non -Layers
Pullets
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Design Current
Cattle Capacity Pope
2aia Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
E3cef Fecder
Beef Brood Cow
❑ Yes �- o ❑ NA ❑ NE
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
[] NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
' ❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Rr No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
WNo
❑ NA
❑ NE;
of the State other than from a discharge? ,
Page 1 of 3 ' l P,�; I 21412011 Continued

Facility Number: - hate of Insp ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �'No ❑ NA ❑ NE
a. If yes, is waste level into the structural Freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: floWK1 �)t kI
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 4 -
5. Are there any immediate threats to the integrity of any of the structures observed`? ❑ Yes 'V " .o ❑ 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 0 - o ❑ NA ❑ NE
waste management or closure plan? T
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 M No ❑ NA ❑ NE
S. Do any of the structures lack adequate markers as required by the pertnit? ❑ Yes J'No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wct stacks)
9. Does any part of the waste management system other than the waste structures require Yes] No ❑ NA ❑ NE
maintenance or improvement? T�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes NfNo ❑ 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): et
13. Soil Type(s):
14, Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes J]q1<u ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage £or land application? ❑ Yes �dNo ❑ NA ❑ NE
I S. Is there a lack of properly operating waste application equipment? Yes []No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility !'ail to have the Certificate of Coverage & Permit readily available? ❑ Yes No [] NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes T ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21 Does record keeping nee�irovcmcntl? , ❑Ycs No ❑ ❑NE
;Za'in
ste ApWS1
ion ckly Freeboard Waste Analysis ail Analysis eather Code
fall ocking [Crop Yield ❑ 120 Minute Inspections Monthly and 1" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes AKNo [] NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes JW'No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facilit dumber: IAI-Q 10 jDate of Inspection:
Q / .-.
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual Sludge survey ❑ Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation ofan actively certified operator in charge?
❑ Yes
No
❑ NA ❑ NE
2T Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
jq;;Ll10
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[ No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern'?
❑ Yes
No
❑ NA ❑ NIs ,
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 ❑ NH
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE,
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss reviewlinspection with an on -site representative?
❑ Yes
Vo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency'?
❑ Yes
No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or an other comments.
Use n-gs of facility to better explain situations (use additional pages as necessary).
�,[• e d- t bral-`H on due a-01,2. _ up
JLe-m-
. h 6,<e_,- 0 n a w"fe,
o o h 4e6js Y-fi be
6�- V - ro -� f- L r-iC �-5 [ tk t� 0 5 N L e a �5 e-+ ` `�I c� U y� p
s u e-s i- reoC4LC, P I Pe- (xt rosseS
D�e�
L1
Reviewer/Inspector Name: IM 6 6_150L yas-� b r6cy—
Phone: 1 -7 1-SP-S 2
ReviewerlInspector Signature:
Page 3 ref 3
Date:
21412011

IF
Type of Visit: (X Compliance Inspection Q Operation Review Q Structure Evaluation t)'I'echnical Assistance
Reason for Visit: Routine ❑ Complaint ❑ >Nollnrr-up ❑ Referral ❑ Emergence ❑ Other ❑ Denied Access
Date of Visit: ! Arrival Time: ❑eparture't'imc: County: RAhd 0�egion.. UDS Q-0
F arm Name:: R m)y G e ! r' of c m - _- Owner Ismail:
Owner Name: it �! ! f 1 [] FCC U�� ��- Phone: S 1,,p —75 f f
Mailing Address: Q w u wm ll 1 �-+� 3 7 2 1
Physical Address: 4 7 L7 i PA s Pal c . +J C� r-) 7 3 1 k
Facility Contact: Robin eoy.. _or Title: Phone: to -? —3 1 q
VI nCey\t T- ssup fi-2 °I - Fcirm P i a -asB
Onsite Representative: it RU _C Lr dth - Integrator: -
T
Certified Operator: him IQ L� UC_t° 4'42_ _ Certification Number -
Back -up Operator:
Location of Farm:
Certification Number:
Latitude: 3 j 3 -7 i 5_ Longitude: ­7 q 3 fp T-
tiL 4-a- S, -Front AShe.b0rd , �I h+0ntu G0e- Re'
Swine
Wean to Finish.
Wean to feeder
ceder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Cauacitr• POD.
Layers
Non -Layers -
Pullets
'i'urke s
Turkey Poults
Other
❑ischarues and Stream Impacts
Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c, What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Cali'
Dairy Ilei for
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [t No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑Yes ❑No ❑NA ❑NI:
❑ Yes ❑ No
❑ Yes [ No
❑Yes No
❑NA ❑NE
❑ NA ❑ NE
[] NA ❑ Nl;
Page I of 3 21412011 Continued

/acility Number; b - 0 bate of Ins ection: 2
X
Waste Collection &'Treatment4• Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1� No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
❑ NA ❑ NE
[DNA ❑ NE
Structure l Stricture 2 Structure 3 Structure 4 Structure 5 Structure 6
ldcntificr: l )PP(
Spillway'':
Designed Freeboard (in): �I a`t—A0 17—+- 1
Observed Frceboard (in); � % 93
5. Are there any imnmediatc threats to the integrity of any of the structures observed? ❑ Yes CX No ❑ NA ❑ NE
(i,c., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes dNo ❑ 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, notifv DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) �`
9. Does any part of the waste management system other than the waste structures require ❑ Yes 19 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Ycs 10 No ❑ NA ❑ NE
maintenance or improvement?
1 1. Is there evidence oi' incorrect land application? If yeti, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc )
❑ PAIN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate ManurcJSludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside ot'Approved Area
12. Crop Typc(s): �� tJ t AL eau Yi — — — — —
13, Soil Type(s);
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement'?
lb. Did the Facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
IT Does the facility lack adequate acreage for land application'?
18, is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes No ❑ NA ❑ NE
❑ Yes V 'Nkm ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
re
❑ Yes ❑ NA ❑NE
YesjNo
No ❑ NA ❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
'>
❑ NA
❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. ` es record keeping need ipmprovement'r , Yes ❑ No
�stc Applic• ion �/eckly Frceboar Waste Analysis Soil Analysis aste Transtcrs
R;tinfaIl StockingCrop Yicld 120 Minute Inspections onthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selceted, did the facility fail to install and maintain rainbreakcrs on irrigation equipment? ❑ Yes ❑ No
Page 2 of 3
V
❑ NE
ather Code
►[Sludge Survey
❑NA ❑NE
J4NA ❑Nl:
21412011 Continued

Facility Number: 07 16 - U3 hate of —Inspection. 0,1
124. Did the facility fail to calibrate waste app cation equipment as required by the permit? C] Yes 9N❑ ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? Ifyes, check ❑ Yes NNo ❑ NA ❑ NE
the appropriate box(cs) 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 O(No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification`? ❑ Yes �No ❑ NA ❑ NE
Other Issues
2K Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes WNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit'? (i.e., discharge, lieeboard problems, over -application)
31. Do subsurface the drains exist at the facility'? if yes, check the appropriate box below.
❑ Yes �No
❑ Yes �No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes W Nn ❑ NA ❑ NE
❑ Application field ❑ LagoonlStoragC Pond Other.
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No [DNA ❑ NEE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NEE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [ Na ❑ NA ❑ NE
Comments (refer to question #): Fxplain 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).
�{' DUB• aZ a [ + d � 'I'VIr �Q- y`a � � 5 o C�.O ice[' 1 In 9-2 a
;z ao io o 01CM Soil exnCx-115es ? a o to '<;Y o
:R1)31301 11 Waste- Ana.t�5 i 5= U pp4-r- = 4- q Lowe'r 3, 3
1a+ -7Jto a uPPex­ = 3. 4 L,6u_vp�= a.9 stud e_ 13.0
ai �m�a b � .-Eamdze q�n4t i
� �► ry.cL� w r -
���D S r4u h t✓
Reviewer/Inspector Name:
Reviewerllnspector Signature:
Page 3 of 3
Phone: ?- ��$ 9�._
Date: 4 a 1
214,12011

N 04 — dm o .-M- orb
e
Facility Number I —7
Division of Water'uality
Division of Soil and Water ConseryaIion PM
Q Other Agency
Type of Visit Compliance Inspection 0 Operation Review Q structure Evaluation Q Technical Assistance
Reason for Visit Routine O Complaint O Fallow up Q Referral Q Emergency ❑ Other ❑ Denied Access
Datr or V jNil- Arri► at 'lime: Deparlure lime: o County: h Region:
Farm Name: ` Owner F mail:
O►yner Name: , � �'1 i � i I jQ� 3 Le 3—e- - - Phone: 110 7 5_1
Mailing Address: a t")CI d- I
Physical Address: I bs'q 1 2-1 �3 I Co
Facility Contact: 1 �C�t� (7 r .,V 11� C eV) title: 1 .. S Q � Phone No: 7 - s_�
6 -g -i 9 --O S-06
Onsile Represeniative, j `
Certified Operator: _N't L� ��Ea k x_e4f .
Back-up Operator:
Integrator:
Operator Certification Number -
Back -up Certification Number:
Location of Farm: Latitudc: �nn Longitude:
NJC' Sc�u`� Fro �5 h-e—�7Or6 4C�t���`Ot1�G
,0 ' � �� � � F
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacit% Population
❑ Layer
❑ Non -Laver
❑
Wean to finish
Ej
wean to Feeder
Feeder to Finish
_ D
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
Dr►• Poultry
❑ La crs
❑ Non -La ers
❑ Pullets
❑ '1"urke s
MEj,rurkey l nults
her
Discharges & Stream Imparts
I . is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ O;her
a. Was the convcyance man-made?
b. Did the discharge reach waters of the State? (if yes. notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Daia Heifei
❑
Dry Crow
❑
Non -Dal y
❑
Beel'Stocket
❑
Beef Feeder
❑
Beef' Brood Cowl
I
c. What is the estimated Volume that reached waters of the State (gallons)?
Number of Structures:
d. ]foes discharge bypass the waste management system? (li'yes. notify DWQ)
2. Is there evidence of a Fast 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 0 No ❑ NA ❑ iti I;
❑ Yes,
❑ No
❑ NA
❑ NF
❑ Yes
❑ No
❑ NA
❑ Nl;
❑ NA
❑ NF
❑ Yes
❑ No
N Yes ❑ No
V*es No
12128104
❑ NA ❑ NE
❑ NA ❑ Nl
Continued

FaciIity Numher: � rp — (� - Uate of Inspection
- ��'atitc Collection R 'l'reatment
4. Is storage capacity (structural Pius storm storage plus heavy rain full) less than adequate? Yes
a. if yes, is waste level into► the structural freeboard? Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: 5 hiq\
Designed Freeboard (in): tea`
Observed Freeboard (in): V
0
5. Are there any immediate th to the integrity ce�any of the structures observed'?
(eel large trees, scvcrc erosion, seepage. ctc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closura plan?
Structure
El No ❑ NA ❑ NE
❑No ❑NA ❑Nl?
5 Structure 6
0 Yes ❑ No ❑ NA ❑ N II
❑ Yes XNo ❑ NA ❑ NE
If any of questions 4-6 Here answered yes, and the situation poses an immediate public health or environmental t re 'tify DNVQ
T Do uny ofthe structures need maintenance or improvement? Yes o❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [ YesPo NA El NE
applicable to nmfed pill—, ty Stacks and/or wet stacks]
9. noes any part of the waste managettient system other than the waste structures require Yeseo NA ❑ NE
maintenance or improvement?
Waste Anylication
10. Are there any required buffers, setbacks, or compliance alternatives that need Yes �(No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below, ❑ Yes �No
❑ NA ❑ NE
Excessive ponding ❑ I-iy&aulic ©verload ❑ Frozen Ground El Heavy Metals (Cu. rn, etc.)
❑ PAN ❑ PAN > 1 Da%a or l4 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Hare Soil
❑ Outside of Acceptable Crtip Window ❑ Evidence of Wind Drill ❑ Application Outside of Area
12. Crop types) _ S n`Vx A 1 Ct r-a.1_
13. Soil typc(s)
14. Dothe receiving craps differ from those designated in the CAWMP?
❑ Yes [NNo ❑ NA ❑ NE
15. Dues the receiving crop and/or land application site need improvement? ❑ Yes
SYNo
[I NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or %%-citable acre detcrmination E] Yes
No
❑ NA
❑ NE
17, llotcs the facility lack adequate acreage For land application? El Yes
No
❑ NA
❑ NE
18, Is there a lack of properly operating waste application equipment? ❑ Yes
[ ,No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any tither comments.
jgsQdra►►'ings of facility to better explain situations. (use additional pages as necessary):
U f a erg ce- o� LA 9 w't
c
,ertrH'er - ector Name
kv nspectur Signature:
ve e.-ta f t Y1 S 1 l q- f-e - J boo e,
1 7 c C�
� � h cam.t e_ � f
b _ro �� %Phone: �J { 5 tZ
�H IY J h t:� '"hate: I1 f ` 'A9

Facility Dumber: —03 lTtc of Inspection 5 C7
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 CAWM1) readily available? I yes, check ❑ Yes kNo ❑ NA ❑.N1-.
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other
21. Dot's record keeping need i `rOvement" l ' pr iete lxr lcnv ❑Yes No l/M0ttft
NA ti7fi:C-1
NE
Waste Application L� Wcckiy l reehoard dwaste Analysis Soil tialysisLS f4[D
IM
�Rainflall ly 6/Stocking ►jam Crop Yield V 120 Minute Inspections Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P(No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ti10 ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ NO ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit'? ❑ Yes No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge'' ❑ Yes �(No ❑ NA ❑ NE
27, Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Usher issues
28. Were any additional problems noted which cause non-compliance of the permit or CAW MP? ❑ Yes No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ yes VNo ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �(No ❑ NA ❑ NE
If yes, contact a regional Air Quality represcntativr,: immediately
31. Did the facility fail to notify the regional office of emergency situations as required by �Ycs ❑ No ❑ NA ❑ NE
General Permit? (ic/ discharge, freeboard rob/ s, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes P4 No ❑ NA ❑ NI;
33. Does facility require a follow-up visit by same agency? ❑ Yes WN❑ ❑ NA ❑ NE
Additional Comnien audlor Drawings: cmw
? Tec tl
lcl�
. �S aaD�'1 tvr- 50t—V 5�ut i��57
�• - - �MAIX-aMALAL
.�-ems..
((D A LS 4.3 1 b-5 - I 1 Dui
3� bra 4
►� 3 of 3 `�I :� e �. s/oa S

Division of Water Qualiti• .�
Facifity ;.Number � � SDivision of Soil and NN'ater Conservation 1 :,30
Q Other Agency
Type of Visit Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit 4 Routine Q Complaint Q Foilow up Q Referral O Emergency Q Other ❑ Denied Access
(late of Visit: k III Arrival Tine: Departure Time: County:
Farm ,Name: eld Ir A4 Owner Email:
Region: �4`�
Owner Nance: �ace �. Phone: 6 hop & S & - �sQ
Mailing Address: _ off- 5 Fr I eAL �] �fll . rr"O w� i �a f►n nn1V1 4� I { . d� 7 0� `
Physical Address:
Facility Contact: f�t'��; or Title:
U�no�nt` �s p
Onsite Representati►°e:�Yr}-slr_5�1^�
Certified Operator: PhilhD FauceOe_
[lack -up Operator:
Phone No: - 17- 6 dO
Vr 1jce )- w 79-- 335-?,
Integrator:
Operator Certification Number:
[lack -up Certification Number:
Location of Farm: Latitude: j o ®i ®�= Longitude: ® o
Nr✓ lam•{ pia o u'� � Om 5 h� RS • tt I 4 n ++ t V PXS At
F Mk - �
5 l �- m k o _� 1-
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
' ❑ Laver
❑ Non -Layer
❑
Wean to Finish
❑
Wean to Feeder
Feeder to Finish
b
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
ciits
❑
Boars
Other
❑ Other
❑r►' Poultry
❑
Layers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges & Stream I mpacts
1. Is any discharge observed trom any part ol'the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Cal f
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the Stale (gallons)?
Number of Structures:
d. Docs discharge bypass the waste management system? (If ycs, notify DWQ)
2. Is there evidence of a past discharge from any pan 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 Nvo ❑ NA ❑ N[:
❑Yes El No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ N E
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes kNo ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
12128104 Continued

Facility Number: — C) 3 1 0 [late of Inspection Z Z
Waste Collection & 'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate`? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the strueturai freeboard? El Yes ❑ No ❑ NA ❑ Nl:
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier: e•� �ULI]t
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): C
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ , Ilr
(iel large trees, severe erosion, seepage, etc.)
(. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NHi
through a waste ntanagerttent or closure plan?
It any of questions 4-6 ►vere answered ►'es, and the situation poses an irnmediate public health or environmental threat, notify DN1'Q
7. Do any of the structures need maintenance or improvement" ❑ Yes No ❑ NA ❑ NF
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 andlor wet stacks)
9. Does any part of the waste management system other than the waste structures require 0 Yes No ❑ NA ❑ NI
maintenance or improvement? r .
Waste ApWication
10. Are there any required buffers, setbacks, or compliance alterrialives that need ❑ Yes No [INA ❑ NI;
main tenanceli mprovement?
11. Is there evidence of incorrect application? If yes. check the appropriate box below. ❑ Yes r ,do ❑ NA El NE
❑ l;xcessivc Ponding El Hydraulic Overload ❑ Frozen Ground Ell Leavy Metals (.Cu. Zn, etc.)
[--]PAN ❑ PAN > 10% or lb 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)
13. Soil type(s)
14. Do the receiving; craps differ from those de ignated in the CA WMP?
❑ Yes
�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�;10
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes No
❑ NA
❑ NE
17. Does the Facility lack adequate acreage for land application'?
❑ Yes
No
❑ NA
❑ NTs
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NI:
Comments (refer to question 4): Explain any YES answers and/or any recommendations or any usher comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
N 0414
a
Reviover/inspector Name �', I I M t W E' _, T VETO! M-M
��Mjm INS
12128104 Cu►irr►i►red

Facilim Number: - — e of Inspection
Required Records & Documents
19• Did the facility fail to have Certificate of Coverage & Permit readily available? KYes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components ol'the CAWNIP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. V► ❑ UP El Checklists ❑ Design ❑Maps El Other
2l. D s record keeping need im rovement? ❑ Yes /No ❑ NA ❑ NE
P g
Waste Application Wee y Freeboard aste AnalysisZoilAn sis
VRainfall )eking Crop Yield 2D Minntc Inspections onthly and i" Rain Inspections either Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes O(No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No XNA ❑ NE
24• Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes NNo ❑ NA ❑ NE
25. Did the facility fait to conduct a sludge survey as required by the permit? ❑ Yes 4No ❑ NA ❑ NE
26. [lid the Facility thil to have an actively certified operator in charge? ❑ Yes XNo ❑ NA ❑ NE
27. Did the facility Fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues Xc
28. Were any additional problems noted which cause non-compliance ofthe pennit or CAWMP? ❑ YesN❑ NA ElNE
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 nonnal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes [ No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by P6 Yes ❑ No ❑ NA ❑ NE:
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
33. Does Facility require a follow-up visit by santc agency? ❑ Yes No ❑ NA ❑ NE
Additional Comments artdlcrr Drawings:..-!-
Tar t-
.. .. .'.-y;':�'. ( tin'1"{.'k' .'• i�K'e•'3- ��.. .�.:: AY d,4 r'.}r �: n ;�,,: .�ti �. tiR .... .r�
aS a 5(ue- 5urve� Mu rFobe.►�7c_w
�Uerpou�j
vo% Sot ( 4e 5
resin+s �- I to
r M 0 U
M_" t6 �,
�e le--�I n
viper
16s. V�ooa
ofl�r
CCU
1
per
I�-N
Vj
I

Facility Number
Division of Water Qualit,
Division of Soil and Water
❑ Other Agency
Type of Visit P Compliance inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Routine O Complaint Q Follow up Q Referral Q Emergency Q Other ❑ Denied Access
Date of Visit- h Q Arrival Time: Departure •Mince: Count`�'� [�d Region:
Farm ,Name: Owner Ismail: ff__ Q
Owner Name: Phone: f7 nT��
Mailing Address: I t Frt "Vkh i Q ice" roco f2oM m !� J 1 U C
Physical Address:
Facility Contact: T! C�6 �j1j<+1 V�'�Xtl'i'itic:
Onsite Representative:
Certified Operator: ede_r
Back-up Operator:
Phone N[P n
Vl)S?q- 33s 3
Integrator: �( l r : !
Operator Certification Number:
Back-up Certification Number:
Location of Farm: latitude: o � I [�l Longitude:
lw � V- Sot✓' f ro Q- As h eAoo ro . el q hf ail fa A V"� 5 14 e
. d- 1 l,e5 e + J -
Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
ceder to Finish
WEI
Q
Farrow to Wean
❑ Farrow to feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑
Layers
❑
Non -Lavers
❑
Pullets
❑
Turkevs
❑
Turke Puuets
❑
Other
DischarLes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
Number of Structures: EZI
h. Did the discharge reach waters of the State'? (Il'yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 ofJ
❑ Yes 0 No ❑ NA ❑ NE'
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ Nl:
❑ NA
❑ NE
❑ Yes
❑ No
El Yes
No
❑NA
❑NE
❑ Yes
No
❑ NA
❑ NE
1212RI04 Continued

Facility Number: -7&—,03 [late of Inspection
Waste Collection & 'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes WNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Ycs ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LoLYGf
Spillway?:
Designed Freeboard (in);
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes &No ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [YNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation polies an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvementD'' ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �No ❑ NA ❑ NI;
(Not applicable to rooted 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 El NE
maintenance or improvement`?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need []Yes No ❑ NA ❑ NE:
maintenanceli mprovement?
It. is there evidence of incorrect application'? If'yes, check the appropriate box below. Cl Yes No ❑ NA ❑ NE
❑ Excessive Pornding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc,)
❑ PAN ❑ PAN > 1 d% or it] lbs ❑ Total Phosphorus ❑ Failurc 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. ❑o the receiving crops differ from those designated in the CAWMP? ❑ Yes [ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'! ❑ Yes 1No El NA El NE
16. Did the facility fail to secure and/or oper:ite per the irrigation design or wettable acre determination? ❑ Yes ,eNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application`? ❑ Yes iX�<o
No El NA El NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ NA ❑ NE
Comments (refer to question.#): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Q�Leal�s in swine house
Reviewer/Inspector Name [ - - C�.� P Phone: J7 r— 5a'39
Reviewerllnspector Signature Date: Q
Pave 2 of3 12I 8104 tinrred

Facility Number: ' Date of Inspection 7 -- r
Required Records & Documents ,�,/
19. Did the facility fail to have Certificate ol'Coverage & Permit readily available'? ❑ Yes M N ❑ NA ❑ NE
20_ M)cs the facility fail to have all components of the CAWMP readily available'? Ifyes, cheek ❑ Yes ❑ NA ❑ Nrs
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑Maps []Other
21 _ Does cord keeping need im ovement`?. ❑ Ycs eNo ❑ NA ❑ NE
[S rite A licat' n Wee Freeboar��12OMimftlnspcctiot
ite /anal Sis Soil A i sis L/ Waste Transrcrs ❑ Arn
pp Y y Y
F Rainfall Stocking; Crop Yield s Monthly and I" Rain Inspections lather Code
22. Did the facility fail to install and maintain a rain gauge'?
23. 1f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit`?
25. Did the facility Fail to conduct a sludge survey as required by the permit'?
26. Did the I;scility Fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
29. Wcrc any additional problems noted which cause: non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal.'
30. At the time of the inspection did the facility posc an odor or air quality concern!
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? Oe/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an oo site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
WIo
❑ NA
❑ NE
❑ Yes
❑ No
WA
❑ NE
❑ Yes
� N❑
❑ NA
❑ NE
❑ Yes K No ❑ NA ❑ NE
❑ Yes Nio ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Ycs
No
❑ NA
❑ NE
❑ 1'es
No
❑ NA
❑ NE
❑ `1'es
, o
❑ NA
❑ NE
❑ Yes
I)< No
❑ NA
❑ NE
❑ Yes
No
ElNA
ElNF.
ElYes
No
❑ NA
❑ N F.
Additional Comments and/or Drawings: kD
VtSI�`�
(-a-hare ffo- r boa? ? - aoog e
V 1, e ICE f-8 co
;b D U-)q --F r I r ri a+ 10 n ,
-� 3 j 0<6 2 U
Page 3 of '3 I2128104

