850002_INSPECTIONS_20171231

Type of Visit: tS) Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: (Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergencyv�0 Other CC 0 Denied Access
Date of visit: l�7L1L�ZJ17ArrivalTime: DepartureTime: f Q County: SIO�GP$ Region: lJSPQ
Farm Name: RI a A e-C ne_n -{_ En r nl Owner Email:
Owner Name: h'�wr vL-R) f-0- Phone:
Mailing Address: 207- 14W V 7 07 W , t Lei l,0,50 Yl V I l lf-1, tl C-- a -10 a °'-,
Physical Address: I9 -cZ I H \;Q V 70 K V\I . I /,Q_ L(15dn V It I e-1 N a 70 a- l?_
Facility Contact: Nt-+1- �� aj _e4 Title: Phone(226 qJr--o2 — 56 3
Onsite Representative: K&r lL Tl5 il Integrator:
Certified Operator: SkCertification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: (k ., Longitude: $(-)A I y t 5 t 1
N� Hwy g of J L Nay �o�
Swin
Design Current
C•apasty Pop. +
Wet PouYtry
DesignCurrent
Capacty Poop s
Catl
Design Current
Capacity Pop.
Wean to Finish
La er
Dairy Cow
'
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
t
D , P,oultr,
Design
Ca aci
Current
P,o ..
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
L
I Beef Brood Cow
Q[he
Turkeys
Turkey Poults
Other
Other
Discharpes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
e. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge'?
❑ Yes 00 No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ap No
❑ Yes XNo
NA ❑ NE
�NA ❑NE
XNA
❑ NE
❑ NA
❑ NE
❑NA
❑NE
Page 1 of 3 21412015 Continued

Facili Number: - O Z • Date of Inspection:
Waste Collection & Treatment ,,LL
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No 1 I 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No YCI NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) """ff
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes gNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No NrNA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No �A ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10% or 1016s. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): jt=5 c u e-
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ®No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ZNA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes &No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment'? ❑ Yes ZNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes No
❑ Yes No
❑Other
21. Does record keeping need improvement? I ❑ Yes g No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield n' -2 higpeetimis ❑ Monthly and V Rainfall Inspections
e XNo
�i❑]Yes ❑ No
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?
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Weather Code
y-
❑NA ❑NE
,Ga'NA ❑ NE
Page 2 of 21412015 Continued

Facility Number: IDate of Inspection:
24. Did the facility fail to calibrate waste apption equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No Cj�NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
L4
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes A No ❑ NA ❑ NE
❑ Yes
I gl No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes % No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require afollow-up visit by the same agency? ❑Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.'
Use drawings of facility to better explain situations (use additional pages as necessary).
3 Any Cnn+Inu.Irl g Seth ivmzv�-� r-u r�-oT ? N O
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Ca Vlrcp'lnl -19_J 5 In m-- NGor VA pton7 VA
ENE FARMS ARE CUPR�r1-1 Ur��G'R REORCAW I Z/tP014,
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bnJ A CCArr/,�vovs SCN€� kl&6-
Reviewer/Inspector Name:
uason tbr;
Phone: -1 'l (p — 9 (a? 9
Reviewer/Inspector Signature:
Page 3 of 3
Date:
c 2/4/2015

(Type of Visit: ,® Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: Routine O Complaint U Follow-up U Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time:�D Departure Time: ® County: ,5 -Q J--� Region: A S Rn
Farm Name: ► QS t Owner Email:
Owner Name: -t y' ,A' Phone:
Mailing Address: oZ O O1% > I.t.)/ 6 l ,1 �' V • /fit, w5O n d i ((2 r /\l o� a o 2---
Physical Address: a g I W Y 7 0 W., bob-156 n v 1 7 0 a d­
Facility Contact: (% Title: Phone: t✓ a7�) /� — Stp/[7
Onsite Representative: Integrator: �—
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: 3&0 (6 1 35 11 Longitude: <do o I Y ' S tJ l J
uj g
r w�
Swine
Wean to FinishI
Design Current
Capacity Pop.
Wet Poultry
I Layer
Die —sign
D
Capacity
Cur rent
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to FeederI
INon-Layer
I IDai
Calf
Feeder [o Finish
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dc + P,oultr.
Layers
Design
Ca aci
Current
Pko
D Cow
Non-Dai
Beef Stocker
S
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
jBeef Brood Cow
Other
Other
Turkeys
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
i
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
9Yes
❑ No
❑ NA
❑ NE
Page I of 3 21412014 Continued

Facility Number: S - Date of Inspection: 3 a0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No IXI NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No f❑� NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
;jrNA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
ONo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
gNA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[]No
P;'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
eNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �(No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
XNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
®'No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[]No
N—NA
❑ NE
acres determination?
17.
Does the facility lack adequate acreage for land application?
❑ Yes
2rNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
�No
❑ NA
❑ NE
Required
19.
Records & Documents
Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�qNo
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�Po
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
2oes record keeping need improvement? ❑ Yes 4 No ❑ NA ❑ NE
Waste Application ED Weekly&reebeard Waste Analysis Soil Analysis Dp�T sfers— [Weather Code
Q Rainfall ocking �rop Yield ❑ 120 Minute Inspections Monthly and V Rainfall Inspections E]o',uagcva;+.
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 CRI�A ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: Q O Date of Inspection: 3 oZ'�Z 1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No C'NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? [—]Yes tRfNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes r'9No ❑ NA ❑ NE
Otherlssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �<No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �(No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the []Yes Cg'*No NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. [:]Yes Dj�No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 0Yes ❑ No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes �No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? []Yes �ZNo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any,additional recommendations orany other. comments.
U_V.kawings of facility to better explain situations (use additional pages'as necessary).
(MP11f ru1)-0�-F ?MU-1,& 1 1
Sol l ie54�- d Up a o l i ' __ "`e
Cali �Jrltl �'�v� dUP_ do l6, c aO ►g.
a. oorp e Shore rc�ri tO_hd ? bwk. 6U6 now re CICA vie_ C�dP ®wU
49
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/a o 1to = 4. SS SSB
t3
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
�-•
Phone: _ n 6 — ('P J
Date: 3 ; 020
21412014

for Visit: Routine 0 Complaint Q Follow-up 0 Referral 0 Emergency O Other O Denied Access
Date of Visit: — 1 Arrival Time: O 00 Departure Time: : OQ County: 5-fOke5 Region: 10526
Farm Name: R l (>p Q �t�f�` i Tray m Owner Email:
Owner Name: M 6 Lr V— RPhone:
Mailing Address: o1O7S 14 wy ?1)4 Lt-Lo5onVi 119, /Q C of 7d a ;—
Physical Address: l q j5 I HLLj V 76 7 W
Facility Contact: �L Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone: C 2-76, 9Sa . S/
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Y w70
Design Current Design Current
Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Cattle Capacity Pop.
Wean to Finish La er
DairyCow
Wean to Feeder Non -La er
DairyCalf
Feeder to Finish
Dairy Heifer
Farrow to can
Design Current
Dry Cow
Farrow to Feeder
Dr, P.oult .+ Ca racit P,o P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes eNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
U(No
❑ NA
❑ NE
Yes
❑ No
❑ NA
❑ NE
Page 1 of 3 21412014 Continued

Facility Number: Date of Ins ection: Q S
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? `j ❑ ❑ ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., 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?
Structure 5 Structure 6
❑ Yes []No IA I NA ❑ NE
❑ Yes Wo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes C] No �NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes [—]No NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) I
9. Does any part of the waste management system other than the waste structures require ❑ Yes XNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes D6o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): V
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes � No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes K No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No �_grNA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes gNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [,Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. oes record keeping need improvement? {Fyeerehee ete bebelea ❑ Yes ffi No ❑ NA ❑ NE
V�Wastc A lic ion Waste Anal sis Soil Anal sis a ran ers Weather Code
PP 6��� Y Y ❑
RainfallL—�A,/Stocking Crop Yield ❑ 120 Minute Inspections onthly and 1" Rainfall Inspections u "��
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 IX, NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: • I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No 5 INA ❑ NE
the appropriate box(es) below. rc
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
❑ Yes Dj'No
❑ Yes D�'No
❑ Yes P No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes ONo ❑ NA ❑ NE
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
Pg�No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
DK'No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
❑ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
CR'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Dg"No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments..
Use ALawings of facility to better explain situations (use additional pages as necessary).
I - iw k44 01 I)/ t*'
a SDP t 4k tal ate 9017.
kAA�
VA CPmO-1
i
I, ►UD ► 1
- • . r �'
r 'I
Reviewer/Inspector Name:
Reviewer/Inspector Signature: �MI lt'1 �� JJ
Page3of3 (0/�2/02015 = 1).43 IL$o lV/roN
Phone: -lD —m--�-1—
Date: 7 waols-
j1412014

Date of Visit: Arrival Time: Departure Time: County: e,, Region: 06 0
Farm Name: 12 11 A&Q e a r e—n+ Farm Owner Email:
Owner Name: N\n r it, r&u Phone:
Mailing Address: 28 IS t{ Wy 170 W , 1 Lawsonyi Ile-, MCA a-70 a- ;k-
Physical Address: l q Q) ►-+ Lo y 1 b `i W , La.W S ®fl % V I Ile, NCB • ;Z 740 a a.
Facility Contact: ' V�aJ,4� K. Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
e
Latitude:
Phone: C a76 , g.5-:2 , 43,
Integrator:
Certification Number:
Cirtification Number:
Longitude:
NC S
N tn3) 0&)4 70
Swine
h
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
er
Non -La er
DairyCalf
sh
WtoFeeder
DairyHeifer
an
der
Farrow to Finish
Design Current
Dr, P.oultr. Ca acI P.o P.
Layers
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Gilts
Non -Layers
BoarsI
Pullets
jBeef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[—]Yes I XI No ❑ NA ❑ NE
❑ Yes
,❑No
❑NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
❑ No
❑ NA
❑ NE
❑ Yes
E�No
❑ NA
❑ NE
[:]Yes
VNo
❑ NA
❑ NE
Page 1 of 3 21412014 Continued

Facili Number: - 0 1 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure �1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1) IZ �l
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes kNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ONo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No [!] NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No Dj�RA ❑ 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 Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ YesrNo
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes❑
No
XNA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
O�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
gNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
53/No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design
❑ Maps ❑ Lease Agreements ❑Other:
�21 oes record keeping need improvement?Ui;*";eh" -tito-
W Yes
❑ No
❑ NA ❑ NE
Applica 'on
ante Analysis Soil Analysis �tsfers—
❑ Weather Code
Yaste
ainfall Stocking Crop Yield ❑ 120 M n
inspections onthly and V Rainfall Inspections Id+4=b=P-
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
DjNo
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
[:]No
[)(NA ❑ NE
Page 2 of 3
21412011 Continued

[Facility Number: Date of Inspection:q lAgV,201
{/
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,
DC I No
���""❑
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
XNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
ZNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
$ No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
�,
IXI No
0
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
ONo
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
M No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
�' o
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
O(No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
jNo
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.';
Use drawings of facility to better explain situations (use additional pages as necessary)
I. Soil fes� due
q V
sP trt" we ergs) o-�✓,�ii tA� !�-� -�J
3.44 i in G tom, p
�Poed
oZ0 ��1a�ao08 Do U P U
Reviewer/Inspector Name: AJA rr, - 11 Phone: / S a 2�
Reviewer/Inspector Signature: Date: 1 E oZ 0
Page 3 of 3 21412011

Reason for Visit: ?k-Routine 0 Complaint 0 Follow-up 0 Referral
Other 0 Denied Access
Date of Visit: 3 ao Arrival Time:E�= Departure Time: ®County: 5b Region:W520
Farm Name: rK.$t-" Fart, — 2e.re$-+
Owner Name:
Owner Email:
Phone:
Mailing Address: 2015-- H W\( -70 q W , j LQ w50 n vi ( le-, NL ;t. 70 -q— .7—
Physical Address: I Q $ I 1' H Ugh/ 70`tl UQ . LQ W.50l) V'i / le-.0 N L t a 70 -1- P'--" p
Facility Contact: I Vl(lkjr Iv Title: Phone: G 27(n -I Sol S6 36
Onsite Representative: Integrator:
Certified Operator: Certification Number: A)
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
N�6 w�8
t w
vv�70
1[Swine
Wean to Finish
Design
Capacity
Current
Pop.
Wet PoultnY
La er
Design
Capacity
Curren[
Pop.
Cattle
Dairy Cow
Design Current
Capacity Pop.
Wean to Feeder
Non -La er
Dairy Calf
Dairy Heifer
D Cow
on-Dai
Beef Stocker
S
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D�, P,oulh, Ca eci P,o P.
La ers
Gilts
Non -La ers
Beef Feeder
BoarsI
I
I Beef Brood Cow
Other
Other
Turke s
Turke on is
Other
Discharges and Stream Imoact3
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 21412011 Continued

Facili Number: - Q X, • Date of Inspection: J I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes []No NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No //!❑ NA ❑ NE
SLnwlw= 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
0 NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
NrNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
5�NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
r%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
VrYes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
X No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
XNo
❑ NA
❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Its. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable ❑ Evidence of Wind Drift ❑ Application Outside of Approved
Area
��Crop
"�Window
12. Crop Type(s): _44&:l g (w?LL�1
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?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes No
❑ Yes No
❑ Yes ❑ No
❑ Yes URINo
❑ Yes ® No
❑ NA
❑ NE
❑ NA
❑ NE
]A
❑ NE
❑NA
❑NE
❑ NA ❑ NE
❑ Yes l No ❑ NA ❑ NE
❑ Yes CQ'No ❑ NA ❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
�21. oes record keeping need improvement?
[Raste Applic on ❑re�bord Waste Analysis Soil
ainfall Stocking [Crop Yield �20 Minute Inspections Monthly
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes JyNo ❑ NA ❑ NE
Analysis ❑- MWZFrattsfefs� rather Code
and V Rainfall Inspections 6ludpe S 3c
❑ Yes Do NoNA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No rV'NA ❑ NE
Page 2 of 3
21412011 Continued

Facility Number: - o P4 1 Date of Inspection: )
1
24. Did the facility fail to calibrate waste applica ton equipment as required by the permit?
❑ Yes
Q N
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No
CXNA ❑ NE
the appropriate box(es) below.
��
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
rr��
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
Yes
❑ No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
TT
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
N No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
Dj�No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
eNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0 No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
NfNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�rNo
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or anyothercomments.',
Use drawines of facility to better exDlain situations (use additional Daees as necessarv).
ai , .717
oio 1 sot l fes t 76q, . c+ea . W_5o e-ort&pleieti & h iPo 13 .
D i e-. nn.����O_ -01(0.
3a Ne�,� e l� S added ? �rGlnte's lLtd si 111 ne AS la be added .
NO waste ao`l3
R�mlydeX 4 Q�0.-� avltrnc* 1s �deAo�) MUS' - be d1 s Posed t�itinn
a. l hrs,
' Al
Mcore 11 roxm 4e, id n -Pout
•
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
M
Phone: %7 1 —_S_ 428 3
Date: I Ill. 3 1a V( 3
21412011

