340001_INSPECTIONS_20171231

NCDEMR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Edgar Miller
Gem Farm
4550 Ebert Rd
Winston Salem, NC 271278793
Dear Edgar Miller:
Division of Water Quality RacE,veo
Coleen H. Sullins N.C. Dept of ENR D e Freeman
Director 0 T 1 200g Secretary
Winetonaiertt
October 1, 2009 Regional Office
Subject: Certificate of Coverage No. AWC340001
Gem Farm
Cattle Waste Collection, Treatment,
Storage and Application System
Forsyth County
In accordance with your renewal request, we are hereby forwarding to you this Certificate of Coverage
(COC) issued to Edgar Miller, authorizing the operation of the subject animal waste management system
in accordance with General Permit AWG200000.
This approval shall consist of the operation of this system including, but not limited to, the management
and land application of animal waste as specified in the facility's Certified Animal Waste Management
Plan (CAWMP) for the Gem Farm, located in Forsyth County, with an animal capacity of no greater than
the following annual averages:
Dairy Calf: Dry Cow: Beef Brood Cow:
Dairy Heifer: Beef Stocker Calf Other:
Milk Cow: 135 Beef Feeder:
The COC shall be effective from the date of issuance until September 30, 2014, and shall hereby void
Certificate of Coverage Number AWC340001 that was previously issued to this facility. Pursuant to this
COC, you are authorized and required to operate the system in conformity with the conditions and
limitations as specified in the General Permit, the facility's CAWMP, and this COC. An adequate system
for collecting and maintaining the required monitoring data and operational information must be
established for this facility. Any increase in waste production greater than the certified design capacity or
increase in number of animals authorized by this COC (as provided above) will require a modification to
the CAWMP and this COC and must be completed prior to actual increase in either wastewater flow or
number of animals.
Please carefully read this COC and the enclosed State General Permit. Please pay careful attention to the
record keeuint7 and monitorin-z conditions in this permit. Record keeping forms are unchanged with this
General_ Permit. Please continue to use the same record keeping forms. .
1636 Mail Service Center, Raleigh, North Carolina 27699.1636
Location: 2728 Capital Blvd„ Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Customer Service: 1-877.623-6748
Internet: www,ncwaterquality.org
An Equal ppportunity 1 Affirmative Action Employer
N'ccoi-thCw-ofina
, attfrallrY

If your Waste Utilization Plan (WUP) has been developed based on site -specific information, careful
evaluation of future samples is necessary. Should your records show that the current WUP is inaccurate
you will need to have a new WUP developed.
The issuance of this COC does not excuse the Permittee from the obligation to comply with all applicable
laws, rules, standards, and ordinances (local, state, and federal), nor does issuance of a COC to operate
under this permit convey any property rights in either real or personal property.
Per 15A NCAC 2T .0105(h) a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary. Per NRCS standards a 100-foot separation
shall be maintained between water supply wells and any lagoon, storage pond, or any wetted area of a
spray field.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive relief.
If you wish to continue the activity permitted under the General Permit after the expiration date of the
General Permit, then an application for renewal must be filed at least 180 days prior to expiration.
This COC is not automatically transferable. A name/ownership change application must be submitted to
the Division prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an individual permit by contacting the Animal Feeding Operations Unit for information on this
process. Unless such a request is made within 30 days, this COC shall be final and binding.
In accordance with Condition II.22 of the General Permit, waste application shall cease within four (4)
hours of the time that the National Weather Service issues a Hurricane Warning, Tropical Storm Warning,
or a Flood Watch associated with a tropical system for the county in which the facility is located. You
may find detailed watch/warning information for your county by calling the Raleigh, NC National
Weather Service office at [phone], or by visiting their website at: www.erb.noaa.gov/er/rah/
This facility is located in a county covered by our Winston-Salem Regional Office. The Regional Office
Aquifer Protection Staff may be reached at [phone]. If you need additional information
concerning this COC or the General Permit, please contact the Animal Feeding Operations Unit staff at
[phone].
Sincerely,
for Coleen H. Sullins
Enclosure (General Permit AWG200000)
cc: (Certificate of Coverage only for all ccs)
Winston-Salem Regional Office, Aquifer Protection Section
Forsyth County Health Department
Forsyth County Soil and Water Conservation District
APS Central Files (Permit No. AWC340001)
AFO Notebooks

NCDEHR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Edgar Miller
Gem Farm
4550 Ebert Rd
Winston Salem, NC 27127
Dear Edgar Miller:
Division of Water Quality
Coleen H. Sullins
Director
October 2, 2009
RECENED
H.C. Dept of EMR
OCT O 2. Mpg
WlnetonSalem t
Ro&nW Mw
Subject: Erroneous Issuance of General Permit, and
Confirmation of Permit Rescission
Certificate of Coverage No, AWC340001
Gem Farm
Forsyth County
Dee Freeman
Secretary
Reference is made to the General Permit mailed to you on October 1, 2009. That permit -was
;mailed in error, and is not valid. This lettenis to confirm that the permit rescission mailed to you
on June 17, 2009 is still valid. We apologize for any confusion that this may have caused.
Please contact the Animal Feeding Operations Unit at [phone] if it'would be
helpful to discuss this matter further.
Sincerely,
Keith Larick
Animal Feeding Operations Unit
cc: Winston-Salem Regional Office
Permit File AWC340001
AQW-FER PROTECTION SECTION
1636 Mail Service Center, Raleigh. North Carolina 27699-1636
LoCalion: 2728 Capital Boulevard, Raleigh, North Carolina 27604
Phone! 919-733-3221 't FAX 1. 91�1.715.05W FAX 2: 919-715-6048! Customer Service: 1-677-623 6748
Internet: www ncwaterguality.org
One
NorthCarolin.
Natmrallff
An Fqual Opportunity 4 Atfirnalivn Action rrnp;oyec

Animal Waste Storage Pond and Lagoon Closur�eport Form
(Please ty print all information that does not require a ture)
General Information:
Name of Farm: Gem Farm
Owner(s) Name: Edgar Miller
Mailing Address: 4550 Ebert Road, Winston-Salem, NC 27127
Facility No: 34 -01
Phone No. 336.784,7005
County: Fors h
Operation Description(remaining animals only):
Please check this box if there will be no animals on this farm after lagoon closure. if there will be animals on the site after
lagoon closure, please provide the following information on the animals that will remain.
Operation Description:
Type of Swine No. ofAnimals
o Wean to Feeder
o Feeder to Finish
o Farrow to Wean
o Farrow to Feeder
o Farrow to Finish
o Gilts
o Boars
Type ofPoullry No. ofAnimals
o Layer
o Non -Layer
Type of Beef No. ofAnimals
o Brood
o Feeders
o Stockers
Other Type ofLiveslock:
Type of Dairy No. ofAnimals
o Milking
oDry
o Heifers !
o Calves
Number ofAnimals:
Will the farm maintain a number of animals greater than the G.S. § 143-215.1013 threshold? Yes No
Will other lagoons be in operation at this farm after this one closes? Yes No
How many lagoons are left in use on this farm? : None
(Nolne) Melissa Rosebrock of the Water Quality Section's staff in the Division of Water Quality's Winston-Salem
Regional Office (see map on back) was contacted on June 12, 2008 (date) for notification of the pending closure of
this pond or lagoon. This notification was at least 24 hours prior to the start of closure, which began on June 19
2008 (date).
I verify that the above information is correct and complete. I have followed a closure plan, which meets all NRCS
specifications and criteria. I realize that I will be subject to enforcement action per Article 21 of the North
Carolina General Statutes if I fail to properly close out the lagoon.
Name of La nerReasehin
Signature: L J Date: — d�
The facility has followed a closure plan that meets all requirements set forth in the NRCS Technical Guide
Standard 360. The following items were completed by the owner and'verified by me: all waste liquids and sludges
have been removed and land applied at agronomic rate, all input pipes have been removed, all slopes have been
stabilized as necessary, and vegetation established on all disturbed areas.
Name of Technical Specialist (Please Print):.
Affiliation: osao, I V,QC-s
Address (Agenc
Signature:
'Yv 1 lr- �UL F-
one No.: -?1?6-6 n' '� ?
:te: _6 ho /0
Return within 15 days following completion of animal water storage pond or lagoon closure to:
N. C. Division Of Water Quality
Animal Feeding Operations Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
PLC - 1 May 4, 2007

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 340001 Facility Status: Active Permit: AWC340001 ❑ Denied Access
Inspection Type: Structure Evaluation Inactive or Closed Date:
Reason for Visit: Routine County: Forsyth Region: Winston-Salem
Date of Visit: 07115/2008 Entry TIme:08:30 AM Exit Time: 09:30 AM Incident #:
Farm Name: Gem Farm Owner Email:
Owner: Edgar Miller
Phone: [phone]
Mailing Address: 4550 Ebert Rd Winston Salem NC 271278793
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°00'43" Longitude: 80°18'22"
From WSRO: 1-40 west to Silas Creek Parkway exit and turn left. Go to Ebert St. and turn left. Go south approx. 5 miles and the farm
is on the right.
Question Areas:
N Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Certified Operator: Operator Certification Number:
Secondary OIC(s):
On -Site Representative(s): Name
Title
24 hour contact name Edgar Miller Phone:
On -site representative Edgar Miller Phone:
Phone
Primary Inspector: M i a R sebrock Phone:
Inspector Signature: Date: Q
Secondary Inspector(s):
Inspection Summary:
The purpose of today's visit was to document that all sludge has been reasonably removed from the waste storage pond. Dam is
ready to be pushed -in and hole filled with soil and area graded and seeded.
Solids are stockpiled in field with a ditched berm around the perimeter to contain any leachate. Solids are to be spread with a solid
spreader and then disk -in. Mr. Miller is to seed field with orchardgrass. Liquid waste has already been removed and applied per the
current WUP.
Mr. Miller is to fill a small section of the parlor pipe with concrete to complete closure. ,
Page: 1

M
Permlk: AWC340001 Owner- Facility: Edgar Miller Facility Number: 340001
Inspection Date: 07)15/2008 Inspection Type: Structure Evaluation Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle I
© Cattle - Milk Cow 135 0
Total Design Capacity: 135
Total SSLW: 189,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
ante Pond WASTE POND
Page: 2

0 •
Permit: AWC340001 Owner - Facility: Edgar Miller Facility Number: 340001
Inspection Data: 07/15/2008 Inspection Type: Structure Evaluation 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 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 Waters of the State other than from a
❑ ■
❑ ❑
discharge?
Waste Collection, Storage & Treatment
Yes No
NA NE
4. Is storage capacity less than adequate?
❑ ■
❑ ❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (i.eJ 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?
❑ 0
❑ ❑
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

iI
0
Permit: AWC340001 Owner- Facility: Edgar Miller
Inspection Date: 07/15/2008 inspection Type: Structure Evaluation
•
Facility Number: 340001
Reason for Visit: Routine
Waste Application
Yes No
NA NE
PAN? !
❑
1
Is PAN > 10%/10 lbs.?
❑
Total P205?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Grasses
(Turf,
Centipede, Clover, etc.)
Crop Type 2
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 crop and/or land application site need improvement?
❑ ■
❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation 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?
❑ ■
❑ ❑
Page: 4

v
u re -
"\j,
Type of Visit Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit/ `i Routine O Complaint O Follow up 0 Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: 19 0 Departure Time: 1 County: Region: &L1W
Farm Name: �arm Owner Email S
a
Owner Name: LZIr I Phone: �Il� rA1�
Mailing Address: ft?!? c mac I eM 11C R -7
Physical Address: some
jMt°
Facility Contact: EJ 06-,V- MT
Title: Phone o: -- 70��
Onsite Representative: F d Aat ► - �._ $
Certified Operator:�� Operator Certification Number:
Back-up Operator: Nancy� 9 I f ! _ Back-up Certification Number:
Location of Farm: Latitude: o ® Pa it Longitude:
Saa --� oo�
Design Current
Design C►urrent
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity .Population
❑ Wean to Finish
JEI Layer
Dairy Cow
'Wean to Feeder
10 Non -Layer I I
Dairy Calf
❑ heeder to Finish
El Dairy Heifer
❑ Farrow to Wean
Dry Poultry
[3 Da Cow
❑ Farrow to Feeder
❑ Non-Dai
❑ Farrow to Finish
❑ Layers
El Beef Stocker
❑ Gilts
❑ Non -Layers
Feeder
❑ Boars
❑ Pullets❑Beef
El Beef Brood Cow
❑ Turkeys
Other
❑ TurkeyPoults
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation? .
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than fro disc ge?
Page 1 of 3
rr u P o0
❑ Yes i No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA
❑ Yes y❑�No ❑ NA
❑ Yes No ❑ NA
❑ Yes IkNo ❑ NA
❑ NE
❑ NE

Facility Number: — • Date of Inspection 00,
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 tructure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes XNo
❑ Yes ❑ No
Structure 5
El NA El NE
❑ NA ❑ NE
Structure 6
❑ Yes ONo ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes L No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 7
9. Does any part of the waste management system other than the waste structures require ❑ Yes No I❑ NA ❑ NE
maintenance or improvement?
Waste Annlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidencf of Wind Dr' ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
1 S. Is there a lack of properly operating waste application equipment? ❑ Yes
s
Page 2 of 3 r IC 1 r 12128104 Continued
No ❑ NA ❑ NE
�No ❑ NA ❑ NE
❑ No N( NA ❑ NE
ko ❑ NA ❑ NE
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): .
tejan ? pa�
pReviewer/inspector
Name �� A Phone•erllnspector
Signature: Date:

Facility Number: Date of Inspection17.Mft'•
Required Records & Documents �No
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ElYes ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other /v
21. ecord keeping need im ovement? ❑ Yes�`No ❑ NA ❑ NE
aste Applicat� n Wee Freeboard Waste Analysis;S;01ilA ysis r� "' - — ❑,C. atien
Rainfall Stockin Crop Yield ❑ Month] and V Rain Inspections Teather Code
e y r
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No INA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P(T
o h NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No XNA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes A No ElNA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes IXNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? Yes ❑ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document 6yes No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes *No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes KNo ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?] Yes ❑ No ❑ NA ❑ NE
Add'tional Comments and/or Drawings:
a 0a7 So I fesJ, re s u NS
Sol r 0� Spreader b
G�.j i
� n ?
a1 obi;c� watSt /Idaf7•on5?
3 .ems 11 4m- P)L�
-- U&, .
4 �_4rz
(01a1� -
Page 4) V 1 0�? l(j 1 = f• oZ +5. IV J o a o
ffa,.�
1 [.J
O
I2/28/04
O