� � Division of Water Qualiryl/�j,/,y /t'r]�j�sL.s�C) II
Facility Number �l--I `7 Division envy and Water Gtscrra mn -- 'o PIrr t II/
0 Other Agency
Type of Visit CC�/omplhmce Inspectlon O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (YRoutine 0 Complaint Q Follow up Q Referral 0 Emergency 0 Olher ❑Denied Access
Date of Visit: D Ar iyal'I ime:® I �-6 PO
Q Departure Time: County: RegionaIl
Farm Name: AppP IAP- Farm Owner Email:
Owner Name: '\1tI 0.VC Q--Ik Phone:
hlailing Address:
�n JIMM'lHI Pl� aid-1
Physical Address: -T.7 "1 -1 /� K 1 VP4/ tilU � IaCaa . Imo \ t & >s tX 1 714 awl
Facility Contact: ID 'nIn I me 'Title: Phone Ho:
(n� �Ft, T �j
Onshe Representative: 1�-(1�111\L4. U11_1_'C''-II-nA `Te-Loplotegratur: ?UrULS
Certified Operator: /1 l t uc-eH e Operator Certification Number: rzana
Back-up Operator: 0-ae, Back-up Certification Number:
Location of Farm: Latitude: ni�r'®I EET' Longitude: ®o®, Fsl '
l 1�9
Sr Orono (-she-lgoro ,
R�h� 0A1-6 lvevsi
�a rm 'IS I-X
M11 on leV+.
Design
Current
Design Current
Design Current
Swine
Capacity
Population Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
I
I
1 ❑ Laver
i
❑ Dairy Caw
❑ Wcan to Feerfin
I
❑ Non -Lam
I
❑ Dai Calf
Frechu to Finish
I
Dairy IIcifm
Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Lavers
❑ Non-Dairy
❑ Farrow to Finish
❑Beef Stocker i
❑ Gilts
ElNon-Lavers❑
Bre(Fceder
El Bear'
❑ Pullets
❑ 13ccf Brood Cow
❑ TurkcvN
Other
❑ 1 urkey Poults
❑Other
I El other
Number of Structures:
Discharges & Strmtm Impacts
I. Iv any discharge observed from any part of the operation!
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
h. Did the discharge reach waters of the Slate? (If yes, nolify DWQ)
c. What is the estimated volume that reached waters ol'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 iNo ❑ NA ❑ Nh
❑ Yes
❑ No
❑ NA
❑ NF
❑Yes
[]No
❑NA
❑NB
❑ Ycs
O
❑ No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ Nli
12128/04 Continued

Facility Number: 0 Date of Inspection
Waste Collection & 'Treatment X
�4. Isstorage capacity (structural ptusstorm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NEa. if yes, is waste level into the structural freeboard? ❑Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Stnrcturc 6
(dent+tier: �.�► r
Spillway'?:
Designed Freeboard (in).
Observed Freeboard (in): p� v�-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes X No ❑ NA ❑ NE
(ie/ large trees, severe erosion. seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes �No
❑ NA ❑ NE
through a waste management or closure plan?
if any of questions 4-6 irvery answered yes, and the situation poses an irnmediate puhlic health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [V, Io ❑ NA ❑ NE
8. Do any of the stuctures lack adequate starkers as required by the permit? ❑ Yes VNo ❑ 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 06Yes [—]No ❑ NA ❑ N F
maintenance or improvement'?
Waste Appliratiorn
10. Arc there any required buffers, setbacks, or compliance alternatives that need ❑ } N" ❑ NA ❑ NE
m a i nt ena ncdi n iprove ntent?
11_ Is there evidence of incorrect application? If yes. check the appropriate box below. ❑ Yeti [ No ❑ NA ❑ NE
❑ lixcessive Ponding ❑ Hydraulic Overload ❑ Fnarcn Ground ❑ Ht:avy Metal~ (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% nr 10 Ihs ❑ 'Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Windr ElI"vidence of Wind Drift [IApplication Outside of Area
r1
12. Crop type(s)
13. Soil type(s) 1.`►
14. Do the receiving; crops differ from those designated in the CAWMP:r ❑ Yes P<No . ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes X No ❑ NA ❑ NII
16. aid the facility fail to gccure: and/or operate per the irrigation design or wettable acre determination?❑ Yes �No ❑ NA Cl NF?
17. Dcws the facility lack adequate acreage for land application? ❑ Yes )dNo ❑ NA ❑ NF
18. is there it lack of properly operating waste application egttipmctrt'? ❑Yes �lsf. ❑ NA ❑ NE
Comments (refer to question #!j: Explain any YES answers andler any recommendations or any other comments.
Use drawings of facility to better explain situations.
situations. (use additional pages as necessary):
"t3 ig � �\Q C
a►
I
IV
Reviewer/Inspector Name Phnne:
Reviewer/Inspector Signature f Date:
. - L 1 12128104 1 0011ri►rucd

11
I.Facility Dumber; — Date of Inspection 1 41
Reuuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available"
20. Does the facility tail to have all corn pone of the CAV21,
readi��?
vv ilable`? If yes, check
the appropirate box. WUP Checklists sign aps ❑ Other
❑ Yes kNo
❑ Yes IKJo
❑ NA ❑ NE
❑ NA ❑ NE
21. rR
ord keeping need i provemcnt? s, ,_. f ❑ Yes ,.Nn ❑ NA ❑ NE
e Applic ion Weekly Freeboard Waste Analysis �Soilnalysis L�J Waste Transfers IYI Annual ertification
rall IJ'' Stocking Crop Yield2() Minute Inspections j� Monthly and l" Ruin Inspections Bather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
1ZNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
OkNA
❑ NE
24,
I)id the facility Fail to calibrate waste application equipment as required by the permit? c3C044 ?
❑ Yes
>�No
❑ NA
❑ NE
25.
1)id the: facility fail to conduct a Sludge survey as required by (lie permit'? ,ZMsmk-
❑ Yes
2(No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge? ` _ s
❑ Yes
KNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? aD� 5
❑ Yes
K No
❑ NA
❑ NE
Other Issues
28.
Were any additional problem? noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M-�No
❑ NA
❑ NE
29,
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern'?
❑ Yes
��,,//
EB 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
tdNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did ReviewerAnspector flail to discuss review/inspection with an on -site representative?
❑ Yes
YNo
❑ NA
❑ NE
33.
Does facility require a f011ow=up visit by same agency'?
❑ Yes
tg(Na
❑ NA
❑ NE
Addq I Comments and/or Drawings-.
00(6 o V n
�I I�QS r-q jQ�� �'� i'CL-� a I t0 Send
S. -901Dto 5urv"7 aopt a-
Q ? D ► e,4r t. w 0-1 L� r ti {` e• 3 � l U v e h 0�5e� v
q'n [ S 'Q Ur' p o 5e a
�
aODIp Ce.�-.�-t � � C_.c�-�-t o lr. p�- ►
v"i a s P-rn a lm Si 5 =
31,9 nI 6_7 'er= 3• L-p w \or = 3
U�S�kT
M i Lomas rre4m cV ej .
12128104

I•
a
4
. �[*ilr; z:�;�F�'�'+r��•�w 'P .iy".','� . a: .. r; • t- ,�.i �. t �, ., y. ^,•a;6F i{-�'`r',q_ r1��r..x3Y.•
��+ . ., , r;r1.�;I3ii,'iston nf,Wxter,•QiSali Si,.!fi;'`L i �• �.:;y �¢,. rk�
,.. R
i7[ r1er•"i. t .r ;i,, 4: sir... •;��f' �r;` f:[ $
.�� dcility.�"`trtl 7 - 4 ,0. Divisiao of Sail-alnd ;Witter; [ ♦o1insen"attot , s''` . ` .- ti r:r�
�• .a.�Tr.c'['n:'y l'. y`.�S.r�'r'•::%,r. ti� 'S� �•I '?`� y{l/ i�l�y �'rr.=); ? _'�•� � - i' l'�(��-.�a
r,, - •�'.' ! � fit • S :.r... }�:i L.a art'- 1: n.'fe A
�r%:�: sl�i:+;% ':C�'trY•ix*r..��a : ..�;. .t'� ..:.,.-...^F:�.=.::a.. -.'t=-�d:� t sw: • 3: +Fr:r,; ..: y-•=•= �. �..- �i. �a�i�y�':Ir�'] � sr '
Type of Visit 0 Compliance Inspection (,rt)�Operation Review d Structure Evaluation Q Technical Assistance
JAN J 4 20 7
Reason for Visit WRoutine p Complaint 0 Follow up 4 Referral a Emergency () Other ❑ Denied Access
@ate of VNit: � y-7 1 L+'J Arrival,rime: Departure'l'ime: F-q Y-1 County: 4:.11k.___-_ Region:
Farm Name: �•�� .� 1 �.F� ? - _ _._ Owner Email: - -- ---- — --_ -- _ - — -
Owner Name: j.1.1a��7.. LA�9L7� _-. •---t_w.- _.......... _ Phone: 336 .:Af�.�_-�.����..____.--
,'Nailing Address: ��?�......� i �ti�5�►4.�_._ �� _.... ,...., _ �... ,....��Z.t►.n !_ �l,tj� ti L �V11 �_ -��- " � +� .�
Phvr'ical Address
Facility Contact: �p�i.�._ �� _ -.... _.._A 7 itle: ._.._.._._.......... _ ........ _ Phone No:
Onsite Representath,c: _bv_l_. SQ.O.__.
Certified Operator: _ r�i ,1 t;LIA.� __ .__..___ ___..-_-.�- Operator Curtification Number:
Back-up Operator: L&j J
_._.._..... Back-up Certification Dumber:
�
Location of Farm: latitude: ®c 1i Longitude: FIT1 a 7
F—f$y,n ijVWCb - 74GJU ��. (A �. -- Y/
l SIN.. k 4yvit (tll Lk Wsgc(IM ISWE , u. 3 d
,;Mtr �y s,�.` ' Y' "`S Iicsign :Current 0. t)esign Cerrrcnt 17esigu. _ Current -
`� ;; Capacity 'Population Wet Poultry opacity. Population Cattle Capacity •.1'upulation
❑
Wean to Finish
❑
Wean to Feeder
®
Feeder to Finish
A L400
I Cf �
❑
Barrow to Wean
❑
Farrow to Feeder
❑
Farrow to finish
❑
Gilts
❑
Boars
r•,i y'y�Fj'y �� 1�f r�l�.� it s• '•f
❑.Other
❑ La er
❑ Non -Layer
Dry Poultry
U Non -Layers
❑ Pullets
❑ •I'urke s
❑ `I'urkev Poults
❑ Other
•r• .
❑
Dai Cow
❑
Dairy Calf
❑
Dairy i-ieifej
❑
Dry Cow
Non -Dairy
❑
13eeF5tocket
❑
1.3eef Feeder
Bcef Brood Cowl
I
.. �,. it •rt '. � • ,
Number of Structures: '
Disrhsrecs & Strenm impacts
1. Is any discharge observed from any part of the operation`?
r
Discharge originated at- ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
hZ Did the discharge reach waters of the State? (If yes, notify DWQj
c. What is the estimated volume that reached waters of the Slate (gallons)?
d• Does discharge bypass the waste management system? (Ifycs, notify DWQ)
2, is there evidence of a past discharge from any part of the operation?
t ---3. Were there any adverse impacts err potential adverse impacts to the Waters ()rthe State
other than from a discharge?
It
M 1
M
❑ Yes ETNo ❑ NA ❑ Nr,
❑ Yes
❑ No
D-NA
❑ NE
❑ Yes
❑ No
EI-NA
❑ NE
l_I NA
❑ NE
❑ Yes
❑ No
❑ Yes
B'No
❑ NA
❑ NE
❑ Yes-
214cr
❑ NA
❑ NE
12128104 Continued

i
Facility Number: ► irate of Inspection Ila 11gluie
Waste Collection &'treatment
4. Is storage capacity [structural plus storm storage plus heavy rainfall} less than adequate? ❑ Yes Q4, ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes El No ❑ NA ❑ NI:
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
it Spillway?�
Designed Freeboard (in):
4 L
Observed Freeboard (in):
S. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
lgNo
❑ NA
❑ NE,
(ie/ large trees, severe erosion, seepage, etc.)
6. Arc there structures on -site which are not properly addressed and/or managed
❑ Yes
Q-Iqo
❑ NA
❑ N1s
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an itnrnediate public health or environmental)
tthhreat, notify
I)WQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
L7 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
l io
❑ NA
❑ NE
(Fiat 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
[91 o
❑ NA
❑ NF
maintenance/improvement?
IL . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
E No
❑ NA
❑ N E
❑ Excessive Ponding ❑ llydrakilic Overload D Frozen Ground ❑ heavy Metals (Cu, Zn, etc.)
❑ PAN [] i'AN > i r/o or i01hs ❑ 'rotas Phosphorus '❑ Failure to incorporate Manurc/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidunce of Wind Drift ❑ Application Outside of Area
12, Crop types)
13, Soil type(s)
14, Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
/
O No
❑ NA
❑ NE
15_ Does the receiving crop and/or land application site need improvement?
❑ Yes
[' 3 o
(] NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determinations❑
Yes
B'�o
❑ NA
❑ NE
17. Roes the facility lack adequate acreage for land application?
❑ Yes
[�ilv
❑ NA
❑ Nli
18. Is there a lack of property operating waste application equipment?
❑ Yes
[T�o
❑ NA
❑ Nr
1 "k tdli WU?J, li,fvuc.L �- Yx-,,ec&s
Ntw VLC�L IM�c -
1rxrra
i3.bi -A , ZRb �K yN- .� •%�"��M.�'til:4:Ir.S+{, •'yi L:�..d..i.l�.Jw•�Y= i

tit
Facility \archer: E — (`j ate rrf ln.spection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available`?
El Yes
,,....,, �^^
2 o
❑ NA ❑ NE
20. 1]oes the facility fail to have all components of the CA WMP readily available? If yes, check
❑ Yes
Ogo
❑ NA ❑ NE
the appropirate box. ❑ wup ❑ Checklists []Design ❑Maps ❑ ether
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
LTNo
❑ NA ❑ NE
❑ Waste Application ❑ Wcekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall []Stacking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections El
Weather Code
22, Did the facility tail to install and maintain a rain gauge:?
❑ Yes
LI No
❑ NA . ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
&&'v
❑ NA
❑ NE
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
2,No
El NA
ElNls
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
.�1 No
❑ NA.
❑ NI;
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
E ,� n
❑ NA
❑ NF
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ErNo
❑ NA
❑ N1?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[5No
❑ NA
❑ NE
24. Did the facility rail to properly dispose ofdead animals within 24 hours and/or document
O Yes
O'�No
[DNA
❑ NIA
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
ff No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility tail to notify the regional office of emergency situations as required by
❑ Yes
❑`Nu
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Revicwerllnspector tail to discuss review/inspection with an on -site representative?
❑ ),cs
EI-No
❑ NA
❑ NE
33. ❑oes facility require a follow-up visit by same agency?
❑ Yes
LT No
0 NA
❑ NE
12128104

Facility Number: ' l Date of Inspection
II t�hL
Technical Assistance Needed
34, Waste Plan Revision or Amendment
❑
35. Waste Plan Conditional Amendment
❑
36, Review or Evaluate Waste Plan wlproducer
❑
37. Fornis Need (list in comment section)
❑
38. Missing Components (list in comments)
❑
•
Provided
39. 2E1,0200 re -certification
❑
❑
40. Five & Thirty day Plans of Action (PoA)
❑
❑
41. Irrigation record keeping assistance
❑
❑
42. Organize/computerization of records
❑
❑
43. Sludge Evaluation
❑
❑
44, Sludge or Closure Plan
❑
❑
45. Sludge removallclosurc procedures
❑
❑
46. Waste Structure Evaluation
❑
❑
47. Structure Needs Improvement
❑
❑
48, Operation & Maintenance Improvements
❑
❑
49. Marker check/calibration
❑
❑
50. Site evaluation
Cl
❑
51. Irrigation Calibration
❑
❑
52. Irrigation system designiinstallation
❑
❑
53. Secure irriga;ion information (maps, etc.)
❑
❑
54. Operating improvements (pull signs, etc.)
❑
❑
55. Wettable Acre Determination
❑
❑
56. Evaluate WAD certification/rechecks
❑
❑
57. Crop evaluationlrecommcndations
❑
❑
58. Drainage work/evaluation
❑
❑
59. Land shaping, subsoiling, aeration, etc.
❑
❑
60. Runoff control, stormwater diversion, etc.
❑
❑
61. Buffer improvements
❑
❑
62. Field measurements(GPS, surveying, etc.)
❑
❑
63. Mortality BMPs
❑
❑
64. Waste operator education
❑ ,,
❑
65.Operation & maintenance education
❑
❑
66, Record keeping education
❑
❑
67. Crop/forage management education
❑
❑
68. Sail and/or waste sampling education
❑
❑
69. PLAT
❑
❑
70.Other
❑
❑
List Improvements Made by Operation.
2
4
S.
_ 3. 6. __ - - 1712"4

I -]
�. I
Division of Water quality
Division of Soil and Water Conservation
❑ Other Agency--11
Facility Number. 7§Q003 Facility Status: Activg Permit: NCA27NQ3 Denied Access
Inspection Type:
Reason for Visit: Boutine_ _ County
Date of Visit: 06/06/2006 Entry Time:09:50 ANC_ Exit Time: 11:30
Farm Name: &pI,efield Farm•Lower & Upper
Owner:
Inactive or Closed Crate:
4...i ■ M I
Incident #:
Owner Email:
Phone:
Mailing Address, 7725 F(iendshin_Rd Bro)Un�ummit NC 27214
Physical Address:
Facilility Status: ❑ Compliant ❑ Not Compliant Integrator.,
Location of Farm: Latitude: 35'37'15" Longitude: Z9`ZB'55
Hwy 220 south from GSO. Take Hwy 64 east to Hwy 42 and turn right (east) towards Coleridge. Turn right onto Riverside Rd. Exactly
1.2 miles turn left into farm. 314 mile down the road. Farm is at 4599 Riverside. Fam #336.879.6500
Question Areas:
Discharges & Stream Impacts
Records and Documents
Certified Operator: Philip W Faucette
Secondary OIClsj:
Waste Collection & Treatment 'haste Application
Other issues
Operator Certification Number: 20372
On -Site Representative(s): Name Title Phone
On -site representative Vincent Jessup Phone:
24 hour contact name Robin Cox Phone: [phone]
Primary Inspector: M a Rosebrock
tnspector Signature:
Secondary Inspect"sl:
Phone:
Date: !'P
Inspection Summary:
Farm # is 336.879.6500
Vicent`s (some # is 336,879,3358
7. Suggest spraying embankment with 2+D to kill broadleaf weeds.
15. geed to lime all fields and re -seed, especially F-1. Operator says the fields were limed in September 2005.
18. Still need to install one hose, waiting an clamps.
24. Efficiencies are 70-75% for all three reels. Will need to replace rings lguns etc. prior to next inspection. Will need to calibrate all
three as well.
25. Sludge is increasing at a rate of about d" per year. Need to consider removing sludge in next year or so,
27. Completed in 2005,
Page: 1

9 0
Permit- NCA276003 Owner • Facility: Phillip Faurefte
Inspection Date: 06/06/2006 inspoction Type: Compliances Inspection
Facility Number: 760003
Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Swine
Swine - Feeder to Finish 12,400 12,074
Total Design Capacity: 12,400
Total SSLW: 1,674.000
Waste Structures
Type identifier Closed Date Start Data Designed Freeboard Observed Freeboard
agoon LOWER 30.00
agoon UPPER 30,00
Page: 2

Permit: NCA276003 Owner - Facility: Phillip Faucette
Inspection Data: 06106/2006 Inspection Type: Compliance Inspection
Facility Number: 760003
Reason for Visit: Routine
Discharges &Stream impacts
Yes No
NA
NE
1. Is any discharge observed from any part of the operation?
❑ ■
❑
❑
Discharge originated at
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑ ■
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑ ■
❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify OWQ)
❑
■
❑
❑
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 Waters of the State other than from a
❑
■
❑
❑
discharge?
Waste Collection, Storage & Treatment
Yes
No
NA
NE
a. Is storage capacity less than adequate?
❑
■
❑
❑
If yes, is waste level into structural freeboard?
Cl
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large trees, severe
❑
■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management
❑
■
❑
❑
or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (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 maintenance or
❑
■
❑
❑
improvement?
Waste Application
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or
❑
■
❑
❑
improvement?
11, Is there evidence of incorrect application?
❑
■
❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
Page: 3

•
•
Permit: NCA276003 Owner - Facility: Philip Foueette
inspection Date: 4610812006 Inspaetion Type: Compliance Inspection
Facility Number : 76OW3
Reason far Visit: Routine
Waste Application
Yes
No
NA
NE
PAN?
❑
Is PAN a 10%110 lbs.?
Total P205?
❑
Failure to incorporate rnanurels"e into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Fescue
(Hay)
Crop Type 2
Millet
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management
❑
■
❑
❑
Plan(CAWMP)?
15. Does the receiving crap andlor land application site need improvement?
■
r
❑
❑
16, Did the facility fail to secure andlor opefare per the ifrigation design or wettable acre determination? ❑
■
❑
❑
17. Does the facility lack adequate acreage for land application?
❑
❑
❑
18. Is there a lack of properly operating waste application equipment?
■
❑
❑
❑
Records and Documents
Yes
No
NA
NE
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■
❑
❑
20. Does the facility fail to have all components of the CAWMP readily avadable?
❑
■
❑
❑
11 yes, check the appropriate box below.
WUP?
❑
Page: 4

Permit: NCA276003 Owner - Faclllty; Phillip Faucette Facility Number: 760003
Inspection Date: 06106/2006 Inspection Type: Compliance Inspection Reason for Vlalt: Routine
Records and Documents Yes No NA NE
Checklists? ❑
Design? ❑
Maps? ❑
Other? ❑
21. Does record keeping need improvement? ❑ ■ ❑ ❑
If yes, check the appropriate box below,
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after n 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
Cl
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
■
❑
❑
23. if selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■
Cl
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
❑
❑
25, Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■
❑
❑
Other Issues
Yes
No
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
■
❑
❑
29, Did the facility fail to property dispose of dead animals within 24 hours and/or document and report those
❑
■
❑
❑
mortality rates that exceed normal rates?
30, At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air
Cl
■
❑
❑
Quality representative immediately.
Page: 5

0 0
Permit: NCA276003 Owner • Facility: Phillip Faucette Facility Number: 760003
Inspection Data: 06106=06 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other Issues Yes No NA NE
31, Did the tactility fail to notify regional DWQ of emergency situations as required by Permit? ❑ M ❑ ❑
32. Did Reviewe Mnspector fail to discuss review✓inspeation with on -site representative? ❑ ■ ❑ i!
33. Does facility require a follow-up visit by same agency?
❑ ■ ❑ ❑
Page: 6