Type of Visit: Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visi : C,Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: i j) 7� Arrival Time: Departure Time: o I county:O (-io—$
Farm Name: MaxC, B (rcL-k F a rw1 — 2 t dq Q CC Owner Email:
0.r
Owner Name: I / Phone:
Mailing Address:
Physical Address: t 7
Facility Contact: I v 1 'C k- lL z f Title:
Onsite Representative:
Certified Operator:
Integrator:
Region: (0 J` EQ
oa
tvC_a70a;?--
Phone: Q, 01-16 • Ct S D-E434
Certification Number:
Back-up Operator: Certification Number:
Location of Farm: 'Latitude: Longitude:
t
F 7 Lu
o r
H,.-
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
Layer
Design Current
Capacity Pop.
Cattle
ity Cow
Design Current
Capacity Pop.
Wean to Feeder
[Non -Layer
ity Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
-1 P,oultr.
I Layers
Design Current
Ca aci P,o .
D Cow
Non-Dai
Beef Stocker
o2S
Gills
Non -Layers
Beef Feeder
Boars
Pullets
I
JBeefBroodCow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes] No ❑ NA ❑ NE
❑ Yes [:]No
[:]Yes [:]No
❑ Yes ❑ No
❑ Yes ZNo
❑ Yes KNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 21412011 Continued

Facili Number: - O • Date of Inspection:
mr
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[-]No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
Wi NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
TT
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
T❑' Yes
❑ No
j ' A
❑ 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
N Yes
09Io
❑ NA
❑ NE
maintenance or improvement?
7�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
CR'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, et
.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
��Window
12. Crop Type(s): ""'' /
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
'[S1`Io
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
X No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[]No
WA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
,N'�o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
WNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
121'No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
PNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. oes record keeping need improvement? �a ❑Yes No J IA ❑ NE
W ste Applic ion Waste Analysis Soil Analysis �rans£ers �LI Weather Code
Rainfall Stocking Crop Yield 120 Minute Inspections Monthly and V Rainfall Inspections f1i
22. Did the facility fail to install and maintain a rain gauge? [:]Yes dNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No �IA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: • Date of Inspection: X
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0- No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes jjjj❑] No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PDA for sludge levels
❑ NA ❑ NE
CklQA ❑ NE
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ICl Dim ❑ NA ❑ NE
Other Issues fit'
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes KNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[�rNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
;�'No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
CR No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
! No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.,
Use drawings of facilitv to better exDlain situations (use additional Dages as necessary).
�2 0 ► a- dal i brc'o 11 ?C'&t'44� w
ai 0_0tl4-9-0t')I, Soi l t8S+s ? 2,C) aoi�
3�9 PierM ov> lot rr�atre� ? L — 12t3J+
't Moo re ' �i e l i W, up ? A rc-.l1 i e 's ti ? No cd.ttLQ
vls i-Fo ' la� AUJA * A tee.
At44" 40-f-Y
A.
IA) t milk"
II�a9f 901�Q_ g/ls'/aoil
1. be, . N / TO N N / T-6t4
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3oj3 Joe Hudyncia -7-7 -sCO0
3. 70 lbs.
W 4o
Phone: 'IQ I — S ;k t9
Date: 1,>'-//,g I I Z_
21412011

Type of Visit: N Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1Lp Arrival Time: Departure Time: County: 50 jLieS
Farm Name: I a 2 f r m Owner Email:
Owner Name: L Phone:
Mailing Address:
Physical Address:
Facility Contact: f Title:
Onsite Representative: I
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
N& L+w y g n 0r-t- , W C S t o n t0 ltwy Zo
MAI
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
N C-
Integrator:
Region:
Phone:` a_-7to, Q5 a.5630
Certification Number:
Certification Number:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
❑ Yes ;4 No ❑ NA ❑ NE
[—]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes oNo
1P Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: - % • Date of inspection:
Waste Collection & Treatment �yj
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No 1F�t NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 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?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5 Structure 6
❑ Yes []No 0 NA ❑ NE
6. Are there structures on -site which are not property addressed and/or managed through a ❑ Yes R1 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No] NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) 1777"���
9. Does any part of the waste management system other than the waste structures require Yes ❑ No ❑ NA ❑ NE
maintenance or improvement? 7T�T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes C'No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or. 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidlence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): I ��iiL�tL[LQ A-�U
13. Soil Type(s): 0
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 Wo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No NA ❑ NE
acres determination? IX
17. Does the facility lack adequate acreage for land application? ❑ Yes [V1 No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes XNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes allo ❑ 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 [3 Design ❑ Maps ❑ Lease Agreements []Other: ` /
V21. es record keeping need improvement? l€yes aheok box -below - ❑ Yes �'No ❑ NA ❑ NE
Rste Applicat' n ❑-w=kty-Freeboartt Waste Analysis Soil Analysis �ste Transfers ❑'SVeather Code
ainfall tocking ❑ Crop Yield ❑ onthly and V Rainfall Inspections r l c1 "wNcy
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes lihlo ❑ NA ❑ NE
.o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No [ANA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: S - ()a I Date of Inspection:
24. Did the facility fail to calibrate waste apption equipment as required by the permit? ❑ Yes �Io ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ❑I No NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
TKNo
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
3s� No
❑ NA
❑ NE
❑ Yes )i' No ❑ NA ❑ NE
❑ Yes 19 No ❑ NA ❑ NE
1 � I Yes
❑' Yes
❑ Yes
No ❑ NA ❑ NE
[� No ❑ NA ❑ NE
�] No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments..
Use drawings of facility to better explain situations (use additional pages as' necessary).
a4. em+)e+e_A
d I . aoi o� a� i soy I fes+s ? oZ o t AeO
v� s i
3w-q &� c� P.e ' a tJ wu- -te AAA,-)d d urn
- u J C xke dv-e -t&
'$`6'
`^'v" PY' D l.rs�x-I' V✓ th'l�' w . `ri (�cM-ci/"�Ct a
t' aa� a S, 5-
3a Iglus f `"
uP i) 0 Pat LA-4, LOOP ASAP
iF3 D-2�m�� 1p O L 65 - OZ- PftN t yj- - kw tad -tb 4 _A
Reviewer/Inspector Name:
Reviewer/Inspector Signature: vM
Page 3 of 3
Q )-�() jI� /JN D
.r
D. t 11
412 1

of Visit ?,,Compliance Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit P,Routine 0 Complaint Q Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: J�d Arrival Time: Departure Time: WZ,V County: S ILe-S Region:
Farm Name: lzl �t,ra� j— Farm M Owner Email:
Owner Name: Phone: 59 3 _ $6 7 61)
Mailing Address: aba 5 ) q Ll \NJ . Loil : nn i% l l j e Qc� 2 0 ;z, ,;—
La on Physical Address: `71 W �L/j phi I V I � � e- N� a 76
Q i
Facility Contact: ajX I L H IrLLL Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: �o ®' �Longitude: ®o ®, DE
Nc_
nor` • We5t onto gt�oy 70.
Design Current Design Current
Design Current
Swine
Capacity Population Wet Poultry Capacity Population
Cattle
Capacity Population
❑ Wean to Finish
I0 Layer I
❑ Dairy Cow
❑ Wean to Feeder
1 10 Non -Layer I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ DryCow
❑ Farrow to Feeder
❑ Non -Dairy
Farrow to Finish
ElFarrow
❑
Beef Stocker
2
❑ Gilts
❑ Non -Layers
Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
1110
❑ Turkey Poults
Number of Structures:
Other 11 ❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes �,No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
e. What is the estimated volume that reached waters of the State (gallons)? 0
d. Does discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes D<No ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes 9No ❑ NA ❑ NE
other than from a discharge'?
1 Page ? of 3 12128104 Continued

Facility Num• Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No *A ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5.
Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
D(I 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
0 NA
❑ NE
8.
Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ No
JXNA
❑ 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
tNo
❑ NA
❑ NE
maintenance or im rovement?
P
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA El NE
maintenance/improvement? �..,/
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes lyl No [I NA El NE
❑ Excessive Ponding [3 Hydraulic Overload [I Frozen Ground El 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) `rCS Ckc
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes VNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes ❑ No
N 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 R'No
❑ NA
❑ NE
Co'mmcnts (refer to question #) ,Eaplai&any YES answler's;and/ rainy recomm ndations o -an ( oithe`r comet nls:, xt �"
Use drawings of factlrty to better"explain situations' (u$e;addthonal p ge as'necessel,y')
.. , (e_ ?ga1�31 itYs3k.S&o 41' +`i .fk
t s
ik
BU�r�ers? 4 , ^ -
S iV G4-rat 1 ? sb tx
Reviewer/Ins ector Name ;
P +�%.s 'ta,'s aA t� � , ` , cs0 (� Phone: — S
Reviewer/Inspector Signature: Date: J� 1
Page 2 of 3 k I r 12128104 Continued

Facility Number: — Q 0 of Inspection " " i �� •
Required Records & Documents �J
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ElYes 3�1 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes gNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design [I Maps El Other
21. Does record keeping need improvement? i€ f6S ,ZhCCj th ���-j.,.. �9ti i ,,. ❑Yes No NA ❑ NE
Waste Application ^ "' T
pp ❑ W and Waste Analysis Soil Ana ysis u vras c rrensfcrrAnnual C-A14,fin"t,
�infall Stocking Crop Yield ❑ l20 ections Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes �No
❑ Yes ❑ No
❑ Yes XNo
❑ Yes ❑ No
❑ Yes No
YN
❑ Yes odNo
El NA ❑NE
0NA El NE
El NA El NE
ONA ❑NE
❑NA El NE
❑NA ❑NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
*o
❑ NA
❑ NE
❑ Yes
ANo
❑ NA
❑ NE
❑ Yes
;�No
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
Solid Spreader Ca1ihJ-a4;(Jn due Dube►- aolo.
a a009 w a o I0 5o i l �e,51-5 ? 0100 q
�U2/10
'44N
3
Page 3 of 3 12128104

Facility Number O �� Other Agency I and Water ervation q 3�
Division of Water Quality
Type of Visit 1. Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: S Arrival Time: Departure Time: ® County: ��S Region: (�y�.0
Farm Name: Q r Owner Email:
Owner Name: IVWW Y-- l] r'aiu Phone:
Mailing Address: �015 IVY �� W , i
Physical Address:
Facility Contact: AL41
^ V- ;� Title:
Onsite Representative: A /1(wy i7 ra-4-t
Certified Operator: (Moul P) rq=�4
Back-up Operator:
Location of Farm:
MMM
Swine
Other
❑ Other
Latitude:
®o
w t 5 Kt 70,
X, a�oz2-
Phone No1�/14Sa
Integrator:
Operator Certification Number: on
Back-up Certification Number:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
I ❑ Non-Layet
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Longitude:
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy
❑ D Cow
❑ Non -Dairy_
Beef Stockei
t
Beef Feeder
❑ Beef Brood Cow
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ((No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify D WQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
0
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yei
O No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
Yes
❑ No
❑ NA
❑ NE
other than from a discharge?
12128104 Continued

Facility Number: �— QZ� • Date of Inspection 0•
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No YNA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ yes
❑ No [(NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
�No ❑ NA ❑ NE
through a waste management or closure plan?
/ ``
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
❑ No VNA ❑ 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
9 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
9 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidpnce 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
KNo
ElNA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
ElYes
YNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
❑ No
XNA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
XNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[jNo
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
5{bCJL_� ? KUCVN 64ec— S 1I heccisone rip-ra'� m �[a_ces
140udeA fror/L middle lot �hEtl1 behind pout-tr� houscs?
3 �Za'tmeruL 4 r�o,(, r�gO.i reel ? N� — avi'I f loops �md .
,\11 A" Zr �,m /A.f of �E D� t�7 � /itt � �t libl% e
Name
Reviewer/Inspector ��}
1'1 a" "
v inz
Phone:
Date:
74 LLtUALA%J',A/..(.f-,►r-t�dap - n-
SM.cO O #4 /A/' 1 I AAMAIP

i

95-1
Facility Number: — Q • of Inspection IS /6►Oa11 •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No []NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes /❑ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other �..,/
21. Does cord keeping need improvement? I pmepriatebmrbelow. ❑ Yes L87 No ❑ NA ❑ NE
aste Applica 'on aste Analysis Soil Analysis Waste Transfers / , tiart—
;yR
ainfall Stocking Crop Yield r"I ' ^^"--..::^ .,,'^^peetiens ER -Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 9No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ���❑///No [(NA ❑ NE
pµ 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes /❑ No )(NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes XNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes �No ❑ NA El NE
and report the,mortality rates that were higher than normal'?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes eNo ❑ 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 gNo ❑ 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 WNo ❑ NA ❑ NE
Additional Comments and/or Drawings:
a . ;LO()1 50 t i e5t ?
Abt t a0 I a
574A10q wc� �t� _ I b S . NU/7-11
Page 3 of 3
12128104

. 1
Division of Water Quality
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 850002 Facility Status: Alive Permit: AWC850002 ❑ Denied Access
Inspection Type: Compliance Insoection Inactive or Closed Date:
Reason for Visit: Routine County: Stokes Region: Winston-Salem
Date of Visit: 05/28/2009 Entry Time:09,50 AM Exit Time: 11:25 AM Incident M
Farm A)]me: :617—M•TiC t , o • r .. . u
IdriI11T7i Erin ena;r - r
Physical Address: 1981 Hwy 704 W Lawsonville NC 27022
Facility Status: 0 Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude:36°16'35" Longitude:80°14'55"
Hwy 8 north to 704. Take left onto 704. Go 1.9 miles to farm. Barn is on the left.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Mark A Bray
Secondary OIC(s):
Operator Certification Number: 21387
On -Site Representative(s): Name Title Phone
24 hour contact name Mark A Bray Phone: [phone]
On -site representative Mark Bray Phone: [phone]
Primary Inspector: Melissa Rosebrock Phone:
Inspector Signature:
Secondary Inspector(s):
Date:
0
Page: 1