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 340001 ___ Facility Status: Active Permit: AWC340001 ❑ Denied Access
Inspection Type: Com liars sggoion
__
Inactive or Closed Date:
Reason for Visit: Routil3j
County: Forsyth Region: Winston-Salem
Date of Visit: Q2/15/2007
Entry Time:01 10 PM
Exit Time: 03:30 PM Incident #:
Farm Name: Gem F&M
_
Owner Email:
Owner:
Phone: [phone]
Mailing Address: 4550 Ebert Rd
Winston Salem NC 271278793
Physical Address:
Facility Status: ❑ Compliant
❑ Not Compliant
Integrator:
Location of Farm:
Latitude: 36°00'43" Longitude: °
From WSRO: 1-40 west to Silas Creek Parkway exit and turn left.
Go to Ebert St. and turn left. Go south approx. 5 miles and the farm
is on the right.
Question Areas:
Discharges & Stream Impacts
Waste Collection
& Treatment Waste'Application
Records and Documents
Other Issues
Certified Operator: Nancy W Keith
Operator Certification Number: 21418
Secondary OIC(s):
,J
On-Slte Representative(s): Name
Title Phone
On -site representative
Edgar Miller
Phone:
24 hour contact name
Edgar Miller
Phone:
Primary Inspector: M i sa R sebrock
Inspector Signature:
Phone:
Date: a' to
Secondary Inspector(s):
Inspection Summary:
3. Still getting wash of sediment and waste into freshwater ditch. Is being filtered prior to entering stream.
8. Temporary marker has been installed. Permanent marker to be placed within 15-30 days, per owner.
21. Slurry waste is being hauled this week. Check records next visit.
21. Soil tests for 2006 were not pulled until February 2007. Will count this for 2006 if another set of samples is pulled next fail (2007).
21. September 2006 slurry application records are ok.
21. Must record ail solid waste applications made with spreader.
24. Need to calibrate solid spreader ASAP.
28. Need to add matualrescuegrass (pasture and hay) to WUP for 2325 F-1A and T-2323 F-1C.
28. Need to clarify acreage for T-2323 F-1 B. Records list 3.5 acres and 7.0 acres. Revise WUP to match.
28, Application records state that T-2326 F-2A is listed is orchardgrass hay with a PAN of 140 lbs. WUP lists this 6 acre field as
orchardgrass pasture wI less PAN (1177).
Page: 1

i
Permit: AWC340001 Owner- Facility: Edgar Miller
inspection Date: 02/15/2007 inspection Type: Compliance Inspection
i
Facility Number: 340001
Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
Total Design Capacity: 135
Total SSLW: 189,000
Waste Structures
Type Identifier Closed Data Start Date Designed Freeboard Observed Freeboard
k1ste Pond WASTE POND 28.00
Page: 2

. • •
Permit: AWC340001 Owner -Facility: Edgar Miller Facility
Number:
340001
Inspection Date: 02115/2007 Inspection Type: Compliance, Inspection 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?
❑ 000
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 DWQ)
❑ ■
❑ ❑
2. Is there evidence of a past discharge from any part of the operation?
❑ SOO
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
4, Is storage capacity less than adequate?
❑ ■
❑ ❑
If yes, is waste level into structural freeboard?
❑
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
❑ MOO
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?
❑ 0013
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
Page: 3

Permit: AWC340001 Owner -Facility: Edgar Miller Facility Number: 340001
Inspection Date: 0211512007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No NA NE
PAN? Cl
Is PAN > 10%110 lbs.? ❑
Total P205? ❑
Failure to incorporate manure/sludge into bare soil? ❑
Outside of acceptable crop window? ❑
Evidence of wind drift? ❑
Application outside of application area? ❑
Crop Type 1 Small Grain (Wheat,
Barley, Oats)
Crop Type 2 Grasses (Turf,
Centipede, Clover, etc.)
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Sail 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 crop and/or land application site need improvement?
❑
■ ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation 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?
❑
■ ❑
Cl
20. Does the facility fail to have all components of the CAWMP readily available?
{ ❑
■ ❑
❑
If yes, check the appropriate box below
Page: 4

Permit: AWC340001 Owner - Facility: Edgar Miller Facility Number: 340001
Inspection Date: 02/15/20137 Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents Yes No NA NE
............................................._......................_..............
WUP? ❑
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?
❑
,l
Rainfall?
❑
Inspections after a 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
■
Crop yields?
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)?
❑ ■ ❑
❑
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 properly dispose of dead animals within 24 hours and/or document and report those
❑ ■ ❑
❑
mortality rates that exceed normal rates?
Page: 5

Permit: AWC340001 Owner - Facility: Edgar Miller
Inspection Date: 02/1512007 Inspection Type: Compliance Inspection
Facility Number: 340001
Reason for Visit: Routine
Other Issues
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air
Quality representative immediately.
31, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewer/Inspector fail to discuss review/!nspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Yes No NA NE
❑■❑❑
Page: 6

Division of Water Quality Q
Facility Number Q 0 Division of Soil and Water Conservation f:
....... __.. _._. _�_� __ 0 Other Agency
Type of Visit IT Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: l0,2 l Arrival Time: Departure Time: County: 5 Region: 1.c�56ed
Farm Name: I—M I Owner Email:
Owner Name:
. Phone: —1$% r g T S b
Mailing Address: _ L1 E S o E bey+ . 1 LOS N L a:i a
Physical Address: So
Facility Contact: �-:r , Title: Phone No:
f all 1 005 H,
Onsite Representativef"ntegrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Design Current
Capacity Population
J J Wean to Finish J
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
I.Q Other
Latitude: n c
Back-up Certification Number:
Longitude: gt7
Design Current
Wet Poultry Capacity Population Cattle
❑ La er
❑ Non -Layer
Dry Poultry
ElLayers
ElNon-Layers
El Pullets
ElTurkeys
❑ TurkeyPoults
El Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at; ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design' Current
Capacity Populat
Dai Cow
❑ Dai Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures. n
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes *No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
WNo
❑ NA
❑ NE
❑ Yes
;<No
❑ NA
❑ NE
12128104 Continued

Facility Number: — is Date of Inspection 0
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
Struct r 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: �}
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):UNDO
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes �(No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ,❑( Yes �No [I NA [I NE
8. Do any of the stuctures lack adequate markers as required by the permit? W 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 WNo ❑ NA ❑ NE
maintenance or improvement?
Waste ADDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Xo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift ❑ Application Outside of Area
12, Crop,type(s)
13. Soil type(s) (Oad
14. Do the receiving crops differ from -those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
❑ No ❑ NA ❑ NE
ANo ❑ NA ❑ NE
❑ No W,
NA ❑ NE
VNo ❑ NA ❑ NE
tkNo ❑ NA ❑ NE
Comments (refer to question ##): Explain any .YES answers and/or any recommendations or any other comments. r
Use drawings of facility to better explain situations. (use additional pages as necessary): :'
rttir �� i r \6+&t1 ea ?
Reviewer/Inspector Name dc AZ I Phone: 7 1— SoZ
Reviewer/Inspector Signatu : Date: a S O
Page 2 of 3 �� �� 12128104 Continued 31
v�( PgSs ure_l h") -0 WUP for 0 3ozs 1 A c, 5�

Facility Number: — Q Rate of Inspection �Q
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes N No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Do need im rovement? Ifyeszhe )kYes [:]No ❑ NA ❑ NE
Waste Applicatio Weekly Freeboard t4 Waste Analysis Soil Analy'
Rainfall Stocking Crop Yield Monthly and 1" Rain Inspections MrWeatherCode
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
'] No
❑ NA
❑ NE
❑ Yes
❑ No
[(NA
❑ NE
0Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
XNA
❑ NE
❑ Yes
$No
❑ NA
❑ NE
Cl Yes
❑ No
[(NA
❑ NE
Xl*Y"es
❑ No
❑ NA
❑ NE
❑ Yes
6No
❑ NA
❑ NE
❑ Yes 0 No
❑ Yes WNo
❑ Yes tNo
❑ Yes A No
El NA ❑NE
❑NA ❑NE
El NA El NE
[I NA ❑NE
Additional Comments and/or Drawings: ]
aj. a04{0 sbl� ��sf reSU[ ac�o?. �,t�jll
all. S,�-}. a o o l i C.a d i a rr1 r-e co r� 5 D�-.do boo{°
b
77-
'j T
' .%�' ��

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 340001 Facility Status: 6ctive Permit: AWC340001 ❑ Denied Aocess
Inspection Type: Compliance inspection___ _ Inactive or Closed Date:
Reason for Visit: Routine _ _ County: E012 th Region: Winston-Salem _
Date of Visit: 09/07/2006 Entry TIme:01:05 PM _ Exit Time: 02:30 PM Incident #:
Farm Name: Gem Farm Owner Email:
Owner: Edgar Miller
Phone:336-788A458 _
Malting Address: 4550 Ebert Rd Winston Salem_NQ271278793 _
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude: Longltude: 80° 18'22"
From WSRO: 1-40 west to Silas Creek Parkway exit and turn left. Go to Ebert St. and turn left. Go south approx. 5 miles and the farm
is on the right.
Question Areas:
Discharges & Stream Impacts
Records and Documents
Waste Collection & Treatment Waste Application
Other Issues
Certified Operator: Billy Lee Morgan Operator Certification Number: 26667
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
On -site representative Edgar Miller Phone:
24 hour contact name Edgar Miller Phone:
Primary Inspector: Melissa Rosebrock Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
8. Marker needs to be re -set due to damage during pumping.
9. Curbing has been repaired and looks good!
7. Need to cut woody trees on dam of WSP.
15. Need to establish crop on west side fields.
21. Animal waste was not applied this year until Sept. 5 or 6th. Check these records next visit.
Don't forget to complete 2006 soil test analyses.
22. Rain gauge is to be installed Win the next few days.
24. Calibration is completed.
1/20/06 waste analysis=1.6 lbs. Nl1000 gal.
Page: 1

Permit: AWC340001 Owner - Facility: Edgar Miller Facility Number: 340001
Inspection Data: 09/07/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
O Cattle - Dairy Heifer
1 23
Cattle -Milk Cow
1 135
1 63
Total Design Capacity: 135
Total SSLW: 189,000
Waste Structures
Type Identifier Closed Data Start Data Designed Freeboard Observed Freeboard
aste Pond WASTE POND I I 1 1 7200
Page: 2

Permit: AWC340001 Owner -Facility: Edgar Miller Facility Number: 340001
Inspection Data: 09/07/2006 Inspection Type: Compliance Inspection 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 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 Waters of the State other than from a
❑
■ ❑
❑
discharge?
Waste Collection, Storage & Treatment
Yes
No NA
NE
4. Is storage capacity less than adequate?
❑
■ ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led 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?
■
❑ ❑
❑
B. 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: AWC340001 Owner - Facility: Edgar Miller
Facility Number: 340001
Inspection Date: 09/07/2006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yes No NA NE
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total P205?
❑
Failure to incorporate manurelsludge 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
Small Grain (Wheat,
Barley, Oats)
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
Cl ■ ❑ ❑
Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
■ ❑ ❑ ❑
16, Did the facility fall to secure and/or operate per the irrigation design or wettable acre determination? Cl ■ ❑ ❑
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 available?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Page: 4

Permit: AWC340001 Owner- Facility: Edgar Miller
Inspection Date: 09107I2006 Inspection Type: Compliance Inspection
Facility Number: 340001
Reason for Vlait: Routine
Records and Documents
Yes No NA NE
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
E 11110
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
E
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after > 1 inch rainfall $ monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
■
❑
❑
❑
23. If selected, did the facility fall to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑
■
❑
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?
❑
❑
■
0
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?
❑
❑
■
❑
Yost
Nn
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? ❑ ■ 0 ❑
29. Did the facility fail to properly 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 ❑ ■ ❑ ❑
Quality representative immediately.
Page: 5

0
•
Permit: AWC340001 Owner - Facility: Edgar Miller
Inspection Date: 09/07/2006 Inspection Type: Compliance Inspection
Other Issues
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Facility Number. 340001
Reason for Visit: Routine
Yes No NA NE
❑ ■ ❑ ❑
ONOO
❑ ■ ❑ ❑
Page: 6

Divtcionof Water Quality.
Facility Number } � D Q Division. of Soil and Water Conservation
-- - -r. Q Other.Agcncy
Type of Visit
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
,C�oj/mpliance
CX_Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: tiip Arrival Time: o� Departure Time: Q 3 County: O Region:
Farm Name: �A t4 08 V—_0_ "-M Owner Email:
Owner Name: F Qr nil" Phone:
Mailing Address: 4mo Ll �X'� W 1 n S I O r1 t_]a �Q,rY1 �� a 71 02
Physical Address: &me.
Facility Contact: a� 1 �I�JIr Title: So W6one No: M b3
Onsite Representative: N- C Integrator:
Lee o�4 019 i
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: 5k] o [6d' 0] Longitude: ®o ®' �'
Design Current Design Current
Capacity Population Wet Poultry jCapacity Population Cattle
❑
Wean to Finish
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
❑ Layer
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Capacity Population
E&Dairy Cow
3 5
El Dairy Calf
❑ Dai Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
a
Number of`S
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: 3 — • Date of Inspection Z 0 •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes j No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: it )4l - 4nJ
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
>rNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
XNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes
❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? Yes
❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
(No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
�No ❑ NA ❑ NE
maintenance/improvement?
11, Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
O(No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Yes
A
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
%
NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
9No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ 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):
y r �O i 12V
a 1 Lam' Iv-eaL p uu-, C2 oa S¢.
to
1 J n e o
Reviewer/Inspector Name Q (Q� �—------]Phone: 1 —SoZg
Reviewer/Inspector Signatur x A Date: "]
Page 2 of"J ' %, - " " ` 12128104 Continued