Division of Water Quality
Facility Number �
Division of Soil and Water`Conservation _
3 36
Q Other Agency
Type of Visit P Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Routine Q Complaint D Follow up Q Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: � Departure Time: �-i- County: EgirRegion:
Farm Name: 'ry Owner Email: p
Owner Name:� t.En-0 C_ Phoffe:
Mailing Address: � � a s--- �� l,P�� �� � 1 � ► `J roiU n � V 1Y1 M,4-Ft , � L
Phvsical Address: 0_n,q���
Facility Contact: )q 2 S ![Tit le: Phone No: FALr+'1_�_7
Onsite Representative: Co 1� Integrator:
Certified Operator: 0 + Lll]L �l[� - - - Operator Certification Number: 20 ,3-1 a
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: �O ® © Longitude: o ® J1
4wq aao 5o Lytp) Sd . U s � l� q e a5+ as+ `its La�.r 5 •
Cd l p-r to qe . Q--� a n-�o I� � v e rs'r� � � • C�v 6 l a m � 1� � •
Design Current
Swine Capacity Population
❑
Wean to Finish
❑
can to Feeder
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other — -- - --- -- -
's Design Current
Wet Poultry Capacity Population
❑ t.a er
❑ Non-t.a er
Dry Poultry'
❑
La ers
❑
Non-I.a ers
❑
Pullcts
❑
Turkeys
❑
Turkev Poults
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the Slate? (Ifycs, notify DWQ)
Cattle
Design Current
Capacity Population k
❑
Dairy Cow
❑
Dairy Call'
❑
Dairy Heifer
❑
pry Cow
❑
Non-Dai
❑
iicef stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Siructures: ®'
❑ Yes No ❑ NA ❑ NF
d. ❑oes 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
❑ Yes XNo
❑ NA
❑ NE
❑ Yes .T- tr
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: — 5 hate of Inspection 0
Waste Collection & 'rreatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) Iess than adequate?
a. If yes, is waste level into the structural freeboard?
❑ NA ❑ NE
El NA ❑NI?
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
bp
S illway?: NO C
Designed Freeboard (in): f�
Observed Freeboard (in): 3 Q
❑ Yes o
❑ Yes No
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 ❑ Yes19
No ❑ NA ❑ NEE
through a waste management or closure plan`?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify D►►'Q
7. Do any of the structures need maintenance or iniprovement'r' ❑ Yes IN ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 4
,_,/
9, Does any part of the waste management system other than the waste structures require Yes [ No ❑ NA ❑ NE
maintenance or improvement? Ik
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
rnai ntcnance/improvement? 9
1 l . Is there evidence of incorrect applic stion? ifyes, check the appropriate box below. ❑ Yes �<No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Ln, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑'Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 1114j,1 ,�41AA ) I h-j
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
*o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design ar wettable acre determination ?
❑ Yes
�r`No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
Ayes
❑ No
❑ NA
❑ NE;
Comments (refer to question #): Fxplain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
os� s rep laced ?
K
a
Reviewer/Inspector flame Phone: —7 —
Reviewer/Inspector Signatur lkDate: Q
W
Page 21#'3 ' if 12128104 Continued

M
4
Facility ,Number: — ate of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available'? ❑ Yes VNo ❑ NA ❑ NE
20. Does the facility fail to have al I components of the CAWMP readily available'? If yes, check ❑ Yes IZNO ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
2l. rye record keeping need improvement? ❑ Yes ,�,'c�a ❑ NA ❑ Nr-
Waste Application 047cekl Freuboard Waste Analysis .'nil Anal sis L1fi'1k'aste'rransfers D'Annu 1 Ccrtificatitm
nl Y � Y
fZainfall DX'/locking rop Yield 120 IV9inute Inspections pd 1�1onthiy and 1" Rain Inspections eather Cade
22.
Did the tacility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected. did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
XNa
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE;
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Vo
❑ NA
❑ NE
27_
Did the facility laiI to secure a phosphorus loss assessment (PLAT) certitication?
❑ Yes
06o
❑ NA
❑ NF
Other issues
28.
Were any :additional problems noted which cause non-compliance of the permit or CAWMP?
ElYes
yKjo
❑ NA
❑ Ni
29.
Did the facility fail to properly dispose of bead animals within 24 hours andlor document
❑ Yes
No
X
ElNA
ElNr:and
report the mortality rates that were higher titan nomtaP
M
At the time of the inspection did the facility pose an odor or air quality concem?
❑ Yes
�No
❑ NA
❑ NE
If yes. contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑Yes
No
❑ NA
❑ NL"
Ceneril Pcrntil? [iel discharge, freeboard problems, over application}
32.
Did Reviewerllnspectar fail to discuss review/inspection with an on -site representative'?
❑ Yes
No
❑ NA
❑ NE
33.
Docs facility require a follow-up visit by same agency?
❑ Yes
�No
❑ NA
❑ Nk;
Additional Comakcios and/or Drawings:
,&Aif
f } Azilit
i LTZ l
_Z�
s
s i
OW
�A
12 1
r�s1rra UCOW
3 3.4

■ Division of Water Quality
[] Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 760003 — Facility Status: Active Permit: NCA27600, . ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Roason for Visit: Routine County: Randolph __ Region: Winston-Salem
Date of Visit: 07/06i2 05 _ Entry Timer Exit Time-, 12:00 PM
Farm Name: AooieGeld Farm -Lower & Upper
Owner: Phillip
Incident p:
Owner Emall:
Phone: [phone]
Mailing Address: 7725 Fr'grid jip Rd _Brown Summit NC 27214
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator: NAG ujyls Farms Inc
Location of Farm: Latilude: 35'37'15" Longitude: �79°36'55"
Hwy 220 south from GSO. Take Hwy 64 east to Hwy 42 and turn right (east) towards Coleridge. Turn right onto Riverside Rd
Exactiv 1.2 miles turn left into farm, 314 mile down the road. Farm is at 4599 Riverside. Fam #336-879.6500
Question Areas:
Discharges & Stream Impacts 0 Waste Collection & Treatment Waste Application
0 Records and Documents 0 Other Issues
Certified Operator: Philip W Faucette Operator Certification Number: 20372
Secondary OIC(s):
On -Site Representatives): Name Title Phone
On -site representative Robin Cox Phone:
24 hour contact name }robin Cox Phone:
Primary Inspector: r
a M Rosebrock Phone: [phone]
! Ext.383 _
Inspector Signature /;LDate:
Secondary Inspector(s):
Phono:
Phone:
Inspection Summary:
Philip Faucette was also present for the inspection. His shop number is 336.656,7594
Casey Alan Cox is the back-up operator.
7. May want to spray lagoon embankments with broadleaf herbicide.
15. Field 99 needs to be sprayed for broadleaf weeds. Need some time on all fields per soil test report.
18. Need to replace other two suction hoses that are dry -rotted. Other new hose, stopper, and pressure gauges look great.
Waste analyses:
2116105 Lower-2-5 and tipper-3.0
612M5 Lower--2.8 and Upper-2.7
Page: 1

0 0 1
Permit- NCA276o03 Owner • Facility: Philip Faucelto Facility Number: 760003
Inspection Bate: 07/06/2005 Inspection Type: Compliance inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Swine
Swine - Feeder to Finish 12,400 10,145
Total Design Capacity: 12,400
Total SSLW: 1,674,000
Waste Structures
Type Idantlfier Closed Date Start Date Designed Freeboard Observed Freeboard
Lagoon LOWER 26.00
Lagoon 7EPER 20.00
Page: 2

•
Permit: NCA276003 Owner • Faculty: Phillip Faucolto Facility Humber: 7600M
Inspection Date: 07M612005 Inspection Type: Compliance Inspection Reason for Visit: Routine
1. Is any discharge observed from any part of the operation?
Yes
❑
No
NA
❑
NF
❑
Discharge originated at:
Structure
❑
Application Raid
Other
G
a. Was conveyance man-made?
❑
■
❑
❑
G. Did discharge reach Waters of the Mate? (it yes, notify DWG)
❑
■
❑
❑
a. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
■
❑
Cl
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 Waters of the State outer than from a discharge?
❑
Yar,
■
No
❑
NA
❑
NF
WaMp CollMlion, Storage & TMatmppi
d. Is storage capadty less than adequate?
❑
■
❑
❑
If yes, is waste level Into structural freeboard?
❑
S. Are [here any Immediate threats to the integrity of any of the structures observed (I.a.l large trees, severe erosion,
Cl
■
❑
Cl
seepage, etc.)?
6. Are there structures on -site that are not properly addressed andlor managed through a waste management or
❑
❑
❑
closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■
❑
❑
9, Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks
C]
❑
❑
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
■
❑
❑
improvement?
Yes
No
NA
NE
Waste ApUlicaWn
10. Are there any required butters. setbacks, or compliance alternatives that need maintenance or Improvement?
❑
■
❑
❑
11. Is there evidence of incorrect application?
❑
■
❑
❑
If yes, check the appropriate box batow,
Excessive Pending?
❑
Hydraulic Overload?
Frozen Ground?
❑
Heavy metals {Cu, 2n, etc)?
❑
PAN?
❑
Is PAN > 10741101bs:?
❑
Total P2057
❑
Failure tc incorporate manurelaludge Into bare sail?
❑
Outside of acceptablo crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1 Fescue (Hay)
Crop Type 2 10'0et
Crop type 3
Crop Type 4
Crop Type 5
Page: 3

0 0
Permit: NCA276003 Owner- Facility: Phillip Faucette Facility Number: 760003
Inspection Date: 07/06/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste AnHicatiem Yes No NA NF
Crop Type 6
Sol Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Sad Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAW MP)7
15. Does the receiving crop andlor land application site need improvement?
16. Did the facility fail to secure andlor operate per the irrigation design or wettable acre determination?
17. Does the faChty lack adequate aCroage for land application?
18. is there a lack of properly operating waste application equipmenl?
Records and,D,aQjInents
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
20, Does the facility fail to have all components of the CAWMP readily available?
If yes, check the appropriate box below.
Wt1P?
Checklists?
Design?
Maps?
Other?
21. Does record keeping need improvement?
It yes, check the appropriate box below.
Waste Applicalion?
120 Minute inspections?
Weather code?
Weekly Freeboard?
Transfers?
Rainfall?
Inspections after a 1 inch rainfall 8 monthly?
Waste Analysis?
Annual soil analysis?
Crop yields?
stocking?
Annual Carlification Form (NPOES only)?
22, Did the faality fail to install and maintain a rain gauge?
23, If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPOES only)?
24. Did the faclllty fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did The facility fail to have an actively certified operator in chargc7
27. Did the facilely fail to secure a phosphorous loss assessment (PLAT) certification?
C ■ ❑ ❑
■ ❑ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
■ ❑ ❑
vas N , ti!A ue
❑ ■ ❑ ❑
❑ ■ ❑ ❑
Page: 4

Permit: NCA27WM ❑wnar • Facility: PNMp Famelte Faculty Numtxor :
760003
Inspection date: 07/0612005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other Issues
28. Were any additional problems noted which causo n on -comp I ja n co of the Permit or CAWMP?
Yes
Cl
No_
■
NA
❑
NE
❑
29. bid the facility fail to properly dispose of dead animals within 24 hours andfor document and report those nx>ilality
❑
■
❑
C1
rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality coneern7 It yes. contact a regional Air Quality
0
©
Q
reprosentativo immediately.
31, Did the facifily fail to notify rogional DWQ of emergency situallons as required by Pen•Y+it?
❑
■
❑
❑
3Z Did Reviewerllrapector fail to discuss reviewCrmpection with on -silo representaLve?
❑
■
❑
❑
33. Does fad ity require a follow-up visit t7y same agency?
❑
■
©
0
Page; 5

._:. f .Division of Water Qualit
Faeilimt>er �p { x
�Y �: Divisirin,(if Soil and Water Coe acrvation c
` - - — — — - r) Other Agency;
Type of Visit Compliance Inspection n Operation Review Q Structure Evaluation a Technical Assistance
Reason for Visit Y Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑ Denied Access
Date of Visil: ~] .i'rri►:rl'I'ime: D s Departure Time: C oun(}': -alp-b_ Red i[rn: -,�6
Farm Name:`_t'isf' !Fayn Owner Email:
Owner Name: [ 11f 1 ��ll��pXYL � Phone:
Mailing Address: vZE;_ 1, 1-t
Physical Address:1�1 V l� A
y��
b1.7� '13
j_Facility Contact: Contact: n� 0 T�' it�c: Phone tit�� r 57 ip
, 4S-Do
a
Unsite Representative: _ -QU-1L L.U� f� h j i I V 3rlt�integratrtr:___!"� P� r T ��'���
Certified Operator: _r n1 POLU Operator Certification Dumber: a 0 3 -7 Z'
Alan �o (348� L'fil
Back-up Operator: Back-up Certification Number:
!,oration of farm: Latitude: �° }�' Longitude: F °
fi I aQO Sciin -Fro rn 6SO l) S FhA-) 4 (4 e QS . N)0, 2- eca5 f . 5
�Aertciy on+6 R, vers' a pA - 60 t. a m+ les fogs9 9 .
Swine
Design Current Design Current
Capacity Population %N'et Poultry Capacity Population
❑ Laver
❑ Non -La et
❑
Wean to Finish
❑
Wean to Feeder
Feeder to Finish
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other _
Dry Poultry
❑
Lavers
❑
Non -Layers
❑
Pullets
❑
'Turk-e s
❑
"furkev Puults
❑
Other
DischprL,cs & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ structure ❑ Application Field ❑ Other
a. Was the conveyance roan -made?
b. Did the discharge reach waters of the Stale'? (Ifyes. notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Ileif'ei
❑ Dry Cow
❑ Non-Dairy
❑ Bcet' Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estirnated volume that reached waters of the State (gallons)?
Number of Structures: FTI
d. Does discharge bypass the waste management systctn? (I f' ycs, noti ry D WQ]
2. Is there evidence of a past discharge frorn any part of'the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the Statc
other than from a discharge?
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NI:
❑ Yes
❑ No
❑ NA
❑ NFs
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ Ni;
12128104
Continued

Facility \umher: — 0 Date of Inspection 1 ❑
Waste Collection & Treatment
4. IS storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,W o ❑ 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; Lo vV-.r—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �0
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes KINO ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan'!
If any of questions 4-6 were answered yes, and the situation pose~ an immediate public health or environmental threat, notify D%N'Q
7. Do any ofthe 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 ol'the waste management system other than the waste structures require ❑ Yes o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ yes No ❑ NA ❑ NE:
maintenance/improvement?
%X
l 1. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ E-xcessive Ponding ❑ Ilydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Co,Ln, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) e-o P ( ha-," ) m 41 le-4- -- -.
13. Soil type(s)
14. Do the receiving; crops differ from those designated in the CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
74Yes
❑ No
❑ NA
❑ NEE
16. Did the facility fail to secure and/pr operate per the irrigation design or wettable acre
determination?❑ Yes
�No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
N�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
y Yes
❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of Facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Re►•fewer/Inspector Signat
Date: -I �, ..� D 5
12128104 Continued
3

Facility ~umber: — Djef Inspection 1he Q
Required Records & Ducuments
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes 1No ❑ NA El
20. Does the facility fail to have all components of the CANV111P readily available? if yes. check ❑ Yes W., ❑ NA ❑ Nn
the appropiratc box, ❑ W UP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need iimm rovenient'? if yes, chee the appropriate box below. Nrl'es ❑ No
❑ NA
❑ NE
[ zste Application A'eekl Freeboard (�► Waste Analysis (rj Soil Analysis
�Frterw3ers -El
-
Crop Yield Monthly 1"
RainlallCE)
Rain Inspections
eathcr
Code'
and
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
DeNo
❑ ,NA
❑ NE
23.
If selected. did the facility fail to install and maintain rainbreakers on irrigation equipm it'?
El Yes
❑ No
�NA
El NE
24.
Did the tacility fail to calibrate waste application equipment as required by the permit?
Yes
No
❑ NA
❑ NE
25.
Did the 1"wility tail to conduct a sludge survey as required by the permit:' AA 00T
❑ Yes
XNo
NA
❑ NE
26.
Did the facility fail to have an actively certified operator in Charge'?
❑ Yes
,�
❑ NA
ElNE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certilication'? AW5'%❑ Yes
� No
❑ NA
❑ NE
Other
Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP'?
❑ Yes
/'
> Vo
❑ NA
❑ NE
29.
Did cite facility fail to properly dispose ol'dead animals within 24 hours and/or document
❑ Yes
>(No
❑ NA
❑ NE
and report the mortality rates that were higher than nonnal'?
rr►��►��
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Ycs
) N«
❑ NA
❑ NE
1f yes. contact a regional Air OUality representative itnmediateIy
31.
Did the facility fail to -notify the regional ,office of emergency situations as rC+1ired by
❑ Yes
D(No
❑ NA
❑ NE
General Permit? (ie/ discharge. freeboard problems, over application)
32,
Did Revis:wer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE
33. Does facility require a 601low-up
visit by same agency?
El Yes XNo ❑ NA ❑ NE
Additional Comments and/or Drawings:
l
6212/6s L_ow� _ �2-u
;'-) I te I 0-�T- Lo U-� ;? - U p p-,r 3
12128104

Assistance Site Visit Repo
DRWon of Soil and Water Conservation
Q Natural Resources Conservation Service
a Soil and Water Conservation District
Other...
Facility Number 76 - Date: 12l13104 Time: 1 830 1 Time On Farm: fi5 WSR❑
Farm Name Applefield Farm -Lower & Upper County Randolph Phone:
Mailing Address 7725 Friendship Road
onsite
Representative Robin Cox & Vincent
Typeof Visit
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
10 Swine ❑ Pouitry ❑ Cade ❑ Horse
Brown Summit NC
Integrator IN G Purvis Farms. Inc,
Purpose Of Visit
Q Routine
❑ Response to DWQ/DENR referral
❑ Response to DSWC/SWCD referral
❑ Response to complaint/local referral
❑ Requested by producer/integrator
❑ Follow-up
❑ Emergency
❑ Other.,.
Design Current Design Current
Capacity Population Canacitv Po ulation
❑ Wean to Feeder
® Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
12400
10500
❑ Layer
❑ Non -Layer
❑ Dairy
❑ Non -Dairy
❑ Other
336-656-7594
27214
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes (9 no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure Marge trees, ❑ yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ® no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ® no
and/or public health?
fi. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes (9 no
Structure1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier I 1 2
Level (inches) 1 12 14
CROP TYPES
SPRAYFIELD
SOiL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/ 1010 3

r1�
a
Facility Number 76 - 3 Date:
12/13/04
PARAMETER
p No assistance provided/requested
❑ 8, Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
10. Level in structural freeboard
25. Waste Plan Revision or Amendment
El
El❑
❑ 11, Level in storm storage
26, Waste Plan Conditional Amendment
❑
❑
27, Review or Evaluate Waste Plan w#producer
❑
❑
❑ 12. Waste structure integrity compromised
❑ 13. Waste structure needs maintenance
28. Forms Need {list in comment section}
El
❑
29. Missing Components =fist in comments)
❑
Cl
❑ 14. Over application >= 10% & 10 lbs.
❑
❑
❑ 15. Over application < 10% or < 10 lbs.
30. 2H.0200 re -certification
❑ 1& Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
❑ I & Late/missing waste analysis
33. Organ izelcomputerization of records
❑
[]
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
❑ 21. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22. Crop inconsistent with waste plan
36. Sludge removallciosure procedures
❑
❑
37, Waste Structure Evaluation
❑
❑
❑ 23, Irrigation maintenance deficiency
❑ 24, Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39, Operation & Maintenance Improvements
®
❑
40. Marker checklcalibration
❑
❑
Reaulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
Duet....
43. irrigation systemdesign#installation
❑
❑
Date:
44. Secure irrigation information (maps, etc.)
❑I
❑
LIST IMPROVEMENTS
45. Operating improvements (pull signs, etc.(
❑
❑
MADE BY OPERATION
❑
❑
46. Wettable Acre Determination
1
47. Evaluate WAD certification#rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2.
49. Drainage worklevaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52, Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4'
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5'
55, Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6.
58, Croplforage management education
❑
❑
59. Soil and#or waste sampling education
❑
❑
03/10/03

Facility Number �� - + .J Date: 1 121131a4
TECHNICAL SPECIALIST relsy K. Gerwig
SIGNATURE
Date Entered: 12/17/04
Entered By: 16etsy K. Gerwi
03/10103

. isioii of Water Quality
ision of Soil and Water Conservation
0 Other Agency
Type of Visit O Compliance Inspection ❑ Operation Review a Lagoon Evaluation
Reason for Visit 0 Routine Q Complaint Q Follow up Q Emergency Notification ❑ Other ❑ Denied Access
Date of Visit: 91212ot14 Time: [1915
Facility Number 3
Operational O Below Threshold
M Permitted M Certified 0 Conditionally Certified © Registered Date Last Operatted or Above Threshold:
[,'arm Name: At�ulc���l�i.farna-l��.r x..s.lJl�nc.r....................... .. Counly: WalldQlPh ......................................... W.$RO..... ...
Owner Name: 'faillita(,1.C1f1Cy......................... 1:alA�ltt.C1.ARFit............................. ...... E'hone Nn:f-iS-l.Si.........................
Mailing Address: 7725.FrjCRdA11.p.,1Z..Qa0
Facility Contact: R0.W.C.Ox.......................................................Title:....
f.x.Q.-A' 5.VMMA..ANC........................................... 2.72.1.:1..............
Phone No:,.>2.�4,Z5.1........................
Onsite Representative: ),p.1�1I1,.',hill.kaus.�t.ttv..Y�>x��tzt.,leisuR ........................... Integrator: h.... t 'u..lFaxms.,.1R�...............
Certified Operator: pUjp..W................................ Faw.41tC..lA...................................... operator Ccrtifica(ion Nit inher.2037Z.... .........................
Location of Farm:
IIwy 220 south from GSO. 'rake Hw'y 64 east to ]Hwy 42 and turn right (east} towards Coleridge. Turn right onto Riverside �
Rd. Exactly 1.2 miles turn left into farm. 314 mile down the road. Farm is at 4599 Riverside. Fam #336.879.6500
® Swine ❑ Poultry ❑ Cattle ❑ Horse I'atitude 35 " 37 l5 Longitude 79 3b 55
Design Current
Swine Canacity Ponuiation
❑ Wean to Feeder
M Feeder to Finish
)2400
9870
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Car acity Population Cattle
Capacity Population
❑ Laver ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 12,40D
Total SSLW 1,674,000
Number of Lagoons 2 Spray Field Area
n
Discharges & Stream Impacts
I . Is any discharge observed From any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? El Yes ❑ No
b. If discharge is observed, did it re,ich Water of the State? (IFyes, notify DWQ) El Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Docs discharge bypass a lagoon systcml (Ifycs, notify DWO) ❑ Yes [--]No
2. Is there evidence of past discharge from any pan of the operation? ❑ Yes M 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 & •rrcatmcnt
4. Is storage capacity (Freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes M No
Structure l Structure 2 S.rUCtUre 3 Structure 4 Structure 5 Structure 6
Identifier: ............ Uppor............ ........
Freeboard (inches): 29 35
12112103 Continued

Facility Number: 76--3 1 I)atc of inspection 9/2/2004 0
5. Are there any immediate threats to the inoty of any of the structures observed? (ie/ trees, severe erosion, ❑Yes ®No
seepage, etc.}
6. Arc 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 tlian waste structures require maintenance/improvement? ❑ Yes N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes N No
elevation markings?
Waste Applicsition
10. Are there any buffers that need maintenance/improvement? ❑ Yes N No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes N No
❑ I'sxcessivc Ponding ❑ PAN ❑ Hydraulic Overload ❑ frozen Ground ❑ Copper and/or Zinc
12. Crop type fescue (I lay) Millet
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management flan (CAWMP)'? ❑ Yes ® No
14. a} Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does (lie facility need a wettable �scre determination? ❑ Yes N No
c) This facility is pended for a wettable acre determination? ❑ Yes N No
15. Does the receiving crop need improvcment? ❑ Yes N No
16. Is there a lack of adequate waste application equipment? N Yes ❑ 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 ❑ 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 N 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 ® No
Air Quality representative immediately.
Comments (refer to question h): Explain .any YES answers and/or any recommendations or any other comments.
Use drawings of Facility to better c►plain situations. (use additional pages as necessary): ❑ Field Copy ®Final Notes
7. Continue efforts to control broadleaf weeds on lower lagoon.
7. Suggest piping/cuIverting diversion water to to stop erosion near top of dam of the "upper lagoon."
15. Ilay b<Sles to be removed within next 10 days.
16. Suggest new pressure gauge on reel near F'-15011 near lower lagoon.
16. Must replace worn/dry rotted hose on reel in field one. May need gauge also.
16. reel in field 9 needs new soppers for gun and suggest maintenance on gun so that it pivots freely. Need new oupling since it's
leaking today. Must install gauge on reeligun. Suggest portable.
23/04 Waste analyses:
pper=2.2 lbs. N/1000 gal. and lower=2.3 Ibs. NI1000 gal,
Reviewer/Inspector Name Melis¢q Rose
Reviewer/Inspector Signature:
I):ate:
12112103 1Continued

1Facility.Numbcr: 76-3 1)f inspection 9/2/2004
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 ali components of the Certified Animal Waste Management flan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
N 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
N No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N 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 Reviewer/Inspector fail to discuss review/inspection with on-sitc representative?
❑ Yes
N No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
NI'DES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
N 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
N No
34.
I)id the facility fail to calibrate waste application equipment?
N Yes
❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
N Yes
❑ No
❑ Stocking Form N Crop Yield form ❑ Rainfall ® 1nspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
s
Additional Comments and/or Drawings:
EM
12112103

