860004_INSPECTIONS_20171231

Ir ype of visit. A �:o-mpuance inspection v Loperaaon rcevtew v structure r.vamanon tJ t ecnmcat Assistance I
Reason for Visit: Routine O Complaint 0 Follow-up O Referral O Emeraenev O Other O Denied Access
Date of Visit: 2 Arrival Time: �Departure Time: ! County: SurfI Region: W�
Farm Name: 11 J0146L ei t'�)T(W�y' Owner Email: �
Owner Name: �� to � t EI Heim DD"J6, t I A.A00 Phone rj' �;p 6 - 766 ` r%'2.51/
Mailing Address: '�P UZ W kIR F-di . I K )I-t A) L 2if to 2- 1
Physical Address:
L Y1
Facility Contact: t:JJJ'e, or Ell" Title:
Onsite Representative: t5 Pe TA01. ,
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: �6�2`i/08 Longitude:
or
Design
Current
Design Current
Design Current
Swine
Capacity
Pop.
Wet Poultry Capacity Pop.
Cattle Ca _PAC i!r-ym Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Design Current
D Cow
Farrow to Feeder
Dr, Poultr. Ca tacit Pao ,
Non-Dai
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
I
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
10ther
Discharees and 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 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 ol'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
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes tNo
o
ElYes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

[Facility Number: • 1 Date of Inspection: 2
Waste Collection & Treatment },,,,,/
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes �;I7�1 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes Y❑ No ❑ NA ❑ NE
Structure I Structure 2 f Structure 3 Structure 4 Structure 5 Structure 6
Identifier: :S Ci/h 6.,
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
(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 111 No ❑ NA ❑ NE
waste management or closure plan? .j'
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No kNA ❑ 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 I�yl No ❑ NA ❑ NE
maintenance or improvement? Y�
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 10lbs. ❑ 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): � IN 0 Mi
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
'yl No
❑ NA
❑ NE
❑ Yes
"Jp���
❑ NA
❑ NE
❑ Yes
[—]No
OVNA
❑ NE
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes yNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Trans ers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ YeS xm No NA ❑ NE
Page 2 of 3 21412015 Continued

Facih Number: - z7v• 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 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? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes f 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
A
❑ 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
k
❑ 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:
l'�
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes iyNo
❑ 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).
�0 VJ4gAe aMoll to ,(4vV% AD C- 4 ne 5DILr A6 W4s� a,taiyl�s.
Cai�bntQtaw� arD�lf a�A,lt�scrfwZs%e �lyf-ef� t�. P�Vf/�'i
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
M1
r
�►M - Mr MM
Phone: ✓?3G,'rf
Date:
21412015

Type of Visit: lkcompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Vuoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Jt Arrival Time: Departure Time:
E ' ounty: SUS r Region: UJS P-d
Farm Name: 1 Owner Email: /,
Owner Name: r, "i & q� E'i I & To 6.5on Phone: (3 3�P) 36 to — 7 -;t S % edd l e.
Mailing Address: Spa Wlntk� F-�•, F, Ila n, N(L' a�6 a1
Physical Address: E.D+ Earl e.
Facility Contact: FcUiL nr btlw Title:
Onsite Representative: F Ad i to -
Certified Operator: y
Back-up Operator:
Location of Farm:
T-1-7 N.
I Ic.Zx.)
Phone:
Integrator: �—
Certification Number:
Certification Number:
Latitude: 3 �V
2 White �-°7
Longitude:
rfiNK4Z
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes WNo ❑ NA ❑ NE
Discharge originated at ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
C R*No
❑ NA
❑ NE
Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
\3.
f the State other than from a discharge?
-age I of 3
21412015 Continued

]Facility Number: J& - CTP• Date of Ins ection: ,
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑YesIo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
CC
Structure 5
Structure 6
Identifier: q�-h
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
>j No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
y
I 4
❑ NA
❑ NE
waste management or closure plan?
77
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
C5'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
�2NA
❑ 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
XNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
D!fNo
❑ 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 ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ 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
CR-tQA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application'?
❑ Yes
ZQ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
I ]yjVo
%
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
*o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
1o
❑ NA
❑ NE
the appropriate box.
7C
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21 oes record keeping need improv t? l€-eNecicS repFiu ❑ Yes No ❑ NA ED NE
aste Applic ton ❑ eAkl . �reeboar Waste Analysis Soil Analysis e+cm Bather Code
Rainfall Stockingop Yield 120 Minute In
Monthly and I" Rainfall Inspections �`
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes C5k<o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 2 NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: en Date of Inspection,
XNo
24. Did the facility fail to calibrate waste applicc ion equipment as required by the permit?
❑ Yes
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes ❑ No
[N-KA ❑ 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 provide documentation of an actively certified operator in charge?
❑ Yes o
azo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA ❑ 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
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 XNo ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
❑ Yes
N'o ❑ NA ❑ NE
No ❑ NA ❑ NE
8-No ❑ NA ❑ NE
,OV'No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use dmvings of facility to better explain situations (use additional pages as necessary).
a aol5 Cvt l� bra 1-i o✓i �,or�pl�f ? p. �aasi� I ie
sI nc2 Ro I US t W) bIro_+e i n �oLr 4+1 w 00 .�
a-- Ptiq wastes
tLzt c, �
Reviewer/Inspector
Reviewer/Inspector
Page 3 of 3
Phone: — &
qq
Date:
21412015

Type of Visit: 10 Compliance Inspection 0 Operation Review Q Structure Evaluation t) Technical Assistance
Reason for Visit: I* Routine 0 Complaint O Follow-up Q Referral Q Emergency 0 Other 0 Denied Access
Date of Visit: $ ! -IPl/S, Arrival Time: QI o0 a Departure Time: SO, County:Sf/f'�
�Y Region:
Farm Name: ILl /e L!/ Gttw_5
Owner Name: {�
Mailing Address: 5o Z �� h 20� Min n It/,
Physical Address:
Facility Contact:
t dr �//F111 rL Title:
Onsite Representative: L d/o-
Certified Operator:
Back-up Operator:
Owner Email:
Phone: dell 3M-3il 7167 g�,/,/,L
z(?t2-/
Phone:
Integrator:
Certification Number: .vI4
Certification Number:
/y 1 /, D y6 r /
Location of Farm: Latitude:36O I?/ Q F Longitude: TJ / y
Z'77 N Zef Air 2 WLIke iz�Ar+l dn�
Design Current
Design Current
Design Current
Swine Capacity Pop.
Wet Poultry Capacity Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -Layer
Dai Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
Dr, P,o.ulhry Ca aci P,o
on -Dairy
Farrow to Finish
Layers
1222f Stocker
Gilts
Non -Layers
Beef Feeder 50
Boars
Pullets
j13cefBroodCow
Turkeys
Qther
Turkey Poults
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 '?,No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page I of 3 21412014 Continued

Facility Number: p • Date of Inspection: S-IS
lS
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Q No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I S cture 2 Structure 3, Structure 4
rJ� /�,fi
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
n
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ 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
JZ No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
-No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
fNA
❑ 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
.0 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
Z 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 Cop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s): (S/J
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
S-No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Z No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
UNA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
fR No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
aLNo
❑ NA
❑ NE
Reuuired 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:
,2�1,. /DDoes record keeping need improvement?fie i eb� ❑ Yes �lo ❑ NA ❑ NE
1,�Waste Application �d EWaste Analysis oil Analysis � -s Q eather Code
ainfall cocking ❑ Crop Yield d20 Minute Inspections e<onthly and I" Rainfall Inspections Poree.
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes $2L'No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 'Q NA ❑ NE
Page 2 of 3 21412014 Continued

Facilit Number: fA - t0 c • Date of Inspection: $-1 <-
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:)Yes ELM ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [-]No -ONA ❑ 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?
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
fallo
❑ NA
❑ NE
❑ Yes
[Z No
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes R_No ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes J�jLNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes IE .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,anyndditionalxecommendatlons or any other comments.,:
Use drawings of facility to better explain situations (use ,additional pages as necessary).
— arise./
—//eeof 6 Alit be.k, /Z/3//Zo/S
AN vP I,"[-.
cC-a1141-Akron. 12015 V
? r rvA Crain(j,etds. Zol I /cs
Gone ye<-����
1c.5
'S�a So�ne,Lj
WuP?
0rM I'd 1j Za ch
— e"Y �- s4�'ie.
neo ) , r�
S T1 a pG re Lc, rood 4, m »�CL
SU rc y10 f- d,/�G�a�4
it, 9. Ste_
c,1-2� -z�rts
P A/s-3•1i52
Reviewer/Inspector Name: colvo e, / J e of Phone: I7
Reviewer/Inspector Signature: Date:
Page 3 of.? 2/4/2014

Type of Visit: Op Compliance Inspection V Operation Review U Structure Evaluation O Technical Assistance I
Reason for Visit:( `Routine 0 Complaint 0 Follow-up 0 Referral 0 Emereencv 0 Other 0 Denied Access
Date of Visit: �I
Arrival Time:
Departure Time: U County:
Surru
Farm Name: boobl e
E Farin.5
Owner Email:
Region: iL25 cab
Owner Name: Fdd l2 N- El I,0-n SD hoarl Phone: *64e, I 33/0 , 366 • 7 a5 % 6 44le
Mailing Address:
�Q� ��1t fe, PA
• E I (L.j n t
IV L a 86 a-/
10
Physical Address:
FeeA
Lot 1,"e-
Facility Contact: Edd
l t; D
q-
kefN Title:
Onsite Representative:
&dA t
e
t __
Certified Operator:
Back-up Operator:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: 11,61
�(�� a.'/ � � $ � Longitude: $Q°
T -T7 N,
zed h Yr
le-
WHi+e
Av'A, on
Swine
Wean to Finish
Wean to Feeder
Design Current
Capacity Pop.
Wet Poultry
[Layer
Non -La er
Design Current
Capacity Pop.
Cattle
DairyCow
DairyCalf
Design Current
Capacity Pop.
Fceder to sh
Farrow to an
Q-T 2 $oultr
Layers
Design Current
Ca aci + P,o
DairyHeifer
D Cow
Non -Dairy
Beef Stocker
Farrow to Feeder
Farrow to Finish
,�
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
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 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 21412014 Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes eNo
❑ 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: SIQ.} Bax aoy'eX�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):I-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes XNo
❑ 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 Wo
❑ 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 J�'No
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes []No
� IA ❑ 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 1r No
�C
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes XNo
❑ 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 ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
Yes
❑ No
❑ NA
❑ 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
r';IPdA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
J .I b
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
CSI-4o
❑ NA
❑ NE
Required Records & Documents
Nq
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
'aYes
A
❑ NA
❑ NE
20. Does the facility fail to have all QqM2onents of the CAWMP readily available? If yes, check
F�No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements [:]Other:
21 Does record keeping need impro vement?-4'yesrcueck pp<opri>t�b�C- ❑ Yes o N/1 ❑ NE
r-t .. T G — ��/
Waste Applicat n Waste Analysis Soil Analysis -rs Weather Code
❑ Rainfall Stocking Crop Yield 120 Minute Inspections Monthly and V Rainfall Inspections Bljiti�--
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes )S5 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No tSrA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: tV - 0• Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes LyNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No DjrNA ❑ NE
the appropriate boxes) 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 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes M'No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ?-No ❑ NA ❑ NE
and report mortality rates that were higher than normal? �
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes I� o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. ��C /
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) rrr���
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? IXL Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? E] Yes
34. Does the facility require a follow-up visit by the same agency?
�R o ❑ NA ❑ NE
KIM
❑ Yes ll No
❑ NA ❑ NE
❑NA ❑NE
❑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).
S'�ocK.pi led uxtst� a boards reNwrec ? y,P�� +E� .
`' 13urlet� tobacco addeA tM LOuP ? (J 6 PA N v,-,.
oZ 4 N.ey.t- Ml i b row �j o v1. d ve- a.o i s-
a► A-A,4- ems_
w� C�) �e ✓u� C.�t�.a�t� u�J
,31((1a010 /,sB =
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
S 1' /�S./v/j606q P . /1/ia113 = 6,10a
Phone: _�%771 5-293
Date: & 19—_L.761i
2/4/2014

Date of Visit: ( U I Arrival Time: LS JZi7� Departure Time: Q® County: r � $ /� Region:
Farm Name: 1 oU b l e. ty. . Fa.rrvtS Owner Email: "
Owner Name: E6We* t IVt Toohnsorl Phone: C' 3_�b-3%� - 7.ZS7
._1
Mailing Address: 0 X w h 1 +� 2d • F I IL► n 11 NCB Silo 2 a. Si/
Physical Address: NL P_A L&t Lan e
Facility Contact: Edd 12 O rJ% E I k-n Title: Phone:
Onsite Representative: ECJ dho Integrator:
Certified Operator: t V mm , TD N n5on Certification Number:
Back-up Operator: / Certification Number: t
Location of Farm: Latitude: VA6 1 Y t �$ 1� Longitude: 100 46 / /Y tl
_-�-► n11 Ze_phyr d,/ wh.i6_ Rat. , Fo-rm or, 1ef'4-,
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No ❑ NA ❑ NE
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 ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes IXI No ❑ NA ❑ NE
Page I of 21412011 Continued

Facility Number: sto - n• I Date of Inspection: I I
Waste Collection & Treatment MW
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 5 r
Spillway?: e 6W
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ZNo ❑ 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
o
❑ 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
Jno
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
[�NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
Yes
❑ 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?
T
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
�No
❑ NA
❑ NE
❑ Excessive Ponding H draulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN AN > 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): (jZJ� J
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
Diryes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
WNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
K No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
CR`�o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�9No
f7U No
❑ NA
❑ NE
the appropriate box.
7
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? Ify esrc>aecl�}heappropriate bOx Yeto�r— ❑ Yes �No Nq ❑ NE
�,U,( asteAppl_i/cation S�Freeboa!d. [5WasteAnalysis I,�J/SoilAnalysis n"�- . f�; - 5 WeatherCode
ainfall [VJ Stocking Crop Yield �20 Minute Inspections [i')vlonthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [g No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No C5(NA ❑ NE
Page 2 of 3 21412011 Continued