Facility Number: — 1 we of Inspection O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑Design ❑Maps ❑Other
21. Does record keeping need imp ovemen . taYes �Noo ❑ NA ❑ NE
L`f W ste Application Weekly Freeboard Waste Analysis 7Soil
alysis o�
Rainfall MKStocking rop Yield Bert^ and I " Rain Inspections 6"Weather Code
❑ NA ❑ NE
❑ Yes *o
❑ Yes (No
❑NA ❑NE
22. Did the facility fail to install and maintain a rain gauge? Yes
❑ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
❑ No
NA
❑ NE
24, Did the facility fail to calibrate waste application equipment as required by the permit? to "W+e& Yes
V 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?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes 1W No ❑ NA ❑ NE
❑ Yes ❑ No gNA ❑ NE
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document Yes No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ElNA ElNE
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 KNo ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE
Additional Comments and/or Drawings:
c� �b 1r�Q.- ram- t hS��i� t YL � �� �� C� s� �l,l rtj, v► �
11
LAM UM-MME111
i
Page 3 of 3
� �{' � 12128104

Division of Water Quality
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 340001 Facility Status: Active — Permit: AWC340QOI ❑ Denied Access
Inspection Type: Compliance Insnection Inactive or Closed Date:
Reason for Visit: Routine County: Forgyth Region: Winston-Salem
Date of Visit: 06/20/2005 Entry Time: 10:05 AM. _ Exit Time: 12:10 PM Incident #:
Farm Name: Owner Email:
Owner: Edgar Miller - Phone: [phone]
Mailing Address: 4550 Ebert Rd -Winston Salem NC 271278223 _
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°00'43" Longitude: _8011822"
From WSRO: I40 west to Silas Creek Parkway exit and turn left. Go to Ebert St. and turn left. Go south approx. 5 miles and
the farm is on the right. _ T
Question Areas:
0 Discharges & Stream Impacts 0 Waste Collection & Treatment Waste Application
Q Records and Documents 0 Other Issues
Certified Operator: Billy Lee Morgan Operator Certification Number: 26867
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
On -site representative Lee Morgan Phone:
24 hour contact name Lee Morgan Phone:
Primary Inspector: M i a M Rpsebrock Phone: [phone]
Ext.383
Inspector Signature: Date:
Secondary Inspector(s):
Phone:
Phone:
Page: 1

• •
Permit: AWC340001 Owner -Facility: Edgar Miller FacilityNumbcr: 340001
Inspection Date: 06/20/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Inspection Summary:
3. and 9. Waste is entering freshwater grate and is discharging into a freshwater ditch that goes into surface waters. MUST
install 6-8 inch containment to contain waste to lot and suggest raising grate level about 4 inches.
9. Owner has been approved through NRCS for financial assistance for guttering, concrete pads and travel lane.
9. Need to repair damaged curb near west side of cow lot. Some waste has started leaking through the gap. To be repaired within
60 days.
15. T-2323 F4 must be re-established prior to receiving any new waste. Field is denuded and vegetation is mostly broadleaf
type weeds.
21. Don't forget to send in waste sample for June 2005 applications and 2005 soil samples.
21. Need to send in waste sample immediately after tatting. Operator has two waste samples taken 4/15/04 and 12/27/04 that
are dated 3I1105.
28. T-2325 F-6 is on map in new WUP, but I could not locate this field in the chart in the WUP. See tech specialist for
assistance.
Page: 2

Permit: AWC340001 Owner -Facility: Edgar Miller Facility Number: 340001
Inspection Date: 06/20/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
Cattle - Milk Cow 135 82
Total Design Capacity: 135
Total SSLW: 189,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
aste Pond WASTE POND 29.00
Page: 3

°' Permit: AWC340001 Owner - Facility: Edgar Miller
Inspection Date: 06/20/2005 Inspection Type: Compliance Inspection
Facility Number: 340001
Reason for Visit: Routine
Discharges & Stream Impacts
Yes No NA NE
1. Is any discharge observed from any part of the operation?
❑ 0 ❑ ❑
Discharge originated at:
Structure
❑
Application Field
j ❑
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 DWQ)
❑ ❑ ❑ ❑
2. Is there evidence of a past discharge from any part of the operation?
❑ N ❑ ❑
3. Were there any adverse impacts or potential adverse impacts to Watcrs of the State other than from a discharge?
■ ❑ ❑ ❑
Waste Collection Store e & Treatment
Yes No NA NE
4. Is storage capacity less than adequate?
❑ ❑ ❑
If yes, is waste level into structural freehoard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ 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'? ❑ M ❑ ❑
7. Do any of the structures need maintenance or improvement?
❑ ■ ❑ ❑
g. 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 Pending?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN> 101/o/10 lbs.?
❑
Total P205?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
Cl
Crop Type 1
Grasscs (Turf,
Centipede, Clover, etc.)
Crop Type 2
Matua (Hay)
Crop Type 3
Crop Type 4
Crop Type 5
Page: 4

Permit: AWC340001 Owner • Facility: Edgar Miller
Facility Number : 340001
Inspection Date: 0&2012005 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yea No NA NE
Crop Type 6
Soil Type l
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)?
❑ M ❑ ❑
15. Does the receiving crop and/or land application site need improvement?
0 ❑ ❑ ❑
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑ ❑ 0 ❑
17. Does the facility lack adequate acreage for land application?
❑ ❑ ❑
1 B. Is there is 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?
❑ so ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ MCI ❑
If yes, check the appropriate box below.
W UP?
❑
Checklists'?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
0
❑ ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code`?
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after> 1 inch rainfall & monthly?
Waste Analysis?
Annual soil analysis?
❑
Crop yields?
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
•❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑ 0
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25, Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑ 0
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑
❑
Page: 5

•
•
Permit: AWC340001
Inspection Date: 0&20/2005
Owner - Facility: Edgar Miller
Inspection Type: Compliance Inspection
Facility Number: 340001
Reason for Visit: Routine
Other Issues
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
29. Did the facility fait to properly 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 ycs, contact a regional Air Quality representative
immediately.
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Rcviewerllnspector fail to discuss reviewlinspection with on -silt representative?
33. Does facility require a follow-up visit by same agency?
Yes No NA NE
❑ ❑ ❑
❑ E ❑ ❑
Page: 6

Type of Visit k7
mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0GrOther ❑ Denied Access
]� [�
Date of Visit: Arrival Time: Departure Time. ® County: 1'DrS Region: " �!
Farm Name: exv1_ Farr i Owner Email:
Owner Name: aIr 1P� Phone: 33 b Mailing Address: __ 4�6_) I Y \� I Y] �X1�1______; _�� 2 -70
Physical Address:
Facility Contact: Title:
Onsite Representative: Q41�
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No: O� C_
Integrator:
Operator Certification Number: tD S G -7
Back-up Certification Number:
Latitude: M ° ®` P: 'M" Longitude: ®° ® `
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Clpttle
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean i
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Fer
on -La et
Dry Poultry
❑ Layers
i
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & 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?
Design Current
Capacity Population
Dai Cow
Jr
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: =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 State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3, Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes �No ❑ NA ❑ NE
XYes ❑ No ❑ NA ❑ NE
12128104 Continued

Facility Number: — Q Date of Inspection��
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure Lord
Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes jNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes VNo ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes L(No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes %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 Anplication
i
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA Lj NE
maintenance/improvement? 1K\
] 1. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidene f ind Drift [I Application Outsideof Area
12. Crop type(s) ) , AU&' 'MIA A - A
13. Soil type(s) v v V_
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes A No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination. Cl Yes ❑ No 16NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
/ � 1
Reviewer/Inspector N
'4 IF 12128104
'i1'►11lfiI111!'�_: 111�_ ice' �•
r Y__J464_��

Facility Number: — DIf Inspection �s •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑ Other
21. Doe ecord keeping need im ovement? If yes, check the a propriate box b ow. Yes ❑ No ❑ NA ❑ NE
ante Application IJ We
Freeboard Waste Analysis Soil AnaLvsi Ipmlftl owl
Rainfall Stocking Crop Yield Monthly and V Rain Inspectio Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
r
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ANA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ElNA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No �`A
❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes XNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No VNA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[INA
❑ NE
and report the mortality rates that were higher than normal?
���/77��"``�No
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
)4No
❑ NA
❑ NE
General Pen -nit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
to
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency'?
❑ Yes
❑ NA
❑ NE
I k l k k iWfA
--
r
fro-
i
s r
rs�■�

Technical Assistance Site Visit
O Mion of Soil and Water ConservatidW
• Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number 34 - 1� Date: 121281 Time: 1 9:30 Time On Farm: 105 WSRO
Farm Name Gem Farm County Forsyth Phone: [phone]
Mailing Address 4550 Ebert Road
Winston Salem NC
Onsite
Representative Lee Morgan Integrator
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
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current Design Current
Capacity Population Capacity Population
❑ Layer
❑ Non -Layer
El
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
® Dairy
❑ Non -Dairy
® Dairy
❑ Non -Dairy
135
95
❑ Other
27127
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 ® 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 ponding ❑ yes ® no
requiring DWQ notification?
6• 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
Structure1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier Holding Pond
Level (Inches) 19
CROP TYPES Fescue -graze 10rchard Grass (ha )
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

7j
S
Facility Number 34 - 1 Date:
12/28/05
PARAMETER
0 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
®
❑
❑ 11. Level in storm storage
26. Waste Plan Conditional Amendment
❑
❑
27. Review or Evaluate Waste Plan wlproducer
®
❑
❑ 12. Waste structure integrity compromised
❑ 13. Waste structure needs maintenance
28. Forms Need {list in comment section)
❑
❑
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
❑
❑
❑ 15. Over application < 10% or < 10 lbs.
30. 21-1.0200 re -certification
❑ 16. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
®
❑
❑ 17. Deficient irrigation records
❑ 18. Late/missing 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. Crop inconsistent with waste plan
36. Sludge removallclosure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
❑ 24. Deficient sprayfield 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:
43. Irrigation design/installation
El
El Other...
system
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45. Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certificationfrechecks
❑
❑
48. Crop evaluationtrecommendations
❑
❑
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)
El
❑
5'
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6.
58, Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
1*1111MIC'.

I Facility Number 34 - Date: 12/28/05 l
COMMENTS:
25,27. Need to run PLAT on the farm.
32. Review and verify irrigation application records.
39, 40. Look at areas of heavy use for cost -share assistance.
51. Roof runoff management.
53. Look at and recalculate field acres.
TECHNICAL SPECIALIST IRandy Blackwood
SIGNATURE
Date Entered: 113105 Entered By:
lRocky Durham
3 03/10/03

I.1rI. fi li-. �'I r{<-,i''1.P'd r rrrl, ,I {I ,.If,,il-s':e�iSlnn3°af Watc"r Quality i lil{(`(tilts {Ii I.qE Iii lfsj:l {sliP'`i;? i u yttirlr,'. ?E€tE I 1 rp,,'a ,rrria3,.3i,',Iflif? jj?:(fl+t;Ii;lrlil
I � '_" I€ I. a• s..,,�.1. ?t E ,_ "' , ;i1:.:€:." €I 'r+�,, .��€!
[t!;;DiVisio111Of"SOil�iand''Water'Conservation+
,o- 1.: �� I? a �el�l t�.;€lPlf iff � °P I I I'ir'{ Ir'lli �rr>•...91,{I..If € :! ,t i !a rt }rl1 10...,w€<.as
.. �€ . !! ,'!' �? .:lift �.ij9.t=P,. ;ti? f{.,.t 3 if 'I{rr. HI I - I.�'ti:l.. tl1 �<€ =pj 13 P I �`!� =i i.._ �., ! i ,€°� ali € "•IPI,I,'.?i s i , � ? �f. '
Qthcr•Agencyl.r ° ;°i'. r sl, rrj:li,l ri `I:II r lP'��..l,cir �f r,iir}€fI .fl.i IrP,,rf'i�l 11 Sil 1rix I+{`I iil,
?<�l, ;I.P! I €i+,?. �
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rP�. n.lP:.IPIEil1r!rlbl,9k�,�l.,Poii�rx7i„rfH€,i;?1i>P,i,Idio;;Iil ti�,.,.I(}.€tl:,,:!�Ii.l,la� s4�i�,i}i.i��laili�l�Ir-,rGuGir
Type of Visit O Compliance inspectipn O Operation Review Q Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 34 l Date of Visit: 3/t t12Q04 'Time: 1400
0 Not Operational O Below Threshold
® Permitted ® Certified [3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: ... -- --
Farm Name. Gem.Farm.......................................................................... ... County: F_Qriytb-.................................. Y. S&Q _.._.
Owner Name: Edgar 1YL71er----------------------------- Phone No:(33-fi1.7AS-44,5a--------------------------..
Mailing Address: 455Q.Ebert.RQAd............................................................:......................W.in9.tQ,0.5alexWj09AQ,0J5;A19M.N.0 ............................................. 2,712.7 ..............
Facility Contact: LU.No.rgan................................... ....Title:............................................... Phone No: 336,316,079.1..t�'.t,)........ OnsiteRep reseutative: Up, Morgan -
Certified Operator:B91y..Leg ............................... J. gr.gA11............................................ Operator Certification Nurnber:2($¢7.............................
Location of Farm:
rom WSRO: 1-40 west to Silas Creek Parkway exit and turn left. Go to Ebert St. and turn left. Go south approx. 5 miles +
Pnd the farm is on the right.
❑ Swine ❑ Poultry ® Cattle ❑ Norse Latitude 3ti • 00 43 Longitude 80 • 18 ° 22 «
Design Current
Swine Canacitv Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population - Cattle Capacity Po ulation-
❑ Layer 7 1 IN Dairy 135 85
❑ Non -Layer I JE] Non -Dairy
❑ Other
Totalbesign Capacity 135
Total SSLW 189,000
Number. of. -Lagoons 0 �I 1 -
-- ,.. — I. ...m 1
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:__._VysteP_ancL.... ........................... .......................... .................. ......... ...........................
.....
Freeboard (inches): 24
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
12/12/03 " ,fir w d` Cpntinued