.. *i''►'Y.rrsr�.•ay �Y.1,.-..Z— - •1rx `.r :� ry. jam- � �.R: .4 ,t r� r"` a» �y� ik` x �"
�Y
raAll
, an of SOiI a_nd ester, Cartservativ ,
'r �.y �r e.�. _rr ^ �, S' �,' �• �'1�. .wens i' "'�;' q � o .: E' ` ;.�Y .. :•' •.ca
+... r-+(' ti•� •: a. 1/y:; r�,.:.�:�r ;A 'k. �£'� Y r1r _? - 4= i;.. " {,.d y��.-� ♦ *.r,^w' a Y
-�{' fir:=:.�;��-
� ei ;4+r +i x ..vv , a. �- �.�to - F A•:a-_ Y`,�kz•i�s.a i x y"x¢,. 1riZ '..J��:�,�.i
f :; :.,r. t.:o- �'.-.1�'..,.YtY:3�,T .'•hY _�.:.n'YF:.: _1L.= �..i{� - �Nl• rA.�i��_�iaSeTi."��::�%...�e��:'�.se.�i: i`_�i.�.c•:4�..._ .:'.�•..1k'.:1. 'Y.s.�3 .r..i' 1 ".��L "t_+...�il
Type of Visit Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit Routine 0 Complaint ❑ Follow up O Emergency Notification p Other 0 Denied Access
[:::Facility Number Date of Visit: i IU - Time-
O Not O erational ❑ Below Threshold
.1
19 Permitted [3Certified 0 Conditionally Cerfified 0 Re ' tered
yy >� Date Last Operated or bore Threshold: ..........._._....._.
Farm Name: 1 Q L Form Country: ��"U
._>....__...- ...._..............._._...._...._._......._._._.._....__. _ _._._._._.. h_..._
. f l . {— 1� f /� q
Owner Name: l I l f a �.�C3 E I���t? !r� I`f �- Phone No: �JJ 1475 1µ
Mailing Address:... ?�� -�� i� ��.h. ._..!�Gi%...rr�� �r� �� r� t'?. ! � ... QC-....... .. 7..�_�..�
Facility Contact: �Title.
Phone No: ,
�0�71��UX VI'1 P�� rtPS�u ��yr`Vt5
Onsite Representative: ,.-_.,..___�.._.w_ ..i �� :.f . __.. _�.. Integrator:
��j,� �� • �� �l
Certified Operator:--1----Lt.�.E, _.,..,..— ......... Operator Certification Number:
Location of Farm:
�Ct. r� wV �'L� �QSf f-raM f�5rf��'JCrQ �Qtrt'c�-,—d. CU��.rt
GG *,
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 3S ' `�"
9
Longitude © • ©6
'Design
4f"
•i.
Cnrreot '
t;Desi
C
gn_Dtrrrn
Swine Capacity
3
Ctl
Capacitypa�Ulation' Ca aci ~Po ulaiion
❑ Wean to Feeder
❑Layer
Feeder to Finish
❑Non -Layer
❑Nor -Dairy
ID
Farrow to Wean
.s:��•:
;
Farrow to Feeder
Other
-
Farrow to Finish
A,
_ ., :...:• - ,.: .i
_;T0W Design;Capacity':I
J a, L�60
Gilts
❑ Boars<TOW
SSLW''
Nur ilier: of Lagoons-..
wma;na il= c I L`ral�ri i'r+i
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (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)
tiw r .F: wi
Ak - • .rs i
❑ Yes VNo
❑ Yes ❑ No
❑ Yes ❑ No
Cl Yes
2. Is there evidence of past discharge from any pan of the operation? ❑ Yes
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? kpillway UStructure 1 Structure2 Structure 3 Structure 4 Structure 5
Identifier: V - ------
Frr:.choard (inches):""..""..".".._....._..__ ... .............................
12112103
❑ Yes
Structure 6
NO
Continued

Facility Number: �j(/� �� Date of Inspection I `i TW)
5. Are there any immediate threats to the&ty of any of the structures observed? (iel tre�severe erosion, ❑ Yes No
seepage, etc.)'
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an �K
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
S. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes INO
11. Is there evidence of over application? if yes, check the appropriate box below. ❑ YesNo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving cro4 differ with those designated in the Certified Animal Waste Management Flan (CAWMP)? ❑ Yes ❑
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 'Po
16. Is there a lack of adequate waste application equipment? IL
<Yes ❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below—aYes—❑'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 o
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes
Air Quality representative immediately. !!
-- �_•.-T.: TT' -�'�..,..•;—'•'_.s1.'L'A. •;,Mt[T.......z'vi.,yr'd`s"C
Couuntnts (rdcr. to gncS�on #): YF.xplarn any -YES air'r,wcis and/orr, any. recommeadabons or. _yyother eamments..
-t1se drawings of facility to lbetter..explain sitaatioim {use additional gags as necessary):. Feld Copy ❑ Final Notes
r_ ra..•_u__- . .. _ _z._._.- _ �.-.btfidw..._._w__.......-.-.., r.._ �.�- -__ - __.._.s._ _._ _ _ _ 4'i.._ . 1.i_. u_�.� � _. _. e.-�_ _ �_��_ ... -. ,.. .
'%_.. 1 (!,614 — -
Lower a•B'
Reviewer/InspectorName
Reviewerllospector Signature jj// P./j. ' r1 / A, ►7 Date: �r/ , 'I) y
I21I2103 ] � � Cnnfinued
I/ ,

Facility Number: — 7y Date of Inspection
Reuuired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WIM, checklists, design maps, etc.)
23. D record keeping need ' provement? if es, check the ap2'nate box below.
Waste Application Freeboard Waste Analysis Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliv-ice of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey? t�
34. Did the facility fail to calibrate waste application equipment?melaa
35. D record keeping for D aired fo need im es, check the appropriate box below.
Stocking Form Cro ie Form Rainfall Inspection After 1" Rain or, l'Ct 1 t 1 C� r l'Yi
�20 Minute inspections Annual Certification Form
❑ Yes XNO
❑ Yes X.No
❑ Yes 1j No
❑ Yes o
❑ Yes No
❑ Yes N
❑ Yes o
❑ Yes o
❑ Yes No
Yes
❑ Yes
❑ Yes
❑ Yes
9Yes
"Wes
❑ No
XNo
No
No
❑ No
❑ No
113 No violations or deficiencies were noted during this visit, You will receive no further correspondence about this visit. E
JAdditiaaal Coin irients andlof Drawings.'
a• Y `� _ �_. _a•:s1
� F tso-26 id'r
-
1 . + I �►
II I
12112103

1/
ago01
vision of Water Quality ;.
°ision of Sail and Water Conservation
`0 other Agency
Type of Visit Q Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason far Visit IgRoutine O Complaint O Follow up O Emergency Notification O Other 0 Denied Access
Facilif►' Numhc r 7fi 3 ]tole rat Visit: 121211211t1 i Tinm: 0430
Q Not [] wrolional Q Belo►► Threshold
M Permitted ® Certitietl 13 Conditionaliv Certified 0 fteTistered
Farin Name: �Al�)4��i�.F;arm-X,orrsr..�.11nvsr..........................................
1)ate I.a•t Operated or ,lhnve 'I'llreshoId: - .- -- -- .... -
Count•: BARdQj .bL.__.
WMQ......
[l►►ncT ti:inte: 1'hi1Gl�vlcxry__________-- ksiLciLFIADRI------------------- Phone No: 3G_CS57Q4----------------•-----•-------
Mailing Address: 77.25..Fri€,tallip..Ru;.kd.......................................... ..... J3.rqz}:1a.SJj smut...;N.C................................... ..... M1.4...............
:rcilil� Caant:ict: AiQltin.Gv. ,#i 4.�5.$1....................'I'itle:............................................... Phone No: 3�6,tf79,65V0..................
[]nsile Representative- k'hll_Hxi[trcttet�ins€nLJ ss p,l3stalin G�x_-_-_-_-_ lntegrarnr: Y G_PuryjS_U atx�._Lni._._--.-._---------.
Cerlilied Opera 1or:Pit.ihlq..K! ............................... F;d!!rw1tVJ1... ............. ...................... []perator Certification Ntainber:z0372- .... ................. ......
Location of Farm:
Hwy 220 south from CSC]. Take Hwy 64 east to Hwy 42 and turn right (east) towards Coleridge. 'Turn right onto Riverside A
Rd. Exactly 1.2 miles turn left into farm. 3/4 mile down the road. Farm is at 4599 Riverside. T
® swine ❑Poultry ❑Cattle ❑Horse l.;tlitttde 35 37 15 l.otagifu[ic 79 • 3b 55
Design Current
Swine C -Inneity Pnnulntion
❑ Wean to Feeder
N Feeder to Finish
12400
9976
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Soars
Design Current Design Current';
Poultry Capacity Population Cattle Capacity Population
❑ Layer ID Dairy
❑ Nan -Layer ❑ Non -[dairy
❑ Other . E:
Total Design Capacity 12,40U
Total SSLW L1,674,000
Number of Lagoons �.J ❑ Subsurface Drains Present 110 Lagoon Area ® Spray Field area
Holding Ponds l Solid 'Traps ® ❑ No Liquid ]Waste Management System
Dischaycs & Stream Impacts
1. Is any discharge observed from any part or the operation? [:]Yes N No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. li'dischargc is observed, was the conveyance man-made? ❑ Yes ❑ No
h. If discharge is observed. did it reach Water of the State'? (Ifyes, notify DWQ) ❑ Yes ❑ No
c. I1'discharge is observed, what is the estimated flow in gal min?
d. Dues discharge bypass a lagoon system? (If yes. notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'? ❑ Yes N No
Wasle CoIIeel ion &
Treatment
4. Is storage capacity
(freeboard plus storm
storage) less than adequate? ❑ Spillway
❑ Yes ® No
Structure 1
Structure 2 Structure ; Structure 4
5[ruc:ture 5 Structure 6
Iclentilier:
Upp.0---------
--------- Lawrc.0-------- -•--•---------- -•--•--•-------------------
--------------------------- -•--•--•--•--•--•--•--•--..
Ireeboard (inches):
31
24
05/03/01
�'G��G� {� �C'nrrtirrired

Facility Number, 76-3 1
41 Date of In,pection 91
5. Are there any immediate threuts to the integrity of any of the structures observes]? (icl trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
clnsure plan'?
(if any oryuestions 4-6 was answered yes, and the situation penes an
immediate pubfic health or environmental threat, notify D%VQ)
7. Do any of the structures need maintenance/improvement?
S. Does any pan of the waste numagcment system other than waste structures require maintenartcclimprovement'?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation snarkings?
Waste'knnllcation
' s
❑ Ycs N No
❑ Yes N No
❑ Yes 19 No
❑ Yes N No
❑ Yes N No
10. Are there any buffers that need maintenancelimprovetnent? ❑ Yes N No
11. Is there evidence of over application? ❑ Fxcessive Ponding N PAN ❑ Hydraulic Overload [ N Yes ❑ No
12. Crop type Fescue (Nay) Millet (hay)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)? ❑ Yes N No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes N No
b) Does the facility need a wettable acre determination? ❑ Yes N No
c) This facility is pendcd for a wettable acre determination? ❑ Yes N No
15. Does the receiving crop need improvement'?
❑ Yes
N No
16.
is there a lack of adequate waste application equipment?
❑ Yes
N No
Required
Records & Docunivuls
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
N \c3
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
N No
20.
Is facility not in compliance with any applicable setback criteria in uffCCt at the time of design?
❑ Yes
N No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ief discharge, freeboard problems, over application)
❑ Yes
N No
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative'?
❑ Yes
N No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to yuetitiun #]: Explain any l E5 answers and/or arty recornrttendatiuns ur any either comments.
Use drawinga of facility to better explain situations. (use azlclitional pufes as necess:sryl: ❑ Field Coley N Final Notes
7. Repairs to the swine houses took good. Continue efforts to repair diversion ditch at the upper lagoon.
-4
11. Several fields were overapplied (PAN). Fescue PAN stated in the WUP is for 12 monlhes... not for each season, cutting, etc.
15. Need to control broadleaf weeds in field near lower lagoon. Several fields treed to be limed per the soil test results.
19. Don't forget to record weather conditions and initials every 120 minutes on the application forms (IRR-2) per NPDES requirements.
19. New NPDES requirements: rainbrcakcr form, sludge measurement by April 9, rainfall records, certification form by March 1,
stocking records, and mortality records.
Reviewerllnspector Name Melissa Rosebrock
Reviewerllnspector Sign ature:-JAd 7 1' �`� p _f Date:
05103101 Continued

Racilit►5 Number: Dee Inspection 1212112-003
E'
Odor I.yurs
26. D►es the discharge pipe from the con Iinement building to the storage pond or lagoon fail to discharge allor belo►v
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 lanes 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 tan(s) noted? (i.e. broken fan belts, missing or
or broken Fan blade(s), inoperable shutters, etc.)
3 L Do the animals feed storage bins Fail to have appropriate coveO
32. Do the flush tanks lack a submerged fill pipe: or a permanent/temporary cover'?
❑ Yes ❑ No
❑ Yes ONO
❑ Yes ® No
❑ Yes ® No
El Yes MNo
❑Yes ®No
❑ Yes tR No
A tt anal ommen ts and or. D ra Wl 11gs:.
Waste tinulyses:
1 1 /21 /03 - Upper = 2.1 and Lower = 1.7
9/11 /01 - Upper = 2.1 and Lower = 1.4
713/03 - Upper= 3.5 and Lower = 2.2
05103101

1, 1
Division of Ni ater Quality
Uivisirin of Sail and E►'uter COxtstri ottun,;'' t - `'-• "
"IQQtFirr Aericv'. _: ..+.�! „ �; ;�A :� i
�=
AL
Type of Visit Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit � Rouline Q Co^i pl a i r t Q Fc-ilow up ❑ Emergency Notification Other ❑ Denied Access
lute or This:
Facility.Number
Permitted 13 'ertilierl CoindifonLall►' Certified [, Registered
Farm Name: ��1 �� U
...1� Li �- .. I
Owner Name:
Alailing Address:
Time:
hwratinnal ❑ Be
Mile Last Oper:t ed or ,fib t►'e ' 'hreshold:
Count►: Q h_
w Phone No:. �.,5 6 759�
! 0 to 1 51 1 C4 C4 �
33[v . '9aq. a5-61 7�4
FacilitV contact: Title: Phone No-
on
Onsite Representatiss: lntcgratur: _ s
Certified Operator: Onerator Certification Number:
I.ocation of Farm,
P1'aU ce
iSwine ❑ Poultry ❑ Cattle ❑ Horse I.atitude • - l.iiilgitudc + ®• ®"
Design. Current
tixfnr i^ nariix• Pnnnl"fin"
❑ wcail Ilt Fccdcr
❑ Feeder to -Finish
❑ Farrow ka Wean
❑ Farrow tot Fecdcr
❑ Farrow lot Finish
❑ Gilts
❑ fioars
I)eciPn Current Design Current
Poultr►• Ca aciti' Population Cattle capacity Population
to Laver a I ❑ Dairy
❑ Non-L;r er j Non -Dairy
❑ Other
Total Design Capacity goo
Total SSLW j (p-N �D Q
No in her or Lagoons Fff.SubNurface Druins Present ❑ I_a+nnn Area ❑ S p ray Nield Arca
Holding Ponds 1 Solid 'I'rups ® ❑ ;No l.ir uid Waite Maita gemenl S►stem
Discharge; & Stream lntnstl3s
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lat;ncm ❑ Stsrav Field ❑ Other
a. if discharge is observed, was the wiwcyance man•madc?
b. If discharge is observed, did it reach Water of the State'? (if yes, notify DWQ)
c, I 1-discharge is observed, what is the estimated flow in gallmin?
d. Dues discharge bypass a lagoon syst=9 (if ycs. noli(y DWQ)
2. is there evidence oft' past discharge from any part of the operation?
3. Were there any adverse impnets or potential adverse impacts to the Waters of the State other Shan from a discharge?
Waste Collection & Treatment
4. is storage cap:ieity (freeboard plus storm storage) less than adequate? ❑ SDillWaV
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
1 dent i ficr: t
Freeboard (inches):
05103101
❑ )'es No
❑ Yes ❑ No
❑ Yes ❑ No
❑ ti'cs ❑ N��
❑ Yes �,��}
❑ Ycs X� Nil
❑ Yes 11Lf No
Structure 6
Coprriuued

w
q gr �J'
Facility Number: ? hate of lnsptelion
5. Are there any immediate threats to the integrity ofany of the structures observed? (icl trees, severe erosion, ❑' es �I`o
seepage. etc.)
6, Are there structures on -site which are not properly addressed anVor managed through a waste management or
closure plan? ❑ �'cs (o
(if any of questions 4.6 was answered yes, and the situation poses an I]]
immediate pubiiic health or enr•"ironmental threat. notify DWQy
7. Do any of the sttvcrures need maintenancefimprovemem? ❑ Y'cs .No
S. Does anv pan of the waste management system other than w'asic structures require main tenancelimpro■•ement? ❑ 1'es Lam`❑
9. Do any' stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes [No
VVaate• ll[thcatian
it?. Arc there any buffers that need maintenancelimpmyemem? �� ❑ 1'es a
11. Is there evide::2-
13.er application" - Excessive Po»ding �; PA ❑Hydraulic Overload 1'cs N❑
12. Crop type r 1 _
Do the mceivine. cF
differ with th se a g ted i the Certified Animal V� to I` ,a ement Plan (CAWNIP)? [] i'es ❑
14. aj Does the facility lack adequate acreage for land application? ❑ } is No
b) Does the faciIit■• need a ► c—,wbla acre determination? ❑ )•es do
e} This facility is pended for a wettable acre determination? ❑ Yrs No
15. Does the receiving Crop need improvement? M�.ts ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes )eNo
Re aired Records & Documents
i 7. Fail to have Certificate of Coverage & General Perini or other Permit read iiv available? ❑ Yes ko
18. Does the facility fail to have all components of the Certified An mat Waste Management Plan readily available?
(id %VUP, checklists. design. maps. etc.) / ❑ Yes No
19. Does record keeping need improvement? (ie irrigation. freeboard, waste analysis & salt 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 chute? ❑ Yes No
22. Fail to noti5c regional D« Q of emergenc}' situations as required by General Permit!
(ie' discharge, freeboard problems. over application) ❑ YesINo
o
Did Reviewer'Inspector fail to discuss revicwiir_spection with an•Siu representative? ❑ Yes
?4. Does facilit• require a follow-up visit by same agency? ❑Yeso
?5. «sere xnv additional problems noted which cause noncompliance of the Certified AU MP? ❑ Yeso
1© IN violations or deficiencies were noted during this visit. YPu w'iII receive oa further correspondence about this visit.
hy.S� _-• ... ...y :... µor L:Li7_:; •6..S:f" G's� •x:.:e�..a... �r..w.—.y[�sr_r.;w►>�.»"r •.�G-t:�l,•;=Y"s�z:••..- '+".. a;w
Ctitnments (refer to question �3j;' Eisg]am any ansRets andlur any recomment3tttions or. any other comments ,
,Final
rise dr2Oings of facil16, to Netter erp12in situations. (use additionaI pages as necessan• :I ,__ �: 37.ield�Copv' Notes
A.)
c
Re-0ewertins eetorName w
=4
Reviewer/Inspector Signature:'
Date: t -21
1 3IOI r r ti— — _ _ Continued
f

Facility Number: — Date of Inspection
[1 n ti i'•
26. hoes 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?
2T Are there :any dead animals not disposed of properly within 24 hours'?
29. 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?
X 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
El Yes o
❑ Yes o
Additional Comments and/or Drawings:
up pe,r ,/u -
cal-
a
12%

Technical Assistance Site Visit
of Soil and Water Con
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 76 - Date: l21103 Time: 13.10 Time On Farm: WSRO
Farm Name Applefield Farm -Lower & Upper County Randolph Phone:
Mailing Address 7725 Friendship Road Brown Summit NC
Onsite
Representative Robin Cox, Vincent Jessup Integrator N G Purvis Farms, Inc.
Type Of Visit
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
® Swine ❑ Poultry ❑ Cattle ❑ Horse
Purpose Of Visit
OQ Routine
O Response to DWQ/DENR referral
Q Response to DSWC/SWCD referral
O Response to complaint/local referral
Q Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current Design Current
Capacity Population Capacity Population
❑ Layer
® Feeder to Finish 12400 10800 ❑ Non -Layer I F�]
❑Wean to Feeder
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Dairy
❑ Non -Dairy
❑ Other
656-7594
27214
GENERAL QIIESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached
❑ Dairy
❑ Non -Dairy
❑ Other
656-7594
27214
GENERAL QIIESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached
❑ yes ® no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees,
❑ yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive pond ing
❑ yes ® no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment
❑ yes ® no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure?
❑ yes ® no
Structurel Structure 2 Structure 3 Structure 4
Structure 5
Identifier Upper Lower
Level (Inches) 2 $
CROP TYPES lFescutgraze Fescue -ha fillet
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

a
a
Facility Number 76 - 3 Date:
4121/03
PARAMETER
Q No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
25. Waste Plan Revision or Amendment
El
El
1D. t_evef in structural freeboard
26. Waste Plan Conditional Amendment
❑
❑
❑ 11. Level in storm storage
27. Review or Evaluate Waste Plan wlproducer
❑
❑
❑ 12. Waste structure integrity compromised
213. Forms Need [list in comment section]
El
❑
❑ 13. Waste structure needs maintenance
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
❑
❑
❑ 15. Over application < 10% or a 10 lbs.
30, 2H.0200 recertification
❑ 16. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
❑ 17. Deficient irrigation records
32. Irrigation record keeping assistance
❑
❑
❑ 18. Latelmissing waste analysis
33. Organize/computerization of records
❑
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
❑ 21. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22. Crap inconsistent with waste plan
36. Sludge removaticlosure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23, Irrigation maintenance deficiency
❑ 24. Deficient spray€ield Conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40, Marker check/calibration
®
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
Irrigation designlinstallation
❑
❑
Other...
system
Date:
Date:
44, Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45. operating improvements (pull signs, etc.)
❑
❑
11. MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
47. Evaluate WAD certificationfrechecks
❑
❑
48, Crop evaluation/recommendations
❑
❑
2
49. Drainage worklevaluation
❑
❑
50. Land shaping. subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
®
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5.
56, Operation & maintenance education
❑
❑
57, Record keeping education
❑
❑
6.
58. Croplforage management education
❑
❑
59. Soil andlor waste sampling education
❑
❑
03/ 10/03

Facility Number 76 - Date: 4 221103
TECHNICAL SPECIALIST 1B. Barton Roberson IF
SIGNATURE
Date Entered: 7/18/03
Entered By: lRocky ❑urham
03/10/03

vision of Waiter Quality
vision of Soil and Water Conservation
0 Other Agency
Type of Visit Q Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit C$ Routine 0 Complaint 0 Fallow up 0 Emergency Notification 0 Other ❑ Denied Access
Mitt. of l'i�it; ti113CL042 'I'inre•; !23{}
)Fac•ilit► Number 7� 3
171 0 ]slot Operational 0 Belo -A Threshold
® Permitted M Certified [3 Conditionally Certified C3 Registered Date Last Operated or Above Threshold:
. Count
h'urrn Name:I�RRI�,faclsl.�rar.Ixl-I,.tal�ies.&.LJp.AstC....................................................... 3" F,,A[x[1mIRht......................................... 1!',4R0........
[)caner Name: l'hilliitl.lccry........................ Fatmette/.Apple................... .. Phone No: J frf fa-7S�4................................... ........ ........................
MailingAddress: 7.725_Fr1ft"j5hiP..KQAd.............................................................................................. 2.7.2.14 ..............
Facility Contact: ...........Title:
Phone No: 336 87965..99.farm..........
Onsite Representali►e: Yuar��X.J.e ► r..l abia.GaM.....:........................................... integrator: N..�..>'t�rxis..l axzt ,.lnle....... ....................
Certified 0Peratrtr:iPlcilip..W.R.............................. Faloe"01e.11...................................... Operator Certification Number: Z[1322 .... .........................
Location of Farm: _
Hwy 220 south from CSC. Take Hwy tio east to I [wy 42 and turn right (east) towards Coleridge. Turn right onto Riverside �
Rd. Exactly 1.2 miles turn left into farm. 314 mile down the road. ];arm is at 4599 Riverside.
® Swine ❑ Poultry ❑ Cattle ❑ Horse latitude 35 ' 37 1$ Longitude 79 • 36 5S
Design Current
Swine C'anacity Pnnrrlation
❑ Wean to Feeder
® Feeder to Finish
12400
10800
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Po ulation Cattle Capacity Population
❑ Layer ❑Dairy
❑ Nan -Layer ❑ Non -Dairy,
❑ Other
Total.Design Capacity 12,400
Total SSLW 1,674,000
Number of Lagoons 10 Subsurface Drains Present ❑ Lagwin Area IN Spray Field Area
Holding Ponds 1 Solid Traps {} ❑ No Liquid Waste Management System
Dischames & Stream Inmact
1. Is any discharge observed from any part of the operation? [:]Yes ® No
Discharge originated as: []Lagoon ❑ Spray Field ❑ Other
a. ll'discharge is observed. was the con%eyance man-made! ❑ Yes ❑ No
h. li' discharge is ubserv0. did it reach W-wer (if she State:' 01 ►•es, notify DWQ) ❑Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min'?
cl. Does discharge bypass a lagoon s}'slenl:' (ll'yes, 11,1ify 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
11a%l Cullt-ction c\ Tryotinyist
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure I Ssruclurc 2 Structure 3 Structure 4 Structure 5 Structure h
Identifier: Upper...................... Luwer.... .......... ........... ............. ............ ................... .... ......................................................................
I-rcehoatrd (inches): 39 42
05103101 Continued
p� y