Zfj
Facility Number: - Date of Inspection: O a013
24. Did the facility fail to calibrate waste applll!6tion equipment as required by the permit? ❑ Yes 9No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
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:
❑NA ❑NE
IONA ❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
0No
❑ NA
❑ NE
❑ Yes
C'No
❑ NA
❑ NE
[:]Yes eNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes $C No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes XNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes V No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes P No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any,additional recommendations or anyotther comments %'=�ii 5 0
Use d a ings of facility to better explain situations (use additional ages as necessary).ut
N2K1'C��l�tzLllonc�t� QCfo►�-aUl'�. `.aa'3. u4.a�IS
/3a Gurle" r - D6(06_CCO &AAeA to WUP ? iJO t Ayt �
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1 %' — 5 a 87
Date: 02 020
21412011

for Visit: 0 Routine O Complaint O Follow-up O Referral O
Technical
Other O Denied Access
Date of Visit: 9jj�:3 11 Arrival Time: Departure Time: LSO County: KPr Region: WS PO
Farm Name: Doh%blc �, FrfMS /I OwnerEmail:
Owner Name: 6_11;c EllEvt J0`1n5061 Phone: [phone] %2_57
Mailing Address: SO 2 W 11; R�, E�/c n j�) G Z,�L• Z
II i
Physical Address: �G� LG .1 Lyi �
Facility Contact: E7JJ,e Cr II511F4 Title:
Onsite Representative:
Certified Operator: i rl a meq f E• Jd �1 �f oJl •J /,
Back-up Operator:
Location of Farm:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: 36 2r Q� r� Longitude: No
Z 7 7 N. �kyr
R�K
LJN;+e
Swine
Wean to Finish
Design
Capacity
Current
Pop.
Wet Poultry
La er
!Myer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
DairyCalf
Wean to Feeder
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr. P.oultr.
Layers
Design
Ga racit +
Current
P,o ,
D Cow
Non -Dairy
Beef Stocker
SO
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
01lier,
Other
Turkeys
TurkeyPoults
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 YNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes ❑ No ❑ NA ❑ NE
❑ Yes �4 No ❑ NA ❑ NE
❑ Yes xNo ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: - 6 • Date of Inspection:
Waste Collection & Treatment �J
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [—]Yes I XI No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes E] No ❑ NA ❑ NE
Structure 1 Structureggq2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:S a4
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XrNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) �f
6. Are there structures on -site which are not property addressed and/or managed through a ❑ Yes I XI No ❑ NA ❑ NE
waste management or closure plan? 7x
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment/al threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes f�T No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes iii❑] No NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? / \
Waste Application �[
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes IX I No ❑ NA
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, et Y
❑ 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): "To SA
❑ NE
❑ NE
g,
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
NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�(
IYI No
!!!!!"""` CCCCC
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
Jj�T
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. Does record keeping need improvement?
❑ Yes
No
❑ NA
❑ NE
EW ste Application-�eek}jFreebestfi Waste Analysis oil Analysis
_ [v] Weather Code
Rainfall Stocking Crop Yield E3120mil
E3-*m+ge-&wyeg
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
X NA
❑ NE
Page 2 of 3
21412011 Continued

Facili Number: • Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes fi�No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
n/St
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 XNo
[1 NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes ❑ No NA ❑ NE
Other Issues
ilA�t[I
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
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
❑ A 1' ' F' Id ❑ L P d ❑ Oth
pp [canon to agoo orage on er.
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or anyothercommems. '
Use drawings of facility to better explain situations (use additionalpages as necessary). '
rJt�p_1
4., Uu,11
-)s« 4 Wq
T4uio ykJ<14 ,���,
/GO- zoo tt'
/�n/
Far ree-o y-JeA
PArJ,
_W��G �kl-Ysss
?/o l — 7} lb nl
f/z9/l►= y;l #tj
9..7 larl
3lbf 12% l�.�lbrl
70e /IZ = 5slb J
Reviewer/Inspector Name: �i TL` (fit v+l r'TL{ t2 I' Phone: I J3 y S per
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412011

IType of Visit 'P..Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 3 Arrival Time: �-i Departure Time: oZ a County: S U� Region: W52Q
Farm Name: Do u b le- E . Fa rrA,5 Owner Email:
Owner Name: FdQle Y-EIIen p�ohnson 10 Phone: 36-72-5- e�
Mailing Address: So oZ l nt. (h I - ,P_ /ed • 1 EI 16 n , /\x. a 86 a-1
Physical Address: Flee D-t- uairi e .
Facility Contact: FAQ op _ or E 1 �-exn Title: Phone NJ q /
Onsite Representative: ak a Integrator:
Certified Operator: )_how4-5 F • S_ohn.5o n Operator Certification Number: e::�
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: QU o ®' © "Longitude: Fqo� ° ® ' FW
r--7-7 -te
R3
,
-
a*
�
np
-
a.' x ... s ss�r, Y # t . x, i j ] •X art < z ��fi A +t
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es , d t ,, IDeslgn ICurrent ) ) tD,eslgn
z °ts' °t ` sl r r#
J; '�
#': i.il,'t#
+Current$$
t�It4 JU,4e
Sv,h GaP
P
city iP.o ulatlon '� Weti ultr ;` '
Y, P Y
attle 1 it6a
Capaeity,,
PZoopulahont
# ,Capac�tylfopulatlon
y
❑
Wean to Fi7nish7
ido
Layer
❑
Dairy Cow
❑
Wean to Feeder
;
❑ Non -Layer I
1
❑
Dairy Calf
❑ Feeder toFinish,'
1...t
r�❑Dai Heifer
❑Farrow to Wean
�' Dry(Poultry; t�k�,� ,
i
❑ D Cow
El Farrow to Feeder
„r ,
Non-Dai
Farrow to Finish
❑ Layers❑
�Beef
Stocker $0
nj ❑Gilts
Non -Layers
Beef Feeder
❑Boars
❑Pullets
❑ Beef Brood Cow
r m ❑ Turkeys
xs}, Ft+} ' xi tt o ,Jt t+g l❑Turke
r -
" tt11 ° f '
iOjthte �¢ Poults
❑ Other ❑ OtherNumbe{r(}f6g`Sjt�ru$ctures
d
i
'.t. :Gt
ni aYt $tE&.$P3 $##i5x s`i:i. r!' t
i
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes INo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[]Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
[] No
[]NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes >(No ❑ NA ❑ NE
Page I of 3 12128104 Continued

Facility Number: — 9 Date of Inspectionr / / •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ANo ❑ 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): S
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes VNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes XNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �KNo ❑ 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 ❑ Yes MNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Jo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes e No ❑ NA ❑ NE
❑ Excessive Pouring ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > l0% 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?
XYes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
N No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
KNA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
f N[o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
$No
❑ NA
❑ NE
C,ommeitts (refer-tot"question #): Explain any YES answers and/or any recommendations ur--any other -comments: ,r1 t ,;
Use drawings of facility to better explain situations. (use additional pages as necessary): ,
Leoudrlo4e, eor)taine-d 7
Reviewer/Inspector Name e.- 170, � at t; t> I Phone:
Reviewer/Inspector Signature: 1 AAA. ,m-p Q I h & kJ Date:
12/2RAM Cna/invad

F$cility Number: — DBICof Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �0 No ❑ NA El NE
S20. oes the facility fail to have all components of the CAWMP readily available? If yes, check El Yes �y'No ❑ NA [I NE
,yie,appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
JU
21. DoeVRa
s record keeping need improvement? If yes, chec the appropriate box below. ❑ Yes [�No ❑ NA ❑ NE
as[e Applic n '�_} IFFeebeari rite Analysis Soil An "si ❑r�.o,.a-,-ruasfcrs [a�°cnC�^infall Stocking Crop Yield 120 Minute Inspections Monthly and I" Rain Inspections Bather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes XNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [$NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ANo ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No >rNA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes iNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes CRINo ❑ 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 �6o ❑ 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 XNo ❑ 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 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? ❑ Yes WNo ElNA ElNE
33. Does facility require a follow-up visit by same agency? ElYes )(No ❑ NA ❑ NE
Additional Comments and/or Drawings:
a ao t o a-VN ol es+s
-0116 Cali bra lido
`�'- Solid SPreade.rused.? Noa NoC�tII(�rQ1�10Y) f ��
-
C 9�a3�1 IS.� 14-5,NI1000 .
PAN
0
M �
7 O 11 N1 A .
'Mr.
z ioa
I S- .rUr►e3e

(Type of Visit lCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 a 1Arrival Time: �� c� Departure Time: I I 1 y > I County: JU r r Region:
t�0
Farm Name: /�- f�U YJ �f� ri . 1 arm e, Owner Email:
Owner Name: E� GI.& e_9- e; l [" _SO Vw,5on Phone: _4� 3� 6 - -7 a S -%
Mailing Address: '500L tivk lt"e. R-d ' r E I K-1 n
Physical Address: FIQA A ID+ L Qh P_
A Facility Contact: (l 1 P_ e) r 1-7� 11 e4a Title: Phone No:
Onsite Representative: ri�Iil I C� Integrator:
Certified Operator: )1MrnQ 5 E . Jr Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: Imo ®I E91
Longitude: FOo L4'
�
S�wme A=
Design
Capa�ctty
ab Y^`^JCWtNCt
@urrent ; �' Design
yP�opulatt�onWet Poulatry `Capa�cwty
;i¢;eLts
Current e�f° .
P pint ahon nCattl"ip
a. E]Dairy Cow
Design '
ity
®urrent
Population
❑ Wean to Finish
I
❑ Wean to Feeder
1
❑
Non -La et
I
E]Dairy Calf
El Feeder to Finish
Dry Poultry '
K!
❑Dai Heifer
❑Farrow to Wean
❑ D Cow
a
❑ Farrow to Feeder
❑Farrow to Finish
Non -Doi
eef Stocker
❑
Laers`
❑
Non -Layers
❑ Gilts
Beef Feeder
❑
Pullets
❑ Boars
❑ Beef Brood Cow
❑
Turkeys
O,, It
.t
Number of Structures:
El
Turkey Poults
w ❑ Other
❑
Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation'?
❑ Yes
*o
❑ 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)?
0
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
El No
❑ NA
ElNE
2. Is there evidence of a past discharge from any part of the operation?
ElYes
XNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
XYes
❑ No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number:— (�l� • Date of Inspection2 • ( XJ/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ko ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Atru�ctuu,re I Q jStructure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: • TILA. + —t--(4 —
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): eJ V
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
bdNo ❑ 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 O(NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ 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. El Yes
,I�_,/
LV{ No ❑ NA ❑ NE
❑ Excessive Pouring ❑ 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 El Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) tp y A
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
KNo
El NA
El NE
15. Does the receiving crop and/or land application site need improvement?
El Yes
� No
El NA
[I NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
❑ No
0NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
VNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ba No
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Used 'Lavings of facility to better explain situations. (use additional pages as necessary):
IJi's Ibs, Nj-rw 3/1110
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone:
Date: 3 -a

Facility Number: — � D e of Inspection I �(1 •
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 El Maps El Other
21. Does record keeping need improvement? 191
�[ ❑ Yes �No ❑ NA ❑ NE
aste Application CViieekboallidam( �i Waste Analysis Soil A alysis no Vraste femeafe�sCrertifielaii
Rainfall i Stocking ACrop Yield �kl20 Minute Inspections 4onthly and I" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o El NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes //❑ No 0 NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes ❑ No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? Yes ❑ No ILL 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 �Lo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ������,,,,,((((No ❑ NA El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document El Yes No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes L No [INA ElNE
If yes, contact a regional Air Quality representative immediately /
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑Yes No ❑ NA ❑ NE
11111 1 _
n
Dd
Arc
'V\
Page 3 of 3 12128104
n
Dd
Arc
'V\
Page 3 of 3 12128104

IType of Visit P Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: {' YJ Departure Time: County: rr Region: 1• 10
Farm Name:•"riE ""1-Q.ii�.) Owner Email:
Owner Name: - J l y 11.0 W- e- 1184 Ta it Yl Phone: I�LJ
Mailing Address: S�r�- J�-- �; I lei n C- 02
Physical Address: �e PC) ,Ai-_ Lane -
Facility Contact: Title: Phone No:
Onsite Representative:�w�y� �Q/ `� L Integrator:
Certified Operator: -T�( mw; F " • D 11 nson, T n Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: Mu D�fl ' W " Longitude: lK 17 OF l 14 1
Design Current
Design Current
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑Dai Cow
❑ Wean to Feeder
ILI Non -Layer I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
Beef Stocker
❑ Gilts
❑ Non -Layers
Beef Feeder
❑ Boars
❑ Pullets
❑Beef Brood Cow
❑ Turke s
Other
❑ Turkey Ponits
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes XNo [I NA ❑ NE
El Yes (((El No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
0
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ,,,A��,,//No [I NA El NE
❑ Yes //L1���''No ❑ NA ❑ NE
12128104 Continued

Facility Number: — Q Date of Inspection I ,�// q /(J •
�T�T
Waste Collection & Treatment
�,,(
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes lbhNo ❑ NA ❑ NE
6❑
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 I 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 El NA ❑ NE
through a waste management or closure plan?
11
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
lNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ No
INA
❑ 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
ElNA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
1
❑ 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 XNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �6o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ❑ No 9 NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes [ No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? El No ❑ NA El
ba ,'�'x1,ti tltl�ik�kE�k,� ti°} '- Y
Comments (refer to question #): Explain any YES answers and/or rectommendalti s or anylothcr comments:
Use drawings of facility ro better explain situations (use aldtttonal pages as nec'esrsary)
i
°�. " zF.'
a,z € e
Reviewer/Inspector Name
Reviewer/Inspector Signatu e:
{;ruk€� i s itsa «may ' . i Phone:
Date:
g
r- " v 1 12128104 Continued