Facility Number: 34-1 0 Date of Inspection 1 3/11/2004 1
0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes N 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 f
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes N No
8. Does any part of the waste management system other than 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 Application
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 ® No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Orchardgrass hay Small Grain (Wheat, Barley, Matua (graze)
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ENO
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 pended 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 ® 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 N 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 N No
Air Quality representative immediately.
­.
Comments (refer'to`qucstion #) Explain any Y115:answers and/or an rccommend'atlo ' '4 ' �� " ns or an • y y other comments. ��-
iUse drawings of facility to better explain situations. use aqq1tional pages as neccssary): ❑ Field Copy N Final Notes
3. Need to repair fencing at creek in old milk cow pasture since cattle have eroded stream bank. Check again in 30 days.
8. Barn roof to still be repaired. Suggest fencing and establishing vegetation in heifer lot to help contain sediment and manure. Not a
water quality concern today, though.
15. 2,4-D and Banvel to be sprayed on matua w/in 1-2 weeks. Crops look much better overall.
23. Per operator, soil samples were taken in 2003 but not sent in until 2004 so results are not back yet. NOV only if operator will obtain
2004 samples within 30 days.
10/17/03 waste analysis = 3.6 lbs. N/1000 gal.
Reviewer/inspectorName Melis Rosebrock,,,in - - - ...';.
Reviewer/Inspector Signature Date:
12112103 Continued

Facility Number: 34-1 1 DO Inspection 311112QQ4 0
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ® Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes: ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Not' ' 'on 0 Other © Denied Access
Facility Number Date or visit: Time: L.
O Not Operational O Below Threshold
Permitted [3 Certified [3 Conditionally Certified 13 Registered
FarmName: ..... �ylt. ......V-aj-............................................................................
OwnerName:...... 64..0...K1 ±..i.......ryttles..................... .............................
Mailing Address:
Facility Contact:
Onsite Representa
Certified Operator
Location of Farm:
Date Last Operated or Above Threshold: .........................
County:........Fac.a.q.....tr...................`....................
Phone No:.. 1.P...... ..L$. �.I. .......1:...,1....'.'...............
An.n..-.....ti a .............. .. ..�. .
Phone NO: ..X'.►..IA.L...t..4..i. 1
Integrator•......................................................................................
Operator Certification Number: ..............IQ �..
❑ Swine ❑ Poultry [Cattle ❑ Horse Latitude lao• ®t ®66 Longitude ®• ' ®"
pq - Y p i ff1r rrr - 1 _. I t S WM { {,L',' ii r _ 7 'e Rtn �.ry. r. 1r �1
fXi £ifeE. 1j" ! ii r:.3t1D �{
Design�. li 3Current:{£jf,. .. 1 Current I. r' 'rF -T r �, lh D�Jlgn ,-!j}Cdrre�t f:
]]Po
r•E.4 Rr d>h k
ll -g i ! F f ;
i`.a�r:•IItt P j■r� i, f .t # - �lili[' `j i �i i �' {F .`C •i, E�� I
Swine •
Ca
: aca ulii`
i • y ', r .f a 1! !, ,r,
tion. 3' .PAnI--J.Y.-.€�i ., -.Ca aC� Y. 0 {Fl•✓��Vnvtue �i�i.. �..r%.Ca a411 �PQ M1a11VY yr
Wean to Feeder
El Layer air
No. -Dairy,[
T
jj£
Y
r i
�rf S �y� 3£1�1i` £��-" i.•k'..r i f . .r'• SF. �:e•h
s
iCapac><ty4'
i -
..�..__ ._.....•.. „_.,...:. -.. ,:.
,ui.�,„r.... tlt�; si._ .a r. .k.$dLi11►JOiLW
$Es�iat
i%ii$�Q!¢L
%61
amber afrLagoonsr� �,f,,C
fi�
1,
l � I �� f ���i8-a.• s� i r E� I t i1 a: €r.' r 3� �!1
°
t£'t�� � it a 1
.-i � f � �� t r
r , .• �.Ia�
❑
`,!�
❑ Feeder to Finish
'�'
❑Non Layer
❑ Farrow t0 Wean
, i f- "�:•i6>..:r.. ,.' :^ p; ay a;
�
££',._
1� '
Other
❑ Farrow to Feeder
Farrow to Finish
ef' r j3 i,,l i•" er xi,�R � £i s -i li! a'ss r�f eV a¢�If�r
n£{
�il,�°�,
[I Gilts
❑ Boars
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
❑ YesXNO
Discharge originated at: El Lagoon El Spray Field El Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes El No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway ❑ YesXNo
j� trust e 1 cture 2 Structure 3 Structure 4 Structure 5 Structure
Identifier: .li.a1�,..0.................................................................................................................................................................
Freeboard (inches): a
12112M Continued

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
closure plan? •
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes X
o
elevation markings?
Waste A/cation
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? If yes, check the appropriate box below. El Yes No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc _ A
MS!*t7_�_'r►]UW1//I�1`I'
13. Do the receiving crops differ with thosel4esignatUd id the Certified Animal V/aste Management Plan (CAWMP)? i/ ❑ Yes '*-RN
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
o
16. Is there a lack of adequate waste application equipment?
❑ Yes
X No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
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
o
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yeso
t
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.
f'2 iir •n'=flt, 6a.„rw F �. �t#F .,.N - €,./.E d�' dFi3 0 _iil:iSC'P{3 - 3 c: M1 r K'�:.3e, 7 3- r i.. ,..w..'?R., G'P . -
m,�.o-.<r�w":,_; qr,
reo l{ars � anF.,. :d. ;ecominenan" .�t,,s
and sdwr
in1l-�ra1 s"Y: r.x3ae-s, ah*n.ir.��
ol�ms!� t,[:'i;$ko:
Er
��;'
�ield
��¢ ner#xisrit ;" ayrt
fr_t
�t:-m._!.
hr°'
;•i :e :
,h
�'/..�,o.:t
oUse drawengslf acLtyto better enarysu.
t:Copy Final Notes
7qf-lY.E.
ds
E;;,Cf i k-fi•.e�r! ��#FE:).
'`i`. ru. _
�y'nr
.e3:G1=ei.!i�n?�'ti9NF1f'E]+S�)Y 31 rr'1,i-.. '•�1n ri�� '�a!'t"-^SfFfii .. }'^kiltjj.l
:.�F)�":F�.?tl?.�_iif: E-��. `13'�.#•� �a`'.i��t}�Y(-w��i1.�_..ta �11.Z3z:����M.�t�d�fiZ�i�i't.8t't48"��V �'riG�ECr¢;4&3%�3'I�kSv_.t�33:�. �E����i.flf_E::§f:�37idpr3r�1�L.1���;°n,�,E�vX��-i701f341"'}H !>.,.�i.1�i �>a.13..3.3i>,3.,.L'Fi:1 :Fi.a�,r�'"-S�i.b v-i�' �il. ,.1 E1=
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v V oo
a
.
vw
SpF:Si tpy W. fy.wYt9P"'?yt iii� f.+j?jp'j'f Fgfi I r�A hi* (` IiT` =i
Reviewer/Inspector Name.:d.tfFiE��"°p �dl��Y..11 �u.��L
FiE };��.h �T .�W€. 3✓.'<.ii: r!�{,dd
Reviewer/Inspector Signatu • Date:
12112103 Continued

Facility Number: — 16of Inspection
Required Records & Document.~ `TT
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, desig , maps, etc.) ❑ Yes No
23. Does record keeping need i provement? If yes, check the appro ate box below. Yes No
❑ Waste Application hard ❑ Waste Analysis Moil Sampling
24. Is facility not in compliance ith any applicable setback criteria in effect at the time of design? ❑ Yes No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes No
26. FaiI to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ YestNo
o
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes
29. Does facility require a follow-up visit by same agency? ❑ Yeso
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ElYeso
NPI)ES Permitted Facilities .
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes WN 0
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
@ At"t'� kata4j'v
10%l-�103— 3o6#N1I000go..Qe
„U
12112103

nical Assistance Site Visit Repo
DiM5'fon of Soil and Water Conservation
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 34 - Date: 12/11/03 Time: 1 13:30 1 Time On Farm: WSRO
Farm Name Gem Farm
Mailing Address 4550 Ebert Road
County Forsyth Phone: [phone]
Winston Salem NC 27127
Onsite
Representative Lee Moran _ Integrator
Type Of Visit Purpose Of Visit
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Morse
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
O Routine
O Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
Q Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
Q Emergency
O Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
® Dairy
❑ Non -Dairy
O Routine
O Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
Q Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
Q Emergency
O Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
® Dairy
❑ Non -Dairy
® Dairy
❑ Non -Dairy
sa
HL
❑ Other
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 ® 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 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?
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 W SP
Level (Inches) 45 1F_ IF IF If
CROP TYPES lCorn, Silage I Ismall grain silage Matua-hay Orchard Grass ha
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

•
•
Facility Number 34 - 1 Date:
12/11/03
PARAMETER
QQ 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❑
❑ 11. Level in storm storage
26. Waste Plan Conditional Amendment
❑
❑
27. Review or Evaluate Waste Plan wlproducer
El
El
12. Waste structure integrity compromised
❑ 13. Waste structure needs maintenance
28. Forms Need (list in comment section)
❑
❑
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
❑
❑
❑ 15. Over application < 10% or < 10 lbs.
30.2H.0200 re -certification
❑ 16. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
❑ 18. Late/missing waste analysis
[119. Late/missing lagoon level records
33. Organ izelcomp uterizati on of 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 removaltclosure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
[124. Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker checklcalibration
❑
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
43. Irrigation design/installation
❑
❑
El Other...
system
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45. Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluationlrecommen dations
❑
❑
2.
49. Drainage worklevaluation
❑
❑
50. Land shaping, subsolling, 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)
❑
❑
'
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Croplforage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

•
•
Facility Number 34 - Date: 12/11/03
COMMENTS:
The operator is in the process of collecting soil samples.
The operator will spray weeds in the matua grass next Spring.
TECHNICAL SPECIALIST IDede DeBruhl IF
SIGNATURE
Date Entered: 12/12/03
Entered By: lRocky Durham
03/10/03

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 34 Date of Visit: 12/01/2003 Time: lOtO
0 Not Operational 0 Below Threshold
Permitted ■ Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold: ......... ....
Farm Name: G.eM.FATM....................................................... County: UrUtb................................... W111M .....
Owner Name: Esar ------ ---------- MiJI¢r---------------------------- Phone No: -------------------
Mailing Address: ..4. 51t..lub¢rx.l3QiAd......................... .............................................. .......... ..W.insl Winsloin.&LIgin.N.0 .................... I.............1.1........ 271.2.7 ..............
Facility Contact: x,ee.M.man.......................................Title: .......... Phone No: 3��.I IC.Q7Q.1.1cttll).........
.....................................
Onsite Representative: tatMum-Integrator:-----------------___._..--•----------------•
Certified Operator: Hilly..ln ............................... mpCggp,......................... ... Operator Certification Number. 26.8.67.................... ................ ........
Location of Farm:
from WSRO: 140 west to Silas Creek Parkway exit and turn left. Go to Ebert St. and turn left. Go south approx. 5 miles A
tnd the farm is on the right.
[]Swine []Poultry ®Cattle []Horse Latitude ET3 K Longitude 80 • 18 22
De_sign
p
Cu�rren�f
Design,. Current
Design Crrent
N` Swine Ca aci
" 1?o ulation Poultry
Ca aci Po ulation CattleMCapaeitj�P606lation
a
.:f
Wean to Feeder
Layer
❑ ®Dairy 135 88
El Non -Layer
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [I Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
[I Yes ® No
❑ Yes [3 No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: __._W str.Psi ............................... --------------------------
Freeboard (inches): 54
05103101 -.0 �p 3 / Continued
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [I Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
[I Yes ® No
❑ Yes [3 No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: __._W str.Psi ............................... --------------------------
Freeboard (inches): 54
05103101 -.0 �p 3 / Continued

Facility Number: 34-1 . hate of Inspection 12/01/200
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? [I Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement'? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste ADDlication
10, Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Small Grain Overseed Corn (Silage & Grain) Small Grain (Wheat, Barley, Matua (hay/graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15, Does the receiving crop need improvement? ' l ® Yes ❑ No
i
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ® No
18, Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/]nspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? []Yes ® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
M
to question ): Explain an YF.S a s er a dlor anfaeili , It be ter explain situations..us a itional a nec ar ❑Field Copy ®Final Notes
8. Repairs to the ramp, and surface/parlor pipes looks good. Barn roof still needs to be repaired, though to keep excess rainwater out of _
the waste pond.
15. Matua/erchardgrass pasture needs to be sprayed to control curly dock. Matua stand looks much better this year.
19. Don't forget to obtain 2003 soil analyses.
25. Approximately 10-15 acres of leased land is to be sold and may need to be taken out of the WUP. Check acreage after buffers, too
(200' to another property).
10/17/03 3.6 lbs. N/1000 gal. _
T
Reviewer/Inspector Name [Melis a Rosebrock
Reviewer/Inspector Signature: Date:

Facility Dumber: 34-1 Dat0nspection 12/01/2003
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[.' t bna [•_ommentTan o1 _raw ngs:
AL
05103101

loam
Type of Visit A Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit XRoutine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
F7 Facility Number
Date of Visit: 'rime: T
Via' 1 /�
rO Not Operational 0 Below Threshold
Permitted 0 Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: ffi r m County: Ft3rsvth
I
Owner Name: E ota'y— �,� I �_ '! 1 Phone No: C� $' `7 S
Mailing Address: s� C] f ► [ r ii � t7 l��
Facility Contact: Lee- drO<2 n Title: Phone o: 1
Onsite Representative: e-e— Integrator:
Certified Operator: I{ Operator Certification Number:
Location of Farm:
Sa v , on E b,,+ S4. Prr1 Si a5 ree Y- k-w y e S rvli Ies. FQ ► o r�
❑ Swine ❑ Poultry 90 Cattle ❑ Horse Lat►tuae t .z8p ►- i -- - i —r .. Longttuue t ov i I t 7L l• I 4r—J^
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Pob ulati6n Cattle
Capacity Population
❑ Wean to Feeder
JEI Layer
I
Dairyi
❑ Feeder to Finish
❑ Non -Layer
Non-Dai
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Caoadty,4
3 s
El Gilts
Total Skw
g QQD
.
❑ Boars
Number Lagoons❑ Subsurface Drains Present Lagoon Area
❑ Spray Field Area '
Holding Pondsa=5oi►d Traps ❑ No Liquid Waste Management System
Discharges & tream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
=tructre Structure 2 Structure 3 ��I ••• Structure 4 Structure 5
Identifier:
Freeboard (inches): S
14
❑ Yes x No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Jj No
❑ Yes x No
❑ Yes x No
Structure 6
05103101 1 T Continued
i