Facility Number: 76-3 1 0 13str Of Inspecli+rn 8113/2002 1 0
5_ Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
WaSlK.A 11p14r:-1 ion
10. Are there any buffers that need maintenance/improvement?
1 1. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Fescue (Hay) Pearl Millet (Hay)
❑ Yes
9 No
❑ Yes
® No
® Yes
❑ No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management I'lan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage For land application? ❑ Yes ® No
h) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes Im Nn
15_ Does the receiving crop need improvement'?
16. Is there a lack of adequate waste application equipment?
Tired_Rccords_&-Documews
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
00 WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (iei irrigation, freeboard, waste analysis & soil sample reports)
20. 1s Facility not in compliance with any applicable setback criteria in effect at the time of design?
2 L 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?
Cl Yes CK No
❑ Yes N No
❑Yc% ❑No
Cl Yes ® No
❑ Yes ® No
❑ Yes X No
❑ Ye; 9140
❑ Yc'; ® No
❑ Yes N No
❑ Yes ® No
❑ Yes ® No
❑ No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Cn��m�nnts [rquestinn #}; Explain any YES answers and/or Any recommendations nr any other comments.
Use drawings of.facility to better explain situations. (use additional paf;ea as necessary); ❑ Field Copy ® Final Notes
7. Erosion on upper lagoon dam to be repaired soon. Continue efforts to control vegetation on upper dam. A few small woody trees have_
started growing on the dam.
15. Field F-5 and some other fields need to be limed per 2002 soil test results.
19. Steil results for 20D1 to be faxes! to DWQ, since they were not available for 2001 inspection and weren't onsite today_
Waste sample results: 212102 Upper =1.9 Lower =4.1, 5/20102 Upper =4.3 Lower =4.1, 8112/02 Upper =5.2 Lower 5.0 lbs N/ l (Xlt)
Reviewer/Inspector Name Melissp Rosehrock
Reviewer/Inspector Signature: tr t Date: 13 Cta-
0.1/03/01
Continued
,A

l: acOity Number: ^ 76.3 1? ,i' 1 n.prrt i,rn0
811312[1[F2
[ hlor 1,hues
26. Does the discharge pipe from the confinement building it) 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?
29. Is there any evidence of wind drift during land application'? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover'?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
[]Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
A, 1
0510310 1
J

l
Division of Water Quality
Division of Soil and Water Conservation
Q Other Agency
Type of Visit �k Compliance Inspection Q Operation Review 0 Lagoon Evaluation
Reason for Visit � Routine O Complaint Q Follow up 0 Emergency Notification Q Other ❑ Denied Access
Date nt %,isit:
i EfE
l acilih Number
❑ Permitted Certified ❑ Conditionali►• Certified ❑ Registered
n t I� , h r`
Farm,Name: fI
Os►ner N ame:
Mailinb Address:
Facility Contact: T
Onsite Representative:
Certified Operator:
Location of Farm:
u.�6
Yrvi
M-071C
2wo
Swine ❑ Poultry v ❑ Cattle ❑ Horse Latitude
Design Current
3"AlIc "a acin• ro utatton
Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Date Last Operated or Above Threshold:
Count.•: _^1�C-an f ph YAA�6
Phone,No: s1 �Y''_�S(,o• 7,9-f[]
rotsN 5Ucow' I _ 7,2��
Phone No:
Integrator•
ry� �currnS arm
Operator Certification Number. ___ 0
,Zml
Longitude [!M'
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver ❑ Dairy
❑ Iron -Laver 10 Iron -Dairy
❑ Qther
Total Design Capacity
Total SSLW
Number of Lagoons © ❑ Subsurface Drains Present 110 Lagoon Area JEI 5 ra►• Field Area
Holding Ponds 1 Solid Traps ® ❑ No Liquid NVaste Mana ement Svstem
❑ischarges R Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. I I discharge is obsmed, was the conveyance man-made?
b, if discharge is observed. did it reach Water of the State? (If yes, notify DWQ)
c. I f discharge is observed, what is the estimated flow in gal/min`?
d. Does discharge bypass a lagoon system'? (If ycs, notify D%VQ)
?. Is there evidence of past discharge from an• pan 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 S Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? XsPillway
Structure 1 Structure ? Structure 3 Structure 4 Structure
Identifier: owe 1r
Freeboard (inches):
09103101
❑ Yes , rNo
El Yes ❑No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ,N-No
❑ Yes .VN,
❑ Yes', Vo
Structure G
Continued

Faciiiri Number:-71,— Date of Inspection �.
5. Are there any immediate threats to the integrity of any of the s-xuctures observed" (ie/ trees, severe erosion. ❑ Yes �n
seepage, err.)
6. Are there structures on -site which are not properly addressed andror managed through a waste management or
closure plan' ❑ Yes Yo
(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 maintenaneeiimprovement? �<Ycs ❑ No
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes
w c t e A 2pliCAlion
10, Are there any buffers that need maintenancelimpro.•ement? ❑ Yes NrNlo
11. Is there evidence of over application? n ElExcessive Ponding ElPAN ❑ Hvdraulic Overload ❑ Yes 1�'0
13. Crop type
13. Do the receiving Yops differ with those de(gnatedin the Certified Animal 'Aaste Management Van (CAWMP)?
❑ Yes
o
14,
a) Does the facility lack adequate acreage for land application?
ElYes
a
b) Does the facility need a wettable acre determination?
❑ Yes
J5�No
c) This facility is pended for a wettable acre determination?
❑ Yes
_3 ?$4o
15.
Does the receiving crop need impr0vement!
❑ Yes
All�o
16.
is there a lack of adequate waste application equipment?
❑ Yes
'D�Ni
_g1lited
Records &_Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oel WUP. checklists, design. maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (iel 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
Nu
31.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
92.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23.
Did Review•erlInspector fail to discuss review/inspection with on-sitC representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes1Vo
25.
were any additional problems noted which cause noncompliance of the Certified A%%'MP?
❑ )'es
No
No violations or deficiencies *ere noted during this visit. You witl receive no further correspondence about this visit.
Comments krefer to question #): Explain any M answers andier any recanunene dations or anv other comments.
Use drawings offstrillity to better explain situations. (use additional pages as nceessary): Field CnPv ~❑ Final notes
i� P�
wi► �/� � CQ !od
Reviewer/Inspector Name -
Review'erllnspector Signature: Date: M3L
05103101 Continued

Faeil':t, tiumkrer: — ' Bate of lnslarcti+on
10
Lidu i,-%ues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or bclov
liquid level of lagoon or storage pond with no agitation"
27. Are there any dead animals not disposcd of properly within =4 hours?
IM is ti,ere anr• e■•idenee of wind drift during Sand application" i i.e. residue on neighboring ►egetation. asphalt.
roads, building structure. andlor public property)
24. Is the land application spray system intake not located near me 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). inoperahle shutters. etc.} y
31. 0o the animals feed storage bins fait to have appropriate cove
32, Do the flush tanks lack a suhmcr��cd till pipe or a pcnnanent;tcmpnrary Corer?
AddRion •aI Comn►ent�- and/or Draw ino,
❑ Yes No
❑ Yes o
El Yes 1io
AVAd 7
. �k
O'ed `t9 b0q)
aco
19, gl�alo2 (,TLAy2- 00 2� UPPv-� S a Lawp-r 5-
low
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voaL-Y- I. 1 coin� I/ I
05103107

-XTorth Carolina
•bepartment of Environment and Natural
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Charles H. Gardner, P.G., P.E., Director
and State Geologist
March 12, 2002
Applefield Farms
Attention: Phillip Faucette
7725 Friendship Church Rd.
Brown Sununit, NC 27214
r7r
e 10A
NCDENR ~'
WINSTON-SALEM REGIONAl-OFFICE
- DMSION OF LAND RESOURCES
NOTICE OF INSPECTION
IZE: APPLEFIELD DAM LAGOON
RANDO-192, Randolph County
Dear lair. Faucette_
The "Dam Safety Law of 1967," as amended, provided for the certification and inspection of dams
in the interest of public health, safety, and welfare, in order to reduce the risk of failure of such
darns; to prevent injuries to persons. damage to property; and to insure the maintenance of stream
flows.
Our records indicate you are the owner of the referenced dam which was inspected on March 5,
2002, by personnel of the Land Quality Section. This inspection found the conditions outlined
below. Please note that references to "right" and "left in descriptions of the dam structure are
conventionally from the perspective of looking in a downstream direction.
1. Erosion is occurring on the downstream slope of the dam and in both abutments. Erosion is
usually progressive in nature and if allowed to continue may even erode into the dam itself.
Therefore, we recommend that the eroded area be repaired and a good grass cover be
establislied to prevent further erosion.
2_ An area of depression was found on the downstream slope of the dam, near the left abutment.
This depression should be investigated further; and repaired,
585 Waughtmvn Street, 11'insten-Saiem, North Carolina 27107-2241
Phone:[phone] ` FAX:[phone] \ Internet; state.ne.Us/ENR/
AN EQUAL OPPORTUNr Y \ AFFIRMATIVE ACTION EMPLOYER - 50% ItECYCLED / 10% POST CONSUMER PAPER

r
APPLEFIELD DAM LAGOON
h1ARCH 12, 2002
Page 3
During this inspection we also investigated the potential for property damage and loss of life in the
event your dam fails. This investigation determined that failure of your dam could result in
significant property damage downstream. Therefore, we are listing your dam in the "Intermediate
Hazard" category.
Any excavation, modification or major repair of the darn must be approved by the Division of Land
Resources. Draining the lake by cutting a notch in the dam. or otherwise breaching the dam, without
prior approval, is a violation of State law.
Although we make every reasonable effort to determine the safety of your dam, our resources limit
us to a visual inspection. There is no certainty regarding the internal stability of the dann. Dams,
and especially their spillways and conduits deteriorate with age. Therefore, you should keep a close
watch on your dam and notify us if you detect any changes, especially cracks, ground movements,
or changes in seepage rate or color.
Your cooperation and consideration in maintaining a sate dam is appreciated. If ownership of the
dam has changed, or if you are not responsible for the dam, please notify us so that we can update
our records. Should you have any questions concerning our inspection, please contact me or Jason
Watkins at [phone].
Sincerely,
C. Scott Sink, arr,
Assistant Regional Engineer
CSSIIs
cc: WSRQ file

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SKE7Z H5610D1I MEKTS

ivisioll of "Watei Qualily,
or
F: ivisial' of Soil and Water Conservation _ 4
f ` . t, .. 'h 0 Other Agcrrcy : � � C � t �? � �. �`�•,•,�;'4
F r ., �iy L
.'.r ti. .. .. _ •} � t rr, tro..�.l . �•S 4-�s-'�ill"�A � r-.
DEC
Type of Visit 0 Compliance inspection ARperation Review D Lagoon Evaivafion 1.
— 7 I
001
Reason for Visit XRoutine O Complaint Q Follow up Q Emergency Notification Q Other ❑ Denied Access
t-.:�1t,.:II
tlzte of Visit: t3 ilm �'-G S Prinir•rl +3n: 1W&2000
EFacility Number I rrr•ra
❑ Not f? lr rtili ,n: 1 -❑ Below Threshold
19 Permilled CL,Certifted © Conditionally Certified [3 Regisfercd Date bast Uperaled or- Ab jove Threshold : .........................
Farm Name: ..... �`.R.��..`.. �'.�'T�.....`��' ..... Couniv; ......!`.!�� �0„1.k]..�..............................................
()►sner Name: _..... } `" °......
TF+.!'r'`' t........ U f ... . � ............ 11honc No: ,...'�� 6......... T.7............spa.. Facility Contact: ....:L ..........................'f itle:...,.,.......................................................... I'llone,No.........................................,,,..,,....
'i „`
ailing ,address: ,...`�7�. �''i�.....�, L.SlkL.o....�..�.............................�3-�..,,.�':�. N�-.......Z..7,. u.�...................................
1
On%ite Repr'esentati►e .�!.� ��wC.t..... .�� �,1-. OIL Integrator: .......11[..[7..pm.fq!�....�"�!"�'�.....................
i.
C;er-fitied Operator-:.......`�K............................ ► .G r .n,,r ...........,,.............. Operator Certification tiumber......Z.... .....T.....,,..........
Location of Farm:
1 •Itil ,.,,... .�
swine El Poultry [I Cattle ❑ Horse urlc Lc �• -.3-7 I.nagitude 7 jr • 3L ®°'
Design Current
Swine Capacity Population
❑ Wean to Fecdcr
jx Feeder to Finish
z jao
jvbf7
❑ Farrow to Wcon
❑ Furrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ So"["
Design Current Design Current
l'oultt'y Ca aacil • Population Cattle Capacity Population
❑ Layer Ron-1)-airy
airy
❑ Noo-Layer
❑ Other
Total Design Capacity Z �0
Total SSLW
Number of Lagoons ❑ Subsurface Draius 1'resenl ❑ Lagoon Are:, JE1 Spr:,y Field Arc•:,
Holding Ponds /Solid Traps U ❑ iin Liquid Waste ManagemenI Sy:stenl
Dischar & Stream Iniyacts
1. Is any discharge observed from any part of the operation?
IJiscltalrgr oril;insrtcrf at: ❑ Lagoon ❑ Spray Ficld []Other
a. If discharge is observed, ►vas the conveyance man-nladr"
h, if tfixwhargc is ohticrved. dirt it reach Water of the State? (if yes, notify DWQ)
c. If disc:harve is observer], what iti the esiilnawd flow in gailrnin'?
d, Does discharge hypass :i lagoon system? (il•yes, notlly DWQ)
2. Is then: evidence of past dischargc from any part of the operation's
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than Irmo a discharge?
Waste Colledion & 'i'rcatnutrt
4- Is storage capacivy (srecholyd plus storm ,,wrage) Icss than adeyunle? ❑ spill►v,►r
SH Ulariru I SII lb"Ril Z SIMCILII-U .; 'itruclure 1. StruCtu V 5
ldctuifiet: ...fAJ �._....c 4r 41--t G`�''..... _..........
........ .......
....------........--------....................-----............
Frcchr>irr(l finches): >Y`` I'D tv
5/00 L 1 (tea? L, [�v.•�
❑ Yes 9No
❑ Yes ❑ No
El Yes ❑No
❑ Yes AM,
❑ Yes DjNo
❑ YC% ❑ No
51ructurc 6
f;o+trrriurd net hack

Facility Number:76 - 03 I)„ tc nl' IIvgwctigIn ���/ I� Printer/ on:
5. Are there any immediate threats to thco-grity of any of the structures observed'??'((iiee// tr�ti. severe erasion,
seepage, etc.)
6. Are there structures ern -sire which are riot properly addressed and/or managed through a waste tnanageFile nt or
closure plan?
(If any of questions 4•6 was answered yes, and the situation poses an
imntediate public health or environinental threat, notify DWQ)
7. Do any of the structures need maintertttncelirrlprovemo;nt?
10/26/200❑
H. Does any part of the waste management systein other than waste structures require tnaintenancelirnprnvement?
]. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes R[ Net
❑ Teti LCf No
Yes ❑ No
❑ Yes V No
elevation markings? -t- ❑ Yes 1XNo
MWe Arinlication "-A nrft
10. Are there any buffers that need maintenancehinprovcment?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ ["AN ❑ Hydraulic Overload
12, Crop type
13. Do the receiving craps differ with those designated in the Certified Anitnal Waste Management Plan (CAWMP)?
14, a) Does the facility lack adequate acreage for land application?
h) Dees the facility need a wettahie acre determination?
c) This facility is pended fora wettable acre delennination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Hymni-ed Records & l tocnnivals
17. FUiI to have CCCtrficate of Coverage & Geneial Permit readily available'?
❑ Yes Uk No
❑ Yes Z No
❑ Yes VK No
❑ Yes 14 No
❑ Ycs ❑ Nt�
[:]Yes [] No
[]Yes [XNo
❑ Yes L] No
Q Ye, V% No
19. Dues the facility fail to have it]] components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, clzccklis(,, design, snaps. etc.) ❑ Yes IX No
19. Dues record keeping need improve ment? (ic/ irrigation, freeboard, waste analysis & sail sample reports) <,K vji{c, -RE] Y es ® No
20. Is facility not in consphance with any applicable setback criteria in effect at the titno of design" ❑ A is'-ti
21. Did the facility fail to have a actively certified operator in Charge? ❑ 1`es J'No
22. Fail to notify regional DWQ of emergency situations as required by General I'Vininit`!
(iel discharge, freeboard problems, over application) ❑ 4'cs [�dNo
21, Did Reviewer/Inspectow fail to discuss reviewlinspcetion with on -site representative? ❑ Yes No
24. Dotes facility require a follow-up visit by same agency? IV Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 4 No
a vi,plati9ps:or. 0t irieiejvpj this'vjsit:-Ytiu Wei! -receive iiq fui-fte
'Co deh ' e' ab' k thiLS ;visit
C66- erits (refer to question p): Explain any YES answers ttridlar any recommendations ttir any nttier,�niniinents: << " .i �i
616~ drj*ings of facility to better explain situations. (use additional pages us necessary): " <
r1 er { k a r .w ..- .. qJ�-% y tn.•w a
Reviewer/Irnspeetor Nanrc
?Ifit?
Reviewer/Inspector Signature: _ (late: � /

Facility Number: 7 Q 'Q of l►rvrt:ti=+n 0 i'rinte(I on: 10126/2000
tv
26,
1N)cs the discharge pipe from tfrc confinernettt 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 ani pals not disposed of properly within 24 hours?
❑ Yes
11
P,
28.
is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
`-1 ''cr
reads, building structure, and/or public property)
29.
is the land application spray symern intake not located near (tic tiyuid surface of the lagoon?
❑ Yes
VN0
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blades), inoperable shutters, ctc.)
❑ Yes
NiVo
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
32.
Do the flush tanks luck a submerged fill pipe or a permanent/temporary rover?
r] Yes
FNo
Additional.Comments and/orDrawings:
_SM
_SM

• i ""ion of Water Quality 9
vision of Soil and Water Conservation
Cher Agency
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation I
IReason for Visit 0 Routine 0 Complaint Q Follow up ❑ Emergency Notification O Other ❑ Denied Access
1}atc of Vi"il: 11R1RIlill Time: fl'1211
Facility' Number 43
Q -Not-operational Q Below Threshold
® Permitted ® Certified [3.Conditionally Certified 17 Registered Date [.ast Operated or Abrme'1'hreshold:-- ..............
Farm Name: ........................ .. County: Rotidaluht..... ................................... . MR, Q........
Owner Name: P illiFl.Ic:uY........................ Fauc te/.ElAR1c....................................... phone No: RkC:bib.-15S4....................................... ....... .......
......
Mailing; Address: 7...725..k:dwdshiw..Roa►d...................................................................... B rown.Summi,t...N.C...............................---......... 2.7.2.1.4............ --
Facility Contact: 1'.t�ill'ip.iE�tu�t xttil4ofxn .4 i axd�tt lr............. Title:
Onsite Representative: bbla.Gax:dx gr...............................................
Phone No: ..33.Ct,.}i79&5.V.11..kA rxtx..........
Integrator:
Certified Operator-. J.9blukalhomy.................... Ga r.dAter........................................... Operator Certification Number: ZOO .............................
I.ocation of Farm:
Ffwy 220 south from GSO. Take IIwy 64 east to Hwy 42 and turn right (east). Take right onto Riverside Drive. Exactly 1.2 +
miles turn left into farm (should be a N.G. Purvis sign) 314 mile down the road. Farm is at 4599 Riverside. �
® Swine ❑ Poultry ❑ Cattle ❑ Horse I,atitudc 35 • 37 i5 longitude 79 `F-T6 7. F 55
Design Current
Swine CaDacity Population
0 Wean to Feeder
® feeder to Finish
12400
9550
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
I
I
❑ Boars
EE1
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I Non -Dairy
❑ Other
Total ❑esign Capacity 12,400
Total SSLW 1,674,040
Number of Lagoons 2 1[1 Subsurface Drains Present 110 f.agwm Area IN Spray Field ,area
[folding Ponds 1 Solid Traps ll ❑ No Liquid Waste Management System
Dischsar= & Stream
1. Is any discharge observed from any part of the operation'? ❑ Yes ® No
)discharge originated at: ❑ I.aboon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance roan -made'! ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State'! (If yes. notify iJWQ) ❑ Yes ❑ No
c. lifdischarge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation'? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'? ❑ Yes ® No
Wasie Collytion X Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Stricture 6
Identifier: .........., Upper. ..... . ... ........... Lawer......... ............... ....:..........
Frcelxrard (inches)':- 36 42 t
1IS/0.3/01 - `Continued

Facility Number: 76-03 0 Dale of 111.4pvcIiu11 1112112{I[ll
5. Are there ativ immediate threats to the integrity of any of the structures ohsened? tie/ tree. "vere erosion.
seepage, etc.)
6. Are there structures on -site which are no( properly addressed and/or managed through a waste management or
Cli7tiatrC plan?
(If any of questions 4-6 ►+'as 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 marker.: with required maximum and minimurn liquid level
elevation markings?
►'4`asle_ A pplit; action
10. Are there any buffers that need maintenanccrimpmvement?
11. Is there evidence of over application? ❑ Excesiive Ponding ❑ PAN ❑ Hydraulic OVVIO11d
12. Crop type Fescue hay w/ winter wheat
❑ 1'e.;
N ti,�
® Yes
❑ No
❑ Yes
® No
® Yes
❑ No
❑ Yes
® No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes N 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 crap need irnpro ement?
lb. Is there a lack of adequate waste application equipment?
Required 8ccords & Documents
17. fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available:'
(iel WUP. checklists, design, maps, etc.)
19. Does record keeping need improvement? (iel irrigation. freeboard, waste analysis & sail sample repc)rt,)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
2l. Did the facility fail to have a actively Certified operator in charge?
22. Fail it) notify regional DWQ of emergency situations as required by General Permit?
Oc/ discharge, freeboard problems, over application)
23. raid Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency''
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes. KNo
❑Yes NNo
❑ Yes ® No
Cl Ycti ER No
® Yes Q No
❑ Yes ® No
❑ Yes ® 'oaf]
❑ Ycr, ® No
❑ Ye% ® No
[]Yes No
❑ Yes Dg No
❑ No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ComTile nts (refer to question #): Explain any YI;S answers andMr anv recommendations or any other comments.
Use dratvaings of facility to better explain situations. (use additional pages us necessary): ❑Field Copy ®Final Notes
7. Need tU mow/spray the few woody vegetation that has started on the dam of the upper lagoon.
9. Marker on upper lagoon does not look accurate. Call SWCD for assistance in determining max., rnin., and top of darn for marker.
May also want to check the lower lagoon marker as well.
15. No lack of equipment, but the suction hoses for the primers of both pumps are dry -rotted and need I be replaced. The rubber gaskc(
n the outlet need sto also be replaced. Should NUM pump out of the weather or cover when not in use.
Reviewerllnspector Name IVlel'ssu Rosebroc[c
/Reviewer/Inspector Signature []ate:
0.1/03/01 1 Continued