Facility Number: — Q Date of Inspection •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,KNo ❑ 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 r ord keeping need improvement? If yes, check t appropriate box below. ❑ Yes J No ❑ NA ❑ NE
aste Appplicaa ion aste Analysis Soil, alysis' �ansfers+ ation—
ainfall �yStockin Cro Yield / �y"Monthl and I"Rain [ns ections Weather Code
L r Y r
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No N(NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes 0 No [XNA ElNE
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 ❑ 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 o ❑ NA ❑ NE
and report the mortality rates that were higher than normal? //``''
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes VNo ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE
Additional Comments and/ori0raw. ings ..§ I i r " y i
02 . ao09 Sot -
a ao10.
as
Jp
12128104

j Type of Visit V Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit- Ckoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: V -tI1Departure Time: ' County: r ir Region:
Farm Name:11M O_ E ✓✓• V1� OTwner E ail:
Owner Name: Edge a. b'�Pr���CLLl��n ^P'hofn ItMo�
Mailing Address:
Physical Address: �A Ed 10 f: bCI YI e
Facility Contact: or r5ile-L., Tit
Onshe Representative:
Certified Operator: .a
Back-up Operator:
Location of Farm:
Phone No:
ao
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [;5�v�A , [Ea/ Longitude: IY50 1, ER
a
Design Current
Design C>urrent
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
El Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
❑ Dairy Heifer
❑ Feeder to Finish t
❑ Farrow to can
Dry Poulfry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
Farrow to Finish
❑ La ers
Beef Stocker
Gilts
FBoars
❑Non -La ers
Beef Feeder
❑ Pullets
❑Beef Brood Co
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
El Other
Number of Structures: I / I
^, '
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 I of 3
❑ Yes �No ❑NA ❑NE
❑Yes ❑No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 0 No
❑ Yes No
❑ Yes fo
12128104
❑NA ❑NE
❑NA ONE
❑NA ONE
Continued

Facility Number: — Q • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Struc ure 1 e Structure 2 Structure 3 Structure 4
Identifier. �1 �
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 o
❑ Yes No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes iNo ❑ NA ❑ NE
❑ Yes Vo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental tpreat, 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 ❑ Yes No ElNA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes XNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
12.
[:]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
A
Crop type(s)
13.
\`
Soil type(s) �] o
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?
El Yes
(/`,p,�'J,7j,
►�No ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No A NA
❑ NE
IT
Does the facility lack adequate acreage for land application?
❑ Yes
1�No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
iNo ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name I Phone: — pZ
Reviewer/Inspector Signature: Date: s pig t�
Page 2 of 3 r , k- ' V — 12128104 Continued

Facility Number: — •Date of Inspection 15 / �JOLQJ X •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes p(I No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes o El NA [I NE
the appropriate box. ❑ WUP El Checklists [I Design El Maps El Other
21. Do s record keeping need i�ro ement? If yes, the the appropriate, boo below. ❑ Yes O N ❑ NA ❑ NE
Waste Applic ion LJ W kly Freeboard pQ Waste Analysis MJ SXonthly
ysis ❑ 'lteeio Tr^^ + ear
,/Rainfall Stocking Yrop Yield and V Rain Ins ections Weather CodeA/ P
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
o
tNo
❑ NA
ElNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
ElYes
*A
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit? DU 2
El Yes
�`,No
❑l NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
XNA
El NE
26.
Did the facility fail to have an actively certified operator in charge?
[I Yes
No
/I NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
o
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
KN'o
El NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
// L_ytyo
)
❑ NA
[I 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
El Yes
...�
XI No
0
[I NA
[I NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
I �- resu 1*5 ? ar
.21.
a
M
Page 3 of 3 12128104

lXDivision of Water Quality- / • /�' 1 ?)
Facility Number Division of Soil and Water Conservation l/ t 1
0 Other Agency
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
0 Technical Assistance
Reason for Visit
0 Routine 0 Complaint
0 Follow up 0 Referral Q Emergency
0 Other ❑ Denied Access
Date of Visit: H 3 I O"7 I Arrival "Time: ;5 6 Departure Time: County: Region: W 'S
Farm Name: DnuWp P, . Fa r Ins Owner Email:: /
Owner Name: C�e1 1 I�_TO�,n,nnn,3 Phone: 1 t't J� � F� — S oZ
Mailing Address: 50 a h i iJ L a 8 (� a
Physical Address: (-ee.d Lo+ t-L o-n e.
Facility Contact: G _ Title Phone No:
A -zoo3
Onsite Representative: t Integrator:
Certified Operator: `i"hoM E • � 1 T A I'I . Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
L Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Back-up Certification Number: _
Latitude: ®o [;q, ivy ' Longitude: nu 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
` �❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
ElTurkey Poults
❑ Other
m
Design Current
Cattle Capacity Population
Number of Structures: F
Discharges & Stream Impacts ��� ///
I. Is any discharge observed from any part of the operation? ❑ Yes l� No El NA El NE
Discharge originated at: ❑ Structure ❑ Application Field El 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)? 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 IgNo ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes IXI No ❑ NA El NE
other than from a discharge? !T
12128104 Continued

Facility Number: — Q • Date of Inspection O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: R_bpFej P, }
Spillway?: 1�1 t7
Designed Freeboard (in):
Observed Freeboard (in): �-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
❑ NA
❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
0
❑ 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 t)treat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
El Yes
1,`fV'/'I No
ElNA
ElNE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ No
KNA
❑ 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, setbac , or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement'? �No
1I. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ NA ElNE
ElExcessive Pending [IHydraulic Overload ElFrozen Ground ElHeavy 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 Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
ElNA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
❑ No
VNA
❑ 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
tZ No
❑ 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):
Reviewer/Inspector Name
Reviewer/Inspector Signai
Phone:
Date:

Facility Number: — Q *ate of Inspection [��lT�] •
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 KNo ❑ NA ❑ NE
the appropirate box. El❑ Design ❑Maps ❑Other WUP ❑ Checklists
21. Doe ecord keeping need improvement? If yes, chec a appropriate bo�bow. ❑ Yes No ❑ NA ❑ NE
Waste Apph t' n eeklr Freebeerd Waste Analysis na ysis❑��/aaea uiGeaNen
alnfall Stocking Crop Yield ' ❑ins onthly and 1" Rain Inspections L1p Weather 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 XNA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 1XNo ❑ 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 XNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No )XNA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 1,81 No [I NA El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document El Yes '� No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ 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 I,III No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? No ❑ NA ❑ NE
Additional Comments and/or Drawings:
QQR 02006 l h5pe-c 16►1 no }B5 . uSC'
a� � „� ►�-
,� �
917 /0-7 �. `f 000
12128104

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 860004 Facility Status: Active Permit: AWC860004 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Surry Region: Winston-Salem
Date of Visit: 10/31 /2006 Entry Time:09,05 AM Exit Time: 11:00 AM
Farm Name: Double F Farms
Incident #:
Owner Email:
I;j77�kI;151I4;15, Yid
Mailing Address: 502 White Rd _ Elkin NC 28621
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant
Location of Farm:
Integrator:
Latitude:36°24'08" Longitude:80°46'14"
White Rd. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Thomas E Johnson
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative Eddie Johnson
24 hour contact name Eddie Johnson
Primary Inspector:
Inspector
Secondary Inspector(s):
Operator Certification Number: 21416
Title Phone
Phone: [phone]
Phone: [phone]
Phone:
Date: Y 0 3 (I 0(0
Inspection Summary:
22. Operator is using rain gauge at his home and using rain records from swine farm. This is ok since the waste structure is a roofed
pit w/ no fresh water entering.
21. Operator is awaiting tobacco yields to complete yield records. Need to also record small grain yield for all fields receiivng cattle
waste. To send these records to DWQ by Nov. 30, 2006.
24. Calibration not due again until Oct. 2008.
8/18/06 Waste analysis=4.1 lbs. N/ton
Page:1

Permit: AWC860004 Owner -Facility: Eddie Johnson
Inspection Date: 10/31/2006 Inspection Type: Compliance Inspection
Regulated Operations
Design Capacity
Facility Number: 860004
Reason for Visit: Routine
Current Population
Cattle
O Cattle - Beef Feeder 350 169
Total Design Capacity: 350
Total SSLW: 280,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
aste Pit PIT 24.00
Page: 2

Permit: AWC860004 Owner- Facility: Eddie Johnson Facility Number: 860004
Inspection Date: 10/31/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No
NA
NE
1. Is any discharge observed from any part of the operation?
❑
■
Cl
❑
Discharge originated at:
Structure
❑
Application Field -
❑
Other
❑
a. Was conveyance man-made?
❑
■
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■
❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
■
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
❑
■
❑
❑
discharge?
Waste Collection, Storage & Treatment
Yes
No
NA
NE
4. Is storage capacity less than adequate?
❑
■
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large trees, severe
❑
■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management ❑
■
❑
❑
or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits,
❑
■
❑
❑
dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
■
❑
❑
improvement?
Waste Application
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or
❑
■
❑
❑
improvement?
11. Is there evidence of incorrect application?
❑
■
❑
❑
If yes, check the appropriate box below.
Excessive Ponding? ❑
Hydraulic Overload? ❑
Frozen Ground? ❑
Heavy metals (Cu, Zn, etc)? ❑
Page: 3

Permit: AWC860004 Owner- Facility: Eddie Johnson
Facility Number:
860004
Inspection Date: 1013112006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yes No
NA
NE
PAN?
❑
Is PAN > 10%/10lbs.?
❑
Total P205?
❑
Failure to incorporate manure/sludge into bare soil?
Cl
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Small Grain
(Wheat,
Barley,
Oats)
Crop Type 2
Tobacco
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: AWC860004 Owner - Facility: Eddie Johnson Facility Number:
860004
Inspection Date:.10/31/2006 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?
❑
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
■
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■
Cl
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
❑
❑
25, Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■
❑
❑
Otherlssues
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
Cl
■
❑
Cl
Quality representative immediately.
Page: 5

•
Peinnit: AWC860004 Owner - Facility: Eddie Johnson
Inspection [late: 10/31/2006 Inspection Type: Compliance Inspection
Other Issues
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Facility Number: 860004
Reason for,Visit: Routine
Yes No NA NE
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
Page: 6

I Type of Visit ?A Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ARoutine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit:
Arrival Time: R55E] Departure Time:
County:
l% r Region: W5
Farm Name: hnuble_
E FarM5
Owner Email:
Owner Name: FAAI
e. W L � kiri �� Y1.S OF7
Phone:
G
(o — � o a
Mailing Address: S o I- wh't+e_
Qd 11
E l t�
n , Nx -
Physical Address:
1-
"J � ( L" e-
1
Facility Contact: rdA
ieeor 5UP—n Title:
Phone No:
OnsiteRepresentative:
14, `Y Ei11gn
e—�-�
Integrator:
Certified Operator. ` I(y011Y�Q5 Ebro h n son . Operator Certification Number: B n!
Back-up Operator:
Location of Farm:
Back-up Certification Number: 01 I q I (,P
Latitude: ®0 Long nude:®o 0 ' FoIr
1-1-1 No
4-o o on Exl+. 2T on -to Zephyr 1ZTan- o
`
�V11ke R
Farvvl
Design Current
Design
Current
Design Current
Swine
Capacity Population
Wet Poultry Capacity
Population
Cattle
Capacity Population
❑ Wean to Finish
10 Layer I❑Dai
Cow
❑ Wean to Feeder JLJ Non -Layer I❑Dai
Calf
❑ Feeder to Finish
❑Dai Heifer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
El Turkeys
❑ D Cow
on- airy
Beef Stocker
Beef Feeder
3 O
❑Beef Brood Co
Other
❑ Other
❑ Turkey Pouets
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [XNo ❑ 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)?
0
it. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
El NA
El NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
}}}}��❑..,,,,����No
ElNA
ElNE
Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑3. Yes
WNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3 12128104 Continued

Facility Number: $ . • Date of Inspection 1 0 •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes >(No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA ❑ NE
Structu e I Structure 2 Structure 3 Structure 4
Identifier: R'�
Structure 5
Structure 6
Spillway?: IV O
Designed Freeboard (in):
Observed Freeboard o� t
(in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
ElNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 4No
❑ 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 I pp No
El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes ,❑`No
I ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
)KNA
9. Does any part of the waste management system other than the waste structures require
❑ yes f61 No
❑ NA ❑ NE
maintenance or improvement?
IT
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 L[f,No
❑ NA ❑ NE
El Excessive Ponding [3 Hydraulic Overload ❑ 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)
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
LXI No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[3 No
0 NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
gNo
[INA
[INE
18.
Is there a lack of properly operating waste application equipment?
ElYes
❑ 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):
Reviewer/inspector Name llyrk=1< e- bcoc vK I Phone: /1— 5 a
Reviewer/Inspector Signatur -41�ogtgdj, I a 9b .b Date: 1q31 loco
Page 2 of 3 12128104 Continued

Facility Number: — Ote of Inspection I •
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 El Maps El Other
21. Doe record keeping need improvement. w. AYes ❑ No ❑ NA ❑ NE
dwa to Applicati drd Waste Analysis Soil Analysis Waste Transfers
ainfall Stocking Crop Yield 8-t2llivtitm� [�'1\Qonthly 1" Rain
Inspections
Code
and
Bather
22.
Did the facility fail to install and maintain a rain gauge? a*
Yes
ANo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation eq pment?
❑ Yes
❑0� N""o
�NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
L,p„i�o
El NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
ll/❑ No
�(NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�No
❑ NA
[3 NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
E] No
XNA
❑ 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
❑ 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
�QI
❑ 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
,/_/`
qQ No
❑ NA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
I`
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE .
33.
Does facility require a follow-up visit by same agency?
❑ Yes
N4o
❑ NA
❑ NE
4dditional Comments and/or Drawings:
Page 3 of 3 12128104