Facility Number: 3 q Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Appligatioa
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
13. Do the receiving crops differ ith those designated in the Certi
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c).This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
O%r9,W
5"-Q.Q
16. Is there a lack of adequate waste application equipment?
RUuired 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?
(ie/ WUP, checklists, design, maps, etc.) V V / V0ti
rr 19, Does record keeping need improvement? (ie/ iigation, freeboard, waste analysis & soil sample reports)
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewerlinspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
❑ Yes XN 0
❑ Yes XNo
❑ Yes No
ElYes 0
No
❑ Yes �No
❑ Yes No
❑ Yes No
ft�es XNo
❑ Yes %No
❑ Yes No
❑ Yes No
Ayes ❑ No
❑ Yes X No
❑ Yes 'KNo
❑ Yes P1No
❑ Yes No
ElYes tNo
❑ Yes XNo
❑ Yes No
El Yes No
❑ Yes 16No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? — ❑ Yes Is No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Coinments. i efer fo uestio `µ
1 (r q h #) _'Expialn any YFES,answers and/or,any recommendations orany=other comments : „ w.i
Usedrawings of far ilityto� better. explain s=tuations .;(use additiona�pageses+neeessary) Field Copy ❑ Final Notes
e
05103101 `, Y — Continued

Facility Number: — ! Date of Inspection I -),/1 j 6
Oder him
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29, is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a pennanentitemporary cover?
❑ Yes o
❑ Yes �'No
w-
Add
jLional Comments and/or Dirswings:. -'� « ,,,� �, ')`.: _
tea r,�� 0
19 d c200A oz.) �2003 ? N42QA
. a0 03
/ 1 /
!�-!S CIO P
w
05103101

Type of Vielt © Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 34 1 Date of, Visit: 7/1t1/2002 Time: 1035
r Not O erational Q Below Threshold
® Permitted ® Certified [3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold ........... :.-.-:..........
Farm Name: GAAA.Fixrw......................................:::.. County: E.Qny.th ............................................. WSR.0........
Owner Name: '
Mailing Address: 45.50.Ebgt:t.Ro.ad ............ :..................
Facility Contact: >Get.IdQxgalq.................................................... Title:
Onsite Representative: Lee,Mp.rgal l..........................................................
Certified Operator:=Y.Let~................................ lY QjCg0'U.......................
Location of Farm:
Phone No: Q3.C1.7$.7445.$............................. :::.::.::!...... .............
1!'iut~xtant.Salina.�F............................................. 2.7127...............
Phone No:
Integrator:
Operator Certification Number:2,{,g(.7,,,,;,,,,,;;,,,,
rom WSRO: I-40 west to Silas Creek Parkway exit and turn left, Go to Ebert St. and turn left. Go south approx. 5 miles +
tnd the farm is on the right.
I —
[]Swine []Poultry ®Cattle []Horse Latitude F 36 ' 00 43 44 Longitude SO • 18 ' 22 G{
r k 'r.: a.s v 67 y°„<.- teYKw' ' Vu aMCI
'ems:am+ }< ` e
r �� l)esign °,.Current Design Currentestgn�`,Current
F
g - -- ._ ------ _... - — --. 5 ra Field Area
Number of�La oons © Subsurface Drams Present ❑Lagoon Area ❑ p y
`- -
a� `.. How grl?aonds 7Soiid i raps ❑ No Liquid Waste Management System,„' I
�Ca 'Poultry°
Jf'�`..^�. -
Ca
��4.
Cattle Po
actt �P:o elation
actt elation
actt etlation
❑ Wean to Feeder
❑Layer
®Dairy
Non -Dairy
l35
94
❑ Feeder to Finish
r.' ❑Non -Layer
❑ Farrow to Wean
❑Other
-Capacity 135
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
f 189,000
❑ BoarsTotaIASSL�W�
Discharges rea Impacts .. 1 ,
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Witter of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ®No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4,.. Structure 5 Structure 6
S
ldent i f ier. ...... lTi.aste.Ptattd........................................... .................................... ................................... ................................... ...........................
Freeboard (inches): 54
05/03/01 Continued -

Facility Number: 34-1 Date of Inspection 7/10/2002
o-
5. Are there any immediate threats to the iw
ity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Spring oats Wheat (graze) Soybeans
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
M. 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?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents I I 1 , I
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?
Oe/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments refer to question #): Explain any YES answe an or an eca endations or an other com ts.
Use drawings of faciIi to better ex lain situations. (use additional pa es a cessary : C] Field Copy ® Final Notes
8. Cattle waste does not appear to be entering the surface water drain near silo trench. May want to add a "speed bump" next to the gate,
though.
8. Facility will be doing some repairs to the push -off ramp, freestall barn, surface water pipe, and parlor pipe by the end of the Summer.
o WQ issues noted today.
15. "Cow Pasture" field (field 2 of tract 2325) is mostly bermuda. May want to revise CAWMP to Bermuda? Field also needs to have
applications of herbicide to control broadleaf weeds.
15. Field 2D of tract 2336 (Kimmels) had waste applied to oats in February of this year. Evidence of a good stand was noted, but the oa
[have been harvested and the new grass crop has died due to drought. Cannot put waste on this field until a crop is established.
[R]eviewer/Inspector Name PMeli osebrock
er/Inspector Signature: Date:
05103101 Continued

Facility Number: 34-1 14 Inspection 7/10/2002
Odu Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ 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 permanent/temporary cover? ❑ Yes ❑ No
Additional omments an or .rawipgs:
Need to also control broadleaf weeds in this field.
15. Some fields need to have lime applied per 2000 soils analysis report.
16. Southers is still doing waste application for facility.
* 19. Waste applications made in February 2002 did not have a waste analysis within 60 days (more like 90 days). - NOV
* 19. No soil analysis was obtained for 2001. - NOV
25. Need to add "Dumpster" to mortality checklist (calves).
*25. Facility is still working with technical specialist to revise CAWMP.
Questions that were left blank were not applicable to this facility at this time.
1W
05103101

la : 3btfm
Type of Visit ACompliance Inspection 0 Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time:
N t O e ati nal 0 Below Threshold
Permitted IAFCertified UConditionally Certified Registered Dafe Last Operated or Abov Threshold:
Farm Name: a ry) County: 1rs
Owner Name: __Se_6
Mailing Address: ,_
Facility Contact: _
Onsite Representative:
Certified Operator:
Location of Farm:
m 55pZ
❑ Swine ❑ Poultry
Design Current
Swine
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Gilts
Boars
�7
Title: Phone No:
Integrator:
0 Operator Certification Number: a
LW7 5 ini IeVw Fav),
I In
Design Current - -Design, Current
Poultry Ca acl Po ulation Cattle Capacity Population Z
E. '7
❑ Layer 'airy
❑ Non -Layer I ---Ion-Daityl
❑ Other -r .
Total Design Capacity.
Tota] SSLW �}
k�N.umbor of Ugoons , ' ❑ Subsurface Drains Present ❑ La oon Area 10 Spray Field Area
Holding Ponds 1:SaUdiTraps ...,, ❑ No Liquid Waste Management System ,...� ...
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
i
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) -
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
Stru ture Structure 2 Structure 3 Structure 4 Structure'5"
Identifier:FD
Freeboard (inches):
05103101
❑ Yes �No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes VNo
❑ Yes �(No
Structure 6
Continued

Facility Number: -- Date of Inspection �Q
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.) /
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes VNo
(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
S. Does any part of the waste management system other than waste structures require maintenance/improvement? X Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level XNo
elevation markings? ElYes
Waste Aaulication
10. Are there any buffers that need maintenance/improvement? ❑ Yes K,No
11. Is there evidence of over application? a ❑ Excessive Pondi ❑ PAN ❑ Hydraulic Overload El Yes )<No
12. Crop type
13. Do the receiving crops differ wit those desig t d in the Certified Animal Waste Noagement Plan (CAWMP)? ❑ Yes VNo
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 d No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Requirgd Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes o
1 S. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes .e j No
1C� 19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) Yes El No
t
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes X'No
21. , Did the facility fail to have a actively certified operator in charge? ❑ Yes �No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? El Yes /!fir ``vvX``, No
24. Does facility require a follow-up visit by same agency? ❑ Yes XNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? 9yCs .NO
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence shout this visit.
Comments (refer ito°question.#) E3xp1a1nany YESaitswers andlow'any recoimmendations.orany other comments ;. T " ;r
�
s ne diti :ecessa
Use drawings of,faclllty to betterkeaplain ns (use situatioadno al!��p ges
• ❑Field Copy Final Notes
Y
Reviewer/]nspector Name
Reviewer/Inspector Signature. Date:
/ 05103101 ' Continued
o 1)-)14t - SXil_�'o
(+

Facility Number: -- Date of Inspection
Qdor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below E9 i-es —B lq o
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, El Yes A No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?'es--�T�a
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?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? E3 " S Ne
Additional Comments and/or Drawings:
r�S sC. A r6 fKP
3, &)V-��
� /• .� � rJj Ili„ ` �
1
r
m
o5l,31o, ln5 4
.0,4�- � jgw* 76 e,*-)c�
a6
m

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Vislt O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 34 1 Date of Visit: 12/14/2Q01 Time: 13:3Q
Not Operational 0 Below Threshold
® Permitted M Certified p Conditionally Certified (3 Registered Date Last Operated or Above Threshold:.....
Farm Name: fitnt.FArm...............................:...........:........................................................... County: FQnytk ............................................. WSXA........
OwnerName: Fdad...................................... Millgj............................. I .......... I................. Phone No:(33,61.7.88:-.445.8 ........................................................
Mailing Address: 45S0.Ebut-R9.8d....................... ....................... .................................... W]W01I.S.41CMAC ............................................. 27121 .............
Facility Contact: LM.Morgim.................................................... Title: 1. URAW..................... Phone No:
Onsite Representative: lac.Mor'.pa..........:..................................................................... Integrator:......................................................................................
Certified Operator: Rif"bard.A............................ M.iliac................................................ Operator Certification Number:22133 .............................
Location of Farm:
iilas Creek Pkwy. exit from I-40 and go to Ebert St. and South approx. 5 miles and the farm is on the right. A
w
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 36 • 00 43 Longitude 80 • 1$ 22
Design Current Design Current Design°' Currrent
Swine @a acit P,o ulation Poultry Ca acit M ulation Cattle CaII t ``P,o ulation
1. ❑ Wean to Feeder' ❑ Layer ® Dairy 135 108
❑ Feeder to Finish ❑ Non -Layer 10 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑Farrow to Finish 'Total Design Capacity 135
❑ Gilts -
is
❑ Boars h Total SSI.W 189,000;' Rj
A°.
Number of Lagoons ---1❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holdin on /Solid Tra s I� q g y P
g p ❑ No Liquid Waste Management System
Discharges & Stream Impacts
L 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 ohserved, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Ooliection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ...................................
Freeboard (inches): 24
05103101
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
Structure h
Continued

Facility Number: 34-vt Date of Inspection 12/14/2001 y�
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, 0 Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
WasteApulic�ttion
10.
Are there any buffers that need maintenancelimprovement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12.
Crop type Soybeans $mail Grain (Wheat, Barley, Matua
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required
Records & Documents " • . 1
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
® No
t9.
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
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
® Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
(3 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy ❑ Final Notes
3. Due to repair work on pond, fence had been taken down (small section), cows had access to creek for a limited time. Manager has _
:en told to remove the cows from this area. He has agreed to do this.
19. The farm manager has changed. Soil samples and waste analysis need to be taken.
21. New farm manager has taken course and test (12/ 13/01) to become a certified operator. The prior certified operator still works.
24. Due to change in cropping system, a new WUP will be developed.
Reviewer/Inspector Name Bede DeBruhl
Reviewer/Inspector Signature: Date:
05103101 Continued

Faciliti-Number: 34-1 [3 of Inspection 12/14/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes IN No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes IN No
❑ Yes ® No
❑ Yes ❑ No
.&I
05103101

Facility Number 34 01 Date wf Visit: 7/20/2001 Time: 130o Printed on: 712512001
0 Not Operational 0 Below Threshold
■ Permitted N Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold.. ........................
Farm Name: G.Pm.k:r3tt:nu................................................................................................... County: Fonyth.............................................. WSRO........
OwnerName: Edgar ...................................... MIlhclr.......................................................... Phone No:
Mailing Address: 455Q.> bCr.t.,R9.8d................................................................................. 1�!'it tart.Selena.NG............................................. 2717...............
Facility Contact: iilek.NURex..................................................... Title:................................................................ Phone No: ccU.#..326.,S.7.4.[ i ...........
Onsite Representative: RkkMjlk......................................
Certified Operator:Rkbard................................. biller......
Location of Farm:
Integrator:,.
Operator Certification Number:2<2133.............................
gilas Creek Pkwy, exit from I-40 and go to Ebert St. and South approx. 5 miles and the farm is on the right. +
w
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • ®� 43 �� Longitude F22 «
-'�' - � J !.- �
,;� Design r`: Current
A "•' c°cs�
i �-� \f1 Y'." 1 '. SY F..y 5 i.` } L, . ,�1
x�WI?estgn Current s� r` Design , �',Currentr i
t..'`fme{uon Poaltry a actt aP:o elation Cattle Ct� `acit;Po ulations '
❑ Wean to Feeder
'. ❑ Layer ®Dairy 135 110
:v..
i
dP5;.;, ❑ Feeder to Finish
k'
❑ Non -Layer ❑ Non Dairy
❑ Farrow to Wean
Farrow to Feeder
'L ❑ Farrow to FinishGilts
t ❑Othern
ty "' TOtfA�DeSI n Ca "8Gt ' 135
❑ BOar51y`
` rw�vT�,y&����T✓T� ppnn nnnn
-��'..;.x.-rrf.roi dfdTOta�jvS�71i•r 107�UUU
Number of Lago�o p', ; 0 ❑Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds /Solid Traps ❑ No Liquid Waste Management System a.
Oischarees !& Stream GIs
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? Of yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection i e
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ...................... ...... asle.P.oand...................................................... ............................ :...... ................................... .......
Freeboard (inches): 54
❑ Yes IN No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
05103101 Continued