Facility Number- - - 76-113 lol' lnsperlinn l 11Z1121141
[ doff Issu
26, Does the discharge pipe frorn 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 systern 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 pertnanem/tetnporary cover?
❑ Yes ❑ No
❑ Yes ® No
[]Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes [:]No
r itional Comnicrits and/orDrawings:
14. Irrigation design is by Larry Graham (PE) and is dated 912198. +
19. Soil results have been received but were not with records. Need to check for these on next visit. Nate that all records are to be
available at time of inspection.
19. Per Robin Cox, waste analyses were were taken but were not readable. She wrote "by hand" the following, information.
7/ 17/ 1 l N=4.9 Ibs./l ON) upper and 3.8 ]bs./ ] U[]ti lower
10/3l!{11 N=3,1 lbs,/lM upper and 3.4 lbs./1000 lower
These records are to be re -printed and included with records.
19. Suggest punting heading on each IRR l and 2 form. Label records as fescue "hay" to be more specific. Label IRK forms with
lagoon description (i,e upper, lower). Suggest tabbing CAWNIP book for ease of review.
il

c C,
h' ivision of Water
Q
*ivision of Soil and Water Conservation,
i •'xf a
.1 ''• r 0 Other Agency s•. N, -. o,:.,.
of I
Type of Visit Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit )6 Routine D Complaint Q Follow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit: -r"�rt 'rime:
Q Nnt O erational � Below Threshold
Permitted Certified [3? Conditionally Certified © Registered Date bast Operated or Above Threshold:
Farm Name: .......Farm,. h� d ,
.............................................. County: ...L.`.�............ .�. .�................•.......I...........
Owner Namc:.........�� �11.1 .. Q VGP. ....... r`.1 fT .P. � ............. Phone No:.....4........ :.1.5. . Far ].............................
FacilityContact: ........�.���..�. I.: ...... ...Title:................................................................ Phone No:......................................... ....
�a n Ctnv
cola n Su a i
MailingAddress: ....... .......�Z....... ...t�.......�fkl.":Y.7t'.�..1'1...1�......�.:.�..... 5.... ........�.��.................................. ..........................
7Si � �G1
scan...(I&r, .n �.�n,.�f .r...Fr ....... .... >; �......., .��5.....
Onsite Representative: ,,, Inte rator• [1 r ...........................
. a�t l e
Certified Operator:.. 1��.�.....� .........�(��,��Q... � ........................... Operator Certification Number:....�t...........
Location of Farm: doh v) rvr44100 6xx r4y142A—
o a5t}L� r,0j ESQ, 6 -4s rp � r5``�4� Qa �n�]I' w
b f� l 1660,V5 i d e r, - Urr) [ �'� i 1746 fa rM III f n�{'I le-51
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �'' ©'° Longitude' ®� �
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Capacity Population
❑ Wean to Feeder
❑ Layer
❑ Dairy
Feeder to Finish
1 2
$Q
10 Non -Layer
I
JE1
Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
JEI Other
❑ Farrow to Finish
Total Design Capacity
11,40
❑ Gilts
❑ soars
Total SSLW
1 t 6 -7 ❑0O
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System
Discharaes & Stream 1mpacGti
r� 1. Is any discharge observed from any part of the operation?
•r
0 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)
❑ Yes VNo
❑ Yes ❑ No
❑ Yes [:]No
c. If discharge is observed. what is the estimated flow in gallrnin?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'? ❑ Yes -No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? 4spillway ❑ Yes 5N0
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure b
identifier: ... .p.p:�..................... L .....................................................................................................................................
�[
Freeboard (incites): Uo �{
SIUO Continued on back

facility -Number: — 3 Date of inspection ►j 7�
5. Are there any immediate threats to the tity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑Yes
�,'No
(If any of questions 4-G was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancclimprovement?
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
*o
It. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
No
1 '
12. Crop type
13. Do the receiving tops differ with those 6esignafted in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
%
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
A*! rNo
1
16. Is there a lack of adequate waste application equipment?
❑ Yes
K No
r
I
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
0fNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan Tea fly available?
WUP, design,
❑ Yes
V4o
(ie/ checklists, snaps, etc.) � /
19. Does record keeping need improvement? (ie/ irri ation, 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
ONo
21. Did the facility fail to have a actively certified operator in charge? ,.dQ.yc�
❑ Yes
)KI No
22, Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
M No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? b4 /o _�r
❑ Yes
VNn
24. Does facility require a follow-up visit by same agency? ^' 4- ��
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
R11p
YiA1a tQtls.�l d fcle�ctes ►v re lrt0te�1 d t°ir}g it}s:V,jspt� Yvp wi11 see0iye 40 Furs r :
corres oridenCe. about: this Yisit.'
1,
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): ''
T 6U�/
Reviewer/Inspector Name
Reviewer/lnspector Signal
r�r
Date: 11 I -;Z l I I 5/00

Facility Number: of inspection ri
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below —t-vr& n 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 XNo
28. Is there any evidence of wind drift during land application'? (i.e. residue on neighboring vegetation, asphalt. ❑ Yes
roads, building structure, and/or public property)�<No
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 biade(s), inoperable shutters, etc,) ❑ Yes tj-No
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the Bush tanks lack a submerged fill pipe or a permanent/temporary cover? ,
Additional Commen s an�1� 1
r 0,61
• e •�= rb •. • ��• A1�1■
r " %' I% , / PtA�tt-j , r ' /
r. .� 'r�r�•r��►' 1 �'�u►. wrrr: �rs�%/ rrrrjir � � � r..: � . � .� k
►% r' i � r r► / I
*6 +
L
f
kpf-L
U`0t
5100

NORTH CAROLINA
DEPARTMENT OF
ENVIRONMENT AND
NATURAL RESOURCES
FAX TRANSMITTAL
Water Quality Section
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, N.C. 27107
Phone: [phone]
11,a :
Fax: [phone]
t:AX NUMBER: 3 366 5� ��
t=l2OM:
DATE:
-3i 6 1b a -
Number of page~ (including cover page): l
COMMENTS:
NJ/
I
Q� t
�;6 s_e
l
d

'.: A ,
1
wry• �~}` _` Li ��-��•r���� � r'� `� �-~��{kF +'

If-
wg-
.
Ir
4
I

0
•

ision of Water (duality
( ision of Soil and Water Conservation
❑ Other Agency
Type of Visit *Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit 0 Routine Q Complaint © Follow up 0 Emergency Notification D Other ❑ Denied Access
llatr of Visit:1i3112441 '1'inu•; ilcJ34
Facility ~lumber 76 03
F07, t t] erational Q mow Threshold
® Permitted ® Certified [] Gmditionaliv Certified [3 Registered I}.ite bast Operated or Ahove'1'hretiherld:
Farm Name: G...Uplpvx...... ....... - ......................................... County: Rj4ndojpkt......................... ................. J.V�i RO.......
Owner Name: JPhAlIWI..IqX-,ry........................ E4119. IXt;IApP,19....................................... Phone No: 13.6,165b-759.4............. ....... ..........
.............................
Facility Contact: Fb AYAwc(tt...................................................Title:............................................................... Phone No: D6.1.2%65..09...... .................
Mailing Address: 77.S.k.t le�lldxhlR.u;Ad.... ............................................ VD4..............
[}nsile Hepresentati►e:.1j1t1.SaXldutrK............................................................................ Intet;rator:N.G.Fux�:i.k aria►�..in�........... .............
Certified Operator: i'UI. E.a.a .11C......................
Location of Farm:
Operator Certification Number:
From NC 22 in Coleridge take NC 42 west l mile onto 42, turn left an Riverside Drive. Exactly 1.2 miles - turn left into the �
'arm (should be a N.G. Purvis or Hal; Slats sign) 3/4 mile down the road.
® Swine ❑ Poultry ❑ Cattle ❑ Horse latitude 35 37 15 t--- longitude
Design Current
Shine C"anarit❑ t'nnnlatinn
❑ Wean to I"ceder
® Feeder to Finish
12400
10450
❑ Farrow to Weak
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Sears
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
El[.aycrT. ❑Dairy I I E]
❑ Non -Layer I I ID Non -Dairy
Other
'Dotal Uesign Capacity 12,40
Total SSI'W 1,674,00
Number of Lagoons JOSubsurface Drains Present ❑ I.at;uan Area IS Spray Field Area
llolding Ponds 1 Solid'rraps 10 No Liquid Was(c Management Sr'stcm
Discharges �& Stream lnt acts
1. Is any discharge ahservcd from any part of the operation? ❑ Yes ® No
17isch,trge nrif+inareci at; ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the conveyance man-made:' ❑ Yes ❑ No
b. Ii' discharge is observed. did it reach Water of the State? (If yes, notify DWOi ❑ Yes ❑ No
c. if discharge is observed, what is the estimated flow in -,alhnin?
d. Dees discharge bypass a lagoon system? (il' yes. notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge frorn any part of the operation?
® Yes -❑ Nn
3. Were there any adverse impacts or potential adverse impacts to the Wdrters of the State other than from a discharge? ❑ Yes ®No
w _ ❑r�r�r�oi _ - — - - Conlinued-

racili[y Number: 76-03 Date (it' ln.pertioll 11.3112001
1� f as(c Q)Ilectiqn & ' Cyfltmj:1)t
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Strru:ture 5
Identifier: ............ U.ppc[... ........ .... _l.1B.&I-..... --- --
Freeboard(inches): ...............�........ ........ ... ............. 36............... ._.... -........... _.... ........ ............... ........... ...... _ ......... ..... - .... _
5. Are there any immediate threats to the integrity of any ot'the structures observed? (ic/ Irees. severe erosion.
seepage. etc.)
6. Are there structures on -site which are not properly addressed andlor managed throigh a waste management or
closure plan'?
(If any of (luestions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Deg any of the structures need maintenancelimprovcment?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuclures lack adequate. gauged markers with required maximum and tninimum liquid levee
elevation markings'?
N'a5te A-pnlie11W( t1
10. Are there any buffers that need maintenance/improvement?
1 I. Is there evidence of over application? ❑ I?xcessive Panding ❑ PAN ❑ Hydraulic Overload
12. Crop type Fescue (Huy) Millct Wheat
❑ Yes ❑ No
Structure 0
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes N No
❑ Yes N No
❑ Yes ® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes IN No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Dries 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?
16. Is there u lack of adequate waste application equipment'?
17. Are rock outcrops present?
❑ Yes N No
❑ Yes ® No
❑ Yes N No
18. is there a water supply well within 250 feet of the sprayfield boundary'? N Unknown ❑ Yes N No
❑ ❑n-site ❑ Off --site
Restuired Rec-or_ds-&_Doculuots
19. bail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes N No
20. Does the facility fail to have all components of the Certified Animal Waste Maringement Plan readily available?
(eel WUP, checklists, design, maps, etc.) ❑ Yes N No
21. Does record keeping need improvement? (ie1 irrigation, freeboard. waste analysis & soil sample reports) ❑ Yes ® No
22. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ® No
23. Did the facility fail to have a actively certified operator in charge'? ❑ Yes N No
24. Fail to notify regional DWQ of emergency situations as required by General Permit'!
(icl discharge. freeboard problems. over application)
25. Did Reviewerllnspector fail to discuss review/inspection with on -site representative?
26. Does facility require a follow-up visit by same agency'?
2T Were any additional problems noted which cause noncompliance of the Certified AWMP?
_odor Issu s
29. 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?
❑ Yeti Ili
❑ Yes No
❑ Yes ® No
❑ Yes N No
❑ Yes ®.No_,.._��
--- 29. Are there any dead animals not disposed of properly within 24 htlurs? T ❑ Yes--® No -
1111011111Currlirru�d---

.� Facility Number: I6-03 D• of lnsprc•tion 113112i1[ll
0
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
reads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon'?
32. Were any major maintenance problems with the ventilation fans) noted`? (i.e. broken fan beats, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover'?
I'rinled nn: 1/31/2001
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence shout this visit.
❑ Field Copy ® Final Notes
42. and 47. Continue efforts to fix leaks around houses as they occur. Repairs look good and were made prmptly. Holes in dams have
been repaired and trees cut where needed.
�9. Markers loos: good and meet requirements.
�l 1. Millet bales have been removed from field.
421. Weekly frecbourd is being kept. I will send form to help with recordkeeping. Acreage discrepancies have been corrected.
Q3. Left operator form for Mr. Faucctte to complete.
�34. Not a problem.
John Gardner, Jr.
4754 Log Cabin Rd.
Ramseur, NC 27316
Review•erllnspector Name Alelissa Rosebrock
Revieherllnspector Signature: '-!d/�� 4,/4-d,4 I�J,� 1p ��,..�7 2 _ Date:- - �JI .
1111011111

l r
' vision of Water Quality `
,*vision of Soil and Water Conservation IL IR
Q Other Agenc►'
Type of Visit OQ Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit & Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Da IV of Visit: 1 lIJ2{}t}0 Thole. I}9$5 Printed on: 11I1i12000
7fi 113
Q7r � 7 T_Mperational 0 BelowThreshold
® Permitted ® Certified 0 Conditionally Certified 0 Registered !late [.ast Operated or Altn►'e Threshold: .......................
Farm Name:satritlet"t�l�i.k�trnttrl�ur+ie�. ..4]ppt �....................... ..... Count)': ki;antdulRh�.......... E1'�,k 0........
...........................
Owner Name: l.' ilip(Juir):........................ LAur.CXis/Appl.e............................ Phone No::���i-�i��.:.I.Sk F.....k ara:.3����7.��fiSUR.............
Facilit►' Contact. i'.bAlipl.'a ;cl.lk.................... S iZ l
Title:................................................................ l'hririe Nit �f ll..�Ll, ,..,. ........
Mailing Address: ..... �A►!'t1..�tAllaltlll... M-C............ ;7214..............
1, 7.T,...k.xAtiradsititr,.HUtt�...............................................................
tlnsite Representative: J.Rill.�i xdAltlC,.l �l:F:ie.1c .uu�..lZcri?ltR..Q ................... I►itcgrator: N..[:..1.'.ttx►.'i ..k:axnl ,.lCh►s. ....................................
Cert'ilied Operator: Operator Certification Number:
f.ocation of Farm:
From NC 22 in Coleridge take NC 42 west 1 mile onto 42, turn left on Riverside Drive. Exactly 1.2 miles - turn left into the #
rarm [should be a N.G. Purvis or lint; Slats sign] 3/4 mile down the road.
® Swine ❑Poultry ❑Cattle ❑Horse I.utit►ide 3S • 37 l5 Longitude 79 ` 36 55lb
Design Current
Swine Canacit►• Ponulation
❑ Wean to Feeder
® Feeder to Finish
124N)
10.450
❑ Farrow to Wcan
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ uyer I ❑ Dairy
❑ Non -Layer I JE1 Non -Dairy
❑ Other
Total Design Capacity 12,400
Total SSLJW 1,674,000
Number of lagoons i ❑ Subsurface Drains Present ❑ Lagoon Area ® Spray Field Area
Holding fonds 1 Solid '!'raps 1E1 No Liquid Waste ,Management .System
Discharges �. Stream Impacts
1. Is any discharge observed from any part.of the operation? ® Yes ❑ No
Discharge originated at: ❑ I.agoon ❑ 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 gallmin? Not measurable
d. Does discharge bypass a lagoon .;ystcni? (If' yes. notify DWQ) ® Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ® Yes [:]No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge! ❑ Yes ® No
Waste Collection R Trcatmeiyt
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............ Uppr:c............ ....... ....1[ aw''cr.......................................................................
l�reeboa� rd [inches]: 54 60 //�I �l
Slflfl Canli►iued on back

Faciiiti' Number: 76-03 Date of Inspec•lion 11�2�2tlrnl 0 Printednn: 11I612000
5. Are there any immediate threats to the p9rity of any of the structures observed? (ie/ trees, severe erosion. El Yes 19 No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered ves, and the situation poses an
immediate public health or environmental threat. notify D%VQ)
7. Do any of the strictures need maintenance/improvement? ® Yes ❑ No
S. Does any part of the waste management system other than waste structures require maintetiance/itnprovetnent'? ❑ 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 maintenancelimprovemcnt? ❑ Yes ® No
l 1 • Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Creep type Fescue (Hay)
I3. Do the receiving, crops differ with those designated in the Certified Animal Waste Management Plan (CAWMI')? ❑ 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) •Phis facility is pended fora wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need impro►•ement'?
16. Is there a lack of adequate waste application equipment?
Kcuuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
19. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ice WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (iel irrigation, freeboard. waste analysis & soil sample reports)
20. 1s facility not in compli:tncc with any applicable setback criteria in effect at the tune 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 Gencr.tl Permit?
(iel discharge, freeboard problems, over application)
23. Did Reviewer/]nspector fail to discuss reviewlinspecIion 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: Nei-yiolatkms.or deficiencies-were-noted:during.this visit. 'Yoou'will receive no -further
correspctridencc abiout this.risit.
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
1. Several leaks and seepage of waste was noted around houses at lower lagoon. Needs to be repaired as soon as possible? A,
7. May want to repair holes/washed out areas on dam that have started to form.
9. Need to mark top of dam on lower lagoon marker.
1 1. Need to.renutve tuiIlet bales from fields as soon as possible.
19. Waste applications in March and April were not within 60 days of waste sampling.
19. Need to start keeping weekly freeboard readings. Operator has been keeping b-weekly freeboard readings.
19. Some of the pull acres are slightly different than WUP pull acres.
19, need to add field #10 in case operator needs to use it for waste application.
Reviewer/Inspector Name �Melis,,a Ro5ebrock—
Rev iewerliinspector Signature:1 f�U!_..� �� _i��fM�D.� _47 _P Date: I I I (No 60 _51of)

Facility Number: 76-0-1
Ioif Lispectinn 1 11/2/2000 Printed on: 111612060
[ldnr ISS11es
2fi.
Does the; discharge pipe from the confinement building to the storage pind 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 net located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted'? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31,
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the flush tanks lack a submerged fill pipe or a permanem/temporary cover'?
❑ Yes
0 No
A.I
J
3 00

1�
ivision of Water Quality
Division of Soil and Water Conservation
O Other Avmy 11
Type of Visit %Compliance Inspection ❑ Operation Review 0 Lagoon Evaluation !
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other
❑ Denied Access
Facility Nurnber 1)at►'r,f Yi�it: DD 'l'ime. E� Printed on: 712112t]4Q
Q Not Operational Q Below Threshold
�Perntitted 0- Certified 0 Conditionally Certified [3 Registered [gate bast tape -rated or ,thesve'C'hreshold:
�IHarrn ;•1anu: �h, fly ry....��1�. Cnuntr:..d��l!'1�.L1.�.�i'.�...._................................._..
Owner Name; Aez ...1��! �. t �. �� � �................................................ P ne No: ....�1J�.'...fG�7..�... '...7.��.�.,.�1..........................
PFacility Contact: ..�J✓��.s....� �► ............... r1'itle:...... ..... ....... U........... Phone No: (L t....a3tidT
Mailing Address: ...77.2-57... �rLiEr�-�.hi.�].... .�..-.......:.... ,-'Brwon.:!�Y-nry +.A..)........27 1 ...............................
❑nsite Representative: ,. .. .................interrotor:..N.A._.....) clok J-01 tll�
..Vr.1(1, ...... �.r...Ct
Certified f)prrator:, r' .,�}. ............................. Operator Certification . .............................
Location of Farm:
l-mIM K-" a t n e r- r e- q.7- We5F I M r e- o n4o no, e O ►1 kiverl,,
_a--
fir, ►I es q JU rin f i R io
bd Swine ❑ poultry ❑ Cattle ❑ Horse Latitude ■ � �•� Longitude • �� ��►
Design Current
owmw ., t-apacity rn uianon
Wean to Feeder
Feeder to Finish S(3
Farrow to Wean
Farrow to Feeder
Farrow to Finish
... Gilts
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer I I I[] Non Dairy
Other
Total Design Capacity
Total SSL W
Nuioahtr of Lagoons ❑Subsurface Drains Present ❑ f.a nun Area
1. H*kWv Ponds 1 Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impag
1. Is any discharge observed From any pan of the operation?
Discharge originated al' ❑ Lagoon ❑ Spray'MeldOther
it. If discharge is ohservcd, ► .is the conveyance man-made?
h> if discharge is observed, ►lid it reach Wauer of the Stale'? (If yes, notify MQ)
c. ]f discharge is obscrvcd. what is the estimaled flow in gallntin?
d_ Does discharge bypass it lagoon syswin? (If yes, notify DWQ)
2. 1% there evidence of past discharge frorn any part of the operation?
Spray Field Arra
3. Were there any adverse impacts or potential adverse irnpacts to the Waters of the State other than frorn a discharge?
Waste Collection & Treatnrent
4. Is storage capacity [freeboard plus storm storage] less than adequate'? >rspillway
Structure: I Structure 2 SlruClurc 3 Struclurc 4 Structure; 5
]denti Fier: .. Vi? .......... ........ LoLr...................,.................................................................,.........I..............
Freelloar'd cinches]:
50?
,Yes kojLR--
0 Yes XNo
❑ YesNo�]No j]
lwYes ❑ No
Yes I►k> JL/
❑ Yes No
❑ YvskNo
Structure G
Continued eon buck

Facility`Numher: — ❑ 0 Date of Inspection j�j.�►�� I 0 I'rjuteti on. 7/21/2000
5. Are there: any immediate threats to the integrity of any of the structures obs'e7rrveed''?`(ie/'trees, severe erosion, Cl Yes �No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan'! ❑Yes XNo
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes A N o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes X10
Wa%te.Application
10. Are there any buffers that need maintenancelimprovement'? ❑ Yes No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 4N0
.
12. Crop type P,S n )g a. ca S5 Zh aj I
13. Do the receiving crops differ with those designated in the
14. a) Does the facility lack adequate acreage fnr land application?
b) Does the facility need a wettable acre determination''
c)'Mis 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'?
Animal Waste Management Plan (CAWMP)?
Required Records & Documents
IT Fail to have Certificate of Coverage &. General Pcrmit readily availabic?
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'!
(ic/ 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?
1a yk4h igtis;or defide
. . r. r� neq00ing thls'visit- You *Will 16 fueft
nee.' : :correspade.A,Athisvisit
❑ Yes XNo
❑ Yes . 00
❑ Yes �No
❑ Yes l`t' - -
❑ Yes 1jrV0
❑ Yes A114o
❑ yes .IVo
❑ Yes o
"Wes ❑ No
❑ Yes ); No
❑ Yes ❑ No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
❑ Yes XNo
❑ Yes No
❑ Yes No
❑ Yes No
Wits fe V�lr C'L Pp n / W,6re, ntf tj ii 6 6
C�ats 0,� U_�Qsfe SoAfi
bW UeJ L 1q. o (h e- o � -�1,1 I lf�en a_re_,shA4rU;V' 0_V_PJA+ 41"01 A) P
Reviewer/lnspector Name
Reviewer/] nspector
Date: ijTaTT51011