L
Permit: AWC850002 Owner- Facility: Mark A Bray Facility Number: 850002
Inspection Date: 05/28/2009 Inspection Type: Compliance Inspection Reason for Visit: Routine
Inspection Summary:
3. Cattle excluded from middle? No, but it looks good. Hill behind houses?
3. Sediment trap repaired? Better. Suggest turning freshwater out into traps. May want to turn runoff from first paddock into
sediment trap. Continue?????.
9. Stock trail? Much better.: Still need some riprap in places.
21. 2008 soil tests? Yes.
21. Records look great!
24. Calibration? Completedl Not due again until 2010. 5/22/09 waste analysis = 4.2 Ibs N/Ton.
Page: 2

•
Permit: AWC850002 Owner- Facility: Mark A Bray Facility Number: 850002
Inspection Data: 05/28/2009 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity - Current Population
Cattle
O Cattle - Beef Feeder 325 213
Total Design Capacity: 325
Total SSLW: 260,000
Page: 3

Permit: AWC850002
Owner - Facility: Mark A Bray
Facility Number: 850002
Inspection Date: 05/28/2009 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? ❑ 0 ❑ ❑
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
4. Is storage capacity less than adequate?
❑ ❑ ❑ ❑
❑ ■ ❑ ❑
■ ❑ ❑ ❑
Yes No NA NE
❑ ❑ ■ ❑
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?
❑
❑
m
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits,
❑
❑
■
❑
dry slacks 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
Cl
■
Cl
❑
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: 4

n
Permit: AWC850002 Owner- Facility: Mark A Bray Facility Number: 850002
Inspection Date: 05/28/2009 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No NA NE
PAN? ❑
Is PAN > 10%/10lbs.? 0
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 Fescue (Hay, Pasture)
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?
Records and Documents
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?
❑ ■ ❑ ❑
❑ ❑ ■ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
Yes No NA NE
0■00
❑ ❑ ❑ ❑
A.
Page: 5

Permit: AWC850002 Owner -Facility: Mark A Bray Facility Number: 850002
Inspection Data; 05/28/2009 Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents Yes No NA NE
Checklists? ❑
Design? ❑
Maps? Cl
Other? ❑
21. Does record keeping need improvement? ❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after > 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
❑
IN
❑
❑
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: 6

Permit: AWC850002 Owner- Facility: Mark A Bray
Facility Number:
850002
Inspection Data: 05/28/2009 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Other Issues
Yes No
NA
NE
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?
❑ ■
Q
❑
33. Does facility require a follow-up visit by same agency?
❑ ■
❑
❑
Page:7

'Division of Water Quali
11
Facility Number Division of Soil and Water • onservation 'O
-- 0 Other Agency
Type of Visit A 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�O}t-her El Denied Access
5 p
Date of Visit: Ar ivval T me: Departure Time: � County: " `0 ��S �Region: t
Farm Name: Owner Email-
Owner Name: 1 1' Phone: �q3 — g 6 17
Mailing Address: ROTE Ei CtW4 1 oti N) LAIpe- n U 1 I I Nc a a a
Physical Address: I "1 v' U , 04TL fuipnen V+ a1 o a oZ
Facility Contact: 0 Title: Phone No. e 1(0' q5a . Sb 30
Onsite Representative:Mox � M Integrator:
Certified Operator: raff Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: My ® I Dy Longitude: ® o ©'
nov*k (ueSt on*o Rt.,uy 70q.
Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
Pullets
Design Current
Cattle Capacity - Population'
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
Beef Stocker
Beef Feeder
❑ Beef Brood Cow
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 from a discharge?
Page 1 of 3
❑ Yes lyl No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes No ❑ NA ❑ NE
Yes ❑ No ❑ NA ❑ NE
12128104 Condnued

91
Facility Number: $ S — O A Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[:]No
X NA
111T❑I
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[I No
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ yes
❑ No
gNA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
X No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ;(NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No XNA ❑ 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 I �A yes ❑ No ❑ NA ❑ NE
maintenance or improvement? 7`
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �No ❑ NA ❑ NE
maintenance/improvement?
It. 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 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window �j 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 CA WMP?
❑ Yes AIo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
0 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
KNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawingsoffacility better explain situations. (use additional pages as necessary):
Pam
`tto
9 o JTDC�k-` t►-0.i1 (fleRr
CrOSSm needs to be ('erVI' �e C-
Q l> Q �p�}
Q�e'3 a,S V3el`.
dl t Y) C5 u't' A V VI'S l-o n Q,156,6
@ a Ta/M
Reviewer/Inspector ame 1 11 ic)5a4
r 0 LIB- ] Phone:
Reviewer/Inspector Signature:
Date:
Page 2 of 3
12128104 Continued

Facility Number: 5- Date of Inspection too •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0�`No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes o ElNA ElNE
the appropriate box. El❑ Design ❑Maps El
WUP ❑ Checklists , 21. Does keeping need improvement?.^}�+}eeI ❑ Yes �No ❑ NA ❑ NE
�rite Applic on Waste Analysis Soil A�nalysis [ 1lFasfe 4YansfePs II!
ainfall Stocking rop Yield [2'Monthly and I" Rain Inspections GKcather Code
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
VNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
IP No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
I(NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
XNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
0
❑ 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
o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspeIctor fail to discuss review/inspection with an on -site representative?
❑ Yes
9No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?l t -
land/or
❑ Yes
No
❑ NA
❑ NE
44OWonal Comm Drawings: ��� , �,
0
' ( n0
7• s't L I ,�� ,i ► fd"
1•
1
r �' � .
- �A_t , t Ci
• Qt II I

0 Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number : 850002 Facility Status: Active Permit: AWC850002 ❑ Denied Access
Inspection Type: Compliance Inspection
Inactive or Closed Date:
Reason for Visit: Routine County: Stokes
Region: Winston-Salem
Date of Visit: 01/23/2007 Entry Time: 10,05 AM Exit Time: 12,20 PM Incident #:
Farm Name: Mark Bray Farm
Owner Email:
Owner: Mark Bray
Phone: [phone]
Mailing Address: 2075 HWY 704W
Lawsonville NC 27022
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude:
36°16'35" Longitude: 80°14'55"
Hwy 8 north to 704, Take left onto 704. Go 1.9 miles to farm. Barn is on the left.
'
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment
Waste Application
Records and Documents Other Issues
Certified Operator: Mark A Bray
Operator Certification Number: 21387
Secondary OIC(s):
On -Site Representative(s): Name
Title Phone
On -site representative Mark Bray
Phone: [phone]
24 hour contact name Mark Bray
Phone: [phone]
Primary Inspector: 'ssa osebroc
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
3. Must keep cattle out of three areas discussed so that vegetated buffer may establish. Re -seed as necessary.
14. & 28. Per tech specialist, WUP to be revised by March 2007. Changes to be included are: T-1289 F-8 & 9 add "hay," T-1289 F-4
add "pasture," T-1195 F-1 & 2 remove from WUP since there are three poultry houses now on this land.
21. Records are much better! Keep up the good work.
21. 2006 soil ssamples are in Raleigh, check results next visit.
24. Due again Dec. 2008
28. Don't forget to record all waste (poultry and cattle) applied on land listed in WUP.
10/5/06=6.7lbs. N/ton
Page: 1

Permit: AWC850002
Owner - Facility: Mark A Bray
Facility Number: 850002
Inspection Date: 01/23/2007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity
Current Population
Cattle
Cattle - Beef Feeder 325 250
Total Design Capacity: 325
Total SSLW: 260,000
' r r
:r
Page: 2

•
C�
Permit: AWC850002 Owner- Facility: Mark A Bray Facility Number: 850002
Inspection Date: 01/23/2007 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?
0000
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 Slate 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?
❑
❑
■
❑
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 Ap lip cation
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenanceor
❑
■
❑
❑
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: AWC850002 Owner- Facility: Mark A Bray
Inspection Dale: 01/23/2007 Inspection Type: Compliance Inspection
Facility Number: 850002
Reason for Visit: Routine
Waste Application
Yes
No
NA
NE
PAN?
❑
Is PAN > 10%/l0 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
Fescue
(Hay, Pasture)
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?
❑
■
❑
❑
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: AWC850002 Owner- Facility: Mark A Bray Facility Number: 850002
Inspection Date: 01/23/2007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents Yes No NA NE
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?
❑
■
❑
❑
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?
❑
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?
❑
■
❑
❑
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?
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 0
Permit: AWC850002 Owner- Facility: Mark A Bray Facility Number: 850002
Inspection Date: 01/23/2007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other Issues Yes No NA NE
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? ❑ 0 ❑ ❑
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ In ❑ ❑
33. Does facility require a follow-up visit by same agency?
❑ ■ ❑ ❑
Page: 6

Type of Visit 7" 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:
Farm Name: _
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Arrival Time: ® Departure Time:
-it,r/l. A FQxw, -1X�"Y-Itjn o 1
Onsite Representative:(�I I `WX Ii
Certified Operator: V V_ M r
Back-up Operator:
Location of Farm:
County:
Operator Certification Number:
Back-up Certification Number:
Region: W5P-0
)oa-2
-7 - ?gd -
s�30
Latitude:Ell u ®"®Y Longitude: 10 ° EN' ®Y
Nc 8' no - l,e on46 rJC. 10
0
Design Current
Design
Current
Design Current
Swine Capacity Population
Wet Poultry Capacity
Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
" ❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Dry Poultry
❑ La ers
❑Non -La ers
❑ Pullets
❑ Turkeys
❑ Dry Cow
[__1,Non-Dajry
Ul3eef Stocker
O
El Beef Feeder
:i ❑ Beef Brood Cow
OO [her
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures: �—�
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?
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
0
❑ NA
❑ NE
❑ Yes
❑ No
❑//I Yes gNo ❑ NA ❑ NE
bLI Yes ❑ No ❑ NA ❑ NE
Ih 12128104 Continued

Facility Number: �— Da • Date of Inspection T �f—� •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes ❑ No
❑ Yes ❑ No
Structure 5
TT�NA ElNE
El NA NA ❑ NE
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No XNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes l� No El NA El 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 *A ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No WA ❑ 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 �lN
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ElNA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes VNo ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Windov? ❑ Evidence of Wind Drift ❑ Application Outside of Area
C
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
I<Yes
El No ElNA
ElNE
15.
Does the receiving crop and/or land application site need improvement?
ElYes
D!(N/o ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No X NA
NNE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
pQ No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):,\
I J1� &( A w
p
tl
Reviewer/Inspector Name
I Phone: — S o
Reviewer/Inspector Signatu
Date: oZ
0
age 2 of C - ' ' nq�' ,�-, ) 2128104 Continued
t 1

Facility Number: — Q Qate of Inspection 7 T�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes I
No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other �[[[[[[ [/�,
21. Doe ecord keeping need improvement? If yes, check the appropriate box below. ❑ Yes I No ❑ NA ❑ NE
,�(ZJ�Jaste Applicaf n LN Waste Analysis © Soil Analysis �aasf,_ � [-},4n
U Rainfall Stocking Crop Yield n 126 - --_ _ _ --- Monthly and V Rain Inspections eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Il(I No El NA [I NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes !❑ No tXNA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes VNo ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No Ni" ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes *o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No CIA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 36No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes XNo ❑ NA ❑ NE
and report the mortality rates that were higher than normal? f
30. At the time of the inspection did the facility pose an odor or air quality concern? Ely
Yes (No El NA [I 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 XNo ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? El Yes 19 o El NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes OfNo ❑ NA ❑ NE
Additional Comments and/or Drawings:
OL co
to -1 o4 = ( ._7
El
E pv_'3.a(-�-
aoQ(p -�
M"J"
Has. . N / } 00
�c
I
1070
a
4
,,
r

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 850002 Facility Status: Alive Permit: AWC850002 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Stokes Region: Winston-Salem
Date of Visit: 04/18/2006 Entry Time:10,15 AM Exit Time: 12:00 PM Incident #:
Farm Name: Mark Bray Farm Owner Email:
Owner: Mark Bray Phone: [phone]
Mailing Address: 2075 HWY 704W Lawsonville NC 27022
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude:36°16'35" Longitude:80°14'55"
Hwy 8 north to 704. Take left onto 704. Go 1.9 miles to farm. Barn is on the left.
Question Areas:
Discharges & Stream Impacts
Records and Documents
Certified Operator: Mark A Bray
Secondary OIC(s):
Waste Collection & Treatment Waste Application
Other issues
Operator Certification Number: 21387
On -Site Representative(s): Name Tide Phone
On -site representative Mark Bray Phone: [phone]
24 hour contact name Mark Bray Phone: [phone]
Primary Inspector: Rosebrock / Phone: /
Inspector Signature:Mey s FII-PJ t I A Date: `r 0
Secondary Inspector(s):
Inspection Summary:
9. Sediment and waste retention efforts look great. Just continue.
21. Don't forget to record yields for hay fields that receive animal waste.
28. "Merritts" field received animal waste in 2005 and 2006. This field still needs to be added to the WUP to confirm application at
agronomic rates. Was applied onto 8-10 acres at 88 lbs. N/acre. SWCD/NRCS working on update. Check next visit.
1/6/06 waste analysis:
SSB= 4.2 lbs. N/ton
Page:1

0
0
Permit: AWC850002 Owner- Facility: Mark A Bray
Facility Number: 850002
Inspection Date: 04/18/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity
Current Population
Cattle
O Cattle - Beef Feeder 325 272
Total Design Capacity: 325
Total SSLW: 260,000
Page: 2

L
Permit: AWC850002 Owner - Facility: Mark A Bray
Inspection Date: 04/18/2006 Inspection Type: Compliance Inspection
Facility Number: 850002
Reason for Visit: Routine
Discharges 8 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 DWO)
❑
■
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
I Cl
■ Cl
Cl
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
❑
■
❑ ❑
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

0
Permit: AWC850002 Owner - Facility: Mark A Bray
Inspection Data: 04/182006 Inspection Type: Compliance Inspection
Facility Number: 850002
Reason for Visit: Routine
Waste Application
Yes
No
NA
NE
PAN?
❑
Is PAN > 100/6/10lbs.?
❑
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
Fescue (Hay)
Crop Type '2
Crop Type :I
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?
❑
■
❑
❑
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: AWC850002 Owner - Facility: Mark A Bray Facility Number: 850002
Inspection Date: 04/18/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents Yes No NA NE
Checklists?
Design? ❑
Maps? ❑
Other? ❑
21. Does record keeping need improvement? ■ ❑ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after> 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
IN
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?
❑
❑ ■
❑
Citthe_ r 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?
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

Permit: AWC850002 Owner- Facility: Mark A Bray Facility Number:850002
Inspection Date: 04/18/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Othar IBSIIaS Yes No NA NE
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?
❑ ■ ❑ ❑
Page:6

Division of Water Quality
Facility Number Division of Soil and Water Conservation 1 /(
- O Other Agency / t�
Type of Visit fNcompliance 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: I `f / 1 D /VY) Arrival Time: ° L � �S
o �s Departure Time: off. ; �30 Co�un-ty�: � Region: W� ty
Farm Name:_ftt�aY �EmaH: rnb r 32 � I � • r r,
Owner Name: �l I 1 jr Phone: �� `3 •
Mailing Address: R o-1 S 4 i'W � �q�4 tk)esfi. Ll� w ony i lI e � N �- a1�z Z
Address: , -L O f � w � o4 &S� ,_ Q -D- I1II `j l IPA I3� -1l a� oZ 7-
Physical
Facility Contact: Lz R r n Title: Phone No: & 2 / b _ � Z
Onsite Representative:_ l� I) V-" Integrator: -- - - 3
Certified Operator: DOUL 1—oUAJ 4 Operator Certification Number: c2-13 $7
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: ® o ,10
���`�'`�� T Longitude: Mon, ��`�C��.�/`1�3
` � C �uQo
�Qr ns v; 1e, �or.ju I(� _ o
Design Current
Swine Capacity Population
Other
❑ Other
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
.,Design Current
Capacity. Population
] Dairy Cow
] Dairy Calf
] Dairy Heifer
Dry Cow
Non-Dai
/.7c
Beef Stocker
1
�`
�5 0
Beef Feeder
] Beef Brood Cow
Number of Structures: L� J'
❑ Yes
)6No ❑ NA ❑ NE
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
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes 4 No ❑ NA ❑ NE
❑ Yes Lk(No ❑ NA ❑ NE
12128104 Continued

Facility Number: — � • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 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 ❑ No f)t NA ❑ NE
❑ Yes El No 77❑```NA ❑ NE
Structure 5 Structure 6
❑ Yes ❑ No � (NA El NE
El Yes El No L]I NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No �(NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No YNA ❑ 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 P(No El NA El NE
El Excessive Pending El Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.) TT
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ElNE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ❑ No _WNA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ;Rl�o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
aReviewer/Inspector Name I Phone: of O
Reviewer/Inspector Signat 110 j I djA UPM P A Date:
Page 2 of 3 12 8104 Continued

Facility Number: — *e of Inspection �O •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �LS.IJo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes LTIANo El NA ❑ NE
❑ ❑ Design ❑Maps ❑Other
the appropriate box. ❑ WUP Checklists ,`
21. Does record keeping need improvement? Yes ❑ No ❑ NA ❑ NE
❑ �Ya��ste Applicati n beard ❑ ste Analysis ❑ �il At as ysis ❑ W Transfers • eoiien
❑ R'ainfall Stocking Crop Yield IJ1tGlonthly and I" Rain Inspections ❑ ather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes t6No ❑ NA ❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
WA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit? ®C} 06 ❑ Yes
[ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
>NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ANo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
WA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
�/
IJ�Yes
El No
❑ NA
ElNE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
/❑ Yes
ANo
❑ 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?
El Yes
,
IbI 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
JNo
❑ 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
*o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ko
❑ NA
❑ NE
��Additional Comments and/or Drawings:
9\ ReIJA rec 've-A 0_yx�vuW too-ste- 'v) \o,5
et I
0 (0 . S�7 w P Cool vv1
Cpl I cad ova
(('1Y1�0 �3'16 NC° eEcS (y-�6 `�` �BS • N /Acre, J L, )CZ
i ocl i+.0)eOL Yi-ej_( VISI�o
&3_e-1 1-6 record hw, 40e j*.,,
Page 3 of 3 12128104

•
❑ Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 850002 Facility Status: Active Permit: AWC850002 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Stokes Reglon: Winston-Salem
Date of Visit: 0211012005 Entry Time: 10:00 AM Exit Time: 12:15 PM
Farm Name: Mark Bray Farm Owner Email:
Owner: Mark A Bray
Physical Address:
��kYII•Y-BII�I•Y�t�
r . wriffor.. • r Itai![sYiAYk�
Facility Status: ❑ Compliant ❑ Not Compliant
Location of Farm:
Integrator:
Latitude: 36.28 Longitude: -80.25
Hwy 8 north to 704. Take left onto 704. Go 1.9 miles to farm. Bern is on the left.
Question Areas:
Discharges & Stream Impacts
Records and Documents
Certified Operator: Mark A Bray
Secondary OIC(s):
Waste Collection & Treatment Waste Application
Other issues
Operator Certification Number: 21387
On -Site Representative(s): Name Title Phone
On -site representative Mark A Bray Phone: [phone]
24 hour contact name Mark 9 Bray n Phone: [phone]
Primary Inspector: Mary M
Secondary Inspector(s):
Phone:[phone]
Ex1.383
Phone:
Phone:
Inspection Summary:
3. and 9. Still have several channels carrying sediment and some waste into surface waters. Continue efforts with grading and
seeding. Looks better.
9. Continue efforts to to establish vegetation. Some seeding was completed in Oct. '04.
21. During 7/15/04 to 9/30/04 operator hauled waste to Mr. Sands fields (all in NC). Some fields were in CAWMP and some were not.
During 10/15/04 to 12/30/04 operator hauled waste to Mr. Merritt fields (VA & NC)in exchange for hay. Some NC fields were not in
the waste plan. A total of 37 loads were hauled to Merritt and Sands fields.
28. Need to add NC fields that receive waste to the CAWMP.
29. Burial sites ok.
12/8/04 waste analysis=4.1 lbs. N/ton.
Page: 1

Permit: AWC850002
Inspection Date: 02/10/2005
Regulated Operations
Owner - Facility: Mark A Bray
Inspection Type: Compliance Inspection
Facility Number: 850002
Reason for Visit: Routine
Design Capacity Current Population
Cattle
Cattle - Beef Feeder 325 -_ _ _ 286
Total Design Capacity: 325
Total SSLW: 260,000
Page: 2

11
Permit: AWC850002 Owner - Facility: Mark A Bray Facility Number: 850002
Inspection Date: 02/10/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Page: 3

L]
O
Permlt: AWC850002
Owner- Facility: Mark A Bray
Facility Number: 850002
Inspection Date: 02/10/2005 Inspection Type: Compliance Inspection Reason for Visit:
Routine
Di__afye-q , Stream Imnarfe
1. Is any discharge observed from any part of the operation?
Vas
❑
No
moo
NA NE
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
N ❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
0 ❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
0 ❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0
❑ ❑
3. Were there any adverse Impacts or potential adverse impacts to Waters of the State other than from a discharge?
0
Vac
❑
No
❑ ❑
NA NF
Waste Collection. Slorggp A Treatment
4. Is storage capacity less than adequate?
❑
❑
0 ❑
If yes, is waste level into structural freeboard?
❑
S. Are there any immediate threats to the integrity of any of the structures observed (Led large trees, severe erosion,
❑
❑
0 ❑
seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management or
❑
❑
0 ❑
closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
N ❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks
❑
❑
0 ❑
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
❑ ❑
improvement?
Vas
No
NA NF
Waste lipl ration
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or Improvement?
❑
N
❑ ❑
11. Is there evidence of incorrect application?
❑
N
❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total P2O5?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drtft?
❑
Application outside of application area?
❑
Crop Type 1 Fescue (Hay)
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Page: 4

Permit: AWC850002 Owner - Facility: Mark A Bray
Inspection Date: 02/10/2005 Inspection Type: Compliance Inspection
Facility Number:
Reason for Visit:
850002
Routine
Waste Aooli action
Crop Type 6
Yes
No
NA
NF
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)? ❑
E
❑
❑
15. Does the receiving crop and/or land application site need improvement?
❑
N
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑
❑
E
❑
17. Does the facility lack adequate acreage for land application?
❑
0
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
yes
0
No
❑
NA
❑
NF
R nords and Dncuments
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
a ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0
❑
❑
If yes, check the appropriate box below.
WUP?
❑
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?
E
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?
❑
E
❑
❑
23. If selected, did the facility fall 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?
❑
0
❑
❑
Page: 5
I

r
Permit: AWC850002 Owner -Facility: Mark A Bray Facility Number:
Inspection Date: 02/10/2005 Inspection Type: Compliance Inspection Reason for Visit:
850002
Routine
Other Issues
28, Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
Vas No
❑
NA
❑
NE
❑
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
❑ 0
❑
❑
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/inspection with on -site representative?
❑
❑
❑
33. Does lacility require a follow-up visit by same agency?
❑ E
❑
❑
Page: 6

Type of Visit (&Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit y Routine OComplaint OFollowup OReferral OEmergency 00ther ❑Denied Access
Date of Visit: Arrival Time: Departure Time: 15—County: 51 hCJ Region:,yJP'y
Farm Name: QX � CLLt t FQ� m Owner Email: Ql4 b rt+1M3 Evea
Owner Name: -
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:: 1V 1cx f'— 0 V
I V Certified Operator: �\cL —%— A '
Back-up Operator:
Location of Farm:
Swine
Other
❑ Other
Phone: 3 3 b 5 1 3- `66 1 H
Ajes-+ Lca.uDn6nv1 tie-, >uc. �2 7o a ;L
Operator Certification Number: W 1 3 u /
Back-up Certification Number: -
Latitude: Ike ©',M" Longitude: ®°
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
�' ❑ Non -Layer_
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
Number of Structures: ®,
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 WNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
�(No
❑ NA
❑ NE
XYes
❑ No
❑ NA
❑ NE
12128104 Continued

I Facili —
tY Number: • Date of Inspection 0 O •
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 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 ❑ No XNA ❑ NE
❑ YesNoo
NA ❑ NE
Structure 5 Structure 6
❑ Yes ❑ No VNA ❑ 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 ❑ No XNA ❑ 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 Ia Yes ❑ No ❑ NA ❑ NE
maintenance or improvement? /
Waste Application ,,..,//
10. Are there any required buffers, setbacks, or compliance alternatives that need es t]4.No ❑ NA ❑ NE
maintenance/improvement? TT
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes X(No ❑ NA ❑ NE
-n .,-.____,_._ Rood:-- ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ 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
17YNo
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑ Yes
❑ No
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
18. Is there a lack of properly operating waste application equipment?
❑ Yes
)(No
❑ NA ❑ NE
❑ NA ❑ NE
'VNA ❑ NE
%NAA 0 NE
NA ❑ NE
O
Reviewer/Inspector Name Phone: �Jip 1 X—
Reviewer/Inspector Signatu LVAA IR'0 Date:
. L. 1 12128104 Continued

Facility Number: — a D..f Inspection •
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 apppropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, the the appropriate box bow. / ❑ Yes ❑ No ❑ NA ❑ NE
❑ s[e Application Waste Analysis ❑-tS/oil Analysis [f]�y/as[e Transfers /
Rainfall Stocking ❑Crop Yiel on Monthly and I" Rain Inspecti ns Weather Co ✓
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes % No ElNA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ElYes ❑ No 15(NA ❑ NE
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 property 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?
Comments and/or
Fer,,eiI'd
Mo
MN
a� lee G� va h be
not. akp leled
sc*w a.
a
❑ Yes XNo
❑ Yes ��0� No
❑ Yes No
❑ Yes No
❑NA ONE
XNA ❑ NE
El NA El NE
❑ NA ❑ NE
XYes
❑ No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
O No
❑ NA
❑ NE
❑ Yes
No
El NA
❑ NE
❑ Yes
�9
y
,No
❑ NA
❑ NE
Pon 4,
Proc,ess�b�- a�G�lna T- la8a��4�'� fo
e-

zr ` technical Assistance Site Visit
D1ll%ion of Soil and Water Conservatio7P
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 85 - �2 Date: 7113/04 Time: 8:45 Time On Farm: 135 WSRO
Farm Name Mark Bray Farm County Stokes
Mailing Address 2075 Hwy 704 West Lawsonville NC
Onsite
Representative Mark Bray Integrator
Type Of Visit
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Uperatea:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Design Current
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Phone: 336-593-B617
27022
Purpose Of Visit
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Po ulation
❑ Layer
❑ Non Layer
❑ Dairy
® Non -Dairy
❑ Dairy
® Non -Dairy
325
1 160
❑ 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
Structural Structure 2 Structure 3 Structure 4 Structure 5
Identifier N/A
Level (inches)
CROP TYPES ]Fescue -hay lorchard Grass (hay)
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 85 - 2 Date:
7/13/04
PARAMETER
O No assistance provided/requested
❑ 8.
waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9.
Wastespill 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 w/producer
❑
❑
❑ 12.
Waste structure integrity compromised
28. Forms Need in
❑
❑
❑ 13.
Waste structure needs maintenance
(list 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
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 removal/closure 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:
Irrigation design/installation
El
El
El Other...
43. system
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
El
46. Wettable Acre Determination
1
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2.
49. Drainage work/evaluation
®
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5.
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6.
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

Facility Number 85 0 Date: 7/13/04
COMMENTS:
analysis: 2-04-04
# 25. Mr. Bray is planning on having T1982 and T6444 broken down into additional fields for 'record
Roping and crop types.
# 49. The stream crossing was repaired, but has since washed out again and needs to be repaired.
uggested that Mr. Bray contact the local NRCS/SWCD office for assistance with the stream crossing
rid installing terraces to reduce the amount of soil erosion from the cattle. pens.
The fence below the stream crossing still needs to be moved up from the creek per DWQ inspection.
Mr. Bray still needs to seed pen # 4, which was mentioned on the DWQ inspection.
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 7/14/04
Entered By: lRocky Durham
03/10/03

vision of Water Quality
vision of Soil and Water Conservation
O Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Fallow up O Emergency Notification O Other ❑ Denied Access
Facility Number 85 2 Date of Visit: 2/6/2004 Time: I000
O Not Operational O Below Threshold
M Permitted M Certified 13 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: . __
Farm Name: Mnrk.iraX.F.arm.................................................................. County:$tpha ..................................... WS.R.Q......
Owner Name: A1ark------------------- RCay-•-----•---------------------- Phone No: 33ItS43:R417.---•---.-.-.-------.-•-----•-
MailingAddress: 2,Q7.5.. wy..7.Q4..West........................................................................... Lawmayllip.AC .................................................. 17921 ..............
Facility Contact: Markilray.......................................... l'itle:............................................... Phone No: 2.7f>.9SZ.563.0.(GRiq........
Onsite Representative: MarkkCax.-deck lyllAD----------------------------- Integrator:.-----------•-•---------•-•-----------._._..
Certified Operator: MA&A................................. Aray.................................................... Operator Certification Number: Z1.3A7.............................
Location of Farm:
Hwy 8 north to 704. Take left onto 704. Go 1.9 miles to farm. Barn is on the left. A
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 36 • 16 35 Longitude F 80 • 14 55 ..
Design Current
Swine CaDBclty Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I Dairy
❑ Non -Layer I airy 1 325 1 334
❑ Other
Total Design Capacity 325
Total SSLW
I Number of Lagoons I 0 I 1 11 1 1 I
Holdinp Ponds / Solid Trans 0 1 1 No Liquid Waste Management S stem
Discharges & Stream Impacts
I., Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ 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 ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......... MA.........................................................................................................................................--.....
Freeboard (inches):
12/12/03 -0-n 6
/ Cyntinued

Facility Number: 85-2 1 • Date of Inspection 1 2/6/2004
+
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ treeRevere 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 maintenance/improvement?
® Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
❑ No
elevation markings?
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
®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 Fescue (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?
❑ Yes
® 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 ®No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ® No
Air Quality representative immediately.
Co me RiEFROFRobet�terexullil
o soon #): Explain any YES a s e a d/o any recommendations o a .other comments.
U dran ait atlon . us additional ages es nece sary : ❑ Field Copy ®Final Notes
8. Operator has re -clone several of the fences aroung the lots/farm. Still need to move the fencing near the crossing back several feet to
stablish a vegetative buffer. Operator to have completed by may I, 2004. Check next visit. Crossing to be repaired too. Was damaged
ue to high water Flows.
8. Terraced waterway needs to be re -seeded as soon as possible to control sediment run-off.
8. Fencing is to be re -done on pen 4. Pen is to be wider but not as deep to allow a greater vegetative buffer to establish (about 15 more
feet). Waste is getting into creek during rain events.
2. CAWMP was missing all the "checklists" for odor, insect, mortality. Have technical specialist complete and keep with the CAWMP
3. Make sure to use the tracts/fields from the WUP in labeling your waste application records. Operator is waiting on waste results to
complete Jan. 2004 records. Check next visit.
29. Need to have 5 acre hay field (T-1982? or T-6444?) to WUP as soon as possible since waste was applied here in 2003.
8/27/03 waste analysis=4.5 lbs. N/ton
T
Reviewer/Inspector Name Melissaoseb ock
Reviewer/Inspector Signature: Date: (67
12/12lui uonnnuea

Facility Number: 85-2 1);of Inspection 2/6/2004 •
Required
Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
®No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
® Yes
❑ No
23.
Does record keeping need improvement? If yes, check the appropriate box below.
® Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
®No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
®No
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
®No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (if no, skip questions 31-35)
❑ Yes
®No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
'diiionaalCComments and%o7Drawi E,
T
12112103

ivision of Water Quality
Division of Soil and Water Conservation
0 Other Agency -
Type of Visit ACompliance 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
Date of Visit: `�f4' 4 lime: 9 • a Printed on: 7/21/2000
�..
,[ 0 Not Operational 0 Below'fhreshold
® Permitted Certifie
d 1] Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
`Farm Name: ._I..!..y�Q�lr !".../. a .......Far_m..... Ric �q�%•�) `1? County':........` 7104.e/.......�.........................................
Owner Name: ....... I..I.ry1.4�-.Y.F..).'......
j�..r........................................... �iYl�i Phone No: ....... 9...'....R..fQ,t..Q1.'.J.............,.........................
Facility Contact: ... MC�.Ir.I....... 8-t' .. I'itle:........................................................I....... Phone No: .`.41......
a'%.
c 1I .......I........ I,,0C� O......... nu► III.- a sb3o
Mailing Address:.......9Q.3 .1". _�.. 4N 1.... � N�' 7bLZ
gr .......1......... y. ..................... �........................................,.........................................................
OnsitcRepresentative: ,.J, a('.1L... 1.C,a�...Md. v V ntntcgrator:................. ...................................... _
rn(�...........i....................
Certified Operator:....m. %1�.. „r.... :....-'............................................ Operator Certification Number...._v,:_.. l ...
Location of Farm: .
15 1.1-1 nil td6 on
❑ Swine ❑ Poultry Cattle ❑ Horse Latitude ®• ®` ®" Longitude MI F 14-1, DO -
Swine
Design Current
Canaeity 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 Population
❑ Layer ❑ Dairy
❑ Non -Layer 10 Non -Dairy
❑ Other 3 u
Total Design Capacity
Total SSLW
I Number of Lagoons I 17 I IU Subsurface Drains Present IILJ Lagoon Area
Holding Ponds /Solid Traps ® o Liquid Waste Management System
ILJ Spray Field Area
Discharges & Stream Imuacte
I. Is any discharge observed from any part of the operation?
❑ yes �No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
'a. II'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 hypass 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 Stale other than from a discharge?
❑ Yes XNo
Waste Collection &'Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway
❑ Yes No
Su'yc)Lire I Structure 2 Structure. � Structure 4 Structure 5
Identifier:.............................................................................................................................................................................................................
Structure 6
Freehoard (inches):
5100
Continued on back

•
•
Facility Number: Z Date of Inspection ����j_''j
5.
Are there anv immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
El Yes
lbl
X No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(It any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
��� ///
�No
/ -
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
it
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
Yes
❑ No
9.
Do anv stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
)46
No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑Yes
)<No
11.
Is there evidence of over pplication? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
No
12.
Crop type
TTT"'
13.
Do the receiving cro4 differ with those 6signated in the Certified Animal Waste Management Plan (CA\1rMP)?
❑ Yes
14.
a) Does the facility lack adequate acreage for land application?
❑ Yesb)
INOo
Does the facility need a wettable acre determination?
❑Yesoc)
This facility is pended for a wettable acre determination?
❑Yeso
15. Does the receiving crop need improvement? ❑ Yes ` No
16. Is there a lack of adequate waste application equipment? ❑ Yes j �'o
Reouired Records & Documents ���,,,///,,,
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? El Yes gl No
18. Does the f tc have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP checklists, sign, maps, etc.) / / / Ayes ❑ No
19. Does record keeping need improvement? (ie/ i tion, fr>a old ard, 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 ,Rlgo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes )QNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit? /`
(ie/ discharge, freeboard problems, over application) ❑ Yes XNo
23. Did Reviewer/Inspector fail to discuss review^inspection with on -site representative? ❑ Yes �No
o
24. Does facility require a follow-up visit by same agency? ❑ Yes
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? Yes ❑ No
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about tkis vitit.
jn i11 +ld,'N .. "J, tk t .ioT iW A:GT r r JtYl4" YYaNINt - .X# IYuI A,KM,
Comments (refer to question:':Eipls3n anyrYES anawets and/or anyrecommendations orany o er, rnmmentsl i(tu 7" "ZPt'J i
s rA
Use drawings of facility to better explain situattoas (use additional pages ss netessaiy)
r r r etx _ r r _ t u , t< t Field Copv ❑ Final Notes _
diem u5w.,.. "!dLw k',�xd.+C..91P.,a....Jai.,..�x�i,riiN2.,ilu,ete'aL.ivfA+:.�xdaiiJJdurx`XYJ.,,N4`,b.Y4.71,.t.rf,(!fis?4.vn1tdv4rd+�Uw!
lq e_ e ¢0 h aVe -f2 chin r c a l 5 P e c_i ct � s f-� eei ry fl
I�� c1�1 i sty q- lL eq w/ w U PO
n
apo,ro`�mr1US r& ovA-e S"vera( -1-"c-eso n2.ed `�@ mo-ve
- C � 1 11�� r C u''USSI i'1 g,aaRom &ra/ e. � i5
eek 54-6 h
-
Reviewer/Ins ectorName 'i-* Stu '''''"
P n.R�,.E.n'u `5 "" ;- r:.s iYir.
."�,,'y°,,.�ffg_,
Reviewer/Inspector Signature: Date:
05103101 d d Co daued
�!ec�.cal ast; c v► ,Chi % OK — v i 51+ i'Vl a� 15 t— 01 s-4.
(',rdssiny L+co

•Facility Number: — Date of Inspection •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Q
i J �r ✓1
Ed,
W U V� Vtu o

Assistance Site Visit
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 85 �2 Date: l27/03 Time: 10:00 Time On Farm: 90 WSRO
Farm Name Mark Bray Farm County Stokes Phone: [phone]
Mailing Address 2075 Hwy 704 West Lawsonville NC 27022
Onsite
Representative Mark Bray Integrator
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Routine
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
❑ Dairy
® Non -Dairy
Routine
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
❑ Dairy
® Non -Dairy
❑ Dairy
® Non -Dairy
1 325
1 205
❑ 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
Structural Structure 2 Structure 3 Structure 4 Structure 5
Identifier N/A
Level (Inches)
CROP TYPES jOrchard Grass ha Fescue -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 85 - 2 Date:
8/27/03
PARAMETER
Op No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
25. Waste Plan Revision or Amendment
❑
❑
❑ 10. Level in structural freeboard
❑
❑
❑ 11. Level in storm storage
26. Waste Plan Conditional Amendment
27. Review or Evaluate Waste Plan wlproducer
❑
❑
❑ 12. Waste structure integrity compromised
28. Forms Need (list in comment section)
❑
❑
❑ 13. Waste structure needs maintenance
❑
❑
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
[118. 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 removal/closure 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 t0 DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
El Other...
43. Irrigation system design/installation
El
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45. Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1 • Mr. Bray installed some 2 by 10 boards along the
47. Evaluate WAD certificationlrechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
lower fence line as suggested by the DWQ.
2. Mr. Bray moved cattle and seeded the denuded
49. Drainage worklevaluation
❑
❑
lot as suggested by the DWQ.
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5.
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

a
Facility Number 85 Date: 8/27/03
COMMENTS:
Waste analysis: 5-12-03 SSB 5.6 Ibs.N/ton B, 3-06-03 SSB 4.2 Ibs.N/ton B
" Remember to get your 2003 soil samples.
All waste application has gone to fields in Virginia so far this year.
Need to locate a copy of the most recent waste plan.
Facility is in compliance.
The stream crossing, below the barn, needs to be repaired.
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 9/2/03
Entered By: lRocky Durham -71
03/10/03

(Type of Visit. O• Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number $$ Z Date of visit: 5/30/2002 Time: 1005
10 Not Operational O Below Threshold
Permitted ■ Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Kark.BraY..Faitu..................................... :................................................... County: S1Akes................................................ lI,SRQ........
OwnerName: l ark ....................................... Uray....... :.:................................................... Phone No: 336r.59J.:86j7............................................................
Mailing Address:2Q75...HtvY...7.Q4.1Yxs1..........::.........::::..:.:..:......................................... Lswsony.ft..K.................................................. 2.7.022 .............
FacilityContact: Hark.B.ray........................................... ::......... Title:................................................................ Phone No:...................................................
OnsiteRepresentative: l.!'Iat:k..fttty...........................:.........:............................................. Integrator:......................................................................................
Certified Operator:Mark„................................. amy.......... :........................................ Operator Certification Number: 213S.7..............................
Location of Farm:
Hwy 8 north to 704. Take left onto 704. Go 1.9 miles to farm. Barn is on the left. A
❑ Swine [I Poultry ® Cattle ❑ Horse Latitude 36 • 16 35 Longitude 80 • 14 , 55
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ 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
a to Collection &1 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):
05103101 Continued

Facility Number: 85-2 • Date of Inspection F5_130/20_02_1 40
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 Pending ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
® Yes
❑ No
❑ Yes
❑ No
❑ Yes
® No
❑ Yes
® No
12. Crop type Fescue (Graze) Fescue (Hay)
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?
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?
Reuuired 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.)
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?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ 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.
Field Copy ® Final Notes
and 8. Still getting some wash -off of sediment and waste from the lots. Suggest scraping and installing 2x 10 or 2x 12 boards along
rttom of fence line to contain solids but allow rain to flow underneath.
Stock Vail, diversions, and crossings look great. Suggest moving fence (pre-stocktrail) back from creek a few feet to increase buffer
:a. Are getting some sediment run-off at this area.
�. 2001 soil analysis results look ok. Still need to obtain 2002 samples. Waste analysis for 2/2001 applications was 6.9 lbs. N/ton.
20/02 Cattle lot scrape waste anlysis was 7.1 Ibs/ton.
T-1982 (F-I and F-3) was not in the most recent CAWMP. Need to put these VA fields in new CAWMP.
Per operator. SR'CD/NRCS had CAWMP revision info in 2/2002. CAWMP is currently being revised by technical specialist.
Reviewer/Inspector Name
Reviewer/Inspector Signature:!"INV uia%it0o 0fifT - Date: T�1�r_
f
05103101 Continued

Facility Number: 85-2 O� of Inspection 5/30/2002 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 ® 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
that were left blank are not applicable to this facility at this time.
r�
J
05103101

• • 10 Pm
Type of Visit 0 Compliance Inspection Q Operation Review 0 Lagoon Evaluation
Reason for Visit x Routine O Complaint O Follow up Q Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: b Time:
10 Not Operational 0 Below Threshold
Permitted /�/C�ertified [3Conditionally Certified [3Registered Date Last Operated or Above Threshold:
Farm Name: I{�f/ a r IL Rnrat A �F/2 r 1y) County:. 546 14e.S
Owner Name: 1i L-1' [)(J��L1v J��/ ,- 1 1'P`h`oneNo: 33(ot.,'�S/q� 3. 8617
Mailing Address: Z( 0T5- (i�t Icy -7V t eV s4j La tA_6on Yjl'e / QC /R'70a-��-t
Facility Contact: I r I�a r l& f. ) 0.r � Title: Phone No: 3310 ' S'/'3 . q 3�
Onsite Representative: (�i/t�t-u � 1J rQ.l.1/ Integrator: �y
Certified Operator: t t t ar Operator Certification Number: 13 0 7
Location of Farm:
❑ Swine ❑ Poultry dCattle ❑ Horse Latitude ®- EWT =« Longitude ®e Eill,
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Ca aci Population'
❑ Wean to Feeder
❑ Laver
❑ Dairy
❑ Feeder to Finish
❑ Non -Layer
Non-Dai
S
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑Boars
- Total$SLW
,3�KI 06r)
Discharges 8& Str, eam 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
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 ll tin & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Stru ture 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
vex:
❑ Yes -�YNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Aa'No
Yes ❑ No
—*CT�
Structure 6
Continued

Facility Number: — a-- Date of Inspection0
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?
(It any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
Immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
�o
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
,Wes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level _
elevation markings?
'—B 1`n
Elidp
Waste Aoolication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
two
11.
Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
❑ Yes
J:S r`
12. Crop type
13.
Do the receivinglerops differ with those designatUd in the CertiUd Animal Waste Management Plan (CAWMP)?
❑ Yes PNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes PQ No
b) Does the facility need a wettable acre determination?
❑ Yes
c) This facility is pended for a wettable acre determination?
ElYeso
Eo
15.
Does the receiving crop need improvement?
ClYeso
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?
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
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
19,
❑ Yes )allo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes gNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes A .No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes �,,,rrt to
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
El Yes 0 No
24.
Does facility require a follow-up visit by same agency?
❑ Yes RNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
)Ries ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
„@ommenta (refer to question #) ,� Explain any Y 8 answer' A d/or any recommendatlona on ari'yt titer
`Use drawings. of facility to better explain situations (use additiorrn�al pages as necessary�,qR + Field Copv ❑ Final Notes ,
=03 1,64A. �c� ✓tad � � �c2��f ��.�1C �
air �o' c�z a x 1 ,2' �� ,�������
✓�
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: Q16QL
05103101 1
T l I ✓ — . Continued

Facility Number: — oZ. Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fans) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals reed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
IN
-7. I:d N1Ion % Z
o?S SrJc��i�k' cS ,,4� SUP b/ a�aooa
`/� e
0510310r11 "v //at6;& V '�e � ,�

Facility Number 85 2 Date of Visit: 6/27/2001 'Time: 10:30
Not Operational 0 Below Threshold
13 Permitted ® Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ..... ..................
Farrar Name: narkAray-Farm......................................................................................... County: Slakes................................................. WS.RQ........
OwnerName: nark ....................................... D.ray.............................................................. Phone No: 33.6r.59...617...........................................................
Mailing Address: Rt,..1.R.0s.433........ 20 7157NW�i 70e% �*......... Lawino..villa...N.0.................................................. 2.7.022...:..........
..............................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
OnsiteRepresentative: MAr.k.BrAy................................................................................... Integrator:......................................................................................
Certified Operator: Mark ...................................... Bray .................................................. Operator Certification Number:713$.7..............................
Location of Farm:
3wy 8 north to 704. Take left onto 704. Go 1.9 miles to farm. Barn is on the left.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 36 • 16 35 11 Longitude 80 • 14 55 ,.
Design Current
Swine CaDacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I I[] Dairy
❑ Non -Layer I I JD9 Non -Dairy 480 1 202
❑ Other
Total Design Capacity 480
Total SSLW 384,000
Holding ray Field Area
Numberg Ponds So d Traps-�' ®No L quid Waste Management System Area ❑ Spray ; o
Lagoon
Discharees & Stream Imnacts
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 ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............................................................................................................................................. ......................................................................
Freeboard (inches):
05103101 Continued

Facility Number: 85-2 Date of Inspection 6/27/2001
5. Are there any immediate threats to the i0rrity of any of the structures observed? (ie/ treNevere 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 strictures 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 Pending ❑ PAN ❑ Hydraulic Overload
12. Crop type Fescue (Graze)
❑ Yes
N No
❑ Yes
N No
N Yes
❑ No
❑ Yes
N No
❑ Yes
N No
❑ Yes
N No
❑ Yes
N No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
N No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre detemunation?
❑ 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 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.)
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?
j■yaw-m
FEINEWM
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #)i EXplain any YES answers and/or any recommendations or any other comments. .
} p situations. (use additional pages as necessary). ❑ Field Copy ❑ Final Notes
Use drawings of faLd�t to better explain s�tua _ _._ _ „_ .-_
7. Plan to go to smaller pastures and rotate. Plans are drawn up w/NRCS. Stock trail, diversion and drystack are planned. Dry, nothing
running off and area around lat are vegetated. Plans to finish work in Aug/Sept. In process of disolving buisness partnership.
Reviewer/Inspector Name Margaret O'Keefe
Reviewer/Inspector Signature: Date:
05103101 Continued

rFacility Number: 85-2 Diff Inspection 6/27/2001 •
Odor Issues
26. Does the discharge pipe from the conf cement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond ith no agitation?
27. Are there any dead animals not dispo V 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 pen ianent/temporary cover?
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes. ®No
❑ Yes ®No
❑ Yes ®No
❑ Yes ®No
r.,e . I x�u�� �u��t" „"'�`P"q4gre�f l�n+,�� �� ��i4?fi°Nu�,l,�,�,��i','�ilJl6n
..„
;
05103101

Type of Visit U compnance inspection U vperanon Heview U Lagoon tvaivanon
Reason for Visit O• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 85 2 Dale of Visit 1J2N/2001 Time: 0950
0 Not Operational 0 Below Threshold
0 Permitted ®Certified ❑Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ............
Farm Name: Mar'Ic.AKAy.f..air►n.......................................................................................... County: Stolies................................................. .W.S[i.Q.......
OwnerName: Mark ....................................... OKAY ............................................................ Phone No: 3.3(tS.9-861.7...........................................................
MailingAddress: ZQ.7.5.. w.y....7.Q4..W.M1.......................................................................... Lm.w.5.oxtyjJIc..N.0 .................................................. UP= ..............
FacilityContact: ............................................................................... Title: ............................................................... Phone No: 3 6,5'1 ,9 39........................
OnsiteRepresentative: 1Yarh.B.r.aY................................................................................... Integrator:.......................................................................................
Certified Operator:
Location of Farm:
Operator Certification Number:z.13$7..............................
iwy 8 north to 704. Take left onto 704. Go 1.9 miles to farm. Barnis on the left.
[]Swine ❑ Poultry ®Cattle ❑ Horse Latitude 367• 16 35 - Longitude 80 • 14 55
t-i;ra4r
Desgnurrent 'q,q$ ��,f+-s' < Designz' ' Uurrentp''
Poultr.Y 'Gatthe��
Swore __
Ca acrt RrP,o ulation; Ca acrt �Poyulation. Ca acrt 8o ulation
❑ Wean to Feeder
❑Layer ❑ Dairy
❑ Feeder to Finish
❑Non -Layer
® Non -Dairy 1 480
350
�"..
❑ Farrow to Wean
❑ Farrow to Feeder
,
❑Other" : '
j Total DeslgngCapaclty 480
❑ Farrow to Finish
❑ Gilts
"
384,0000
l
�4ta?s'SS�ELaWir
Boars
:. __... ..
�i Number of Lagoons 0� ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Arca
Holding'Ponds /Solid Traps 0 IN Liquid Waste Management Svstem
r. .' til
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
it. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the Slaw? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in galhnin?
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
01/01/01 $/373' Continued

Facility Number: I • Date of Inspection 2/28/2001 1 • p
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Cl Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................................... ................................................................................................................................................................................
Freeboard(inches): .......................................................................................................................................................................................................................
5.
Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion,
❑ Yes
® No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ 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 Fescue (Graze) Fescue (Hay)
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
17.
Are rock outcrops present?
❑ Yes
❑ No
18.
Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown
❑ Yes
❑ No
❑ On -site ❑ Off -site
Rcauired Records & Documents
19.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
20.
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
21.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
® Yes
❑ No
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
25.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
26.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
27. Were any additional problems noted which cause noncompliance of the Certified AWMP? ® Yes ❑ No
)dor Issues
28. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge allor below ❑ Yes [:]No
liquid level of lagoon or storage pond with no agitation?
29. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
O1/01/01 Continued
,,

Facility Number: 85-2 Dof Inspection 2/2S/2001 •
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover'?
Printed on: 2/28/2001
❑ Yes ®No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question # : Explain any YE answers and/or any re ornmendations or any other comments.
Us drawings of facility to better explain situat�ditional pages Ms necessary : ❑ Field Copy ® Final Notes
3. and #8. There is some soil/waste washing off the lots which was not getting into the creek on the date of this inspection. Run-off is
being filtered out by grass areas first. Recommend scraping lots as soon as possible.
3. and #10. Need a stock trail and stream crossing as soon as possible as there is some soil eroding into the creek where the cattle are
crossing now. Operator states that this is to be started in July.
19. Operator could not locate 1998 and 1999 soil test results. These need to be kept for five years.
19. No waste analysis results for the 2/2001 waste applications as the sample was just sent off last week. July, Sept., and Nov.
applications did not have a waste sample taken within 60 days of application.
19. and #25. Tract-1195 Field-8 in the WUP lists usable acres as 4.15. This is actually around 2.2 acres now that the poultry houses
have been built. WUP should be revised to reflect this acreage change.
1997 Soil analysis shows all fields to be <100ppm for zinc while the 2000 soil analysis results now report Zinc to be > 1000ppm on
many fields. Suggest contacting SWCD/NRCS for suggestions. Some fields may need to be limed as the pH on some were around 5.7
Poultry house capacity is 20,000 (total). There are approximately 18,000 in the houses today.
3* A►a°� ���a� - �- ce�J
I) izp
0,4LO t6 �J� tu-e. 0 /,mom rrw9_d_M
/W / cx
r w
Reviewer/Inspector Name !Meliss a 4osebrock
Reviewer/Inspector Signature. Date:
01/01/01

Facility Number: S Z Date of Inspection 12/28/OI I Printed on: 1/9/2001
5. Are there any immediate threats to the t egrity of any of the structures observed? (ie'/'tr severe erosion, ❑ Yes VNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes o
(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 t-e U f e
13. Do the receiving crops differ with t rose designated in the
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?
❑ Yes OCNo
A Yes ❑ No
XYes ❑ No
❑ Yes XNo
Animal Waste Management Plan (CAWMP)? ❑ Yes ,W-No
❑ Yes [4 No
❑ Yes In No
❑ Yes VNo
❑ Yes.,�No
❑ Yes XNo
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
p�
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
t(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?
discharge,
(ie/ freeboard problems, over application)
❑ Yes
;)60
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
XNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
]R'No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
Yes
❑ No
9 YiQla(itj11s;o�- 80£cjepcies -w0re noted. ilja;itjg tjus;visit; • X00.mjJ j•#ecQiye ijd ir.4iho • ; • ; •
.
::
ctiriesbmidenceabotiCthis:visit:...............
Comments refer to uestion # • Explain an YES answers and/or any reconime"ndadiDns or•any`othei• eomin wit
( 9 ): xp y', Y
3•''g �e i5 Same Soi�/was{et5hiv� o�-�e �t715 — v&
. s�� .as posse
3a �o Nei SiI-rea c ross n. Q
5 wt S Sco s1 a5
Reviewer/InspectorName � ts�•,' �rn� ,'-' ��' %,; �'�'"� �x,,
Reviewer/Inspector Signaturtejg /i .4✓1.C_.•% i0 /l, .r> %i i Date: 6=2 0 J 5100

'Facility Number: S— Z of Inspection I L/ Lg/p► f Printed on: 1/9/2001
Odor Issues —
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below-E3-les-$Idu
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes *Io
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ATSIo
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.) e
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 'G�40
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 1Pii
Nat�Se ��OS(�n 7 c)a,5te sack f6"✓ 7 Ca7h-a4 7
2000 So'(D �y5i5 sh0Q5 .Zh sn many
U P lboo rpm . — 5uage5 F eon+o,C 4
JQ
5 1997 av�al ys15 5l�owS ziv(c L ►oa�p„
Solm� ��ids mat, hem 6 toe,
Need � L2ocojv 19�� a Ig9�j So(1 re50
I q . No � � S
Q.54 -e, oL no-ttj 5 I S re s � 4-s For 2-12 00 (
la5f week,
Solj ,. S*-, �- Nov. Of�1icou6O(1,5 I'd v)of
4V-p Gvrife sa4VYA� 54� W11
Iq . T--1 Iq S F
ooc� — i g, odd
5100 f

M
Type of Visit V 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 Z Dale of Visit: 442U- Time: �
Q Not Operational Q Below Threshold
E3 Permitted *Certified ❑ Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: ..... I"..1(%1,'�.....W..... f ..... fQ�.. Count .........................
nA......5.r ..... iY1...................................... Y .......� i%.ci..lCc.(��5.......5.t.....................................
OwnerName: ........ 1.".1LR!G.L........... •W..r. .......................................................... .. .. Phone No:.. . ` .:.:,�?...1..`.3..... U.607........................
Facility Contact: ]n��1,,,��,, L B 1..................Titl........................... n336.59.3.:. 39
1 .XttiL...�............... r litle:................................................................ Phone o:.........................
-�r c V ........... '/ C1 1 I I- 1 1
Mailing Address:..._ ..nl.,nJh.....,...... ..iIQJ. ...... 5�.`1..._�........... ................1 .n.�(...1..4.14�..}..1�.� ...U�..%b2Z
Onsite Representative:.......1..:.AfM....1�:g...fJ. r . I.A. ............................................ Integrator:......................................................................................
Certified Operator: ,,,h1�,01 K-Y.........A.. ;,,, Operator Certification Number:,,,,., -„1 3 77
......................
Location of Farm:
4W4 $ r)0PHI 70 TaKe le ' wrv►► es
-Em n r nn Yl 1 50 �� lt--� .on+o -7o o
❑ Swine ❑ Poultry [Cattle ❑ Horse Latitude ®• ®1 =11 Longitude ®• ®, F-37111
Swine
Design Current
Capacity Population Poultry
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds / Solid Traps
Current
�arue,;
❑ Other
Total Design Capacity
Total SSL W $
No Liquid Waste
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?
Area J❑ Spray Field Area
k .I
❑ Yes t No
❑ Yes ❑ No
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
2. Is there evidence of past discharge from any part of the operation? ❑ Yes .W'Sio
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?
Structure I Structure 2 Structure 3
Identifier: ...N.QAR;.;...........................................................................
❑ Spillway ❑ Yes ❑ No
Structure 4 Structure 5 Structure 6
Freeboard (inches): ,
5/00 Continued on back

(Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 85 2 Date oil Visit: 9R0/20110 'Time: 12:00 Printed on: 2/15/2001
0 Not Operational O Below Threshold
E3 Permitted 0 Certified 0 Conditionally Certiried 0 Registered Date Last Operated or Above Threshold: ......................
Farm Name: MarkAray-Fax.m......................................................................................... County:
LA .-rrl�ke
OwnerName: Mmete...................................... Rrs3:............................................................. Phone No: 33.6-SA3.:.617............................................................
FacilityContact: ..............................................................................Title:................................................................ Phone No:
MailingAddress: IZ.t...1...ax.4,33........................................................................................ Lm.sonxitle...N.C.................................................. 27OU ..............
OnsiteRepresentative: .Rar.k..D.rAy................................................................................... Integrator:......................................................................................
Certified Operator: Mark..t'. ...............................
Location of Farm:
Operator Certification Number:A13#.7..............................
4wy 8 north to 704. Take left onto 704. Go 1.9 miles to farm. Barn is on the left. •
[]Swine []Poultry ®Cattle []Horse Latitude F 36 • 16 35 Longitude 80 • 14 55
�v ;`Design d Current
r . lit e ,y.. t �'�"2aai.`
Swore '^ Ga spa it . P,O ulatioms
DesignCur�e'nt¢ °' : ` ^:" D`esrgn' Currents
sW ,:. � 4 u ' .,n
Poultry Ca acit P,o wI Lion Cattle . rGa' acit P,o wlation
❑ Wean to Feeder
❑Layer a ❑Dairy
❑ Feeder to Finish
❑Non -Layer : IN Non -Dairy 480 267
❑ Farrow to Wean
❑ Farrow to Feeder
❑Other ,,:u a , -, �:
F TotaliDeslgn C►apacity 480 6 J
❑ Farrow to Finish
-
❑ Gilts
s
� �r � Tjotal SSLWp: 384,000
�'
❑Boars
(' Number of L� opus 0
❑ Subsurface Drains Present ❑ Lagoon Area ❑tipsy Field Arca
Holding Ponds /Solid Traps O
®No Liquid Waste Management System dr"
Discharge &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 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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ..........................................................................................
................. .................................... .............................
Freeboard (inches):
5100
❑ Yes ® No
Structure 6
Continued on back

Facility Number: 135-2 Date of Inspection 9/20/2(100 Printed on: 2/15/2001
5. Are there any immediate threats to the in"grity of any of the structures observed'? (ie/ irelot 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
® 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
IN No
12.
Crop type Fescue (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) -
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0',r yioiations'ot' ;defciencie$ iver'e'noted;dieing this: visit:'YoWwill receive no fu.rth'e�
correswfideitce about this.vlstt... .
❑ 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
Aug. cost -share approved for stock -trail. Has pulled cows off steep slope where erosion was bad last year, seeded with wheat.
i topo map intermittent stream, fenced 10-20' and 40' where blue line area is( fenced during 25' requirement timeperiod). Plan to
getate and fence w/controlled grazing. Bare patch at low corner of lot, does not travel far downslope(filter strip).
cries dead animals to Lewis Stephens in Mt Airy. Lot scrapped in July, Cecil corn takes it (Virginia) for compost and spreading. 19.
red a waste sample for hauler, keeping track of amount hauled. -
Reviewer/Inspector Name Margaret Okeefe
Reviewer/Inspector Signature: Date: 5100

Facifity Number: 85-2 I d' Inspection 9/211/2111111 Printed on: 2/15/2001
Q dur Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
® No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon'?
❑ 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
Ito a ommen an or aw ngs:
5100
5100

(Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
I Facility Number 85 2 Dale of Vtslt 5/3/2000 Printed on: 5/4/2000
O Not Operational O Below Threshold
0 Permitted E Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: 1Y.1.aril.Hx:ay..Fat:m......................................................................................... County: S.tO.i M................................................ WSRQ........
OwnerName: MA& ....................................... B.ray.............................................................. Phone No: ��br.S43.:Hbt7............................................................
Facility Contact: Harklx:ay ....................................................... Title: Qwmrx ................................................. Phone No: )is.1:tA.d,3b.S9��1�, 4............
Mailing Address: 2U75..iiwry..7.lki.W.est........................................................................... LawsnitriiP..N..C.................................................. 2.7922 .............
Onsite Representative:
Integrator:
Certified Operator:J,!'iark.A................................. Uray .................................................. Operator Certification Number: 23a8..7.............................
Location of Farm:
ki>r ..8..ttarih.ta..7.iki,...Ta1cx..leFt.nxttn..7.04,...Ga..i.Q.txtiles..tn.[arxn ..i{aru.is..na_tine.ie[t.........................................................................................
❑ Swine ❑Poultry ®Cattle ❑ Hot Latitude
36 • 16 35 Longitude 80 • 14 , =11
4':• '. Design Current
`/Swine Ca acit $o uletion
Design Current D g Current
Poultry Ca tacit P,o ulalion Gettle Ca"ecit . P,o ula on,`.
❑ Wean to Feeder
10 Layer
I❑Dairy
❑ Feeder to Finish
ILI Non -Layer
1
334
❑ Farrow to Wean
❑Other
Total Design Capacity 480
Tiotal SSI W 384,000
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 1❑� Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 0� ® No Liquid Waste Management System
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ® Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ® Other
a. If discharge is observed, was the conveyance man-made'? ❑ 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? not estimateable
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
Identifier: ..... No.Strucatrift ........................................................................................................................................................................................
Freeboard (inches):
Continued on back
Om"—

•J
Facility Number: 85-2 Date of Inspection 5/3/2000 0 Printed on: 5/4/2000
5. Are there any immediate threats to the inf ty of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® 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 ❑ Yes ® No
12. Crop type Fescue (Graze) Fescue (Hay)
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?
Rewired 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 viola'tions or deTciencles were noted'd firing this: visit::You:will receive no fti.rther
corresuotidenci . Abut this wlsd. .
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
7, and 24. Pen number four has some runoff coming from the far, downhill side of the lot and running to a small tributary about 20
away. Lot is to be cleaned -off and fences re-done/repaired by end of July. Will try for end of June. Will re -check at that time.
Lewis Stevens
Some guttering may need to be repaired eventually.
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signature: �YVIl✓l/I/10 /AiA�4, nIJAM c ,lh,fP P Date:

Facility Number: 85-2 • of Inspection 5/3/2000 • printed nn: 5/4/2000
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
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

Routine
IFacility Number S I
0 Permitted 14 Certified ❑ Conditionally Certified 13 Registered
nce, ecUoniS�"jib , ;r,,
t {$h
;pechomphao»k7+iSitiE
w-up of DSWC review Q Other
Date of Inspection $- O
Time of Inspection
24 hr. (hh:mm)
Date Last Operated:
Farm Name: .... Mar ..I ..........6..raj. . ....... Fa,I. y)................................. County: .... Sank5
Owner Name: ...... F •U� pT...Y..,./.... f�. �Qi................................................................. Phone No:....,,1.� 4?e.,..,,`�.-.q.�.y.....? �...1.....1.....................
Facility Contact: .... .::.1..OL.-..t.4-:......._L]..1^t�1..............Title:.. .}38rt� ........................... A&rrQo:v,lW _�7 ... ..,�. .
Mailing Address:..... .Q1..,,y.......... 1A%.' 0.4..........Q.-a-`5.�."......... ..�.Qv.wn...v'..1e:........t.....,�.�1.0.s�:..l..........
...........
OnsiteRepresentative: ,,, ,Ql/1;;,V........,j"',,,,,,,,, „ Integrator: :.....................................................................................
.............................................
Certified Operator:......Lv..�a_r.K.....,f�,.... �j_(.......................................... Operator Certification Number:,,,,,,; a„' 387
Latitude ®•E Longitude ®•®®«
Design `;i Current Design Current ,� Destga Current
Swme " Ca acit' i'Po nilation. Poultry Ca' actt Po'ulation :Cattle acit ;Po `ulation
,':i ❑ Wean to Feeder ❑Layer „ ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer Non-Dairy3
'.ti ❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
Tota ', ., ..., .. .
❑ Farrow to Finish I DeMgw Capad y
❑ Gilts•
`', ❑Boars
Total SS QOQ
> C ,�+Number of Lagoons ='`l.� ❑ Subsurface Drains Present ❑ Lagoon Area. ❑ Spray Field ea Ar
+ ,
Holding Ponds / Solid Traps 1 JCI No Liquid Waste Management System
mscnarges & Jrream lmpac[S
1. Is any discharge observed from any part of the operation? 'Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field XOther
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ,<No
b. It' discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes 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) Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? KYes []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
a
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway NO I I ru ld IJ4S+e. []Yes XNo
Structure I Structure 2 Structure 3 Structure 4 tructure 5 Structure 6
Identifier: p
Freeboard (inches): ..... JA..............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes b�No
seepage, etc.)
3/23/99 Continued on back

Facility Number: D Jr% ise of Inspection —r�—
6.
Are there structures on -site which are not properly addressed and/or managed through a ste management or
closure plan?
❑ Yes Wo
(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?
-Kyes ❑ No
S.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes Nio1Qo
9.
Do any stuctures lack adequate, gauged markers.with required maximum and minimum liquid Ieveln) R
elevation markings?
❑ Yes XNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes 'KNo
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes I To
12.
Crop type of t i q nacre'
13.
Do the receiving crops differ with those designated4i the Certified Animal Waste Management Plan (CAWMP)?
❑ YesIo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes N�No
b) Does the facility need a wettable acre determination?
❑ Yes [To
c) This facility is pended for a wettable acre determination?
❑ Yes IP-No
_
15.
Does the receiving crop need improvement?
❑ Yes 1<0
`
16.
Is there a lack of adequate waste application equipment?
❑ Yes _ o
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes , Io
IS.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes NKo
(ie/ WUP, checklists, design, maps, etc.)
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes .jSrNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ANO
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes ANo
22.
Fail to notify regional DWQ of -emergency situations as required by General Permit?
❑ Yes 6kNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes .-No
24.
Does facility require a follow-up visit by same agency?
Yes ❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes �<No
iVti •yiol'aFiptis;op dgfjciencies wore P9ted dirr;irag this;v�sjt; • Yoit will•Keegiye 00 cu�•thQr. ;
corresuoridence: about: this :visit ::::::::::::::::::::::::::: :
W 1, 1, a�. ben n urn b-e, has 56nme runaf r tom®n
i X� v n ►�'l ►� d own _)o
Lai iS+o be. �leane.d o�� av-040ce-5 redone1rgaered
b� 2 nd of Sulk . U)I l 14f-y for o-nd 4 dune . W4) r2�he�l�
Reviewer/Inspector Name �,,1t
P ivI D. � 15-CA .. n ;ai^n t JL.,: t '
Reviewer/Inspector Signaturk4m �AAA I fI&A — IVAI fj 1A. —_40 Date:

Facility iVumber•. — r •e of Inspection �QJ/Q� •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below r
liquid level of lagoon or storage pond with no agitation? OM I T-
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yesfo
28. Is there any evidence of wind drift during land application'? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 'N0
roads, building structure, and/or public property) ��y///
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes /vo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes XNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes Vo
32. Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover? 0 r►! ( t B *eS EB o—
C hecK. Si-oclL. �rau Is �+- f121.J -�ev�ci n�
30- some ���� ( a need 4tt be re-paare-d -e e"+uall�

NORTH CAROLIN
DEPARTMENT OF
ENVIRONMENT AND
NATURAL RESOURCES
WINSTON-SALEM REGIONAL OFFICE
TO:
a4
mw;A
DEN R
FAX TRANSMITTAL
Division of Water Quality
585 Waughtown Street
Winston-Salem, N.C. 27107
Phone: [phone]
FAX NUMBER: 33(0 . 59 -3 a 3
FROM:
DATE:
me655Q ��SQ brac�lL
Number of pages (including cover page):
COMMENTS:
r
r
Fax: [phone]
i

NORTH CAROLINA
DEPARTMENT OF 10
ENVIRONMENT AND
NATURAL RESOURCES
WINSTON-SALEM REGIONAL OFFICE
�V
LA
DEN R
FAX TRANSMITTAL.
Division of Water Quality
585 Waughtown Street
Winston-Salem, N.C. 27107
Phone: [phone]
TO:
FAX NUMBER:
FROM:
DATE:
0
sq3 ..qa3
Number of pages (including cover page):
COMIvENTS
Fax: [phone]

Routine
of
Facility Number 85 2 Date of Inspection 9/12/99
Time of Inspection � 24 hr. (hh:mm)
E3 Permitted ® Certified [3 Conditionally Certified 0 Registered 0 Nat O erational Date Last Operated: ..........................
Farm Name: HarIC.13.raY..fum......................................................................................... County: Stpkca ................................................ WSRQ........
OwnerName: Map% ....................................... 13.r.ay ............................................................. Phone No:33.6-59.3:4617 ...........................................................
Facility Contact: D1A&B.ra3 :......................................................Title: Qwnrx ................................................. Phone No: 336rS93.:$617........................
MailingAddress: Rt...1.&Y.433......................................................................................... Lawsunvilte... N.C.................................................. 27.022 .............
OnsiteRepresentative: AMMr.k..31rt1Y................................................................................... Integrator:......................................................................................
Certified Operator:Mark..A................................. OKAY .................................................. Operator Certification Number: 213.$7..............................
Location of Farm:
Latitude F 36 • 16 35 Longitude F 80 10 14 55
Swine
Design Current'
CBnaclty Population
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Design 4 Current ' Design .Current
Poultry " Ca acit Po ulation Cattle Capacity Po >uI tion
❑ Layer JE1 Dairy
❑ Non -Layer I IN Non -Dairy 1 480
❑ Other
Total Design Capacity 480
Total SSLW 384,000
.Number ofaLagoons F 1 0 �(° J❑ Subsurface Drains Present JJU Lagoon Area JU Spray Field Area
Holding Ponds/ Solzd Trap_-Oi"p' ® No Liquid Waste Management System
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ 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 ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ..............d:{A.................................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
3/23/99 Continued on back
Printed on 12/16/99

FaeilityNumber: 85-2 1 0 Date nspection 9/12/99
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 ® 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'?
Waste Application
10. Are there any buffers that need maintenance/improvement'?
11. Is there evidence of over application'? ❑ Excessive Ponding ❑ PAN
12. Crop type Fescue (Graze)
❑ Yes
❑ Yes
❑ Yes
® No
® No
® 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?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® 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? (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/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
0`No yiolatioris;or deticiencies were;note'dl;dnring this; visit.: ;You;will receive ito further :
eorresnotideikc . about this .visit.::....:. .
Comments refer to question #): Explaain any ES answers and%or any recommendiitians or any other comm
V se drawings of facility to better ex lain situation . use additional pages as necessary :
hack trails are to be built, but fencing is presently being built.
Zonstruction of dry stacks are to be begun first part of 2000.
Reviewer/Inspector Name ;David C. Russell -
Reviewer/Inspector Signature: Date:
on 12/16/99

Facility Nam ber: 85-2 Dat*spcctinn F 9/12/99
Odor ssu
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours'?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon? -
❑ 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 till pipe or a permanent/temporary cover?
❑ Yes
❑ No
J
Printed on 12/16/99

E3 Division of SoWl Water Conservation Operation Revre
A if i F01tvhler
[visin of Soil and Watei Conseration ,ComphanceInspec on E+sionof Water.Quahty'-. Comphance Inspection i Agency=;Uperatiomlk' ew,
itP-Routine O Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number '3. Date of Inspection
'Time of Inspection 24 hr. (hh:mm)
0 Permitted Certified [3Conditionally Certified 0 Registered 0 Not O erational Date Last Operated; ,,,,,,,,,,,,,,,,,,,,,,,,_
Farm Name: ....... ..\!.:!�.................................................... County:.. �
...,.,....�,...4....._...................... /
Owner Name:....._�A72.1 ............................. 1......................................... Phone No:.. f7�.�y. .......,�L.r.3.
IOr�Facilit Contact: v,/....... zwef .. ............... Title: W.......................................... hone No: ....
S/(y.OI t
../..................................................... Mailing Address:...��„r„r... /. ....•,d.Qx..... ................................................ .
Onsite Representative:....,Ofs;2!4 .�-...! ... ......................................................... Integrator:..................... ...........................
Certified Operator: ..... /,{„/,,tyxy„,,...[..4Lt........................................................... Operator Certification Number: ... �.3 $ 7
Location of Farm:
Latitude Longitude
Design
Current. , Design ° ' Current " "�' ' `'; Design Current "'I
Swine p,,l�„g , Capacity
Population GarYr� i ;' Ca acity� Po rpulahon 'Ca�acit Po ulation �.
JE] Dairy
' ❑Non -Layer Non -Dairy $Q jf
r
❑ Other
Total Design'Capacity
iJ
r ,I
ToW SSLW
of Lagoons
' r
❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area ;
❑ No Liquid Waste Management System'
(Number
i` HoldingPotids / Solid Traps
'.
❑
Wean [o Feeder
❑
Feeder to Finish
❑
Farrow [o Wean
❑
Farrow [o Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes o
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 ycs, 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? ❑ SpillwayNb li�&IS JJASk ❑ Yes KIo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier-
Freeboard
f+{/nJ��'�
Freeboard(inches) : ...........:..t....t.........................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes N0
seepage, etc.)
3/23/99 Continued on back

Facility Numher: — Z/ 0 D* Inspection /Z
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan'?
❑ Yes
�o
(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
o
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
'•l0
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
1/7
elevation markings?
❑ Yes
VWo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑Yes
I
11.
Is there evidence of over application? []Excessive Pending ❑ PAN
❑ Yes
/
No
12.
Crop type
13.
Do the receiving cr ps differ with those designated in the Certified Animal Waste Management 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
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
�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
(C�tv
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
El Yes
�IiSh'N"o
o
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
V No
22. Fail to notify regional DWQ of emergency situations as required by General Permit? ,�
(ie/ discharge, freeboard problems, over application) []Yes 'ONo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes o
24. Does facility require a follow-up visit by same agency? ❑ Yes o
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 1PNo
I.10 Qibla(iotis;or clgticiencles •were pgte�l• ilStt irtg 0is:visit; - Yoit ;will•reeeiye fio fui•th$r.: ;
.. correspondence: about. is :visit:::::::::::: ............. .
Jib c�c ��' )�S e `/2t .1/1� OW / (�Qi✓cLii✓� %S �/ted�.✓' st, 6•efN� ice,;
oNsftiec�fily� u �Qnt �l v4f l�� pp 6ejc.w � 2—W0..
Reviewer/Inspector Name n ; 2 /
P
Reviewer/Inspector Signature: Date:
3/23/99

Facility Number: — -L Datouspectiion .
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to dische 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?
,— J
❑ Yes �iNo
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
roads, building structure, and/or public property)
JVNo
29.
Is the land application spray system intake not located near the liquid surface of the lagoon? N(,�—
❑ 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 10
32.
^
Do the hush tanks lack a submerged fill pipe or a permanent/temporary cover? • /t.}
❑ Yes ❑ No
3/23/99

19 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number 85 2 Date of Inspection I l/4/98
[Time of Inspection 0930 24 hr. (hh:mm)
Registered ® Certified 0 Applied for Permit © Permitted 10 Not Operational I Date Last Operated:
FarmName: Ala>tk.B.ray-Fasm......................................................................................... County: Stakea................................................ ..SRQ........
OwnerName: Hack ....................................... Bray.............................................................. Phone No: 336.-59.3.-86.17 ..........................................................
Facility Contact:
Title:
Phone No:
Mailing Address: Ri...I.B.ox.43.3......................................................................................... LaWsunx1110-NC.................................................. 17.022 .............
OnsiteRepresentative.Ma,rk.HtSay................................................................................... Integrator:......................................................................................
Certified Operator: Mai: k.ta.................................. BrAy .................................................. Operator Certification Number: 2.U&7..............................
Location of Farm:
3SO • Latitude 36 • 16 55
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 [j Spray Field M Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
[] No
b. If discharge is observed, did it reach Surface Water'? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is die estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
© Yes
© No
3. Is there evidence of past discharge front mty part of the operation'?
[] Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5. Does any part of the waste management system (other than IagoonMiolding ponds) require
❑ Yes
®No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
7. Did the facility fail to have a certified operator in responsible charge'?
❑ Yes
® No
7/25/97

IFacility Number: 85-2 Date ection
there 11/4/98
8. Are ere lagoons or storage ponds on sit h need to be properly closed? • ❑ Yes ® No
Structures (LaeoonsMoldine Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storni storage) less than adequate'? ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
.......................................................................................................................................................................................................................
Freeboard(11):...................................................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes ® No
11. Is erosion, or any other threats to the integrity of any of the strictures observed'? ❑ Yes 0 No
12.
Do any of the structures need maintenance/improvement'?
❑ Yes
0 No
(if any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maxinumt liquid level markers?
❑ Yes
0 No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ................................. :......................... ...................................................................................................................... ...................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Platt (AWMP)?
❑ Yes
0 No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
®No
19.
Does the receiving crop need improvement'?
❑ Yes
® No
19.
Is there a lack of available waste application equipment'?
❑ Yes
H No
20.
Does facility require a follow-up visit by same agency'!
❑ Yes
® No
21.
Did Reviewer/hispeclor fail to discuss review/inspection with on -site representative?
❑ Yes
® No
22.
Does record keeping need improvement?
❑ Yes
10 No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of flue Animal Waste Management Plan readily available?
❑ Yes
® No
24.
Were any additional problems noted which cause noncompliance of the Certified A WMP?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
® No
Pio violations or'deTielenicles. Wot'e'noted'duripg this visit., You-w li'rNeive'no.Gtlrther
::cotrespoudencea6oiitihis:visit-::•:•:•:•:•:•:•:•:•:•:•:•:•:•:.:•:•:-:-:-:.:•:•:•:•:•:
dry stacks are to be built.
Reviewer/Inspector Name Dat^it1.RltpBell
Reviewer/Inspector Signature: Date:

Facility Number
of Soi1W Water Conservation ❑ Other
of Water Quality
Date of Inspection I If?l i 10 tI
Time of Inspection ®J 24 hr. (hh:mm)
E3 Registered; Certified 13 Applied for Permit 0 Permitted 13 Not Operational Date Last Operated: ..........................
Farm Name: .... ��.......1 t ^�....._ll.._! .�`....'� County:........!.:.e$..................................I...............
Odd
/ /
Owner Name: ... O.:..11.d......8�:.......... .. ... Phone No:.C33.0,,:M.:....��?.Z7....................
Facility Contact:.. j k....f.!a?..................................Title:.... .................................. Phone
MailingAddress: ..... P/...,....../.J............... i�...(............................................................... ..................................................................................... ..........................
Onsite Representative:.- L...
..... .......
/J............................................................. Integrator:......................................................................................
Certified Operator:...�.rl . ... ?f�� j..................................I............... ............. Operator Certification Number:.........................................
Location of Farm: ((
Zm /-LS e C
..............:..................................... .
Latitude ®•=,=« Longitude F-FF10=,©"
'4k ',Design —,Current
V, ��"
Design �-�Q6rrent = ',Design,
CurrenQn,,
Swin e Capacity yopulation
"Poultry
Capacity Population Cattle, Capacity Population
j
❑ Wean to Feeder
Dairy
❑Feeder to Finish
„
❑Non -Layer I
❑Non -Dairy
%
❑ Farrow to Wean
-
`
❑ Farrow to Feeder
❑ Other
��
,
❑ Farrow to Finish
Total Destgn`Capacity"
❑ G,Irs
El Boars
o ` Total SSLW
'Number Lagoons / Holding Ponds r
❑Spray Feld Area
1❑ Subsurface
Drains Present
❑Lagoon Area
M, ',
"+ ❑ No Liquid Waste Management System.,
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes ' o
2. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spiny Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes ❑ No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes ❑ 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
3. Is there evidence of past discharge from any part of the operation?
❑ Yes No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes(No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes o
maintenance/improvement?
.\
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge?
0YesV0
7/25/97

6 ilit} umher-, 5- Z •
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons.IloldinL, Ponds- Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? I j�L� b p N
Structure l Structure 2 Structure 3 Structure
Identifier:
Freeboard (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)
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 W or runoff entering waters of the State, notify DWQ)
Is. Crop type .......l- r F._..............................................................................................................
Structure 5
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?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Were any additional problems noted which cause noncompliance of the Permit?
�JNo violations or deficiencies were noted during this'visit'. You will receive no fortifier
correspoiWeiice about this visit -:
z A2
❑ Yes A No
❑ Yes �&o
Structure 6
❑ Yes h�qo
❑ Yes qNo
❑ Yes �(No
❑ Yes No
❑ Yes No
❑ Yes No
El Yes No
❑ Yes No
❑ Yes No
❑ Yes $y No
/1
El Yes �No
❑ Yes ®'No
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: 1` )ti,y 0 t , Date: 9 0 /l D

' Facility Number I
13 Registered [] Certified [3 Applied for Permit 13 Permitted
Farm Name:
Owner Name:
Facility Contact:
Title:
�; R
Date of Inspection Jg_[2.�Jf/ 46-J n .I,
Winston-t,.�a.;r.n►
TimeoflnspLTtion 9�?l4�! t)f�ft Cry
Not Operational Date Last Operated:
.... County:...... / l.7.Z�9.�...............................................
Phone No:
MailingAddress: ..........................................................�.../..................................................................................
Onsite Representative:.... .AIL(. ................ a. ........................................ Integrator:
Certified Operator..... ..............................................
Location of Farm:
Phone No:
Operator Certification Number: .........................................
Latitude Q• 0' =" Longitude =• =' =11
to F
to
to
to
r to
Waste
General
1.
Are there any buffers that need maintenance/improvement?
Yes
❑ No
2.
Is any discharge observed from any part of the operation?
❑ Yes
[INo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
i
❑Yes
No
b. If discharge is observed, did it reach Surface Water? (►f yes, notify DWQ)
❑ Yes
PrNo
c. If discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
EJ No
3.
Is there evidence of past discharge from any pan of the operation?
❑ Yes
[j( No
4.
Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
1 No
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
Yes
❑ No
maintenance/improvement?
6.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
0 No
7/25/97
Continued
on back

i
}/. Fadlity Number: �— •
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures(Laeoons.Holding
Ponds. Flush Pits. etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3
Structurt 4
Identifier:..........................................................................................................................................
Freeboard(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)
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 . f: k��.u..._4(.t.:✓.L�....... 1'P1'g5... OE
Structure 5
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)7
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?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
p No.violtitions-or deficieucies.were noted during this.visit.• You.Will receive naf irther: •
correspbtidence dhout this* visit:• ;
❑ Yes R�No
❑ Yes /[� No
Structure 6
❑ Yes [JINO
`Yes ❑I No
❑ ri Yes .] No
❑ Yes eNo
❑ Yes No
❑ Yes (T'No
❑ Yes �No
13/Yes ❑ No
❑ Yes XNo
❑ Yes 2fNo
❑ Yes ZfNo
I , Nr=eP Keep cows o+- 41WO -1flev 11)
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r
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Reviewer/Inspector Name
Reviewer/Inspector Signature: /�/ Ilnn-,a,(I , A %)_,% _/A Date: ` 9.40A (�

I Facility Number y I
Farm Status: rRegistered ❑ Applied for Permit
�] Certified ❑ Permitted
❑ Not Operational Date Last Operated: .................................. . ...... . ...... . ..........
h%R ......��`_......__......._......_...._._.....�...... County:...`...�5......_...._.........._.... _.......__.....__.
Farm Name: .....
............._.�.�.�
Land Owner Nante:.......... B1�k......... .....$21..............................
_.................
. Phone No:...�.�_��/,�1 Q b�..7....................
Facility Conctact:...P7'`._.R�Q......................:./................. Title: ...QL!nJQ/L.................... PhoneNo:�l..� pp
MailingAddress:......... f_.0..... L......._........ ............. ................ ........ _....... _............... _......................... _...... _.......... _.... ....... _.................
Onsite Representative:
Certified Operator:
Location of Farm:
Latitude 36 • /6°'
o(7o /J C
Integrator:
Operator Certification Number:
7 a asf(rt�_<<1 P
Longitude FTF1• =1 FFF «
Ueneral
1. Are there any buffers that need maintenance/improvement? ❑ Yes ONo
2. 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?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvemen[?
❑ Yes] No
❑ Yes r No
❑ Yes o
❑ Yes No
❑ Yes No
❑ Yes I
Continued on back

Facility Number:.... B.5......... y
6. Is faci* in A$n?
not compliance with any a*able setback criteria in effect at the time of
❑ Yes o
7.
Did the facility fail to have a certified operator in responsible charge?
(
❑ Yes o
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes 7� No
Structures
fl agoons and/or Holding Ponds)
((
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
®� 0
❑ Yes re
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5
Strut4/ure 6
10.
Is seepage observed from any of the structures?
_.._.._.........
❑ Yes WO
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes No
12.
Do any of the structures need maintenance/improvement?
Yes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes �o
Waste Application
14.
Is there physical evidence of over application?
❑ Yes i_No
(If in excess of WMP, or nmoff entering waters of the State, notify DWQ)
15.
Crop type........................................................................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes �_No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes gNo
18.
Does the receiving crop need improvement?
❑ Yes No
19.
Is there a lack of available waste application equipment?
❑ Yes p
20.
Does facility require a follow-up visit by same agency?
f
❑ Yes `O--No
21.
For
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
Certified Facilities Only
❑ Yes %No
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes ❑ No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ❑ No
24.
Does record keeping need improvement?
❑ Yes ❑ No
Comments'(refer to question #):' Explain any YES answers and/or any recommendations or any other comments
Use drawings of facilityto better explain situations. (use additional pages as necessary) ,' tr
, ,, �• „ F'
4,,sd-SoN
as a� cpe'v ce � v Jt ArS as-eek-f a,.r
Reviewer/Inspector Name
Reviewer/Inspector Signature: -Cy 01.�s
Date: 17,
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97