Facility Number: 34-01 jft Date of Inspection 7/20/2001 . Printed on: 7/25/2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12, Crop type Soybeans Matua Oats Rye
❑ Yes ® 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 Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Rye aired 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?
Oe/ WUP, checklists, design, maps, etc.)
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy ® Final Notes
8. Keep an eye on the concrete "bump" area by the freshwater grate/drain. Appears that some bedding and feed may be getting into the _
drain, Waste is not getting to the creek.
16. Grassy Knob Farms pumps out waste storage pond when needed. 704.883.0511
19. Will need to obtain 2001 soil samples.
Marlene Salyer with the WSRO DSWC was also present for the inspection.
Need to ask SWCD about PAN amounts:
atua PAN = 445-490 lbs.lacre
ve PAN = 400-590 lbs./acre 'IF11
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signature.
Date:
OSIO3101 11! I Continued

Facility Number: 34—tll Dof Inspection 7/20/2001 • Printed on: 7/25/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes IN No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
J
05103101

I P
� ,Sl n'.
..J1 3
IType of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other
Facility Number Date of Visit;
Permitted Certified 0 Conditionally Certified 13 Registered
FarmName: Oaem ....... Farm ...... ..... I .... ... ...............................................
Owner Name:......
............. ..................... .................. ................
e: .........................
Facility Contact: U............. . a 4 ... C - V— -.41itt I
Mailing Address; d LL
T...... AzA ............................................
Onsite Representative: ..... .......................... ....................................................
Certified Operator: ..................................................
Location of Farm:
,5 -11 a's C-'reAX- P&-e y 1001 e-x I V'rom :1 - 40 V3.p—.5+,
mcl�� ke4+-I�SOU40 0 +0& L)ef+ TTMAXI " f
❑ Swine ❑ Poultry
5vine
Cattle 0 H*rse Latitude
1 0 Denied Access
T65ITime; I[=
Not Operational 0 Below Threshold
Date Last Operated or Above Threshold: .........................
County: ........... F r5 ... �.+h ........................................
Phone No: A5arr\ 33b - 7 % 5 - 4. � S? ,
............................ I ...................................................
ko 4
Operator Certification Number: ...... ........
2N
_UU!" %—B FK IMZ2 0 t '-V prt t Ij Ld I 1 0
46 Longitude 0 d
Design,, Current Design ' Current Design Cal
ity CattleP1
'� , �, Capacity �,100 Cipacio: Population T00try, ac "Population
0 Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
I D
FO—Layer airy p
❑Non -Layer Don -Dairy
❑ Other
Total D Design Cap 1 acity r 135__j
ioW SSLW,
e 3 Spray Field Area
.,,,Numbeir-of Ligooini, ❑Subsurface Drains Present ]1771 Lagoon Area
I 4i6i"90oiiils tSolid'-T7ps'., ❑ No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? 0 Yes )(No
Discharge originated at: [] Lagoon [I Spray Field El Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. -If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/inin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) 0 Yes [I No
2. Is there evidence of past discharge from any part of the operation? El Yes O(No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? 0 Yes KNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? lSpillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifler: ............................. ................................... .................................... .................................... ....................................
Freeboard (inches)-
5/00 �y Continued on back

F4aci11ty Number: -• Q 0 Date of Inspection I
f
5. Are there any immediate threats to the integrity 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 4-6 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 EVNo
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 XNO
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes �Vo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes 0
12. Crop type ©'SOUble-lanz
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes yj No .
14. a) Does the facility lack adequate acreage for land application?
❑ Yes No
b) Does the facility need a wettable acre determination?
❑ Yes No
c) This facility is pended for a wettable acre determination?
❑ Yes No
15. Does the receiving crop need improvement?
❑ Yes No
16. Is there a lack of adequate waste application equipment?
❑ Yes No
Required Records _& Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes ��o
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan adily available?
(ie/ WUP, checklists, design, maps, etc.) ,//
❑ Yes No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes'l�fo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes No
24. Does facility require a follow-up visit by same agency?
❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
�'�iq yiQl t�i njs:or, 00ec}encies •wire piofe#• 00n#g 4bjs'visjt; • Yoo wiq•tea$ito ijo fui-tho
corres orici6& 666f this visit:
Comme6ts (refer toquestion #) Ezplain;any'YES ansrwers and/or any recomiiwtettdatioins or any other co`rnrnents.i;i
Use f_i. i 6 situtons.{us, ad! o.�,l'pgeasnery)a o,facil-YtpfE ,3-Pt�
A,
Ito . c U4
09? , SS311
wi I I need "I aw f&P0 a.00 g.-
N,k&�uat -4 YV ) 44 A fAN
ZI a L&
Reviewer/Inspector Name 'Q
Reviewer/Inspector Signature: V//jlli J Jj a/J�A_ WA4 A J 4 A7 JP6, Date: r/ 0101 5/00

Facllit'y Number: 3 — 0 of Inspection
Odor Issues T�
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes <No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ANo
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.) ❑ Yes*0
31. Do the animals feed storage bins fail to have appropriate cover? ❑ YesAT50
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? $1Fe9--B ? o
Additional,Comments an or ri wings:' r 5
�ofes • aaoo Sor/S ' M+Ua
n+r-w* ha u le.r- ?
cLl4,w t,+.]/ 5 roc WaS a 1S o msen
�r�r `�41 e- ►r15 Qe. �Qh o i .
�. �,a o�.� .� c., cep � � � �
�R-u �.
w 7da du.� ixob �.a�
NET l� Gzek_
J
5100

*�141Visionof Waer Qualityvisionof soil and Water Conservatiohey Agency Natural Resources
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 34 1 Date nt' Visit: 12/11/2000 'rime: 14:00
O Not Operational O Below Threshold
■ Permitted a Certified 13 Conditionally Certified © Registered Date Last Operated or Above Threshold: ...........
Farm Name: pia.CM.Fam................................
Owner Name: Edon ...................................... Mlftr ..............
Facility Contact:
....................... Title: .......
County: 1:.Q1CS3'lk............................................. WSRO ........
.. Phone No: Q3.61.7A&445.8........................................................
........ Phone No: ...................................................
Mailing Address:4S.5Q.Ebut.Roffid................................................................................. WixtstQta.S.ale t.NC............................... .... 27127...............
Onsite Representative: �,lG1i �1Q1t T.G..ISilh�tlttxil.]CRXtS......................................... Integrator:.............
.........................................................................
Certified Operator:Ridhard................................. M111cr ............................................... Operator Certification Number:12133...............
Location of Farm:
Mas Creek Pkwy. exit from I-40 and go to Ebert St. and South approx. 4 miles and the farm is on the right.
w
❑ Swlne ❑ Poultry ® Cattle [I Horse Latitude 3t6 • 00 43 Longitude 80 • 18 66
".: ¢ r w}
} F Dlgn 4Curt t�
�Swtne�, "� i{.Ca acit :Po ulatiorr
'. �frlE
% _. (- ars r.•,ss ,• '.haera�e• s.
uk r ''Desi Ciirrernt'
Poultry Ca ace Po ulatron'
e ?+
``r
.CattleCa
n z-� ,raA.t torn+ 'e4d f
;' Desrgn 4 �C ens '
acrt P,o ulateon :.
o Feeder
❑ Layer
®Dairy
135 Ito
ATto Finish
❑ Non -Layer
❑ Non-Dairy
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
10 Other
Total Design
a
Capacity
135t.
El Gilts
r ❑Boars
s`� r4
11'ota1$SLW
a
189,000
x
Subsurface Drains Present
❑Lagoon Area
❑Spray Field Areaoldinel
111
onds /Sod Traps ,� ❑ No Liquid Waste Management System
Discharees.& Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potentiai' adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection 8& 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 Structure 6
Identifier: ......................................................
Freeboard (inches): 18
5/00 Continued on back

Facility Number: 34-1 Date of Inspection 121111200d
5. Are there any immediate threats to the i4prity of any of the structures observed? (ie/ treeoere erosion,
seepage; etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes ® No
❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
® Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crop type Matua grass Small Grain (Wheat, Barley,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15. Does the receiving crop need improvement?
❑ Yes
® No
16. Is there a lack of adequate waste application equipment?
❑ Yes
IN No
Reuuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? Oe/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21,
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
146•*i4A6ris:oir de#iciencie$ welre nbtedl dii ing'this: visit:.• :Y6u:will receive no further•
correspondence. about this .visit. . . . . . . . . . . . . . . . . . . . . . . . . . .
19. Soil samples have been sent to Raleigh. Reports have not been received. AL
8. Stock trails need maintenance.
Reviewer/Inspector Name 'iDeirdre A. DeBruhl
Reviewer/Inspector Signature: Date: 5/00

Facility Number: 34-1 l) c of Inspertion 12/11/20001.0
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
® No
liquid level of lagoon or storage pond with no agitation?
27,
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
IN No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
❑ No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
❑ No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
IN No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
5100

her A ncy ,
Visit ® Compliance Inspection O Operation Review Q Lagoon Evaluation
for Visit O Routine Q Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
E
Date of Visit:
7l2G/20t10 Time: 131t) Printed on: 7/28/2000
Facility Number 34 Ol
Q Not Operational Q Below Threshold
Permitted S Certified 0 Conditionally Certified © Registered
Date Last Operated or Above Threshold: ....................
FarmName: Gm1'gtrm....................................................................................................... County: Fonytb.............................................. WSRQ........
OwnerName: EdgAr...................................... Millex ...........................................................
Phone No: t �l.G� k�. -445............................................
Facility Contact:.11RaathoiVC.r?.M ........................................... Title: .0pert<kctl:............................................
Phone No: 33.6,76.6,51,58.......................
Mailing Address:4S. Q. ��t..tiAafd................................................................................. 1'.1rilaAtQwS. m.SIC............................................. 271,17...............
Onsite Representative:dgt3lr.1Y1111�Ir.�141 d911�tIkRpt.Gt Qtt .................................
Integrator:......................
Certified Operator:.lQnathpin ............................... Cjr.Qjt$ ..................... Operator Certification Number: A4826..........
Location of Farm:
Silas Creek Pkwy. exit from I-40 and go to Ebert St. and South approx. 4 miles and the farm is on the right.
❑ Swine ❑ Poultry ® Cattle ❑ Morse Latitude 36 • 00 43 Longitude 80 • 18 � 22 L{
Design
Current
Design Current
Design Current, Vie„
ne Ca acit
P.o ulation
Ponlavy, Capacit P,o ulation Cattle
Ca acit ,. Po ulation;
Feeder
❑Layer ®Dairy
❑ Non -Layer ❑ Non -Dairy
135 130
o Finish
o Wean
o Feeder
❑ Other
to Finish
irr-7
Ttl DiCapacity
13S
Total SSI�W
1$9,000
Number of Lagoons
l�_JElE— Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds /Solid Traps 10 No Liquid Waste Management System
JIL-
Discharges X abeam Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Wabte c 1 .& Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I ' Structure 2 Structure 3
Identifier: ......Write.Pond.......................................................................
Freeboard (inches): 72
5/00
® Spillway ❑ Yes IN No
Structure 4 Structure 5 Structure 6
Continued on back

Facility Number: 34-01 Date of Inspection 7/26/2000 Printed on: 7/28/2000
5. Are there any immediate threats to the i nloity of any of the structures observed? (ie/ tree , vere erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes I@ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ® Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Corn (Silage & Grain) Soybeans Sudex (Hay) Small Grain (Wheat, Barley,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ® Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes IN No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
RequiredRecord5 & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Noviolatioris;oideficieneieswetre;noted duciitgthis: visif.� :You:willl reeeiiventiftirttier
correspondence. about this .visit.
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
® Yes ❑ No
1. There is some run-off from lot of silage leachate. Would need to travel over 414 yards'before it would enter the stream, however. 1
B. May want to scrape stocktrails.
S. #25 & #15. Fields of matua and orchardgrass are sparsely vegetated. Replant? Have been applying waste to these fields.
4. Need to mark where max level is located and at 6-12 inch increments below that to measure freeboard.
16. Farm contracts with Grassy Knob Farms (704.873.7467) to pump, haul, and apply waste off on/offsite.
19. No waste, soil, pump, or application records were available.
Need to start keeping weekly freeboard readings per permit.
r- __ _. --- --- - - -
Reviewer/Inspector Name (Melissa Rosebrock . n
Reviewer/Inspector Signature:
l�
Date: 5100

°^ "�� �'� �` �'.'�ivision of Soil and Water Conservation � '� 1 ,4 � W 1 ,
�, 0 Other Agency `' I gm '*
•• 'i ' vM „k:�-3 ".��f4�,`�1...�'n���. !iA `7ti, ..i� .'.V AeC
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other 0 Denied Access
Facility Number 34 Ol Date or visit: T/26/Z000 I'imr; 1310 Printed on: 7/26/2000
O Not Operational O Below Threshold
e Permitted ■ Certified © Conditionally Certified © Registered Date Last Operated or Above Threshold
Farm Name: iv'ii;[lol.k'flt m......................................................................... .............................. County:ForsAh ............................................. WS.RO........
Owner Name: Edgar ...................................... ].Y1illtej.......................................................... Phone No: 11aTa,03.6J1188.44S.8............................................
Facility Contact: dtuuilkRat-Oro1b........................................... Title: S2ulr Alor........................................... Phone No: G.7.fiG,S.XS.........................
Mailing Address: 45.50. krxt.ttg.ad ................................................................................. !1'a»a>ant.Salina.�l............................................ 2.7.127...............
Onsite Representative:)dgsx.Ail1�r.�uls�J�t[tRliaet�.GtSt).tt ..................... ... Integrator:........................
Certified Operator:JQlgsttton .............................. Cxctts............................... ............. Operator Certification Number:.....Q..........
Location of Farm:
lilas Creek Pkwy. exit from I-40 and go to Ebert St. and South approx. 4 miles and the farm is on the right. •
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude Longitude F 80 •
Design
Current Design Current
Design, Current
5wine Ca acit
Po ulation Poultry Ca acit -rMPo ulation Cattle
Ca Belt Po ulation`
❑ Wean to Feeder
❑ Layer ® Dairy
135 130
❑ Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity 135
❑ Gilts
❑ Boars
Total SSLW 189,000
Number of Lagoons
® ❑ Subsurface Drains Present ❑ lagoon Area
❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management Sl
ystem
Discharges 4& Stream JfflpacjS
1, Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: ......Waste..Rand..........................................................................................................
Freeboard (inches): 72 -
5/00 l'
❑ Yes ® No
Structure 5 Structure 6
Continued on back