Facility Number: 71p — Q3 I
of Inspection � Printed on: 7/21/2000
[blur la►iuti
2& Does the di.% -barge pipe frorn (he: confinement building to the storage pond or lagoon fail to discharge At/or below
liquid level of lagoon or storage pond with no agitation! OM ! T-
27. Are there any dead animals not disposed of properly within 24 hours" ❑ Yes )kNO
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetatiern, asphalt, ❑ Yes] No
roads, building structure, and/or public property) I�
29. Is the land application spray system intake not located near the liquid surface of the higoon? ❑ Yes YNe
30, Wert: any major maintenance problems with the ventilation fan(s) nol.ed? (i.e. broken fan belts, missing or
or broken fan hladc(s), inoperable shutters, cic_) 0 Ycs No
31. Do the animals Feed storage bins fail to have appropriate cover' ❑ Yes No
32. Deg the flush tanks lack a submerged fill pipe or a pemianentltemparary cover? ❑ Yes No
I + O-OP� DC.'-
z ) d m added , o virseev I pe OL'r !� grc)J ea5f- Wajoo i? da-l1
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� . Ma,..� wwn� �►-� ,re�,,r ho Ins/wr�,sh �d o u+ o..rep�
O n d amt `Nna�- hw�e 5d �a rF'1
a. steed
rw Jj4vlov�
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•'Y
Routine ❑ Cum
e
r: jq Ej,Div siior ..1 isiIi ater;C
4O,Division o!N anidaterJG
r.• .,.y�.,�,KK, aal sfW^ ..7y
"y Divi�Ioan ofWater Qtiali C
"t-- yUtlie�:�Ag ncy�Y;[]peiiatioiurRi
Q Folio►►' -up of DWQ inspection Q Follow-upof 1)S%VC review Q Other
Facility Ntainhcr 1).ttc nl' lnspectiorE (�-7-.(,_ OrJ
� k
Time of Inspection L l3 r,ra 24 hr. {hh:mm)
[J Permiltcd VCerlified 0 Conditionally Certified 'j3,kegi�rytaLr�{�d t allo[ Q erutivat:ti�f _Date Last Operated:
Farm Name: .....A �?. 1. :ire �........�...FQ tJ.......� County:..... ]i75" 1 z..1. 1'1.......... �......__.»
Owner Name:...1 � 1.rti.��.� ..a. �....., .��� 1� 4 �..L��' .`�" �i��� �� Phone No:.....�7 �.�%:....�r �.���......................................_
Facility Contact: '........ �. et�� .F.!1� iCiti�s .. { l .� r..••••••...... Phone No: „......_..__ ....................... ....._.....
Mailing Address: � �.s� �`.]......rya.,�s��:�1�,�.�......�%�..E,.t:.s:!�
Onsite Representative: ..* .).C�.\.,,1....Y,.1, ....4„ ..?.................................................. Integrator :....... ....... ...................................... ........ ...
C9�. y....
Certified Operator....... � . ............ operator certification
Location of Farm:
latitude • �F j5 •' Longitude =' �° =11
4r"�' 6: •I=" '_ , :I)esi n "''� EurrerEt+ : ' ' . l7esi '''Ct'trent"" M'11
rriEie ?' . Ca : eit ",'No' ulaition :' Pioultty Ca ari �ePo "ultt±tionC
❑ Wean to feeder
F-ceder to Finish
C
❑ Farrow to Wean
Rtet!
❑ Farrow to Feeder
Farrow to Finish
i i;';
❑ Gilts
41.
❑ Boars
r-
❑ Layer 'a
❑ Non -Layer :r ❑ N
• '. pigs ► �. :''a� :{N�A=° rtell:i. �- [7p�r,
Y.. '- ...... .. .
�W t Designs ++'l Urre it •.�. •."r.
�6486411
,�E lF. _
:�:„C4 k 6 1#Po utati n
airy
on -Dairy,
pBCetY. 0 .7 40 0 "
,t -.1
1)Eultar es & :stream Impacts
1. Is any discharge observers from any part of the operation? ❑ Yes 2140
DisChargc originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance tnan-made'' ❑ Yes ❑ No
h. If discharge is ob.wrvcd, did it reach Water of the Stare? (If y'es, nolif•y DWQ) ❑ Yes ❑ No
c. If discharge is observed, whist is the estimated flow in galltnin?
d_ DtxSs discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
1 Is there evidence of past discharge from any part of the operation? ❑ Yes EKM)
3, Were there any adverse impacts or potential adverse impacts to the Waters cif the State other than from a discharge? ❑ Yes 2 NO
Waste Collection & Ti atment
4, Is storage capacity (freeboard plus ctornt storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure ? Struclure 3 Structure d Structure 5 Structure 6
Identifier: -s" I-r-W" -+
Freeboard(inches): .,......2 rA,,,,,,,,,,,,,,,, _............jo.i...........................................................................................................,.,................
5. Arc there any immediate threats to the integrity of any of the structures observed? (le/ trees. severe erosion, ❑ Yes ❑ No
seepagc, ctc.)
3f23199 Con inued on hank

Facility Number: Insncrtioo
G. Are there strictures on -site which are no roperly addressed and/or managed through a waste management or
closure plan? ❑ Yes �No
(if any of questions 4-6 was answered yeti• and the situution poses an
immediate public health or environment:sl tItlreal, notify DIVQ)
7. Do any of the structures need inaimcnancelirnproventent? ❑ Yes ["No
8. Does any part of the waste management system other than waste structures require tnaintenanccfiuzpruvernent? Q Yes ria"Nci
]. Do any stuctures lack adequate, gauged markers, with required maximurn and minimum liquid level
elcvatlun markings? ❑ Yes (0 No
%Vwite Application
10. Are [here any buffers that need maintenancclimprovement? ❑ Yes EU Nn
11. is there evidence of over application`? ❑ F.Excessive Ponding ❑ PAN ❑ Yes R o
12. Crop type KA ' I-
13. Do the receiving; craps differ with those designated in the Certifred Animal Waste Management Plan (C:AWM11)'? ❑ Yes R'�ct
14. a) Does the facility lack adequate acreage for land application? ❑ Yes (01I o
b) Does the facility need a wettable acre determination? ❑ Yc.• ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes �El No
15. Does the receiving crop need improvement? ElYas Lys N0
16-
is lucre a lack of adequate waste application equipment?
❑ Yes
Ekfo
Reciaired Records & Document~
17.
Fail to have Certificate cif Coverage & General Perrni; readily :tvailahlc?
Zycs
f,] No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ief WUP, checklists, design, maps, etc.)
❑ Yes
19'N'{r
1 ]-
Does record keeping need improvement? (iel irrigation, frechoard, waste analysis do soil sample reports)
❑ Yes
CeNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
53'I o
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
M41
22,
Bail to notify regional DWQ of emergency situations as required by General Perinit•?
Yes
dN
(ief discharge, freeboard problems, over Application)
❑
r'
23.
Did Rcviewerflnspector fail to discuss reviewfiinspection with on -site representative?
❑ Yes
O"No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
EN/Nc,
25.
Were any additional problems noted which cause noncompliance of the Certified AWhiP?
❑ Yes
dN0
®: *N<j•vicrlaootis.*o - . Ctc�e•n ice i� r� prrtet3 d�tt Trig #his;vasit; Yn41 will i ee iyt? t?ti #u -t rcr
• - ctirres a�idcRce: alwrit: this visit _ .. - .... ..... - . - - . - . ' . - .. • - • - : - . -
n...� �� y ...,��U�'�.s'{:L-`..-•�."�'..'•.' ". l}h :� -. im-•C.."ro�.�.:..,':�i�: i.....'M...,•..�.s' 3Y'.'+:7".I�i�Jsi'':= r:`Y:.x1JY:L;�E:7H1$.iI`:Iir-r:FS9'V1 s�4'r�i 1.�'�n.. •4.Y+i'.:,e.s�.,;k:r-i:-f nanrr�u.-�,Mr.v�i;Yn:iEiNSIll+w!o-e:r�.ii7tis:W,:L.-J 3,...:,.R5w•rD,r.- ..rd,��:ru�n.w .Vr•+sW�*r.­.
:;MekES'
C6nmenis(refer.tn question#uExjlain,an)answersandonny,recornmendatronsonany.otier,aomn
�'?ir'i�"• �Trh.._:
x
e exp_lains {uxc a:ddtivnall)p~es'a5necessar3,f ►alitngs;of•o;:retirit uuok y
co orve`vp rA Wr-m Ot, Vt-,Y\
C1 �Ytvt' c- QDG C1
f � .F. � .4, J ,S d cam, r [ .y • � kR. .h - /s'�•[ T-4.'�^"t
Reviewer/Inspector Name�W .fr i:•i�- V::. }y...�� �' ,.. �+".��`7,. t •
Reviewerflnspeclor Signature: kA k R"rt— QZ�,Qj Date:-•yM
.�

Facility Number. —j_J for Imspcction .0
Odor Issues
26 Br>e a dtsc pipe -from the.cnnliaemenl building To -the -storage -pond or•lagoon•fuil.lo discharge-at/or below ❑ Yes ❑ No
-liquid-levetmf4agoon-or-s(orage-pound-withrto.agitat_ ion?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes dNo
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes dNo
roads, building structure, and/or public property)
29. Is the land application %pray system intake not located ncar the liquid surface of the lagoon? ❑ Yes JNo
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, c(c.) ❑ Yes E
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes Na
3 a u merge 0-Yes ❑ No
tlorla UC omments an d1or Drawings:�Z: a"` "E:f'r. �. e' s r, fY ] Fi t 4 n1f ! ., TIg e � ",.,PJ+
114-0,

r
GOVeRNOR ..:;.
NORTH
PROLINA DEPARTMENT OF
ENVIRONMENT
AND NATURAL RESOURCES
May 25, 2000
Dear Operator:
❑IvIsION OF WATER QUALITY
WINSTON-SALEM REGIONAL OFFICE
A review of our rccords indicates that you have not completed a "Swine
Integrator Registration Card" for this year. Please complete and send the enclosed
card (postage paid) to the addrem printed on the front of the card, if you have
changed integrators let me know and I will send you the appropriate card. If you
have any questions concerning this matter, please do not hesitate to contact me or
Melissa Rosebrock at [phone]. Thank you for your cooperation,
Sincerely,
Matt Czahor
Environmental Tech IV
Winston-Salem Regional Office
cc: WSRO Facility Files
LC1NrAwElefeA`
+3 0•11 .0+
585 WA11GHTOWN STREET, WINSTON-!;ALEM, NORTH GARULINA 27107
PHONE [phone] FAX °.136-771.4630
AN EQUw4 OPPORTUNITY 1 ArFt RMATIVE ACTION EMPLOYER - 50% R!CYCLEp/10 a POST-CON511-EF, PAPER

r
0 Division oaf So0-WaterConservation
Water Conservation - Operation Review�
[3 Division of So - Compliance Inspe
Division of Water Quality - Compliance Inspection
0 Other Agency - Operation Review
* Routine 0 Complaint Q Follow-up of DWQ inspection Q Follow-ue of DSWC review ❑ Other
Facility Number 76 [I3 Dale of Inspection 9129199
l'inte of Inspec•tinn lll:[lll 24 hr. (hh:mm)
® Permitted ® Certified U Conditionally Certified 0 Registered JE3Not Operational I Date Last Operated, ,,,,,,,,,,,,,,,,,
Farm Name: ll�tuls�tG1�d.ktxrrarL�tarieF.�.[Jp.pc.r......................................................
County: Handulftht......................................... !'.!'. R.0........
Owner Name: 1'..Itil>lip..................................... Favccf:t.t................... ......... Phone No: h5,6-259.4...... ....... ..............
Facility Contact:VincuAlAessup .............................................................................. Phone No:3.34-57P.:b59..0.................
.....
Mailing Address: 7..7.25-Frltt:ntdslliP,.Hd........................................................................... lixU►.►.x►.SUtiltx►iLAtii.L:.......... ....... - ...... ............. ...... 272,14— ......
Onsite Representative: Vi tsxja1 J.RSxtlV.................... ..................... - .... Integrator: j�..Cr..1�4�A Y.14�.�'.illrAllSti.�TA�f..........
Certified Operator:fc gk..................................... Jg5b.tip ............................................... Operator Certification Number: J,${ ,7,,
Location of Farm:
F: r. A mt. �'.[�. � Z..i ra. [:•s � I.c r. i.d two. iLat1C �:. N C .42..r.:�>i. l..nx ilt<.�.n,tu..:1 �.. t I�. r.Ix.let'x. U. n..l3it►:�cxa ii dc. � r. ia:t:...l� roc 1, I �:.1 x�..tl't1I.4 }..-..I.lt lCZ1.1R �f..
�I
Latitude 35 • 37 1 1566 Longitude • 3fi 4 55 14
Design Current
Swine Capacity Population
❑ Wean to Feeder
® Feeder to finish
12400
9700
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Resign Current
Poultry Capacity Population Cattle Capacity Population
❑ [,ayer 10 [)airy
❑ Non -Layer JEI Non -Dairy
❑ Othcr
Total Design Capacity 12,40(
Total SSLW 1,G74,iH 0
Number of Lagoons 2 ❑ Subsurface Drains Present 1101.agw, n Arcs ® Spray Field Area
Holding Ponds 1 SolidTraps ❑ No Liquid Waste Management System
Digharugs & Strcam Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originased at; ❑ Lagoon ❑ Spray Field ❑ Other
it. Ifdischarge is observed, was the conveyance than -made? ❑ Yes ® No
b. It' discharge is observed, did it reach Water of the State'' ( If ycs, notify DWQ) ❑ Yes ® No
c. If discharge is observed. what is the estimated tlOW in gal/min?
d. Does discharge bypass a lagoon system? [lf yes, notify DWQ) ❑ Yes ® No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes IN No
Waste Collection & Treatment
4. Is storage capacity (freelxsard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier: upper lower
Freeboard(inches): ................Z4.......................... ................................Z4...................................................................................................................................
..
5. Are there any immediate threats to the integrity of any of the structures observed'! (iel trees, severe erosion. ❑ Yes ® No
seepage, etc.)
3123199 Continued on buck

Facility Number: 76—{}3 Da Inspection
{;• Are there structures tint -site which are n010erly addressed and/or managed through a watt 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/improvemcnt?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenance/irnprovernent?
1 1. Is there evidence of over application'? ❑ E.xcessive Ponding ❑ PAN
12. Crop type Fescue (Hay) Rye
Small Crain (Wheat, Barley.
9/29/99
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Dries the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination'?
c)'I'his 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'?
Re(mir •d Records & Documents
17. Fail to have Certificate of Coverage & GencraI Permit readily available'?
Ili. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
19. Does record keeping neck) improvement'! (ic/ 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. bail to notify regional DWQ of emergency situations as require(] by General Permit?
(ic/ discharge, freeboard problems. over application)
23. Did Reviewer/]nspeclnr fail to discuss review/inspection with on -site representative?
24. Dees facility require a follow-up visit by SaIlIC agcney7
25. Were any additional probicins noted which cause noncompliance of the Certified AWMP'?
O; iv[i ViirI ii>tis:or _d Ii iencies were noted [litring this: visit. ;Ytiti;will receive h Airfher.
correspondence. Aim this:visit. : :: : : • • •
19 - Last waste analysis was 8/12/99. Facility will take waste sample ASAP. No other problems were noted.
Reviewerllnspector Name 1%V. Corey Basinger
Reviewer/Inspector Signature: Date:
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes 19 No
❑ Yes ® No
❑ Yeti ® No
❑ Yes ® No
AL

[] Division of Srd Water Conservation - Operation Revie
0 Division of Sa d Water Conservation - Compliance Inspe on
Division of Water Quality - Compliance Inspection
0 Other Agency - Operation Review
10 Routine Q Complaint Q Follow-up of MVQ inspection _Q Follow-ui of DSWC review Q Other I
Facility Number o3 Date Or Inspection 9 ,C
Time of Inspeclioll Id•4a 24 hr. (hh:mm)
01 lermitted a Certified 0 Conditionally Certified Registered JE3 Not Opera Date Last Operated:
Farm Name: ........f?�P.:<..�.J L�CrJ�Y eP...4��?�/?P ...... Cuunt}': •,,.!�.'? `Id.'.f...................... W �zo
.......
Owner Name: .............................e 7--7+
'honc No:
........ ..................,.-..............................
Facility Contact• I���I. .......... I�f Title:....... e� „Phone Nu: ..1.�r�'..�.�F`I`�..........S�a
'.:...........................................
7 7ZS ► 7`� e �t T 4-
Mailing Address: .... !� �a �iZcx�� -��'►� ! � � Z7Z..
.................................................................................................................................................................................................. ..........................
Onsite Representative:....VnjC .s!.:1�SSJ7 --!j ....... .., lntcl;r:rtor:................ J�!�....................... ................. G ' S
Certified Operator:...... QS���� �� �`+�is .. Operator Certification Number: r#�%?a..................
Location of Farin:
A,
........... ............................... .................. -.... --...... ..................... ............. ..... .-... ..................................................... ............ .............................. ........ — ....... -......
Latitude 35 • 37 1 S •- Longitude F-77/7 • 3ro SS
Swine.-.
Design Current Design Current
Capacity Population Poultry Capacity Population
El Layer
�242d 7pU ❑ Non -Layer
❑ Wean to Feeder
® Feeder to Finish
El Farrow to Wean
El Farrow to Feeder
❑ Farrow to Finish
El Gilts,
El Boars
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity Ix-0?a
'Total SSI,W T 46 lad
Nm ,uber of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ® Spray Field Area
Holding Ponds 1 Solid Traps 0 ❑ No Liquid Waste ,Management Sv'stem
Discharges nr Stream Impacts
IS any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ CIther
a. If discharge is observed, was the convevance inan-made?
b. ]f 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?
❑ Yes , 3 No
❑ Yes PrNo
❑ Yes D9 No
d, Discs discharge bypass a lagoon System? (Ifyea, notify DWQ) ❑ Yes �5No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes yYNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge`? ElLl Yes Nt�
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes `M No
SlrnC[llr[: !
Identifier: upr
I !�
Freeboard (inches): .........2..............
Structure 2 Structure 3
40aek
2f+
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
❑ Yes .M�No
3/23/99 Continued on back

9
Naciiit►',Number: — d 3 i1�'tnspectilot) 9 zF
Ci. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure Man? ❑ Yes KNo
(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 cg'�Io
8. Does any part of the waste management system other than waste structures require maintenance/improvetnent? ❑ Yes [&No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings'? ❑ Yes 1J No
'41'.rtile Application
M Are there any buffers that need maintenancelimprovement? ❑ Yes XNo
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes allo
12. Crop type e. Rye. �OAI C-ah"I
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes �10
14. a) Rocs the facility tack adequate acreage for land application'? ❑ Yes RNo
b] Does the facility need a wettable acre determination? ❑ Yes O;No
c) This facility is pended for a wettable acre determination? ❑ Yes E$ No
15.
Does the receiving crop need improvement?
❑ Yes
5No
16.
Is there �i lack of adequate waste application equipment?
❑ Yes
WINO
Ilk!t uir ed Record,, & Documents
l7.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
®'No
18.
Does the facility fail to have all components ofthe Certified Animal Waste Management Plan readily available?
(le/ WUP, checklists, design, maps, etc.)
❑ Yes
JgNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard waste analysis soil sample reports)
❑ Yes
❑ No
20.
Is facility not in cornpliance with any applicable setback criteria in a re time of design?
❑ Yes
ErNo,
21.
1)id [tic facility fail to have a actively certified operator in charge?
❑ Yes
E•No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
� No
(icl discharge, freeboard problems, over application)
❑
23.
Did Reviewerflnspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
UNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
NMI
ci yi#il;afions:air~ ilefieienc+es i re note• (Whig i;his.v. s. t.. Yc�u l rrer ;
correspondence. ab' f this .visit.. .
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): r
"sic AP. Aa�
Vr
Reviewer/Inspector Name
Reviewer/Inspector Signature: ' Date:
3/23/99

Facility Nuznber:- X —,n3 i)a�Izrsperti�»� I `7/79/q�'a�
Odor Issucs
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
❑ Yes
E No
liquid level of lagoon or storage pond with no agitation'?
27.
Are there any dead animals not disposed ot'hroperly within 24 hours?
❑ Yes
t�No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
9iVo
roads, building structure, and/or public property)
29.
Is the land application spray system intake net located near the licluid surface of the lagoon?
❑ Yes
ErNo�
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
ErNo
31.
Do the animals feed storage bins fail to have appropriate cover'?
❑ Yes
rX No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
)<No
7
.t
J
3/23/99

LM-("t'st"ine
�Cd Uivi.'stiiiit>tStr�"ft• aa 0 A%iIlivisiisat; rd' ►i`f t r ui111tY-.Cori]�lihrn Insp tiRitF = ' + + : ' '�°ie117evi0 co-naplaint Q 1•'olln«.ern tii'1).S11'C revie�+•' O {]thee
Fsacilitr Number r Date of Inspeclion - r WV
Time of. Inslie.:Lion Td hr.' hh:rnmj
❑ I uglstertd 0 Certified © Applied for Pertnit ❑ Permitted © Vert ti acrational Date Last Operated:
F'araat \ante:....... —...............................•---.-----...--.........................................._. C ountv:......�AM� VH11.............................I........
Owner Natne:
facility Contact-
Title:
Phone No:
Phone No:
Muilitil;:icld:F_ss:...............I...J..,.,..,1.....,...../..,........................................................ ,................................. ..........................
Clnsit:, 1�el3rLserat:ttie't:, -v ...k..IN....f.:1:r.. ,,! .,.,..--........... Cr ,1 }.,.......,.. Iizte �ralor:................................................... ...
s
C-urtifted Operalor.................. _................ ......_.................................................... 01wratur Certification Number :................ ................ .........
Location o1 Fsarna:
Ultlititde: �— ' • = - Longitude 0° = i
Design Current
swine Capacity, Potsuftation
Weal to Fced::r
I'cecler to Finish
Farrow to Weatl
t
10 fear ow In Feeder
10 Farrow to Finish
❑ CiiIIS
❑ boars
Deign Current Design Currerit
Poultry Capacity Population Cattle Capacity Population
❑ Laver ❑ Dairy
❑ Non -Laver ❑ Non-I)aity
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoom5 l Holding Ponds ❑ Subsurface I)rains Present J10 Lugwn Area 10 Spray Fit :kd Area
❑ do Liyuitf W:aste,Nlanagcment Svstern
General
1. Are there any buffers that need maintenante/irnprovement? ❑ Yes P�No
?. is way discharge observed from any part of the operation? 0 Yes No
I)isrharae ori-inated air 0 La000n ❑ Spray Field ❑ Other
:i. If discharge is observed, was the conveyance man-made? ❑ Yes 4NO
b. If dischagw is observed. did it reach Surface Water? [If yeti. notify DWQ) ❑ Yes No
c. If discharge iti observed, what i4 the estimated flow in galhnin?
d. ❑eaes discharge hypa�s a lagoon system'! (If yes. notify IJWQ) ❑ Yes /�VIN{,
3. k there evidence of past discharge from any pan of the operation? ❑ Yes P - -'
4. Were: there any :adverse impacts to the waters of the State other than from a discharge? ❑ Yes F"o
5. Does any part cif the waste management system (other than lagoc)n0olding ponds) require ❑ Yee � Nei
maintenance/improvemelit?
5. IS facility gat in compliance with any applicable setback criteria in eff"I at the time of design? ❑ Ycs
f
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yet ' ❑ No
7/25/97 Cnnrintjrd ern hark

A
FaciIitr' :tiumhcr:7 —
8. Are there lagoons or storage ponds on tine which need tU bC prL)t eriV cSOSed? ❑ Yes 4 No
,it ructttres (La:-otnI,,Holdinr Ponds, Flush Fits, etc.)
9, Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes dNo
smicture 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure G
Identifier- rI
t1. r........................................ -.............................. -................... -........ -........... .................... -.............. ... ..............................
Freeboard (111):.-......-.?�....r.... - .................. ... �... ..
10. Is seepage observed from any of the Structures' ❑ Yes ZE(No
1 1, is crosioil, rr aE:y ether threats to ttic integrity of any of the structure~ observed? ❑ Yes ZNo
12. Do any of the Structures need maintenancelimprovetnent? ❑ Yes FNo
(If am• of questions 9-12 was answered yes, and the situation poses
an itttntediate public lwafth or en►•ironmentaI threat, notify DWQ]
13. Do any of the :t uctures lack adequate minimum or maximum liquid level markers?
Waste pplicat iori
14. Is there physical rvidence of over application?
(If in excess of WNil'. or runoff entering waters of the State, notify DWQ)
15. Crop typ;: ��.G.0................ ....... ....................................... __..... __....... -......................
16. Do the receiving crops differ with those designated in the Animal Waste Management flan (AWMP)'?
17• Does the facility have a lack of adequate acreage for land application?
19. Does the receiving crop need improvement?
19• Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
2 L Did Reviewer/inspector fail to discuss reviewlinspection with on -site representative?
21 Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24, Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
[] No. s,ioiatirrns «r deficiencies were note'd-during this visit. You.wi11 receive ito ftirther :
: carrespirr- dehl a about this:►•isiC, ; -' • . -' :
❑ Yes A No
❑ Yes d-1v0
❑ Yes OINO
❑ Yes &No
IVYes ❑ No
Z Yes ❑ No
❑ Yes XNa
❑ Yes ;2rNo
❑ Yes CVNo
❑ Yes 9 No
❑ Yes 10 No
Cl Yes No
Cotninents '(refer'to question #)' Explain" an u 'r ._ or" i d ri i Hier.' F , y .YES s e s and!" airy reci t'{taprtert atians oti a yib airittients
llse.drawtngs of facility. tn.kietter explain:siivatioas: (u'se ailditinrtisl. ales as.rieccssu'ry.1
....... .. .... ... i. .:. .... ......5• ��:•:.o cX �Fc..aiY1�'.�:..f' �S"'n :. .iJ�f'. e.'.Pn+r �'.tg..:-Me: '•IE:: w.1i: f.'�'i��e: �s°s�i.i.� °;�tl.e�. �F: ..#i?j;�g�. :F:�tr�a'..:,i
7/25/97 H,
P.T
Reviewer/Inspector ect{fr Itiamc`W.=` ""'4'" �;
�..nl �/• ■/ •' J[A L:[. a¢ h:.i • .s ,.e qf.'�.' r�r SE ,
1 i .*X• !iF ' F"�' 1 i.4" F4I
,:5.. t•t $F '�Zj «: Lt ;xFw. :i!:;' : �f ! '.''^i�S�1i�:..b... ..�F�e e..!
Heviewerllnspectnr Signature: rflf�V,. t Z� � ��� Date: j j