0 •
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 860004 Facility Status: Active Permit: AWC860004 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Surry Region: Winston-Salem
Date of Visit: 03/15/2005 Entry Time: 09:10 AM Exit Time: 02:15 PM Incident #:
Farm Name: Double E Farms Owner Email:
•Eddie Johnson
„ r d171T ow-.1 4
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator: L & H Farms
Location of Fans: Latitude: 36.24'08" Longitude: 80.46'14"
White Rd. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
Question Areas:
Discharges & Stream Impacts
0 Records and Documents
Certified Operator: Thomas E Johnson
Secondary OIC(s):
Waste Collection & Treatment ® Waste Application
Other issues
Operator Certification Number: 21416
On -Site Representative(s): Name Title Phone
On -site representative Eddie Johnson Phone: [phone]
24 hour contact name Ellen Johnson Phone:
Primary Inspector: Melissa M Rosebr Phone: [phone]
Ext.383
Inspector Signature: Lk1-� Date:
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary:
3.Suggest digging retention hole (behind dumpster) and filling with gravel to contain leachate next Fall.
21. 2005 soil test results look ok.
21. Records look real good.
2/4/05 waste analysis=11.8 lbs. N/1000 gal.
Page: 1

Permit: AWC860004 Owner -Facility: Eddie Johnson Facility Number: 860004
Inspection Date: 03/15/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
® Cattle - Beef Feeder 350 266
Total Design Capacity: 350
Total SSLW: 280,000
Waste Structures
Type Identifier Closed Date Start Dale Designed Freeboard Observed Freeboarc
Waste Pit PIT
Page: 2

Permit: AWC860004 Owner -Facility: Eddie Johnson Facility Number: 860004
Inspection Date: 03/15/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Dismhames $ Stream Impact; Yes No NA NF
1. Is any discharge observed from any part of the operation? ❑ 0 ❑ ❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWO)
❑
0 ❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWO)
❑
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?
❑
Yen
M ❑
No NA
❑
NF
Wastp Collection Stora9 ? Treatment eatment
4. Is storage capacity less than adequate?
❑
0 ❑
❑
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,
❑
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?
❑
❑
❑
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
❑
0 ❑
❑
Improvement?
Yw;
No NA
NE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
0 ❑
❑
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 Ibs.?
❑
Total P2O5?
❑
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
Com (Silage)
Crop Type 2
Small Grain (Wheat,
Barley, Oats)
Crop Type 3
Tobacco
Crop Type 4
Crop Type 5
-
Page: 3

•
Permit: AWC860004 Owner-Faclllty: Eddie Johnson Facility Number: 860004
Inspection Date: 03/15/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Anoligation Vns No NA NE
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?
❑
M
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑
❑
N
❑
17. Does the facility lack adequate acreage for land application?
❑
0
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
0
❑
❑
Records and Docurrinnts
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
Vns
❑
No
0
NA
❑
NE
❑
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 8 monthly? ❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Form (NPOES only)?
❑
22. Did the facility fail to install and maintain a min gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on Irrigation equipment (NPOES 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 fall to have an actively certified operator in charge?
❑
M ❑
❑
27, Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Page: 4

Permit: AWC860004 Owner -Facility: Eddie Johnson Facility Number: 860004
Inspection Dale: 03/15/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other Issues Vea 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 Ume of the Inspection did the facility pose an air quality concern? If yes, contact a regional Air Quality 0000
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 facility require a follow-up visit by same agency?
Page: 5

(Type of Visit aCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit A Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ,j 0 Arrival Time: Departure Time:�—'-1—Icounty:'SUrr— Region: &35p_
Farm Name: OUil12. �i ��'�'-1) �Owner Email: //�� �/
Owner Name: e IP_�l- El Ie" -,T h n,�n f- Phone: V 3 -5 / P • 36 (0 0 C2
Mailing Address: .� ��� 1�2 -?-d 'I
Physical Address: Fed La+- I..a n
Facility Contact: Eddie, itr El(e*, Title: Phone No:
OnsiteRepresentative: W::: l_A-Eibean `lohn,5ar) Integrator:
Certified Operator: 1I'Vl.AS �. • ���ftfiO rl t.7I- • Operator Certification Number:
Back-up Operator: ��1°yG-.ILZV.I� 5bn Back-up Certification Number: a'
Location of Farm:
Design Current
Swine Capacity Population
LI Farrow to Feeder
❑ Farrow to Finish 'I
❑ Gilts
❑ Boars
Other
❑ Other
Latitude: ®o ®, RN" Longitude:
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Da,',
Beef Stocker
35D
Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: I / 1
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �(No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes ���///No ❑ NA ❑ NE
Yes I� No ❑ NA ❑ NE
12128104 Continued

" Facility Number: — t7 • Date of Inspection 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?
❑ Yes
❑ No ❑ NA ❑ NE
,Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: l� T
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): N
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.)
TT��
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
t�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 n NA ElNE
8. Do any oft he stuctures lack adequate markers as required by the permit?
❑ Yes
ElNo I]SI NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
T`
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
KNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
El Yes
,,.., /
L�'N0 ❑ NA El NE
El Excessive Ponding El Hydraulic Overload El Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
/ ,
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P<No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'❑
Yes
❑����,,,,[ No
XNA
El NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Reviewer/Inspector Name I IV . [� r (��f % w r ,-n a w Phone: 11 1. f1(S (— 7715 I
Reviewer/Inspector Signature:41�g�,�j� Date: QS
12128104 Continued

Facility Number: — Da0f Inspection 1 �t/ 1 S/uSl •
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 CA WMP readily available? If yes, check ❑ Yes XNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑ Other
21. Dos record keeping need improvement? If yes, ch�ec`''y/he appropriate box b low. ❑ Yes �No ❑ NA ❑ NE
ta
aste Applica oon L Waste Analysis oil A lysis Waste Transfers ❑-�cMe t
infall Stocking Crop Yield ❑ Monthly and 1" Rain Inspections Bather 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 ONO
❑ Yes ❑ No
❑ Yes XNo
❑ Yes VNo
❑ NA ❑ NE
�(NA ❑NE
❑ NA ❑ NE
I (NA ❑ NE
❑ NA ❑ NE
❑NA El NE
❑ Yes �<No ❑ NA ❑ NE
❑ Yes )< No ❑ NA ❑ NE
❑ Yes �KNo ❑ NA ❑ NE
❑ Yes
A No
❑ NA
❑ NE
❑ Yes
[�Z<o
❑ NA
❑ NE
❑ Yes
06o
❑ NA
❑ NE
• , 1 • ♦ ; r
12128104 1 �

Technical Assistance Site Visit
DWion of Soil and Water Conservatioill
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 86 - ® Date: 10/14/04 Time: 10:30 Time On Farm: 60 WSRO
Farm Name Double E Farms County Surry Phone:
336-366-4827
Mailing Address 502 White Rd Elkin NC 28621
Onsite
Representative Eddie 8, Ellen Johnson Integrator
Type Of Visit Purpose Of Visit
® Operation Review
❑ Compliance Inspection (pilot only)
❑ Technical Assistance
❑ Confirmation for Removal
❑ No Animals -Date Last Operated
❑ Operating below
❑ 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
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
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
1 350
1 270
❑ 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 Pit under roof jC
Level (Inches) 48 C
CROP TYPES jCom, Silage obacco, FC Barle
SPRAYFIELD
SOIL TYPES Cliffield Fairview Braddock
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

7j
Facility Number 86 - 4 Date:
10/14/04
PARAMETER
O No assistance provided/requested
❑ 8.
Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9.
Waste spill contained on site
26. Waste Plan Revision or Amendment
❑
❑
❑ 10.
Level in structural freeboard
Amendment
❑
❑
❑ 11.
Level in storm storage
26. Waste Plan Conditional
27. Review or Evaluate Waste Plan w/producer
❑
❑
❑ 12.
Waste structure integrity compromised
28• Forms Need (list in comment section)
❑
❑
❑ 13.
Waste structure needs maintenance
29. Missing Components (list in comments)
❑
❑
[114.
Over application >= 10% & 10 lbs.
❑
[115.
Over application < 10% or < 10 lbs.
30. 21-1.0200 recertification
❑ 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
❑
❑
[119.
Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
[120. Late/missing soils analysis
[121.
Crop needs improvement
35. Sludge or Closure Plan
❑
❑
[122.
Crop inconsistent with waste plan
36. Sludge removal/closure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
[124.
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:
design/installation
El
❑
❑ Other...
43. Irrigation system
Date:
44, Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating Improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop 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

E
Facility Number 86 - ® Date: F 10/14/04
Waste analysis: 9/30/04 LSB 12.2 Ibs.N/1000 g
Soil samples dated 3/08/04 looked good.
9.3 Ibs.N/1000 gals.
Mr. Johnson has received his new C.O.C. and general permit
. Remember to begin using the new record keeping forms from the new permit.
# 18. The waste sample used on the June corn applications was slightly over the 60 day window of
aste sample.
I reviewed some of the new permit requirements with the Johnson's
TECHNICAL SPECIALIST lRocky Durham I rony Davis
SIGNATURE
Date Entered: 10/18/0477:1 Entered By: lRocky Durham
3 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 86 4 Date of Visit: 4/21/2004 Time: 1030
Q Not Operational . O Below Threshold
® Permitted ® Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
Farm Name: 12auble.E.kaxtus............................................................................................ County: S.uxxY.............................................. .... I. SRO........
Owner Name: Eddie..sSc..Elteu..................... Johasotl...................................................... Phone No: ]3b 3.bb-AS27............................................................
MailingAddress: SA.2..W..hite.lid........................................................................................ EI.kka... K................................................................ 2B621..............
Facility Contact: Eddic-ur-E1.FtUxthnsnu .............................Title:................................................................ Phone No:
Onsite Representative: Ed.lie.axid.ElivuJohusvA...................................................... Integrator:
Certified Operator:11liximas-E............................. d.01IMSRIUrA.................................... Operator Certification Number:XQ0.3.4 .............................
Location of Farm:
White Rd. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson. A,
❑ Swine ❑ Poultry ® Cattle [I Horse Latitude 36 • 24 087.1 Longitude 80 • 46 14
Swine Canacitv Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Nu'mber'of Lagoons 0
Discharees & Stream Impacts
Design Current Design, Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer IN Non -Dairy 350 237
❑ Other
Total Design. Capacity! 350
Total SSLW 280,000
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: ...Pit.under.barn...................................................................................................................................................................................
Freeboard (inches): 54
12112103 (���� —/ Continued

Facility Number: 86-4 . Date of Inspection l 4/21/2004 • -
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 ❑ 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 Corn (Silage & Grain) Tobacco Small Grain (Wheat, Barley,
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
®No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
®No
b) Does the facility need a wettable acre determination?
❑ Yes
®No
c) This facility is pended for a wettable acre determination?
❑ Yes
®No
15.
Does the receiving crop need improvement?
❑ Yes
%No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
®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 IN No
Air Quality representative immediately.
Nrl. 31 q' Si t ihMyj"i' d
hmttoqComents(refeueain any YES answers and/or any recommendations or any,ote,s!
t, {
,
`"flto�
Qse,drawmgsoffacetyUtter explain sitdations ,(use additional, pageas necessay,[]Field Copy ®FinalNotes
F
`
If�{It"it t�{o 5� .is �tv {1 A. AiW" t15 ,�P^P'T'° ,,,.� a 1••v }•-{u7 Yf Tt t. t
NO,!
u9
11. Several fields had slightly been over -applied (approx. 5 tbs.). Be sure to use the PAN value from the CAWMP.
3. Freeboard records not required since bam now has new roof to exclude any freshwater.
3/11/04 waste analysis = 9.3 lbs. N/1000 gal.
�I r� r sebrocr4. � 1
.�.,... Reviewer/Inspector Name H
� -
Reviewer/InspectorSignatureDate.
12112103 k Continued

Facility Number: 86-4 vaof Inspection 4/21/2004 .
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
[]Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form [:]Rainfall ❑ Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103

Type of Visit A Compliance Inspection O Operation Review O lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date or Visit:
Permitted [3 Certified 0 Conditionally Certified 0 Registered
Farm Name: .....W..2.�1I_�......Cr..........r.q! m..��......................... _........
Owner Name:....{—r
Mailing Address:.,... So >r
Facility Contact: ......�
Date Last Operate or Above Threshold: .........................
County:........ V.r.�........................................_.............
Phone No: ...�.3 6.:...... ....�g� �................. .....
t..N.4..............
....8....4.............................._...........
Onsite Representative: Lwk:t...........Lleyl.... ri............ Integrator:
Phone No:
Certified Operator:.. hQ.VA.Q,_a........t�.... d..YYI7S� -r.)._... ...... _............ Operator Certification Number:
Location of Farm: T1 ewo r S • Jo
❑ Swine ❑ Poultry Cattle []Horse Latitude ®• l a ZA1 =`° Longitude ®• FqFl° 11
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
u ULM
Cl Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure �S,ttru`cture 2 Structure 3 Structure 4 Structure 5
Identifier: ...i... .... .. 1Jtt t••Ci.........
Freeboard (inches):
❑ Yes �(No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
*No
❑ Yes
r�No
❑ Yes
o
Structure 6 ! '
12112103 Continued

Facility Number: T Date of Inspection l y / •
5.
Are there any immediate threats to the l grity 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
❑ Yes
I0
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
o
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
o
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
L�o
elevation markings?
y4
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
�To
11.
Is there evidence of over application? If yes, check the appropriate box below.
Yes
//
❑``��No
❑ Excessive Pending PAN ❑ Hydraulic Overload Fro n Ground ❑ Copper and/or Zinc
12.
Crop type
13.
Do the receiving crops differ with those designa in the Certified Animal Waste Management Plan (CAWMP)?
❑Yes
o
14.
a) Does the facility lack adequate acreage for 1 d application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
Iz
No
c) This facility is pended for a wettable acre determination?
ElYes
No
&
15.
Does the receiving crop need improvement?
❑ Yes`
(No
16.
Is there a lack of adequate waste application equipment?
❑ Yes yo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below--Ejyrr—Q-N,6--
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 y�Q `ido
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 Io
Air Quality representative immediately. / `
Field Copy ❑ Final Notes
3J�11 I0� U'-9'08 d4tAh� oo = q6,3 1�5- Njlmw TP.
Reviewer/Inspector Name
Reviewer/Inspector Signai
/ , �
1
Date: L
12112103 L, I. Continued

Facility Number: —e of Inspection ��TT •
Required
Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�/
®No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
%
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑Yes
No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ &l Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
VNo
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
>Io
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
XNo
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
IR 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)
$Yap—ATo-
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
12112103

Assistance Site Visit Report
DivisioTrbf Soil and Water Conservation
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number $$ - ® Date: 9/10/03 Time: 8:40 Time On Farm: = WSRO
Farm Name Double E Farms County Surry Phone: [phone]
Mailing Address 502 White
Elkin NC 28621
Onsite
Representative Eddie and Ellen Johnson Integrator
Type Of Visit
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Design Current
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
U Routine
O Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
O Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current
Caoacity Population
❑ Layer
❑ Non -Layer
❑ Dairy
9 Non -Dairy
❑ Dairy
9 Non -Dairy
350
279
❑ 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 Pit under Roof
Level (Inches) 8
CROP TYPES lCom, Silage ITobacco, FC lBarley
SPRAYFIELD
SOIL TYPES Cliffield Fariview Braddock
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

0 46
Facility Number 86 - 4 Date:
9/10/03
PARAMETER
Q No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
25. Waste Plan Revision or Amendment
❑
❑
❑ 10. Level in structural freeboard
❑
❑
❑ 11. Level in storm storage
26. Waste Plan Conditional Amendment
27. Review or Evaluate Waste Plan w/producer
❑
❑
[112. 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.
El
❑
[115. Over application < 10% or < 10 lbs.
30.2H.0200 re -certification
[116. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
[117. Deficient irrigation records
❑ 18. Late/missing waste analysis
33. Organize/computerization of records
❑
❑
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
[120. Late/missing soils analysis
[121. 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 IJCDA Date:
design/installation
El
❑
❑ Other...
43. Irrigation system
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1 - A new roof has been installed with more
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
overhang than before.
Z,
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)
El❑
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

i
Facility Number 86 - ® Date: 9/10/03
Waste
8-15-03 LSB 15.3 Ibs.N/1000 gals.
B, HLB 28.1 Ibs.N/ton B
Records look good. The new roof looks great. Good farm.
Suggest sending the waste samples to the NCDA lab for analysis. There is a large discrepancy
Btween the NCDA sample and the A & L sample.
TECHNICAL SPECIALIST lRocky Durham ony Davis I Icameron Pardue
SIGNATURE
Date Entered: 9/17/03
Entered By: lRocky Durham
03/10/03

Facility Number 86 4 Date of Visit: 1 01/28/2003 Time: 0930
Not Operational O Below Threshold
® Permitted ® Certified [3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: 1.1.QQble.E..k.artias........................................................................................... County: S.urn................................................... W..S.RQ........
Owner Name: lad.dae..dt..Ellext..................... J.0111ason ...................................................... Phone No: 33.k 3.kb...4.827............................................................
Mailing Address: 5U2.!'l'.hit..e..:d........................................................................................ Elki.0... N.C................................................................ 28621..............
Facility Contact: Eddie..oK..ElleaAQ.iMsQ0 ............................. Title:................................................................ Phone No:...................................................
OnsiteRepresentative: ........................................................................................................... Integrator: l..A.H.Faxim.........................................................
Certified Operator:.ThQmas..E..1ollnsola.Jr..... 3:ee.Y.Qx.S.jQhjta013 ...................... Operator Certification Number:219.1�.or.2$285..........
Location of Farm:
south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 36 •F 24 08 Longitude F 80 • 46 14
Design Current
Swine Canacity Ponulation
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Number of Lagoons I
Holding Ponds / Solid Traps C
Design Current Design Current
Poultry Capacity Popelation Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer I I IN Non -Dairy 1 350 1 153
❑ Other
Total Design Capacity 350
Total SSLW 280,000
Area I❑ Spray Field Area
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or 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 (i
Identifier: ... P. it.under..ham...................................................................................................................................................................................
Freeboard (inches): 72
05103101 . Continued

Facility Number. 86-4 • Date of Inspection O1/28/2 '-
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 Com (Silage & Grain) Small Grain (Wheat, Barley, Tobacco
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit 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?
❑ Yes ® No
❑ Yes ® No
■l�-lzl
❑ 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 YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary)r, �� Field Copy ® Final Notes
7. Barn and roof have been rebuilt. Looks great!
19. and 25. Suggest that CAWMP be modified slightly to specify fields individually to match operator's records. May want to revise
map for T-101Ito show individual fields. Operator needs to contact technical specialist for revisions.
10/14/02 Waste Analyses:
Broiler litter = 30.6 lbs. N ALB = 5.8 lbs. N11000 gal.
Reviewer/Inspector Name Meli sa R5sebrock
Reviewer/Inspector Signature. Date:
05103101 1 Continued

Facility Number: 86-4
Date ol'•ection Ol/28/2003 •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon'? ❑ Yes []No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional'Comments ,and/or Drawings:
Questions left blank are not applicable to this facility at this time.
MUM

• q.
h
Type of Visit A Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit x Routine O Complaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
(late of Visin a2$ Time: 10 1
Facility Number
Not Operational 0 Below Threshold
APermitted o Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: hoUhle— E Fa rfta5• County: A6L-3r l/
Owner Name: ��(:� 1 E "h BI'1_J e �:`,�[� Phone No: 3?i (a • 3-7
Mailing Address: .5_67 6116 n / ft_)C� '2Q6 91
Facility Contact: Ed d IL OIr Phone No:
Onsite Representative: _ 5jd;e ek 6114M J�h n a5Qn Integrator:
Certified Operator: T- hamVn V) J r. Operator Certification Number:
Location of Farm: TryVelr S �p yySOn oZg of $S—p
❑ Swine ❑ Poultry
Swine,,' `
❑ Wean to Feeder
Boars
IVtmber,,of
Holdmel Ponds )..I
Cattle ❑ Horse Latitude®* E]2�fl• Longitude ®� ®•
resign fit. Current ,"'I,<.l "��" .Design "=,Current1. �Destgii�;'^ '`,C
.OA 'k. P/.A..19H(..1 PO\d}N !`nn .nr Dn:. .InNn.. '('oMla df /• ......iw n D�9
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste.Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structu}e l Structure 2 Structure 3 Structure 4 Structure 5
Identifier: P1+ unY pX ba-rt)
Freeboard (inches): 7 21/
KAI
❑Yes $No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes No
Structure 6
05103101 Continued

•
Facility Number: — Date of Inspection 3
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
El Yes
No
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
No
TTTTTTip'''I"'
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
111ccc�...111
No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
r0
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
No
11.
Is there evidence of over application? Excessive Pending ❑ PAN ElHydraulic Overload
ElYes
No
12.
jj,�,, ��/�❑
Crop type f�eli 6 e)ra .
-r�er�
13.
Do the receiving crops differ with those designatein the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
ElYeslNo
No
b) Does the facility need a wettable acre determination?
❑ YesNo
c) This facility is pended for a wettable acre determination?
❑ YesNo
15.
Does the receiving crop need improvement?
❑ Yes
16.
Is there a lack of adequate waste application equipment?
❑ Yes
1r,�t
�1 No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.) / , /
❑ YesINO
No
19.
Does record keeping need improvement? (ie/ iirrrigaattiioc, fr eboardebvoard, waste analysis soil ample reports)
❑ Yes
20.
Is facility not in compliance with any applicablesdtback criteria in effect at the time of design?
❑ YesNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
bKo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
o
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
El Yes
No
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?
ElYes
�N
pp/No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to 46stion q) 'Explain any YES eoswers and/or any,iecommendations or anv other. comments.
Use drawings_of facility' to better eiplatn stuatioos''(nse additronsl pages as Decessery) "; tiCA Field Conv ❑ Final Noes
.,.....-n.
7 %.J �r G�Q,uQ ,bra ✓�. C
D
Reviewer/Inspector Name I' I i I'uro,R% �� !�� ={i�' ,'.,,
Reviewer/Inspector Signature: Date: 02
05103101 Continued

Facility Number: — Date of Inspection
�D( l
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?
41 9., a�., a9-3,). NVa+ cypca.lofe �S
✓✓8 S g lbs. N cca
%r
G i 114-
Ib-s. Nl000 r
!9� asm L Afl 'ktc 1"
lq
05103101
�d✓�c�J o�,�,e�-m-���-„�=e�.a�.de-v Mai
a D Pp4t V AQ4 zi
411---
❑ Yes ❑ No
❑ Yes ❑ No

Facility Number Dale of visit: 6/26/2002 Time: 9:30
86 4
O Not Operational O Below'fhreshold
® Permitted ® Certified 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .., ......................
FarmName: R.uuble....F.Rum............................................................................................ County: S.uxx3:.................................................. WSW........
Owner Name: Edtlae..&.EUela..................... J.01msola...................................................... Phone No: 33.bc3.GG.:.9.827............................................................
MaltingAddress: 502..W.hit..e..tid....................................................................:................... END ... NC................................................................ IOU ..............
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Onsite Representative: E.ddip.aAd.E'i.IIPA.>JO.h.M5QXt...................................................... Integrator:......................................................................................
Certified Operator:;J'U.mas- ............................. dahnS.00.dX...................................... Operator Certification Number: 2.Q0.3.i..
...........................
Location of Farm:
White Rd. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
..........
❑ Swine ❑ Poultry S Cattle [I Horse Latitude 36 • 24 ° 08 Longitude F 80 • 46 14
Design Current
Swine Capacity Ponulation
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Design Current Design Current
Poultry Ca acit Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer I I El IM Non -Dairy 1 350 1 267
❑ Other
Total Design Capacity
Total SSLW
350
1 280,000 1
I Number of Lagoons ❑ Subsurface Drains Present In Lagoon Area ❑ Spray Field Area I I
Holding Ponds / Solid Traps 1� ❑ No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes S 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 DW'Q) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gaUrnin?
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 S No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes S No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Cl Spillway ❑ Yes S No ,
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Suuctute 6
Identifier: ...................................................................................................................................................................................................................
Freeboard (inches): 84
05103101 Continued

Facility Number: 86-4 • Date of Inspection 6/26/2002
5. Are there any immediate threats to tintegrity 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 Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ®No
11. Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Tobacco Corn (Silage & Grain) Small Grain (Wheat, Barley,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14, a) Does the facility lack adequate acreage for land application?
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 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?
❑ Yes ® No
❑ Yes []No
❑ Yes []No
❑ 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 YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑ Field Copy ❑ Final Notes
# 7. The roof still needs to be repaired. The DWQ inspector requested that weekly freeboard levels be kept, since the roof hasn't been
repaired. Mr. Johnson has complied and is keeping weekly freeboard levels.
Overall records and facility are in compliance.
Reviewer/Inspector Name Rocky Durham
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: 86-4 Date spection 1 6/26/2002
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
Additional Comments and/or rawmgs: ' � I- ;:, 11 �, -; ;.:„ ,
Waste analysis: 11-20-01 ALB 7.6 Ibs.N/1000 gals. B, 11.8 lbs.N./1000 gals. SI
5-29-02 LSB 9.7 "
r
05103101

Facility Number 86 4 Date of visit: 1/10/2002 Time: 1330
0 Not Operational O Below Threshold
Permitted 0 Certified E3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Muble.E.A'.UnIn........................................................................................... County: S.ur.T.X.................................................. W;SR0........
Owner Name: F Adie.A.Elleu..................... jQhWQU ...................................................... Phone No:33.6n3..66.'4827............................................................
MailingAddress: S.0.2.Wbite.R.d........................................................................................ EIWAAC ................................................................ 2,8621..............
Facility Contact: Eddle..or..Eltett.lA.imSm ............................ Title:................................................................ Phone No:
Onsite Representative: Eddie.tmd.Ellettlobasm.....................................................Integrator:......................................................................................
Certified Operator:;l',l=0,g.E............................. jAbASA.itJ1G.................................... Operator Certification Number: 2141b.............................
Location of Farm:
Nhite Rd. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson. A
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude r 36 • F 24 08 " Longitude F 80 • 46 14 ,
Design
Swine Ca acit
Current
P,o ulation
Design Current Design Current
Poultry Ca acit P,o ulation Cattle ' Ce acit M P,o ulation
❑ Wean to Feeder
❑Layer
❑Dairy
❑ Feeder to Finish
❑Non -Layer
®Non -Dairy 350
108
❑ Farrow to Wean
❑Other
Total Design Capacity 350
Total SSIW 280,000
Mr, Ma ,..
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
❑ Boars
IMMIbierolLagoons �0 ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps No Liquid Waste Management System
Discharges & Stream ImRacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection &. Treatment -
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier Pit under barn
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
...................................................................................................................................................................................
Freeboard (inches): 60
05103101 . „ r U� / Continued

Facility Number: 86-4 • Date of Inspection 1/10/2002
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ ees, 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?
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes . ®.No
❑ Yes ❑ No
❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Small Grain (Wheat, Barley, Corn (Silage & Grain)
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?
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?
❑ 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
Roof still needs to be repaired to keep excess liquid out of the waste pit. Since roof is still allowing excess water, then freeboard
ords must be maintained for the pit.
Not applicable.
19. Tract -1103 and other fields have had waste applied to only part of the entire field. Need to make a list of fields/partial field acres to
be used consistantly. Also suggest keeping records in ink.
Reviewer/Inspector Name lmeliss Rosebrock
Reviewer/Inspector Signatur> Date: D r�-
05/03101 1.Continued

Facility Number: 86-4 DaInspection 1/10/2002 •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
[]Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
05103101

1P
Type of Visit A Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Vielt 5yRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: 0 0 ime:
��y///
Q Not Operational Q Below Threshold
j Permitted x Ce_rtifieed� 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold:
FarmName: .....LX2JL,?.ffw!.I.....E,...... hQ,�.,'7�.'s.............................................. County: ........ .�1./.V.r2.r.........,../......................................
Owner Name:... 1:,!:.4 l..ye....�.... �� ..... J.of a-6.on........................... Phone No: .s .4R.:.ti 1.�0.�. Tl °2..?......................:.
Facility Contact:..t<(.LLL.1.�i:....r�i.��....0./d n................................................................ Phone No:.C4..3.s6.:..:.336 g
'/ NG a 86 a /
Mailing Address: V..I.T.r.....1 : �....E...l.. K.!_n....� .
Onsite Representative: iGCL(..�,e 9 IQ,,,,�],�,,,,,,,,,,,,,,,,,, Integrator:....,..,.. ,,,,^�`
...........s.........................................../...............
Certified Operator:, Q[?1Q�• [ fir.,.,.... phxis(�,,,,,,,,,,,,,,,,,,,,,„ Operator Certification Number: ,,,,,_�� `(0
..........................
Location of Farm: F PAY) Tit hnS017
tla`�)1X?MIle- 56V\Ph of Zep)yfr Ltd •/Gippi-W• W&Mi/e.S
❑ Swine
❑ Poultry
Cattle ❑ Horse Latitude ®•
®'
E='.
Longitude
®• ®I L_I__n--
1 ,
414Swine:
-
; Design,;'. Current ,;
�Canaeity'Pnoulatinn
Poultry`:
Design
Ciioaeity:
Current
PGold Lion
Cattle
Design ' Current,
Capacit1"Pneuls6nn ..
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
I Non -Layer Non -Dairy
Other
v lJ
Total Design Capacity S
Total SSLW 5 $o 01
4
Number of Lagoons ® ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Ares ;f
Halding!Ponds / Solid Traps.; ❑ No Liquid Waste Management System r y
Discharges & Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
C. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
(� SLtrucl re I Q Structure 2 Structure 3 Structure 4 Structure 5
Identifier: f--. f.1i.)Rxnt.,n..............................................................................................................................
1
I� Freeboard (inches): (00
5100
❑ Yes ANo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �No
❑ Yes o
❑ Yes 777�������No
Structure 6
Continued on Lack

Facility Number: — Date of Inspection �%/ %Q %Q� •
5.
Are there any immediate threats to the in[e y 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
[Xio
(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?
Ayes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
YNo
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
des—�Plo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
XNo
11.
Is there evidence of over application? Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
1Po
12.
, ' l❑
Crop type _ aY%/iL4.0 C (A/L�!/� rdffjAJ
13. Do the receiving crops differ witlAhose 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
o
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 ONO
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 [lo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) XYes ❑ No
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
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes �Ko
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes VNo
24. Does facility require a follow-up visit by same agency? ❑ Yes IWO
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes "�No
v l i91a4Wgs:ol il$fciepsyes Were nDted lliH}�g ti1ls:vE.........�e ....<}........:. /
:•:•cori•isnmidence:abbtfthis:visit:•:•:•:•:•:•:•:•:•: .:•:•:•:•:•:-:•.-:-:•:-:•:•:•:•:•:•:•:•:•:•:•:•.
1
Reviewer/Inspector Name

Facility Number: — DIW Inspection 0 0
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ^[5 Ye,. B 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 b�<o
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?
PME?TM=�?
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 o
31. Do the animals feed storage bins fail to have appropriate cover? - ^— YC —

Facility Number 86 4� Date of Visit: 1 9/18/2001 Time: 9:59
Not Operational Q Below Threshold
E Permitted E Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: I.1uuble.E.F.ar'mx........................................................................................... County: S.Ujpry .................................................. WSRQ ........
Owner Name: Eddle..Bc..Ellett......................1 m on...................................................... Phone No: 3Jbr.3.bb.:4&27............................................................
MailingAddress: 144..Wbjte.Iid........................................................................................ EIMA.B.0 ................................................................ MOM
FacilityContact: ...................... :....................................................... Title:................................................................ Phone No:...................................................
Onsite Representative: E,dfdie.aril.E.ltertd91m52t1...................................................... integrator: L..dt..kl..k:ar'ms.........................................................
Certified Operator:;l'1mmaS.................................. Mmon ........................................... Operator Certification Number: AQ.Q.3.4 .............................
Location of Farm:
White Rd. 1124 1/2 mile south of Zephyr Rd. Approx. 21/2 miles west of Dobson.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 24 08 Longitude 80 • 46 1411
Design
Swine Ca tacit
Current
P,o ulation
Design Current
Poultry Ca acit ' P,o ulation
Cattle
Design Current ..
Ca acit P,o ulation
❑ Wean to Feeder
❑Layer
❑Dairy
❑ Feeder to Finish
❑Non -Layer
®Non -Dairy
350
0
❑ Farrow to Wean
❑Other
Total Design C•+specify
Total SSLW
,. .. ,��.
350 �+
280,000
❑ Farrow to Feeder
❑ Farrow to Finish
1110 Gilts
❑ Boazs
_._.._...a..�,�_...__.....F.wW...,.u.
im�liffiTF-50I
❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area�1 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes. ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the 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 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................................... . ...............................................................................................................................................................................
Freeboard (inches): 14
05103101 Continued

Facility Number: 86-4 1 Date of Inspection 9/18/2001 •
5. Are there any immediate threats to thefegrity 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 smctures 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 Pending ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley, Tobacco (flue cured)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit 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 tail 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 IN 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
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy ❑ Final Notes
25. Applied slightly outside of the windows of application of the crops.
o animals on site today.
verall facility and records look good.
yoke to Mr. Johnson about getting a new roof for the facility.
Reviewer/Inspector Name Rocky Durham I
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: 86-4 Da•Inspection 9/18/2001
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
analysis: 8-14-01 ALB 9.8 Ibs.N/1000 gals. B
2-27-01 LSB 18.9" "
05103101

(Type of visit U• t;ompuance inspection U Operation Heview U Lagoon tvaivation I
Reason for Visit 0• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 86 4 Date oil, Visit: 3/13/2001 Time: 0900
Not Operational Q Below Threshold
■ Permitted N Certified 13 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: ............
FarmName: D.9019..Z.FAKM5............................................................................................ County: Surry................................................... .W.SRQ.......
Owner Name: Daddic.&.E11vn..................... JADmsvn...................................................... Phone No: 3.3.6-3.M.-.402.7 ..........................................................
Mailing Address: S.Q2MIAIDR.Rd........................................................................................ Elkin..NC ................................................................ MAU ..............
Facility Contact: Eddicand.FDI.CAI JahA1 9a.........................Title:............................................................... Phone No:....................................................
Onsite Representative: RdtDIR.,atAd.FiIDR10..J.QIAIASQIU..................................................... Integrator: DeARF,Strm..........................................................
Certified Operator:1119mi................................. doDlta a............................................ Operator Certification Number: 2UO3.43artd.21416......
Location of Farm:
Nhite Rd. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 it24 • 08 Longitude 80 • 46 14 ••
Design
Current
_ Destgn Current . Dertgii
Current
Swine
us ia` it
P,o ulation
Poultry Ca acit P,o ulation.' Cattle Ca acit
P,o ulation _
❑
Wean to Feeder
❑Feeder to Finish ❑Non -Layer 350 188
❑ ❑Layer ) ❑Dairy
Number of Lagoons F— ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds /Solid Traps 1� ❑ No Liquid Waste Management System
Discharges B& Stream
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated in: ❑ 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'? (Il'yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Dues discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
01/01/01 � Continued

Facility Number: 86-4 • Date of Inspection 3/13/2001 •
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:...Pxt.taodcc.kaarz...................................................................................................................................................................................
Freeboard(inches): ................ L� ............... .................................... ................................... .................................... .................................... ....................................
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 Small Grain (Wheat, Barley, Corn (Silage & Grain) Tobacco
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
Reauired
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
Odor Issues
28. 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?
29. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
O1/01/01 Continued

Facility Number: 86-4 I)1d' Inspection 3/13/2001 • Printed on: 3/15/2001
30. 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)
31. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
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.) ❑ Yes ® No
33. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
34. Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Reviewer/Inspector Name ;Melissa Rosebrock
Reviewer/Inspector
Date:
01/01/01

6
�bivision of Snit and Water Coaserva6on t t
0 Other Ageocy', t ' �
4
:
a � . •
Type of Visit
Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit
Routine
O Complaint O Follow up O Emergency Notification O Other
❑ Denied Access
Date of Visit:
6
'rime:
Facility Number
Not O erational
Q Below Threshold
APermitted 0 Certified] 0 .. iCoonditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
FarmName: ......Q.Q.ble...........F�i..rwLs.................................................. County:..... .U_.rt......................................................
Owner Name:.... ........... ,LQ.F n-.S10n.................. Phone No:...�J 310 t0 • Y d
Facility Contact: ..... (JI�..I. .. !.......t I� ...�JQ .vrigcn.......................................................... Phone No: ... �.P...3 ('ro..............
\/, /� 336
Mailing Address: ..!.v.!.I... .......... ..:.......................... .... ► ;..n.....,...!....'.-...............° .(Clal............................
� t. •— it
Onsite Representative :............ .aQ..� .`'t.....C...tLek...................................... Integrator:................................................... ..
�-J �yq
Certified Operator; „•....f,. bwa s.........�� .,....'T,)hj'js¢_int �E;,,,, Operator Certification Number: .;L-0
Location of Farm:
l,k)h e W. Ilay /am. 6,of2-yhyr P-d• Approx. J %aM fles c-r-5
❑ Swine ❑ Poultry 6 Cattle ❑ Horse Latitude E�' , F—M.1 Longitude ®• ®i
Design Current
Swine Canarity Pnnnlntinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design
Cattle
❑ Other
Total Deigg i'Capad0 I LL
Tota1SSLW!', _o2gdt 00
Number of Lagoons' 1❑ Subsurface Drains Present ❑ Lagoon Area
Holding Ponds / Solid Traps E= ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
I Spray Field Area
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: pli-...ima .-zal.rn...........................................
Freeboard (inches): ► U
5100
❑ Yes 0 No
[]Yes ❑ No
❑ Yes ❑ No
❑ Yes ,❑ No
❑ Yes $] No
❑ Yes / No
❑ Yes KNo
Structure 6
Continued on back

Facility Number: Date of Inspection IT ;T • Printed on: 1 /9/2001
5. Are there any immediate threats to the t egrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes K No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? I ❑Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
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
12. Crop type Q P /I&A � 11 o rn / Q ee /) N.Yi e. C n
A Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No
KNo
WNo
*Io
No
13.
Do the receiving cropsdiffer I
with hose designated in th erufied Animal Waste Management Plan (CAWMP)?
❑Yes
)irNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
Wo
b) Does the facility need a wettable acre determination?
❑ Yes
j No
c) This facility is pended for a wettable acre determination?
❑ Yes
0
15.
Does the receiving crop need improvement?
❑ Yes
XNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
9No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
ONo
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
` l
ilX'tl No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
AoYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
P(No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
XNo
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
P/
Does facility require a follow-up visit by same agency?
❑ Yes
�No
P24. No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
::
i� •YiQI�{itjljs:o j•• ilQfjciepcles •wire pQfeadjrri[jg tit js:visit; • ;Y:oj► will •�e:eQiye �}ti fujtjt�I` • : • : • ,
:•:•ctirres
oridence:abolitahisvisit::::•:•:•:•:::::•:•:•:•:•::•:•:•:•:•::•:•:•:•:•::•:•:•:•:•:•:•:•:
facility
a
q. Pik urna" barn. 1 70 /Z60f 5ii heeds (4 ke re1nlred,
14e41 4al16 i LoaS-e anal yS15
19.5e✓ua.l el&S in k)o P need 4 re,Ui�ndle_ A e'ury-PA+ tut-,
Reviewer/Inspector Name
Reviewer/InspectorSignature.ZdAWADate: ,� / Q aa/p

• Facility Number: 7 of Inspection • Printed on: 1/9/2001
Odor Issues to
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes VNo
liquid level of lagoon or storage pond with no agitation?
19.
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
A 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?
$i`erffNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 9 44AS E] o
lJOfes: Afpliea.-�"" W 1'f7d uvs
wee K We /,5 617 to i>L — /O&M
6 "a- �-(�
4&tct &' /MUD
lbs./Aare- Zn 19,5- -> cj�
S/00

Type of Visit O Compliance Inspection O. Operation Review O Lagoon Evaluation
Reason for Visit O• Routine O Complaint O Follow up O Emergency Notification O Other [3 Denied Access
Facility Number Date of Visit: 9/27/2000 Tim9:15e: Printed on: 2/22/2001
86 4
0 Not Operational 0 Below Threshold
Permitted M Certified E] Conditionally Certified E3 Registered Date Last Operated or Above Threshold:
Farm Name: 1?uukle.F. slttt........................................................................................... County: S.ujrjry ................................................. WS.RQ........
Owner Name: F..dtlie.A.01991..................... jithow ...................................................... Phone No: 33..3.kb.:4S27...........................................................
FacilityContact: ..............................................................................Title:................................................................ Phone No:...................................................
MailingAddress: 19.4...Wbite.lid........................................................................................ Elkin...N.C................................................................ 28.621..............
Onsite Representative: Ii4.Il.sg6.1'iddIC.3AbASA.tt......................................................... Integrator: l,..tgG.H.1'.arXW.........................................................
Certified Operator:.Th.9.Mp;$..E............................. .1911r 5.9.A IA:..................................... Operator Certification Number: 21.4.16.............................
Location of Farm:
Nhite Rd. 1124 1/2 mile south of Zephyr Rd. Approx. 21/2 miles west of Dobson. A
❑ Swine []Poultry ®Cattle ❑ Horse Latitude 36 • 24 OS Longitude 80 • 46 14
, Design
urrent
Design .- Current Design` Current
d� waFs.:�' i
Sw ne' Ca tacit
Ro ulation
Poultry f Ca' actt " Ro ulation @attle `,Ca' actt P.o ulation,
��. ❑ Wean to Feeder
10 Layer
I❑Dairy
{,i' ❑ Feeder to Finish
10 Non -Layer
I°
®Non -Dairy
350 247
1 1
i
Number of Lagoons � ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds /Solid Traps ❑ No Liquid Waste Management System
�, ; Farrow to Wean
x v.,
❑ Other
Total Design Capacity 350
. Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Total SSL'W 280,000
Discharges & Stream Impact
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 IN No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 0 No
Waste Collection 4yt Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 0 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ......... conc..pit............................................................................................................................................................................................
Freeboard (inches): 42
5/00 Continued on back

L
- � s
Facility Number: 86-4 Date of Inspection 9/27/2000 Printed on: 2/22/2001
5. Are there any immediate threats to the Wgrity of any of the structures observed? (ie/ trewevere 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
Wuste ADDlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence; of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Tobacco Small Grain (Wheat, Barley, Corn (Silage & Grain)
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?
Required Records Se 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?
Iti piolatititis:oc ldeticien"cie$ were;noted;duriilg this: visit::You;wiIi receive tI6 further
cocresnondeike. about this .visit... ... .... .
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
sure to stay within windows of application for crops from the WUP and don't apply over 30 days before planting.
19. Need to keep weekly levels on the waste pit per General Permit requirements.
7. Gutters and roof sections need repair. These were marked by DWQ inspector.
'ante analysis: 7/22/99 SLB (Broiler) 36.4 Ibs N/ton B, HLB 32.0lbs N/ton B, LSB 22.4 lbs N/1000 gals. B, 30.8 Ibs N/1000
gals. I
2/03/00 HLB 27.3 Ibs N/ton B, LSB 9.1 Ibs/1000 gals B, ALS 3.2 Ibs/1000 gals. B
Reviewer/Inspector Name ;Rocky Durham
Reviewer/Inspector Signature: Date: 5100

'\ Facility Number: 86-4 D f Inspection 9/27/2000 • Printed on: 2/22/2001
Odor IIssnes
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
5/00

Facility Number 86 04 Date of Visit 3/30/2000 Printed on: 3/31/2000
Q Not Operational Q Below Threshold
■ Permitted E Certified E3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Qeublc.E.Farma........................................................................................... County: S.urry................................................... k\'SIiO........
Owner Name: > ddig.K.Ellt:tt..................... dohs soil...................................................... Phone No: 33.6-3.0 4W...........................................................
Facility Contact: EUmI.And.Eddie.Jahasnix.........................Title:................................................................ Phone No: fax.336.36G.a3GS................
MailingAddress: 5V.2.Wjhite..lid........................................................................................ Elkitl...N.C................................................................ 20.621..............
Onsite Representative: ........................................................................................................... Integrator: FOrfOrmalaCe..1,.iY.t:St4C1G.....................................
Certified Operator:.Tb.Q.MM..E............................. 1.01) 1SOtt. X.................................... Operator Certification Number:2,141.6. .............................
Location of Farm:
❑ Swine ❑ Poultry ® Cattle ❑ Hor:Latitude 36 • 24 OS Longitude 80 • 46 14
Design
Swine ii—pa—cit—yapulwlation
Current
Design Current I)estgn Guar nt "
Poultry Ca tacit P,o ulation Cattle M E KC,a acIt P,o ulation •;
❑ Wean to Feeder
❑Layer
❑Dairy
❑ Feeder to Finish
❑Non -Layer ®Non -Dairy 350 1 280
❑Other c
Total Design C►apac1 350
280,000
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑Boars
0 ❑ Subsurface Drains Present ❑ Lagoon Area JCISpray Field Arca
E:= ❑ No Liquid Waste Management System
Number of Lagoons
Holding Ponds /Solid Tamps
Discharges _& Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
19 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:.... Pit.under.hann .......................................................................................................................................................................................
Freeboard (inches): 48
a 76 %
vilft
Continued on back

Facility Number, 86-04 Date of Inspection 3/30/2000 Printed on: 3/31/2000
5.
Are there any immediate threats to the integy of any of the structures observed? (ie/ trees0re erosion,
❑ Yes
19 No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
® Yes
❑ No
(If any of questions 4-6 was answered 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 Pending ❑ PAN
❑ Yes
® No
12.
Crop type Small Grain (Wheat, Barley,
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Reguiired
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
19 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
No viola,tions;or deficiencies wefe A' Oled ;dttt•ittg this; visit: ;You;will ;receive ho further
correspondence: A66f this .visit.::.... .
Roof and gutters need to be repaired to keep out rainfall that is not accounted for in the waste plan.
No marker, is pit under cattle shed. Can measure freeboard with yardstick.
5.Old waste plan signed 5/99 has waste applied on barley Feb. -May and Corn Sept. -Nov. New waste plan signed 1/26/00 has waste
pplied to corn Math -July; barley Sept. -Dec. 15; and Tobacco April -May. We do not have a copy of the new waste plan in our office.
7. Dead animals go to rendering plant.
1. Silage trench is covered with barleywhich is sown when harvest is complete. Is not covered during summer except by root mass
•om barley after it dies off. Nearest creek is 1/4 mile away.
Reviewer/Inspector Name
' � � /%�/%//i%/.mil/yam/✓�.t%L������. t ; .

Facility Number: 86-04 Dates( Inspcction 3/30/2000 • Printed on: 3/31/2000
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
IN 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
' honu omn9Fn1 ari o raw rigs:

a
Routine
Facility Number I Date of Inspection
Time of Inspection
Other
24 hr. (hh:mm)
0 Permitted Certified 13 Conditionally Certified [3 Registered Not O crational Date Last Operated:
FarmName: rrr Q.i? .I ....../—...,.......FG�.r.tY+l_aS........................................... County:.... ��/.r.�....................../......................................
Owner Name:.. .I.tw.. ...... G..�.......Tohrlaon............................. Phone No:....3.6. .3.6.6 ..:_!' A
C I
Facility Contact: .... C.....{�1...I.........T0,'.}n.•.`JQ�n...J........ Title: ................................................................ PhoneNo:�.r......;................................
Mailing Addr2sls:, C.......Ll-.1h1.,le..........1!.'.....................C.I-141...n l...!.v.�.........................`�...��0.°�:.I......... ..............................
OnsiteRepresentative: ... G,� en „(�dd[e;,,,...J—, hj.j;SM. ............. Integrator:......,,Q{ t{)(7 Q�IGe/✓e' �—
Certified Operator:.. rhom �_._E' .�)„Q�I�. bf� f�r. Operator Certification Number:...,,,,, ,�, . .......... .... ............... ... .................
Location of Far
...... ............... ................................. ........... m�..a....:n.......... 4........ ...........r...... .......!........
... .r..�...........
.. .... :ml..... a..:..LJ 2 5 ........rf ...... �.�?......�G.►)................................................................:...............................................................
Latitude ELIT• Longitude ®• ®• ®••
,�' �if,Destgn ,m "IC It,
I)estgn Current q�'' �� ,,9nDestgii Current
Swme 'Ca acity Po ulation
Poultry Catacit :Po ulabon;.,,Cattle 't.'K;Ca'aci Po"iulatiotr
;, ��,-
❑Layer -, ❑Dairy aa�
❑ Non -Layer Non -Dairy
1' E
0other
Total Msign.'Capacity i
J�SO
'' Total SSLW'' Q OOO
Numbmof Lagoons' ' `. >®
❑ Subsurface Drains Present, ❑ Lagoon Area ❑ Spray Field Area 5„
t Holdmg.Ponds / Solid Traps ��,�
❑ No Liquid Waste Management System
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
[]Farrow [o Finish
❑ Gilts
❑ Boars
Discharges & stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. II' discharge is observed, did it reach Water of the Slate'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system'? (ll'yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
S l,ycture I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: �%
l
Freeboard(inches): .........................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes j No
seepage, etc.)
3/23/99 Continued on back
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
Po
❑ Yes
XNo
❑ Yes
J*No
Structure 6

Faciliiy Number: — D d' Inspection
Z7T"
6.
Are there structures on -site which are notoperly addressed and/or managed through a womanagement or
closure plan?
❑Yes
0 No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
X Yes
❑ No
8.
Does any pan 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
ANo
11.
Is there evidence of over application? ❑ Excessive Ponding [I PAN
El Yes
KNo
12.
Crop type
13.
Do the receiving crops diff4 with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
o
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
to
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
IX No
15.
Does the receiving crop need improvement?
Cl Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Rcnuired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
Yes
t<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 tWNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
0 No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ONO
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes )jrNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ,1.2-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 j (No
I`Vq.yiblaiiols;oj- &flciendiag -*ere potted. daring 4bis;visit'. • Y;oit ;wili•Kecgiye tio: fui•thor • ; • ; • ,
:: corresuoridertce:about his:visit'::::::::
seurawmgaurWcmiyr w ueuer explam.Snuauuns.{ube auunaunaupages as,necessary/:;,;� j :u.�, ',1[
12. aL j rFe- fA Old Wc�S plan dine-d 5199 I �m 5� , M/arcJ
Sep4 • - Nov . 3ot,r 1
Sept.
Igo date S+ora�� 7oj 'o +�pril-I
ApPI`caflon daje,5 Nov,4 e-c, N99 Sutple. k4e5; 43foo
�P-o 'fee {�► be �epa��e d -� . Keq Pv1 �v, ae co Un 4-�.4 Fvr rai 'a
Reviewer/Inspector Name
,-
Reviewer/Inspector Signature: _ _ _ _ ",A,& j XAA2
Date:

'Naclity Number: — O 1)�f Inspection •
Odor Issues
26. Does the discharge pipe from the confinement building to thesjprgge pond or lagoon fail to discharge at/or below �'Y`er—e-Nt7
liquid level of lagoon or storage pond with no agitation'? IJV�►I` f\
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 j (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 XNo
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? OA `- Et t' No
31 f S &8e/ s4ark 1 S. CbAPx---e, a
ham I�a+n�J2<
fyjaSs 5,hi1 pry
pro
f
v i tee, 5 v iN rr.

Facility Number Dale of Inspection
'time of Inspection 24 hr. (hh:mm)
a Permitted 0 Certified a Conditionally Certified a Registered in Not OperationalDate Last Operated:
Farm Name: Doohle.E.Farms............................................................................................ Comity: Surry WSRO
Owner Name: Eddie.&,Ellen.................... doknson...................................................... Phone No: 9.1fiT,36.6n4lU.7 ..........................................................
FacilityContact: ................................................................................I'ille:............................................................... Phone No:....................................................
MailingAddress:.14A..W,hite.lid........................................................................................ Elkin..NC ................................................................ 28621 ..............
OnsiteRepresentative: .......................................................................................................... Inlegrator:.......................................................................................
Certified Operator:Thomas.E............................ dohnsoa,dr...................................... Operator Certification Nuinher:21.416 ............................
Location of Farm:
Latitude ®0®' ®" Longitude ®6 ®' ®"
Swine Canacitv Population
[3 Wean to Feeder
E3 Feederto Finish
[3 Farrow to can
[3 Farrow to ee ar
E3 Farrow to Ftnts
p Gilts
p Boars
Poultry Capacity Population Cattle Capacity Population
p Layer 1p Dairy
p Non -Layer I ® Non -Dairy
p Other
Total Design Capacity 350
Total SSLW
Number of Lagoons 0 E3 Subsurface rams resen [3 Lagoon Area E3 Spray to rea
Holding Ponds / Solid Traps JE3 No Liquid Waste Management System
I. Is any discharge observed from any part of the operation? p Yes a No
Discharge originated at: p Lagoon p Spray Field p Other
a. Hdischarge is observed. was the conveyance man-nmdle? [3 Yes p No
b. If discharge is observed, did it reach Water of the State? (11'yes, notify DWQ) p Yes p No
c. If discharge is observed, what is the estintaled Ilow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) p Yes 13 No
2. Is there evidence of past discharge from any part of the operation? p Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? p Yes ®No
Waste Collection & 'treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? p Spillway p Yes ®No
Struetm'e I Structure 2 Structure 3 Structure 4 Structure 5
identifier:I.........................................................................................................
Freeboard (inches): ..........6..inches.......... .................................... ......................... .......... .................................... .............................
.
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
3/23/99 seepage, etc.)
SlrnCtnre 6
p Yes ® No
Continued on back

; Facility Number: 86_4 •nf hispcctiun
s
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? p Excessive Ponding p PAN
12. Crop type Corn (Silage & Grain)
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) Does this facility lack adequate documentation to make a determination of adequate acreage?
15. Does the receiving crop need improvement?
16, Is there a lack of adequate waste application equipment?
Required ltecords fi 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?
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
Cl Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
p Yes a No
25. Were any additional problems noted which cause noncompliance of the Certified A WMP? p Yes a No

Me p Complaint p Follow-up ol Dwy inspection p Nollow-up of uawt, review p vmer
Facility Number Date of Inspection
Time of inspection 24 hr. (hh:mm)
o Registered N Certified p Applied for Permit p Permitted G Not OperationalDate Last Operated:
Farm Name: Douhle.E.Earms............................................................................................ County: Sorry WSRO
Owner Name: Eddie.&.Ellen..................... Johnson..................................................... Phone No: 9ART36.6-AR2.7 ..........................................................
Facility Contact:
Title:
Phone No:
MailingAddress: 194..W..hite..Rd........................................................................................ Elkin..NC ................................................................ Z862J...............
OnsiteRepresentative: Ellen.J.ohimon............................................................................ Integrator:.......................................................................................
Certified Operator: Thomas.E............................ Johnson.Jr...................................... Operator Certification Number:2141.6.............................
Location of Farm:
Latitude ®•®` ®"
Longitude ®• ®` ®"
Capacity'Popalation - Cattle
p Other
Total Design Capacity_
r
Total S9LW '
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: p Lagoon p Spray Field p 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
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
Al
I
p Yes ® No
p Yes to No
p Yes p No
p Yes ❑ No
p Yes p No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
%/N1'

,,n er: 86_4 Date o spection
Are there lagoons or storage ponds on si ich need to be properly closed? •
Structures (Lagoons,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: I
Freeboard(ft): ............ 5..feet........... ................................... .................................... ................................... ....
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)
❑ Yes H No
❑ Yes N No
Structure 5 Structure 6
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
15. Crop type ....................... Calton ...................... ...Timothy,.Orcltard,.&.Rye............................................................................................................
16. Do the receiving crops differ with those designated in theaAsnimal Waste Management Plan (AWMP)? Yes M No
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 Onlv
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 A WMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
::.........rice about. t...visit.:::::::::::::::::::::::: :
❑ Yes ®No
p Yes ®No
❑ Yes ®No
❑ Yes ® No
❑ Yes ®No
p Yes ®No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
neviewerunspector name
i
Reviewer/Inspector Signature: Date•

1f tcouune p e,ompiamr p rouow-up of uvvy inspection p ronow-up of u-,wt_; review p "tiler
Date of Inspection
Facility Number
Time of Inspection 24 hr. (hh:mm)
p Registered ig Certified p Applied for Permit p Permitted in Not Operational Date Last Operated:
Farm Name: Double..E.Earms............................................................................................ County: Surry WSRO
Owner Name: Thnmas-Edward............... Jnhnsan,.Jr............................................... Phone No: 9.11,36.6-.4R2.7...........................................................
FacilityContact: ...............................................................................Title:............................................................... Phone No:
MailingAddress: 194M..bite.Rd........................................................................................ Elkin.NC.................................................................. ..........................
Onsite Representative: E11enAitbuon............................................................................ Integrator:L&R.Earju ............................................................
Certified Operator:T.homas................................. Johmon ............................................ Operator Certification Number:2.1.4.1.6.............................
Location of Farm:
Latitude Longitude
esrgnt ', urren
esign urren
esign;; urren
..
,,
'Capacity, PopulationPoultry;;,
,..
Capacity •Ropmlation:; `Cattle
Capacity Population �,�'
�. ..,
v
a..
p ayer
p airy
p Non -Layer i;'.p Non -Dairy
--
p t er
„ i.6. ,, i
� ,
f f
i�; ... t ,
i
'� TotalaDestgn�Capactty'i.
-. m.
�a
,
tj tq
Totil SSLW �„
}'ii ,'V }
f
. .,
..,r .,_
Number" of;Lagoons / Holdi ng Ponds
Drain s Lagoon rea
�Subsurface
p play rei Area i
l;1,1[3
as e ManagementSystem
f
gm
i f
® can to Feeder
p ee er to mrs
p arrow to can
p arcow to ee er
p arrow to Fmts
p Gilts
p Boars
General
1. Are there any buffers that need maintenance/improvement?
p Yes
H No
2. Is any discharge observed from any part of the operation?
p Yes
®No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made?
p Yes
p No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
0 Yes
p No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notily DWQ)
0 Yes
p No
3. Is there evidence of past discharge from any part of the operation?
p Yes
®No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
p Yes
®No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
p Yes
®No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
®No
7. Did the facility fail to have a certified operator in responsible charge?
p Yes
®No
7/25/97

-- act >y Number: 86_29
8. Are there lagoons or storage ponds on sihich need to be properly closed?
Structures (Lasoons,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (ft): ............ 3..faet............
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.......C.om.(Silage.&.G.rain).......
p Yes
® No
p Yes
M No
Structure 5 Structure
6
.........................................................................
p Yes
N No
p Yes
® No
p Yes
® No
p Yes
® No
p Yes
® No
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
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?
R..p.vroins. or a46ueitretnisevs'wse:re.noa ngrsvisit:. ou.wi.reeeivenouer.•. ia
. . ':::::: :::::::::::::::::• •correspondbee
.......................:.:.:.:.:.:.:.:............................
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
7/25/97
Reviewer/Inspector Name tJe y Rankm �� �r �, ,� .� �, p :n. , u� �t,� rip u
4 tll , x'i tli LI 1 ,�lF., i ,ti r 1 If�� ,rh't6.,in t 0 i. 'i. a ,•�A, tr,l ti t I. cLfi r I i •. 7,
Reviewer/Inspector Signature: Date:

i.
Facility Number
Farm status: ■ Registered p Applied for Permit
p Certified p Permitted
Date Last Operated:
Time of Inspection
24 hr. (hh:mm)
(ex:1.25 for I hr 15 min)) Spent on Review
or Inspection (includes travel and processing)
Farm Name: Double E Farms County: Surry....................................................W.SR.O........
OwnerName:.Eddie...................................... dalunslaa ..................................................... Phone No: 91A-3bb-4fl2.7...........................................................
Facility Contact:
Title:
Phone No:
MailingAddress:.1.94.W..hile.Rd........................................................................................ Elkia..NC................................................................. 281G2.1...............
Onsite Representative:
Integrator: Perfarmance.Livestack.....................................
Certified Operator:11iamas.................................. dahnsau........................................... Operator Certification Number:21416 .............................
Location of Farm:
Latitude ®•®° ®" Longitude ®0 =' ®..
Design Current .
'Capacity Popolatnon :Cattle-
p rarrow to wean
G
PFarrow to Feeder TotaMesign Capacity �:u500
Farrow to Ftms
� fp Other
�_�;t� a TotaLSSLR ��'`400,000
General
1. Are there any buffers that need maintenance/improvement? p Yes ® No
2. Is any discharge observed from any part of the operation? p Yes ® No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discltatge is observed, was the conveyance man-made? ❑ Yes p No
b. If discharge is observed, did it reach Surface Water? (If yes, notify D WQ) p Yes p 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) 17 Yes p 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? p Yes ®No
5. Does any part of the waste management system (other than lagoons/holding ponds) require p Yes ® No
4/30/97 maintenance/improvement?

acH t y um ber: 86_4
6. Is facility not in compliance with any a9cable setback criteria in effect at the time of On?
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Su ucture I Structure 2 Structure 3 Structure 4
2 feet
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 .......Cora.(S.ilage.&..Gcaiul............................ .T.abacco.....................
p Yes
® No
p Yes
®No
p Yes
®No
p Yes
®No
Structure 5
Sh'ucturc 6
p Yes
®No
p Yes
®No
p Yes
®No
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
® Yes p No
p Yes ® No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes p No
l7 Yes ❑ No
24. Does record keeping need improvement? p Yes ® No
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:

Date of Inspection 6/I 12/97
Facility Number ��
Time of Inspection F__TT7ff__j 24 hr. (hh:mm)
E Registered p Certified p Applied for Permit p Permitted
in Not Operational I Date Last Operated:
Farm Name: Bloulala.E.Farms............................................................................................
County: Surry WSRO
Owner Name: Eddie ...................................... Jahnsnn.....................................................
Phone No: 4111-36.6-482.7...........................................................
FacilityContact: ...............................................................................Title:...............................................................
Phone No:....................................................
MailingAddress:.19.4.W.hile..Rd........................................................................................
Elkia..NC................................................................. 2862J...............
OnsiteRepresentative: Ellea.J.ohnson............................................................................
Integrator:.......................................................................................
Certified Operator: .................................................. ..............................................................
Operator Certification Number: 211Q34.............................
Location of Farm:
Latitude =•=' =" Longitude 0. 0' 0"
Design,, ,urren ��
IL i.S7 I
Swtue opuoin, Capacity, Plati
Poultry
..a
esrgn
Capacity Population Cattle„
- Design urren
. .
Capacity Population, r
„t,a
0 Layer
: p airy
i'�d p Non -Layer
"® [eon -Dairy
Other
al Dost 'ti500
g• ;J a act Tot P, 1Yn:
,
,�
„� „Total•SSLW„
JI
,
''i, T O'rofLagoons/!Holding Ponds) "I[3 Subsurface
rams resen [3 Lagoon Area p pray ie rea
Waste System
1[3o
w ana emen
p can o ceder
p ee er to mrs
p arrow [o can
p arrow to ee er
p Farrow to Fmrs
p Gilts
p Boars
General
1. Are there any buffers that need maintenance/improvement?
p Yes
® No
2. Is any discharge observed from any part of the operation?
p Yes
® No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made?
p Yes
p No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
p Yes
p No
c. If discharge is observed, what is the estimated flow in gaVmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
p Yes
p No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
®No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
p Yes
Ig No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
p Yes
®No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
®No
7. Did the facility fail to have a certified operator in responsible charge?
p Yes
®No
7/25/97

act t y Number: 86_4
8. Are there lagoons or storage ponds on site which need to be properly closed?
E
p Yes ® No
Structures (Lagoons, Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3
1 doil ti tier:
Prccboard (ft): ..............2.0..............
10. Is seepage observed from any of the structures?
Structure 4
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 Anolication
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
❑ Yes
N No
Structure 5 Structure
6
...........................................................
p Yes
® No
p Yes
® No
p Yes
® No
15. Crop type ...................... wbacco...................... ....... Corn.(SlIage.,&..Qraua)..................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (A WMP)?
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?
µ 1\U ♦�V L{ILLV LLJ•VJ •LLGliYL4LL4LL.J 1�L.L•Y.LLV LYY•YY�LL�E, 4
:::: co'rresAai+cterie'e a46dt:t#iis:visit:::::::............ •
® Yes p No
p Yes ® No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No

19 tcuutme p eomptamt p ronow-up at owy inspection C ruuow-up of u3w%- review C "tiler 1
Date of Inspection
Facility Number
Time of Inspection � 24 hr. (hh:mm)
p Registered E Certified p Applied for Permit p Permitted in Not Operational Date Last Operated:
Farm Name: Doable..E.Earms............................................................................................ County: Sorry
WSRO
Owner Name: Thnmas..Edward............... Jabnsjan..Jr............................................. Phone No: 9.113-16.6-482.7 ..........................................................
Facility Contact:
Title:
Phone No:
MailingAddress:.1.44..W.hile.Bd........................................................................................ Elkin.NC ..................................................................
OnsiteRepresentative: EllenJbia cu t............................................................................ Integrator: L&H.Earms............................................................
Certified Operator:
Location of Farm:
Latitude ®•®` ®"
F
Operator Certification Number:20.04.............................
Longitude ®' =' ®"
Cattle
'' [3 Other
Total Design Capacity
'T,otal,SSL^W 6
1. Are there any buffers that need maintenance/improvement?
p Yes
® No
2. Is any discharge observed from any part of the operation?
p Yes
®No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made?
p Yes
p No
b. If discharge is observed, did it reach Surface Water? (Il'yes, notify DWQ)
p Yes
p No
c. Il'discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
p Yes
p No
3. Is there evidence of past discharge from any part of the operation?
p Yes
®No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
p Yes
® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
p Yes
®No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
®No
7. Did the facility fail to have a certified operator in responsible charge?
p Yes
®No
7/25/97

ace t y Number: 86_29
8. Are there lagoons or storage ponds on st a which need to be properly closed?
Structures (Laeoons,Hoidintt Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure Strucmre2 Strucmre3 Structure
Identifier:
Freeboard (ft):..............2.0...............
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)
p Yes N No
p Yes N No
Structure 5 Structure 6
15. Crop type ....................... ftsmm...................... ......................................................................................................................
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?
25. Were any additional problems noted which cause noncompliance of the Permit?
Q Pfo'vialations.orctettetencieswere.notea.aunngtntsvisiu.Yotawtu.reeeive.no:mrrner.-.
• Co'rresponOticO abvtil tfiis.vis+t:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
p Yes ® No
p Yes ® No
p Yes ® No
p Yes M No
p Yes ® No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes ®No
p Yes H No
p Yes ® No
p Yes H No

SUL-14-1995. 15:34 FROM DE WR
TER DURLITY SECTION TO WSRO P.02/02
Farm
Site Requites 17ncdiate Attention:
Facility No. 86
DMSION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: A%- �4—, 1995
Time: el: 30 a
4c
Mailing Address: /44f I -A fe ?nod PI K, e 8 G Z
County: ur�r
Integrator:
On Site Representative:
Physical Address/14cation: ,
Phone:.
Phone: q /m 366 -11
Type of Operation: Swine — Poultry ` Cattle
Design Capacity: 3'10, d°" Number of Animals on Site:
DEM Certification
_Npmber: ACE DEM Certification Number: ACNEW
Latitude: �• a ' ' Longitude: g 0 y 1 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard: U Ft 'Inches
Was any, seepage observed from the lagoon(s)? Yes o Was any erosion observed? Yes oo
Is adequate land available for spray Yes or No Is a cover crop adequax?� No
Crop(s) being utilized:
Does the facility meet SCS
setback criteria? 200 Feet from Dwellings. Se or No
!00 Feet from Wells? No uT
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes orb Gdy Ork.
Is animal waste land applied or spray imgated within 25 Feet of a USGS Map Blue Line? Yes of 19
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or alb If Yes, Please Explain.
Does the facility maintain adequate waste management f
spray irrigated on specific acreage with cover crop)?
Additional Comments: 3 Q'4,!?1 x 8 Ta-ereci pf,
Inspector Name
is (volumes of manure, land applied,
or No
cc: Facility Assessment Unit
Use Attachments if Needed.
TOTAL P.02