Facility Number: 34-01 Date of Inspection 1 7/26/2000 1 Printed on: 7/26/2000 , ' . '�" ,
5. Are there any immediate threats to the ifoity of any of the structures observed? (ie/ trees, evere erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes 9No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? XYes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Corn (Silage & Grain) Soybeans Sudex (Hay) Small Grain (Wheat, Barley,
13.. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ® Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records &Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design,'maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
24, Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
No yiolatiolis:or dt!nciencies-were:niDted duriilg-this: visit...Y6u.*iii rece ve•iio•ftir-then: • :
corresooridence: aboilf this* visit: ' ........:.: .
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
® Yes ❑ No
1. There is some run-off from lot of silage leachate. Would need to travel over 414 yards before it would enter the stream, however.
8. May want to scrape stocktrails.
8, #25 & #15. Fields of matua and orchardgrass are sparsely vegetated. Replant? Have been applying waste to these fields.
9. Need to mark where max level is located and at 6-12 inch increments below that to measure freeboard.
16. Farm contracts with Grassy Knob Farms (704.873.7467) to pump, haul, and apply waste off on/offsite.
19. No waste, soil, pump, or application records were available.
Need to start keeping weekly freeboard readings per permit.
1W
Reviewer/Inspector Name Me] osebrock ``
Reviewer/Inspector Signatur . - A ,/,�/,�_ Date: 7 w Q 5100

rracilit+y Number: 34-01 of Inspection 7/26/2000 Printed on: 7/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ 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
2K
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
❑ No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
013. and #25. Tract 2326 - I has corn on it ....... plan calls for summer annuals (soybeans, sorghum, millet).
Tract 2323 - 1 A has corn silage..... plan cals for summer annuals.
I has matua....... plan calls for corn silage.
1C has matua and orchardgrass........... plan calls for perennial cool season.
2B and 2C....... ok?...... matua
3A has corn silage....... plan calls for summer annuals.
•l
sroo
J

00
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection O
Time of Inspection 24 hr. (hh:mm)
A4ermitted *ertified 13 Conditionally Certified [3 Registered JE3 Not O erational Date Last Operated: ..........................
FarmName: .........(Ieyn..... Farm ......................................... ..... ...... county:....Q.�. s�7..�..��..........................................
Owner Name: .......... V. . Q� %`......1.!..1,L1..................................................... Phone No: ..:.. .. g.•...T. ....�.1-fl .......
Facility Contact: ..........Title: ............................................................... P'hone No:.>.,...l+l.F..—}t:
Mailing Address:....�Tt.......r..Lerf........).............................1.iii�....t..rL[....1.`"'.....a.j0.....
OnsiteRepresentative: ... 'a�w `"dYl....... �-!L.D�� ............................... Integrator:......................................................................................
Certified Operator:...QnQ:C?1........�b ........................................ Operator Certification Number:..........................................
Location of Farm:
..................................... ,...................................................
..�.urr>r�.t..r.....���rcra..�an`�t�ie.....t�.... 1
Design :Curr`•enY Design Current' ' )
Sa ciwine' UPoultrCaaciPoultn'Cte
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
E] Farrow to Feeder
Cl Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer ; Dairy
❑ Non -Layer 'P' ❑ Non-D
❑ Other
�, Tofal Des�gnlCapacr
Tofal'SSLN
Current
v ` 1?onulation
M®
Subsurface Drains Present ❑ ❑
Holdtn Ponds / SolEd - ❑ Lagoon Area Spray Field Area b �
,,, I,Nu�nberaR:�.agaons, E, h,i, ,
g Traps" ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes *kNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of' the State? (If yes, notify DWQ) ❑ Yes ❑ No
-1� c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes XNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? x Spillway ❑ Yes No
StructuFc I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches); ..............
...................... ........... ......................... ................ .............. ..... ... ........ I'll .....................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes /j No
seepage, etc.)
3/23/99 Continued on back

- Facility Number: — d 0 & of inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
)Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of yover application? ❑ Excessive Ponding ❑ PAN (61-1
12. Crop type rj 6,i 1 ,0A 1r'\ �i . O a� e C6 i'IF'1 - 'S1 \ OL al . , < uJAP 4. AA. O 1 1
13. Do the receiving crops differ with those designated in the Certified Anin'll Waste
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there'a lack of adequate waste application equipment?
Required Records & Documents
17.. Fail to have Certificate of Coverage & General Permit readily available?
"�,FIa, 01 1
■ n
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ,�
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
.(ie/discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0 �vQ yiQl lriptjS 0 (���C�eIiCiCS 11��rC ppte� cl�xriri...is,Vjsjt;• YOjF wii� >ree�iye'0ti i.0fib, g,
orxesnoric eRce: a�aut this visit.............:: :::.:............... .
❑ Yes , No
Yes ❑ No
❑ Yes XNo
❑ Yes No
❑ Yes No
Yes ❑ No
❑ Yes )ANo
❑ Yes'*No
❑ Yes XNo
XYes ❑ No
❑ Yes No
ees 00 No
❑ Yes eNO
XYes ❑ No
❑ Yes No
❑ Yes k
No
❑ YesX,No
❑ Yes No
❑ Yes No
0 Yes *NO
i4 v ��I .'fl .hi rF " k' ;•�, >.r. ar -•'h fL..:. k3r .i } !.`i7- €i.a..n , ;� �•i.��., R. � . ' E .-s P "C"'� 4 s i .,9�a�;.�ii�N�&9 - t
Xra55 f
l�• �- E� r� cam— r dI.SS ��•2 5 S�- ®-� y�?� �e.��h� ��
—
� �-� [: ��,� Sir �r�,►� �
_,_ x
Reviewer/Inspector Name � �",•t n ' u � '
p , 4 # -::
n mr ... . f_
Reviewer/Inspector Signatunt.. /j11 —.s Date: ;UO 00
No �_�tee 50'11' "pump ®r o-ppfl Sian r-e-cords

• -Facility Numbers��-Z17 Oe of inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation? M IT
1
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes VTNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes JKNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes PqNo
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? D mdes—-Aie--
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Q r ►1 1 $ifee-,_
��/Vj / " 41"� Atfzj
ITS &48-Corn S► �a el ,t fflied "F'r-'Tu n
n nua-1s' An1;e d S
&ed Se&Son dra5se5-draled
c C001 Season 060,5-SeS
,I z;n �� murne-r Pn n ua. 57
�1 n� • d
C�
Q,ornJ tar C4-1�5'1 -� Survwra,��n��o.Q
�� L Soylo@un5, SOrVIYII 1M11 yPJ� a
Trae4 T a 3 PZ
A
Z)

Facility Number 34 1 Date of Inspection 11/9/99
Time of Inspection 14:30 24 hr. (hh:mm)
0 Permitted ® Certified 0 Conditionally Certified 0 Registered V Not O erational Date Last Operated: ..........................
FarmName: G.9M.FACM.............................................................................
Owner Name: Ed&pr...................................... Mwp,.r.............................
Facility Contact: .............................................................................. Title:
County: FQ;< fh............................................. WSRS?........
Phone No: (,33.Ct).70::445.8...
.. Phone No :...................................................
Mailing Address: 45..91bPatRoad................................................................................. W.1wtQa.$.a1mNC ............................................ 3.7.127...............
Onsite Representative: Ed9fwA.RkJk.MM1vC.............................................................. Integrator: ......................................................................
Certified Operator: Rkchard.tA............................. N.tilkCC.......................... I ............ I........ Operator Certification Number, 22133 .............................
Location of Farm:
Latitude 3ti • 00 , 36 I Longitude = • =1 24 ..
Design
Swine Ca acit
Current Design Current
Po ulation Poultry Ca acit P.o ulation Cattle
Design Current
Ca acit ROPElation
❑ Wean to Feeder
❑ Layer
® Dairy
135
110
❑ Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
Other
Total Design Capacity 135
Total SS LW 189,000
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds /Solid Fraps
❑ Subsurface Drains Present jFn Lagoon Area
�1 ❑ No Liquid Waste Management System
JE3 Spray Field Area
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ 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
1. rite Coo11�' & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): 2Q............... .................................... ................................... .................................... .................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
3123/99 Continued on back
Printed on 7/24/2000

Facility Number: 34-1 Oe of Inspection 11/9/99
6. Are there structures on -site which are0properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ 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? I - ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes ® No
12. Crop type Small Grain (Wheat, Barley, Matua
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
I & Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
D; Io yiblatioris;or deficiencies were noted during this visit. ;You;wiIf re4-'i4•po'fVr'ttier• ; •; •
......... about this :visit. :::::::::::::::::::::::::::::::::::
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
to level is at begin pumping level. Producer has contacted contract hauler. Waste will be applied as soon as corn is harvested an
in 30 days of planting small grain.
Reviewer/Inspector Name �
P Deirdre A. DeBruhl
Reviewer/Inspector Signature: Date:
Printed on 7/24/2000

1.
a; ° s ` I,, � Divisi Soil and Water Conservatioaa 'Operatio�� "`�}�,E;'tt� 3 ,l
:0' ivisiSoil and Watee Conservation CompliancZriiis ectioit` 112
s i 1 € -,..�1 1 's�E kF[: f�tt�ge �ti �x ,� i its`
Devisiontof Water Quality Compliance+Xnspection
f s„ r. }, {E� Other Agency Operaho".;1k&iew'.
Routine O Cum taint O Follow-up of DW ins ection O Follow-tt of DSWC review O Other
Facility Number Date of Inspection
Time of Inspection pp 24 hr. (hh:mm)
© Permitted Certified [3 Conditionally Certified 0 Registered 0 Not O erational I Date Last Operated: r� P ..........................
FarmName: ..................... I .......... ...................................... County:........V.a.C.......................................,
Owner Name:..�� v... ... .... NSW. .► ......................................... Phone No: �3 ..1 41.... . x S%.. w. .......
.............. ......
Facility Contact: ..... .15%mR..,.`.............................................Title:..NfW 1..................................... Phone
Mailing Address: 1 1�,. ��► .... ...... . 1].�.IAAS`Q '. l "l\.r. k)_k..... . 743V �.
r........................... ...
Onsite Representative: %s. la� ..... Integrator lv............................... I............................. r
Certified Operator:,%`C ... �tiQ�; ............ Operator Certification Number:..: �. ...........
Location of Farm:
........................................................................... .. ..... .... ........................ ... ........... .....
D.1�.Z. a1�. `C ........ ......................�51 .... �. 5. � ................
Latitude LS�' [ QO fi La, Longitude L21j • LYN
Design Current t ,,,,-Design Current, Design Curi•enE
"Ca acit Po uI tion `' Poultry' Ca 'achy Po' ulahon.., Cattle Capacity Population..
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
❑ Layer I Fff5airy
❑ Non -Layer ❑Non Dairy
❑ Other
4 ! ` Total Design Capacity
I 7 ,1 r �� j i. s•:11 1 is - 'Total';SSL YY:_
s Y Number ofLagoons,• ent Subsurface Drains Pres❑ Lagoon Area 11
0;.
Holdin' °Ponds L S61id Traps ;.' No Liquid Waste Management System
Discharges & Stream Impac
1. Is any discharge observed from any part of the operation?
Discharge origin)cd at: [—]Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If dischargerobserved, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is ob ved, what is the estimated flow in gal/min?
d, DpCS discharge bypass • lagoon system'? (If yes, notify DWQ)
Spray Field Area I,
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I
Identifier: k
Freeboard (inches): .......��.\......
Structure 2 Structure 3
Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes
E21Ko
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes U14o
❑ Yes R<o
❑ Yes RAv )
Structure 6
............................
❑ Yes E/No
Continued on back

•]Facility Number:�y — ` • Date of Inspection L
• 6. Are there structures on -site which arc• not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes V No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes EJ'No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes L3640
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yesio
Waste Applicsttion
la, Are there any buffers that need maintenance/improvement? ❑ Yes VNo'
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes RNo
12. Crop type
13. Do the receiving crops differ ith those deli ated in the Certified Animal Waste Management Plan {CAWMP)? ❑Yes D-14
14, .a) Does the facility lack adequate acreage for land application? 1a$ Ac.rtS\q, ❑ Yes 53090
b) Does the facility need a wettable acre determination? ❑ Yes 9R-fQo
c) This facility is pended for a wettable acre determination? ❑ Yes R(No
15. Does the receiving crop need improvement? - ❑ Yes PKO
16. Is there a lack of adequate waste application equipment? ❑ Yes QrNo
Reauirerl Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
93'KO
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
PTo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
(N10
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
RVo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
B'Ko
22.
Fail to notify regional DWQ of emergency situations as required by General Permit.
(ic/ discharge, freeboard problems, over application) % QM iNt 155�►�
❑ Yes
❑ No
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
RK
24.
Does facility require a follow-up visit by same agency?
❑ Yes
L Zo
25.
�re any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
P-
�q yi. A igns'or• del�iciengpi Wgre pQtet3 dOr iog tihis;visit; ;Y;otit ;will reetriye ijo fui
eorres• ondetike: about: this 'Asit� • • .. • • . • .
C: nir i nts (refer to questtd'n'#) Explainany YES answers and/or any recommendations or any other co
inmentsl° "
:. g F 3 �,,¢ 3 °•, j?¢r tf '@sy ° -g} 7 .
Use drawings of facility to better,explatn situahons. {use additid'inal pages as necessary.)`: �, F E j
1 x� P"tA
Reviewer/Inspector Name - E ; K w,*
Reviewer/Inspector Signature. �; «.fe Date:;, � r ,r��,... y_...r.��; �a ,.,>•�
3/23/99