A-
p Division of Soil and r Conservation - Operation Review
p Division of Soil and or Conservation - Compliance Inspection
E Division of Water Quality - Compliance Inspection
p Other Agency - Operation Review
9. 1611(me G Con] I 1Ii111 p '(I ow-li11 rl In',peclPoll Q 'll ow-iih o ti , r'e►'ie►1' p 01 her
I'nedi1v Ntimber, Dale oi' Irlsperliml
11111V of Irltiprc-uon © 24 hr. (hh:mm)
Registered ■ Certified 0 Applied for E'ermit p Permitted p Not pe n1lona I}a1V L:INI Operated:
f'irl'lll ,Name- Applefield..Ear.nL:Loayer.,&..Upuer ......................... (:tlliitl.': Randolph
WSRO
()i1Fi'I- lN;iinc: Phillip ..................................... Eaum(le ..................................................... I'111)nc No: 656-.7.5.9.4.......................... .......-.................................
Facility f_milact: Hergie.jescup... ............................................... l'illc: GRC...... ..................................... ......... 33fi-SI.9- OD.......................
Mailill�, Adclrelo,:.7.7ZS..F.ri,endship.Hd........................................................................... 13xar:11.Sttumnil.. NC................I........ 2721.4 ..............
Irltct r;rlclr:[ I.'.ut1:i65.................. t:lrrrite Itellresent:rti.e: Yiaccu.1-Jcssrap..Rol?itt..Crz]i................................................ g.................................................
Ccr-tiried ()peratcll•: Hx4g pie.A............................... .lessu:p--.............................................. (lper;ltcrr Certific;llion �Nuinher:188.73......... ....................
Localion of farm:
Latitucke 0 © 0.. Lno(Otlide ©0
Swine Capacity' Population
El Weanto Feeder
IN F ceder to •Inis
p Farrow to Wean
p Farrow to Feeder
p harrow to Finis
p Cilts
p Boars
Poultry Capacity Population Cattle Capacity Population
p l,ayer p Dairy
p - , onayer p Non -Dairy
Other
Total Design Capacity 12,4
Total SSLW 1,676,700
Numher of Lagoons 1 Holding fonds ❑ - tr MIr ace rairts Present rctt ®, pray Field Area
p No Liquid Waste Management System
[general
1. Are there any buffers that need maintenance/improvement?
[]Yes
® No
2. Is arty discharge observed from any part of the operation?
[]Yes
H No
13ischargc originated at: p Magoon p Spray field Other
[i. 11'dISClla1L'C iS ()hsrl'►'rd, ►':Iti IIle Ctcil►'C1'aI1C I11all-111adC.'
❑ Yes
H No
h. I C discharge is obwrved. dill It realcll S111•I11CC Watcl.? (II'\.es. lioliI,\• 11)\V()}
❑ Yes
® No
C. I I'disc 1:11-',e IS what is 111C CS1iillil cd 11ow I11 uallilllll,?
(I. 1-)i)CS dischal. C bvp' Iss a llwomi s`.•sielll'? 111'}'es. Ilollfv I)Wi ))
[3 Yes
®No
3. Is there evidence of past discharge from any part of'the operation?
p Ycs
® No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
p Y c s
® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
p Yes
® No
niai n tenaiice/im prove meat?
b. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
®No
7. Did the facility fail to have a certified operator in responsible charge?
p Yes
® No
712 5197

act t V Number: 76_03 ll;ur of Wili+itt ® 40
8. Are there lagoons or storage ponds ❑n sitePich need to be properly closed? p Yes M No
StrnClnrc•s ( L-w_nons.11oldiu, Ponds. Flush E'ils, ctC.]
ti
9. Is storage capacity (freeboard plus storm storage) less than adequate? EI Yes 0 No
tilruClure 1 siructure 2 Structure 3 StruCture 4 Structure Siructtire 6
Icicnl it icr: Upper Lower
Freeboard01 I:............. .3.5................ .........a............................................................................................................. I............. ...................................
►A
Im
10.
Is seepage observed iionl any ol'the shuctures?
p Yes
N No
11.
1s erosion, or any other threats to the integrity of any of the structures observed?
p Yes
M No
12.
Do any of the structures need maintenancelirnproventent?
0 Yes
® No
(If an►• of questions 9-12 -,vas ans►rered yes, and the situation poses an
inIII ediate public health or environmental threat, notify UWQ)
-13.
Do any of Ili structures lack adequate minimum or rnaximurn liquid level markers?
p Yes
IM No
NYatite 'I tt11lica t fun
14.
Is there physical evidence ofover application?
0 Yes
®'No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15
Crop type............ ........... ............. Ry.0........................... ......................
MiloOats)
16.
Do the receiving crops differ with those designated in the Animal Waste Management P lan (AWME')?
p Yes
0 No
17.
Does the tsciIity have a lack of adequate acreage for land application?
❑ Yes
N No
18.
Does the receiving crop need improvement?
p Yes
®No
19.
Is there a lack of available waste application equipment?
p Yes
®No
20.
Does facility require a follow-up visit by same agency?
p Yes
® No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
®No
22.
Does record keeping need improvement?
p Yes
0 No
Fur
Ce1.1il'ied nr Per'niiIIed F,ICiIiIi" Ortlr
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
El Yes
® No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
p Yes
0 No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
N No
t o-vu>F a tions.or t xerenmes.werc.note . uring: this visit. - nu will.receive no, further
tir' e, �Otinjl 'c' 4WLit .t�li5.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other coma
Use drawings of facility to getter explain situations. (use additional pages as necessary):
-ERTiF[CATION # N000195
APPLIED FOR PERMIT # AWS760003
�ACILITY IS GOOD SHAPE. RECORDS ARE WELL KEPT AND IN ORDER. NO DEFICIENCIES NOTE
)URING INSPECTION.
NPPROXIMATELY 27 ACRES OF NEW LAND BEING CLEARED FOR IRRIGATION.
A
Reviewer/Inspector Name WXorey Basinf;er_-
Reviewurllnspector Signature: Date:

,� ? • .. s .`.wwwr.«.www.nr'a.i>axr�rrw.n+.=« `.......�...-,.r....A��W1
...n.�vw�w« ... Division ofSfil Water Cotiserva[rn 56 ther AM;r -
;'Division of Water Quality
•. L Routine _Q Complaint O l,_rrllt)w-ttl� of {)11'Q inspccticut D Follow-up d l)SWC review O other
Date of Inspection �D Za 9t3
Facility Nurnfrcr C7
Time of Inspection / =4Q 24 hr. (hh:mm)
13 Registered OCertified ,Applied for Permit E3 Pcrrnitted ID Not 0 erational Date Last Operated:....
Farm Name; APPLc--FieLD � M ..'" �Q er I [.c�u.++•R-. Countv:......�ArlDdt_P14 ..... ...... ... WSJ....
.......................................... ........ �............ ..... .............. ... ....I....
Owner Name:.........P-1,-I.................... 'FA4C—ICF Phone No .I 540 5`..................................
Facility Contact: �SJJ? . Tifle:.,.��.C....... I'hortc No: ....a`�:�..�.°a............
:Flailing Address:....
�...
.�r.ti..r........ ...M1........
\Je_SS; �Integrator:.....PkVg5 .Orsitc Representative :..."...............................................o.......... ................................ ......... '
Certified Operator:............�..................
Operator Certification Ntnler:...................... ....................................
i twafinn of Farm:
'f........................trt........c.. 7:..........................51,�` ........ ^!.........a! ......... Zt.... u�1�................. ':n...........!::.::� .:4... .................
I:i wt� 14 —71- is �. Ywt [ n1c�P�i'�ns1�#r�su�r,] 314. nntl�. .. rit.
................. ............... ....... ... ....................... .................. .............................. ........ ........... .............. .............. ................. ................ ........
........ T
Latitude a ; 'f Longitude ' '
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population [rattle
Capacity Population
❑ Wean to Feeder
❑ Layer
Dairy
® Feeder to Finish 1-2GBv �3
❑ Non -Layer
fE Non-I)airy
❑ Farrow to Wean
❑ Farrow to Feeder
❑Other
1 Z' 4,
❑ harrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSIaW
'to,
Number of. Lagoons / /folding Ponds 0 ❑ Subsurface Drains Present JJEI I.aguon Area JE1 Spray field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need trtaintenitnce/itrtprovement:'
2. Is any discharge observed from any part of the operation?
Discharge originate! 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 I)WQ)
c. If discharge is observed, what is the estimated flow in gathnin?
(1, I)oes discharge bypass a lagoon system? (If yes, notify ❑WQ)
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. I)oes any part of the waste ntanagernent system (other than lagoons/holding ponds) require
mai ntenance/i mproverrtcnt?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7, I)id the facility fail to have a certified operator in responsible charge?
7125/97
❑ Yes .&No
❑ Yes la�No
❑ Yes S No
❑ Yes 8 No
❑ Yes ErNo
❑ Yes E'No
❑ Yes B No
❑ Yes MNo
❑ Yes M No
❑ Yes ONO

Facility Number: t7 — Q 0 46
S. Are there Iagoons sir storage Fonds on site which need to be pro periy closed?
NtruduM %: 9,Qons,floldlrtg N1mds-Flush Pits, tc.)
9. Is storage capacity (freeboard plus storin storage) less than adequate?
Structure l Structure 2 Structure 3
Identifier: ,.....UP.P,1.,,,.,..•,,,.•.,,,.... . . .?.':^s[�.---....1.........................••
t�Z 3
Freeboard(f t): ....................... ....»..,,.. ,,,...,,.....--...............................,,,,.•. ,,,......,
10, 1s seepage observed From any of the structures?
Cl Ye-, -'o
❑ Yes bfNo
Structure 4 Structure 5 Structure G
11. Is erosion, or any othCr threats to the integrity of any of the structures observed?
■ ca
❑ Yes [R-No
12. Do any of the structures need main(enanceiimprovement? 0 Yes EtNo
(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 �'B'Nk)
Waste Application
14. is there physical evidence of over application'? ❑ Yes -M:No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type _.. _(Q'.�... �? 1..��.!�a�� f r...... a rrsee:d......�►i~... n.. v31+a!
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ETNo
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
WEI
18. Does the receiving crop need improvement?
❑ Yes
13,No
19. Is there a lack of available waste application equipment?
❑ Yes
UNo
20. Does facility require a follow-up visit by same agency?
❑ Yes
'u
21. Did Revi",crllnspector fail to discuss reviewfin%ficetion. with on -site representative?
❑ Yes
MENo
22. Does record keeping need improvement?
❑ Yes
&No
For Cgriffied or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
t5rNo
24. Were any additional problems netted which cause noncompliance of the Certified AWMP?
❑ Ycs
U"No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
Mlo
No.violitions-©r &ficiencies were "_ Mid -du' Frog Ws:visit.• :You.will i &iive•na'furdier'
.eotrrespvndencealioutthis:visit:-"-:-:.•. .:.:..•.:-:.•.:-:-:-:::-:•.:::..•.:-.- -:
Carnttaettis {refer to question'(#); F:xP.. rt : �O YF.S answers andlor- taffy n"m eniititioets;at: nay v�cir cZ.
iisiiiiirietits:' :� ' T"
EJ drawings of facility ttibetter expluin:situatiuns. {rise $dltiirtitii pii` as necessary):
. - �y
cem6'C'C'b' � N co 0 1 q Sf"
lJrJ1.e i"4 " 7/25197
Reviewer/Inspector Name('- �T>� S, w��+✓ �—
Rev icwerflnspector Signature: ❑ate: ezpA'�

�Mb
{w�,S
re; .li;•p,s,. .a,.., ,0�
p Division of Soil :! 0 iter Conservation ❑ther A en�;.
E Division of Water Quality
I.% i ._.2
ARoutine p Complaint p ❑ ow=up of DWQ inspection p Follow -lip of review p Other
Date of Inspection
Facility Number
Time of Inspection 24 hr. (hh:mni)
p Registered p Certified M Applied for Permit p Permitted JZ3 Not Oper:itaonna Date Last Operated.
Farm Name: Applefield..F..:tr'.ot.-Loxvcir.&.Upper.......................................... .......... County: Randolph "ISRO
Owner Name: Yliillip. ................................... Fit.uce(lc:.................................................... Phone No: h5fi-7.S9!I................ .......................
Facility Contact: Reggie.Jmup....
Title: ................ .............................................. Plione No: !J li1-132 J:.taZQl1....
Mailing Address:.7.7Z5_P.rixndsWp.Rd............................................. B_ro.wn,.Surerriit..NC.................. I ... ......... I ......... ... Z721.4 ..............
Onsitc Representative: 1Zc, ................................................. Integrator: NW,,VtLr.y1,s .................................................................
Certified Operator: f3,egoc.A............................... .l.cssup....................... ......................... Operator Certification Number:1M7.3................. ...........
.
Location of Farm:
Latitude �• ©' �'� Longitude ©• 3 "
Swine Capacity population
[3 can to Feeder
® •ee er to P anas i
p arrow to Wean
p arrow to Feeder
❑ Darrow to Finish
p Gilts
p Boars
Poultry Capacity Population CaIfle Capacity Population
p Layer p airy
❑ Non -Layer p nn- airy
p Other
Total Design Capacity 12,4
Total SS1.,W ,676,
Nuinber of Lagoons 1 IIolding Ponds
lij Su our ace
D raaus
11 resent
saloon r refit
p Spray fie c r 1'L':a
❑ No Liquid Waste
Management
System
General
1.
Are there any buffers that need inaintenancelimproveinent?
[]Yes
® No
2.
Is any discharge observed from any part of the operation?
p Yes
® No
Discharge originated at: p Lagoon p Spray Field p Other
it. i("di scharge is observed, was the conveyance man-made?
❑ Yes
® No
b. if discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
p Yes
no No
c. If discharge is observed, what is the estimated flow in gallniin?
d. Does discharge bypass a lagoon system? (ryes, notify DWQ)
❑ Yes
®No
3.
is there evidence of past discharge from any part of the operation?
❑ Yes
® No
4.
Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
® No
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
I& No
maintenance/improvement?
G.
Is facility not in compliance with any applicable setback criteria in effect at the time of'design?
p Yes
® No
7.
Did the facility fail to have a certified operator in responsible charge?
0 Yes
®No
7125/97

`
:ece I u t y ant ter: 76_ 3
K. Arc there higouns or storage ponds on site which need to be properly closed?
0 Yes
® No
+ Slructnres lat �ttnns Holditt Ponds Flush Pits etc.
9, Is storage Capacity (freeboard Pius storm storage) less than adequate"
Q Yes
® No
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Structure
6
Identifier: [Upper Lower
Freeboard(ft):..........2.ft.4't].......... .......... a.1t..(fa.......... ........ ..,,,,,,....... ,..,,,...,,,..,...................................................................
.......................,.,,,,,,
10. Is seepage observed from any of the structures?
© Yes
® No
l I. Is erosion, or any other threats to the integrity of any of the structures observed?
p Yes
® No
12. Do any of the structures need maintenancelimprovement?
p Yes
®Flo
(If any of questions 9-12 was itnswered yes, and the situattion pores an
immediate puhlic health or environmental threat, n (it ity 1)WQ)
13, Do any of the structures lack adequate minimum or maximum liquid level markers?
p Yes
® No
Waste Annlication
14, Is there physical evidence of over application?
❑ Yes
® No
(If in excess of WM l , or runoff entering waters of the State, notify DWQ)
IS- Crop type ..Fa sc=...................... .... ............. -..... -..... ........ .................... ...... ...... ...... ...... ....:......................... ..............
........ --
16. Do the receiving crops differ with those designated in the Animal Waste Management plan (AWMP)?
® Yes
p No
17. Does the facility have a lack of adequate; acreage for land application?
❑ Yes
® Nil
18, Does the receiving crop need improvement?
❑ Yes
® No
19. is there a lack of available waste application equipment?
p Yeti
® No
20. Does facility require a follow --up visit by saine agency?
❑ Yes
M No
21. Did Revic.verilnspector fail to discuss review/inspection with on -site representative?
p Yes
® No
22. Does record keeping need improvement? p Yes ® No
For Ccrtifled or Permitted Facilities Only
23, Does the facility fail to have a copy of the Animal Waste Management ]Taut readily available'' []Yes ® No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? p Yes ® No
25. Were any additional problems doted which cause noncompliance of the Permit? p Yes p No
Q .. o via •ttions.or uenctes'►vere.note unrtg is v tstt:. nut wi xeeeive stet further .: .
Coirrespt►�+�li'pe ; bauit 't�iis i'i it:. :....... .
Comments (refer to question #): Explaiwatny Y1sS answers anefior any recunintendafions or any.
Use dra►vings of facility' to better explatin situation~. (use additionaI stages as necessary):
grass. c:urrcntiy, crop is
25 - Not.issued,permit yet.
to include changes by
comments.
WC. I �
Ail inf'orinaition contained in -plan calls for fescue grass. except for the,page calculating Nitrogen loading rates. '['his may be
just a simple mistake. Hopefully, reviewer ►vill•determine necessary steps to take with regards to this problem.
�F Facility is in good shape at time of DWQ inspection. Records are well kept and no evidence ofany discharges. Deficiencies
#12 and #13 noted+in SWC operation review. have been corrected,
7/25197
Reviewer/inspector Name 'Corey.IlMssinger
Reviewer/Inspector Signature:
Bare:

i❑ DSWC Anim {eedlot Operation Review €
® DWQ Animal Feedlot Operation Site Inspection
online MConrulaint 02'Follow-an of D
F-F acility Number ato U3
,,�rtegistered ew(:ertified 9-Applied for Permit 13 Permitted
1'rtrm Name:...... .P..f3!= 1 D... ? ........[-z.........t::L.Jc....
�1....-7�.^ .....
(]�+ rter N:�nte:.......... Nrr�LP........................ F .
Facililv Contact: _....��6..
Mailing Address: ... ��'.Zr... G?+rt�grtrP.. �f3:.........
Follow-up of IrilVC review O Other
Date of I nslrecl iml.
Time of Inspcction lfl!3Q 24 hr. (hh:mm)
0 Not () Date List Operated:
C.oun(v: �lFr tT7a H LJS zo
.....................................I..................
]'hone No: F
Ttile: Phone No: &0)
Onsite HeI )reselliative•.....Te—. r� 3Gz111 %.0.F................. Certified Operator,_,. E ....... A............ .................
Location of Farm:
,1ni Se1K7M...r..1.:�f.!;....................... ... ...
f ntegrator:..I•�' 8�46s....,
Opera trrr Certification Numher
,...«�
..l!!G..�z.»+3h�. ....4' R:r S .:. !�_-t=..J!(�r.4. ...W I`....i'...�E!!. ... .7 .. ►t....`.�.k..........( `......1,4..1� 1:..T V.......r.........................
CJ�P
1..................
r.atitud[: 3S • 3� 15 lottl;itnde �y • 3� � �_�
Design Current
Swine Capacity f oimlation
❑ Wean to Feeder
21 Feeder to Finish
iZ �Qm
❑ Farrow to Wean
❑ Farrow to feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver I I ❑ ❑airy
❑ Non -Laver ❑ Nfln-[]airy
❑ Other
Total Design Capacity �
Total SSI..%V !� 64-61
Number of lagoons 1 Holding Ponds ❑Subsurface l)rtins Present ❑ l.at cwn .irea JOSprayField ,1nxr
❑ No Liquid Waste .Management System
General
1. Are there any buffers that need mainten:urceliniprovemetit!
❑Yes
�KNu
2. [s any discharge observed from any part of tltc operation?
❑ Yes
AStNo
[�iseirtrre uriginaFed aS: ❑ LagslUfl ❑ Spray Field ❑ Other
a. [I'discimrge. iti observed. was the coitveyancc. inait-in:uie`?
❑ Yes
I�M
b, li'disrharge is observed, did it rcach St3rfi.we Water? (.If yes. Ewtify° 1.]11'Q)
❑ Yeti
,�tiio
c. ]f dischar-,,e is observed, what is the e5tisnated t1oW in 2al;min?
el. Does discharge bypass a lagoon system? (if ycs, notify D\VQ)
Cl Ye';
e",tio
3, Is there evidence of past discharge from any part of the o1wraticxt?
❑ Yes
W.No
-l. Were there any adverse impacts to the: w:nerti of the State ether than from a discharge:'
El Yes
�Vo
5. Does any part of the waste management symem (other than lagoons/holding ponds) require
❑ Yes
19['�'o
mai rztenanceli i�iprov'eroent?
G. Is tricility not in compliance with any applicable setback criteria in effect at the time ot'desi,n:'
❑ Yes
Wo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
Ai<n
7/25/97 Continued em hack

Facility Number:
i 8. Are there lagoons or storage ponds on site which need to be properly closed'! ❑ Yes ER iN,
St.ructurts (L-w-mons,11oldina Pants -Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes PNo
Structure 1 Structure ? Structure 3 Structure 4 Structure 5 Structure 6
Identifier: VFW .......... ..
Fre cboard (f )]..............11...................
10. Is seepage: observed from any of the structures? ❑ Yes J;2rNet
11. 15 erosion, or any ether threats to the integrity ref any of the structures observed:' ❑ Yeti O"No
12. Do any of the structures need mainte:nancelirnproverrtent? ❑ Yes STNo
(lf any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DIVA)
13. Dry any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes R""'o
Waste Application
14,
Is there physical evidence of over application'?
❑ Yes
,®'Nio
(If in excess ref WM1', or runoff entering water~ of'the State, notify DWQ)
15.
Crop type. ...............................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Ilan (AWMP)"
IR�i`es
❑ No
17.
Does the facility have a lack of adequate acreage: for land application!
❑ Yes
Da"Yo
18.
Does the receiving crop need improvement?
❑ Yes
ONo
19.
is there a lack of available %waste application equipment?
❑ Yes
RNo
2U.
Does facility require a foflow•-up visit by same agency?
❑ Yes
, (�No
21.
Did Keviewerllnspector fail to discuss revicwlinspection with on -site rcprese:nlative?
❑ Yes
RNo
22.
Does record keeping need improvemcnt?
❑ Yes
Itic:
For Certified or Permitted facilities Only
23.
Does the facility tail to have a copy of the Animal Waste Management flan read iIy available?
❑ Yes
1�rNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWNIP?
❑ Yes
®'No
25.
Were any additional problems noted %vhich cause noncompliance of the Permit?
❑ Ye ss
❑ No
j] Nil violations ur deficiencies ►verc n6ted during; this'visit. Not.] ill recei►•e nu further
eurresii[uidencc al��ou( this. visit'. ,
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
lb • Fk_h A c.A1_u5 MZ Be5z-AJOA (kAS3 • C.Ltk"—"Tu f l C-P-OP is t"i Ce �i%, ±'L��l tS
z ..jar
Au- e -Ai"�11o.i cp-VTK1 Qe-i7 � �t PEA tit CALLS
P A C=>c ►a + e�-�'11eae ' tat Hq [ r3 � J
-1r ew Lc*sd t i-cL-{p s _ -�� ,-t e>, u sT 4 Sr.Eri'cC
pjV 1��i2 W�u. 17�YrC'RH� kit:' �SSdkc� �7�'PS r0 7�i UI�7H Ri'5Q,' S * {DNS -
'u�iQ+_ v'- �oa`� $tie`�� 1 • - r�F {�.,.7� w S �xc� t� n , C4C�.S r{ 4-Q o e-,U RLP
l.�i C.7c�ca.uGi2ar �3 �ee,FeaP �,tjL e�a" fop -.sly
7i25r97
Rev ieweOnspector Name ..... �. l...r .� � ... 'i 1 ,'� .-...-.. _.-,., ..�_...,.a...............- w...._..... .w,.w.......w.w ._._... -•
l�V itDate:�.. .... /�I r-
evicwerl[ttspector Signature- �