0 Division of SEIM Water Conservation - Operation Review
U Division of SaIII'M Water Conservation - Compliance Inspects
■ Division of Water Quality - Compliance Inspection
0 Other Agency - Operation Review
Routine O Comniaint O Folloli-un of DWO inspection
I Facility Number 34 1 I
Registered 0 Certified 13 Applied for Permit 13 Permitted
FarmName: 1G.PmYArm.....................................................................................
Owner Name: lash;r...................................... Miller .......................
Follow-up of DSWC review 0 Other �
DA(I of Inspection 9/11198
Time of I11s'pection 15:5)0 24 hr. (hh:mm)
113 Not O erational Date Last Operated:
...............
County: Forsyth ............................................. WSW ........
Facility Contact.: l: dgAAK.l!'filly.................................................. Title: utxtacr......
Mailing Address: 455.l1.JEbcx%.Rtl...............
Onsite Representative- Edgar.millcr....
Plane Nip: 2 i13-4�458...-.fl9ss�....................................................
................................. Phone No- aitd V........................................
.... Winalua.S.alcm.N.0............................................. 7.7.127 .............
........................... I....... Integrator: ......................................................................................
Certified Operator: Rkh;dullA............................ miner ................................................ Operator Certification Number: 2ZI3,3 .............................
Location of Farm:
Sal�tx.xe�lx.�1y�.�xik.fir�ttta.a-4li.:ucl.to.tu.bext.Sth.a�ad.Salzt6.xt�pa ax, .4. iail��.�tntsl.tbti.lrna.i�9..are.tl►e.pis:ht...........................................
Latitude 3( • tlll 1 3G « I ongitude ga • 18 4 24 LL
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to i-inish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Dairy 100 165
Layer 9:
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 100
Total SSLW
Number of Lagoons / Holding Ponds I0 Suhsurface Drains Present 110 Lagoon Area 0 Spray Field Arc:I
© Nip Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
2. Is any discharge observed from any part of the operation`?
❑ Yes
® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
n. If discharge is observed. wns the aouveyauce rnan-Ulfide'?
❑ Yes
❑ No
h. If discharrge is observed, did it reach SU1'111CC Wutcr'? (If yes, noti fv DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated glow in €aUnlln?
d. Docs discharge hypass a 1ag0011 SVStcnl? (II'vcs, notifi, DWQ)
❑Yes
❑ No
3. Is there evidence cif past discharge from any pall 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. hoes any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
® No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
7. Did the facility tail to have a certified operator in responsible charge?
❑ Yea
® No
7/25/97

/Facility Number: 34-1 10>6lnshcction 911U98
8. Are there lagoons or storage ponds on site which need to be properly closed?
L_J
❑ Yes ® No
Structures (Lagoons,llohlinr, Ponds, flush fits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Strucuirc 1 Structure 2
Tdcntificr:
Freeboard(ft):...............................................................
10. Is seepage observed from any of the structures?
❑ Yes ® No
Structure 3 Struc:turc i Structure 5 Su-ucturc 6
.............................................................................................................................................
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
12. Do any ofthe structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers`/
Waste ApOication
14. Is there physical evidence of over application?
(If in excess of WMP, or runof)'entering waters or the State, notify DWQ)
15, Crop type ..................... 55?xgjj=......... ................................... );,kSQlx...................... ...................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack ofadequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20, Does facility require a follow-up visit by same agency?
21, Did Reviewer/Inspector faii to discuss review/inspection with on -site representative?
22. Does record keeping need improvement'?
For Certified or Permitted Facilities Oniv
23. Does the facility tail 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 or the Permit?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
......................................................
❑ Yes ❑ No
-NO. �4ojatiOhs: Oi �4i -*i1Vrecelve'nb Ttl tber : - , -
:: 07espgndencte nlioui this: visit;. • " ' . • " • , . • . • . • . • •
❑ Yes ® No
❑ Yes CO No
❑ Yea ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yea ❑ No
❑ Yea ❑ No
❑ Yes ❑ No.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings (if facility to better explain situations. (use additional pages as necessary):
Owner ha,.recei'vei3''n'SbC li clr cxpirc4,Octc>b�r 1; 1998'; The c�ctentiion.will!allow therm to'comple the�AW ,,-,Fencing along,. ,, .,
streain'andlcatlle�trtul''ia-the,nrairn,work left. Thc,&r nancnt_marker for, the liolding pond has not bcen;installed yet,, ]
1 rf93tEB � h '! ]aGi
The mrlkmg parlor problems here, corrected, The holding pondw sG pumped on 8 15 9R
I I a - t bey;
�B ,,i; E !€i � •(. ,..E dF 3 £q d 1] � a '
IA
t
a
Rev iewerllnspector Name Beth Morton
Reviewer/Inspector Signature: pj(k, jftl�y ]Date:

,
State of North Carol*
Department of Environment,
Health and Natural Resources
Winston-Salem Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
August 14, 1997
Mr. Edgar Miller
4550 Ebert Road
Winston-Salem, N.C. 27127
SUBJECT: Animal Operation Site Inspection
Gem Farm
Facility No. 34-1
Forsyth County
Dear Mr. Miller:
•
`,•
IDEEHNF;Z
DIVISION OF WATER QUALITY
-- Water Quality Section --
On August 13, 1997, Ron Linville and I met with you to perform the required Animal
Operation Site Inspection on the Gem Farm. Mike Bowman with Forsyth S&WCD and Dede
DeBruhl with NRCS were also present.
Attached is the inspection form that was completed during the site visit. The main water
quality concern involved the clogged pipe leading from the milking parlor to the lagoon. Our
office is aware that you are working to correct this problem. In regards to the Animal Waste
Management Plan, it is our understanding that preparation of the plan is already underway. As
you are aware, current rules require -that your dairy operation obtain and implement a certified
plan by December 31, 1997.
Please do not hesitate to contact me should you have any questions or concerns.
gSincerely,
t
Michael M. Mickey
Environmental Specialist II
cc: Forsyth S&WCD
Central Files
WSRO
585 Waughtown Street, ��y� FAX WO-771-4631
Winston-Salem, North Carolina 27107-2241 Nvf C An Equal Opportunity/Affirmative Action Employer
Voice 910-771-4600 50% recycled/10% post -consumer paper

Facility Number
FarmStatus: Moll gistered ❑ Applied for Permit
❑ Certified ❑ Permitted
Date of Inspection
Time of Inspection ® 24 hr. (hh:mm)
Total Time (in fraction of hours
(ex:I.25 for I hr 15 min)) Spent on Review
or Ins fection includes travel andprocessing)
❑ Not Operational Date Last Operated : ............. ............... ..... ........... ................................................... ............................................
FarmName:........................................................................ County:... QT...............................................
LandOwner Name:.. .............\��........................................ Phone No:. ................ .... . .....................
Facility Conctact.................C�►� ►l�1SZ.."..................................... Title:... �h�. P..r�................. Phone No:.........'S mo.. .........................
Mailing Address: .... V\ ,JO...... Zr x\.... 4A ........................ .�1�1•��1 D� l �Q{t ..................... A—.I1�ka
OnsiteRepresentative: .... ..'\ ................ Integrator:.......'.�...................................................................
v \\
Certified Operator:.......... ;'z.Q,................................ ............................. Operator Certification Number:............. ......................
Location of Farm: NAS\N\itt\ \V�I Q.'�AM►
.... ....... . .....tQ�........%\% ... a «..... � ox ,.. ........rx ,.�.................. PO
Type of Operation and Design Capacity
�Des�git Current, Design Cur ntDesign :¢Current
Swine f'° Ca aci Poulafi n l'aaitry,�Ca aci=Po elation 21
t Cattle;Ca 'ace I Po ulatlo
can to Feeder" cr ❑ Dairy
❑Fee r to Finish ,, ❑Non er ❑ Non -Dairy
Farm Wean g
Farrow to eder TotaDe n Capacity ;Y
�.
JU Farrow to Fm Tit 1 W y
W❑ Other SSL q
a, p;
Jij
r Numberof Lagoons Molding Pondsll ❑Subsurface Drams Present
a rr ❑
x a { ,' Lagoon Area Spray Field Area
� r 0 . <. ..
w.._ 4,., .._. �
Cigngral
1. Are there any buffers that need maintenance/improvement?���� [--]Yes ❑ No
Z. Is any discharge observed from any part of the operation? Yes ❑ No
Q���o�+� Qat�oc c�vo� ,�CQ�..
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other ,,,,(
a. If discharge is observed, was the conveyance man-made? ❑ Yes � O
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes 5 o
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ%4,, \ ❑Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? C `�52�� ❑ Yes Q,Ko
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes [�Ko
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes [I No
4/30/97 �NN S3`\\ t��s�l\Q+r �CQ,� 4 maintenance/improvement? Continued on beck

Facility Number:...... s....`.......
6. Is facility not in compliance with anAgicable setback criteria in effect at the time o esign?
7. Did the facility fail to have a certified operator in responsible charge? —),,,,vk;;,\\�
8. Are there lagoons or storage ponds on site which need to be properly closed? �F
StructurgL(Lagoans andlor Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (f1): Structure 1 Structure 2 Structure 3 Structure 4
:>... akt.. ............................ ......... _................. ............................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum 4guid level markers?
Waste APRILution (,)y M04\Vt WN C M\t& rQ,�� � �o\�eot�� .
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15 Cro ty e C,04 [1
❑ Yes [<o
❑ Yes VNo
❑ Yes 2No
❑ Yes
M,?( 0
Structure 5 Structure 6
❑ YesWo
❑ Yes
aKO
❑ Yes
eNo
❑ Yes
❑ No
❑ Yes
P To
pp....... ......... .................... ......... ........................................p...................�................pt ...AC .......................................
16. Do the receiving crops differ with those designated in the Anima] y4asstc�iahageirient Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment? \ '*_
20. Does facility require a follow-up visit by same agency?"""�` -
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?��
For Certified Facilities 0-11w � ,
�s��Aeer No e1 CC ��
22. Does the facility fail to have a copy of the Animal Waste anagement Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP? Nt'l
24. Does record keeping need improvement?
❑ Yes
❑ No
❑ Yes
IKO
❑ Yes
[210
❑ Yes
9 No '
❑ Yes
;1 O
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
[:]No
Comments°(refer to question #)� zplain°any, YES answers'and/or anyseco nmendahons or any other.camments: ,°
Use drawmgs,of facility to better expiam situations'`(use additional pages a's necessary)
a
Name
Reviewer/Inspector
Reviewer/Inspectorsignature: v Date:
cc. Division of Water Quality, Water Quality Section, Facility Assessment"Clnit 4/30/97

�0 Koutme -O Lomptaint0 ronow-up oz uw[t inspection p ronow-up ot,uavvk. review p vtner
r Date of Inspection
Facility Number
Time of Ijispeetion ® 24 hr. (hh:inm)
i e -i rac ion o ffi,.WM=9�
�s44jFarm Status: Registered , Applied for Permit"�`�`'
■ g PP F 2�5j� or hr 15 in Spell vliew "RA 15��
` F n v �4 , F'9i .,�fi 1�Y�7wii �7k 5 -+NS �©
p Certified 0 Permitted or Inspec ion illU ravel and pro`essmg)
�
p Not.Operational Date Last Operated:
Farm Name: Gem Farm County: Farsyth.............................................. .W.SRO........
OwnerName: Edgar ..................................... NdiIler........................................................... Phone No: .7.$[t-4.455....................................................................
Facility Contact: same....................................................................Title: O.witer ................................................ Phone No: same.....................................:...
Mailing Address: 4550.Ehert.R&........................... ........................................................... J?V.i.nsfoxi.,Salleat..NC............................................. 2712.7 ..............
Onsite Representative: Edgar.and.lae.Miller. .............................................................[ntegrator:NA........................................... I'll ....................
............
Certified Operator: ................................................... ...................................................... Operator Certification NU In beY: ............
Location of Farm:
Latitude Longitude
Type of Operation g-', "Des�r�n� CV
i,C rrentI"',4.CilEr1e11xfdr`Y'u;ta rF°�n"rf+ `r,t aDC31 n7@ ' `ti.CUIlerir' aV.
7.. ui a»�f s x i,t g . i�?s4:LDhiyaL �ufiii;e� r g ants T
Poultr '� u:
Swine, er�Capaczty�Papulat�on y�irr Capacity�Populatxpn Cattle Capacity!, Population ;
. S ...tZ.s�L...,,., �W �:',s a�7<' 4 !^:'fuc .:o'.'au1.;� L.l "4 t F i`.�e,
p can to ee er p ayer@ ® airy��� 4
p ee er toFinishE p Non -Layer r p on- airy ,
1
0 arrow to- can y 'l cire``k Ee �rAL{dyh dFs� b #R PdY $Fr4 s"t e€dr L
,i Sri P t p�iyJS
[3 1�arrow t0 ee er e n#fir { jr fn grTotal�De ign,CapaC�ty 1'C F
farrow to finis k j ,
. o}`�� Ar �, P r ,,a Total=SSL�?V� - �.r__.._..__
s
�� ,� f � � h6, d ��sr DER
ei Yr�
p Other �?3, z:t
._»,«...aw.�...«......«....-.........,... ........ a:S=.. a&,. cui:;pf:..a.�.d.».,ae..x•.-�,»..Y.I�..i. _:xre,.h-,iY..-.a.iD� m.i..1�9��,� ti..aG.+�.,..a��. .*� `_e;tea S•vir.tet�� �.Y..e..,:.aw
a?F —�... ru; f"aa �3
l
VP
u sur ace Lagoon Area pray Field
iLrams resenNumbeofLaagoons3/,Holdinndf
7g....G`ia.-....u:
General
1. Are there any -buffers that need maintenance/improvement? p Yes p No
2. Is any discharge observed from any part of the operation? p Yes p No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made? p Yes ® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) p Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min? -
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) p Yes p No
3. Is there evidence of past discharge from any part of the operation? p Yes ® No
4. Were there any adverse impacts to the waters of the State other than from a discharge? p Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require p Yes ❑ No
4/30/97 maintenance/improvement?

l
aci um er: 34_1
6. ,Is facility not in�ompliance'with any *cable setback criteria in effect at the time of esign?
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which'need to be properly closed?
Structures (Luizoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3 '
>8 ft.
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
Structure 4
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15, Crop type .......Coxja.(SAage.&..Grain).
p Yes
® No
p Yes
® No
❑ Yes
® No
❑ Yes
® No
S(ruCILrre 5
Structure 0
❑ Yes
®No
p Yes
® No
❑ Yes
®No
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
2I. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes p No
p Yes p No
❑ Yes Cl No
❑ Yes ® No
p Yes ®No
p Yes ® No
❑ Yes ®No
❑ Yes ❑ No
r3 Yes []No
p Yes p No
24. Does record keeping need improvement? ❑ Yes ❑ No
Reviewer/Inspector Name 1�{e ' ICLCy �.� °" �'� r
, i t
Ilse#a�v P7Tga ,o
Reviewer/Inspector Signature: Date: