860030_INSPECTIONS_20171231

(Type of Visit: ✓Go_mpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up Q Referral O Emergency O Other O Denied Access
Date of Visit: 'L//(Arriv_al Time: 1 R Departure Time: j� County: X -fftq Region:
Farm Name: T`t1,ytT'J`A GFtr.�C E_n'rM Owner Email: —�
Owner Name: M; ICt A. I ko%so 1 . 1 PhoneLH) 3,36 - '3 I�.� ST 76
Mailing Address: P 0, go),- 2(p , S , � ow,y.I , JV C ZrJ Q 947
Physical Address:
Facility Contact: /Vjt)U "
Onsite Representative: 1
Certified Operator: G ✓C(`�- �AiOh
Back-up Operator:
Location of Farm:
iq ++
Title:
Integrator:
r�v­+ ,/ p
Phone: 33t.-370- ,} 373
L4-H
Certification Number: % 9 %gr-
Certification Number: Latitude: 310�%�1�
Longitude: 350 3s,
Wy (col K )+w,l '2-k V E, K l�pc la+td pal led,, t: inn 61e k �'i
L I Siloam Al L bws1fw+I
Design Current Design Current Design Current
@apacity , Pop. e,. W,etiP,oul(ry. .Capacity I;op.. Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Dairy Calf
Wean to Feeder
Non -La er
Feeder to Finish
7r
�� 1 ,Design Current
Dry Poultn Ca aci P,o i.
La ers
Dairy Heifer
Dry Cow
Non -Dairy
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
I
IBeefBroodCow
III
Other
Other
Turkeys
Turkey Pouts
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 A No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[-]Yes [-]No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes x No ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: - Date of inspection: 7_
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard?
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
St�ructurre�I Structure 2
_—
Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes
XNo ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 5 Structure 6
❑ Yes No
❑ Yes No
❑NA ❑NE
❑NA ❑NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes Ixl No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) ,,,���///
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
,,,,,,������,,,,,,//////
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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): �;Otxe. t'C-ti, Mild
91aty^
�—Tr7
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
ElYes
gNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ YesNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes 5(No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yesy No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes lyl No
�"C`
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design [—]Maps [—]Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
�� ((
El Yes �X� No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
El 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 �❑ No
NA
❑ NE
Page 2 of 3
21412015 Continued

Facili Number: 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
"\jSo
❑ 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 IJ(I No
X
❑ 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
'''"''''000CCC
❑ 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 IXI No
X
❑ 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 XNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAW MP?
❑ Yes o
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
jNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yeso
❑ 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).
Z1, 50'/ sapllwl dorw, v on (�skl�r, Ute ►ux� v/sl
Z 1,✓�,Iz e�✓✓u/1° 6d,T 1 i0h �, next Jtxt ©c-"w gal 8,
"
,le(�f'fl �lnf �C1.r� e31a���� o,.jZ.(ooa t
2.21 tb N
Reviewer/Inspector Name:
r4;
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
214,12015

type of Visit: q9 Compliance Inspection V Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: Q6 Routine O Complaint O Follow-up O Referral O Emereencv O Other O Denied Access
Date of Visit: -11 II�sT4(6l/�Arrriival Time:
:-� Departure Time: County: JU rr Region: �7Y�
Farm Name: U41 P4? (meek. V&frn Owner Email: ,
Owner Name: Nh_k e A. To hn5o Y) Phone:�3 36 - 31 q- Sg 74
Mailing Address: PC) Ba . 7-(0/5-1 (po_m., NC, a707
Physical Address: Lw U5i-14
nn i
Facility Contact: AA I V_P_ o-3-7it 91fP�•2 Title: Phone: 13Z6) q - s 3 1 3
Onsite Representative:L Ki tze, 4 eyexetL Integrator: L + H
Certified Operator: V V t re.4 To l)nsorn Certification Number: lq _% 9
Back-up Operator:
Location of Farm:
0
Certification Number:
o t
Latitude: 36 1l 3 S t' Longitude: $ To 3 S / i t tl
bolN NG 14w4 d-hoolog E j (at�n 5c.( ou le C+rae 1(? •�
o .2J� *q 6i 06LM P—d . Lo� b rrdj ,
Swine•.,,. .,,.FCapacity�®.
Design @urgent Design Current MEN,
P.op. d .„H: Wet P.oultry.. Capacity P,op. Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Farrow to Wean
1
Dr P�oult .
La ers
Design Current
C_a acib� P,o ,
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Q[her
Turke s
Turkey Pouets
Other I IMI
10ther
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 DW R)
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 ZNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
[-]No
[:]Yes
[KNo
❑ Yes
WNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: - 3 • Date of Inspection:
Waste Collection & Treatment ,�/
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes � yl No ❑ NA ❑ NE
3 (0 a. If yes, is waste level into the structural freeboard? ❑ Yes 7❑� No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I'MOOO
Spillway?: T
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
pppp,,,,����
Iry, No
❑ NA
❑ NE
waste management or closure plan?
7�
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
,k No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
W o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes NrNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes NKNo ❑ 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) Sou1S. M"IIle.4% -Ies 'Ue' Jrxo_4 rl/n(&n9d n) . rwp (L-jt3u)
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
WNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
XNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
4 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
D, No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the 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
XNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need ' provement? Yes ❑ No ❑ NA ❑ NE
aste A hca ion Weekl Freeboard Waste Analysis Soil Analysis �"'--`- T......_� _� ��-1�,'�'�"�r Code
❑ PP Y ❑ Y Y t^�^a
Rainfall �[ocking �rop Yield ❑ 120 Minute Inspections Monthly and l" Rainfall Inspections Q Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes gNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbrea rs on irrigation equipment? ❑ Yes ❑ No �R A ❑ NE
Page 2of3 �1Qr]�(j� zpt' L 2/412015Continued
1 \

[Facility Number: Date of Inspection: g
24. Did the facility fail to calibrate waste appliOon 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 ``XNo ❑ 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 C &"No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes XNo ❑ 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?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ['No ❑ NA ❑ NE
❑ Yes �d No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes Sa"No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
drawings of facility to better explain situations (use additional pages as necessary).
e)rm ne x' vpge,{-& ors es4a.611 s ked on ow vv5 top e) 7
Soy l ��st ci ve Zo i fo
zdui
d o2Ofsao201(0 5W&3e' survey7Nfl—flaw
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 't — fp
Date: -111'12
Page 3 of 3 21412015

operation xeview V Ntructure
for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: S' Arrival Time: t S5 . n F Departure Time: / O! �Jte County: -5e41 r-1 Region: k5go
Farm Name: (� /1,t nj," /4 erireOwner Email: �—
Owner Name: �i/ft ��• </o�/1SO/L Phone: d" 336'3%y-5?7�
Mailing Address: P. a 60Y_ ;�D, S.loc� n vl/ ;7-7d / 7
Physical Address: / 40"1 //Osf; //'w' /
Facility Contact: i/fe s/ ✓,ee Title:
Onsite Representative:
Certified Operator: �V4-,rL
Back-up Operator:
Location of Farm:
Latitude:
✓„-., . 1
-11
Phone: 336' 3741— 93 7 3
Integrator: L k P-
Certification Number:
Certification Number:
Longitude:
/ 9 79y
Cor a�(Y 7%ai/
%O�e�AY J6 00/ K
L ONV/G C/eek
&4� VGr , 191 L
Swine
Wean to Finish
Design
ap
Cacity
Current
Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
DesignCurrent
Cattle Capacity P. P
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to sh
50
971r
Dairy Heifer
Farrow to an
Farrow to Feeder
Farrow to Finish
I) ,ul
Layers
Design
C•_a aci
Current
P.o .
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
BoarsI
Pullets
I jBeefBroodCovv
Other
Other
Turkeys
Tur ey 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 ff-No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes
[:]No
❑ NA
❑ NE
❑ Yes
E�jNo
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
Page I of 3
21412014 Continued

Facility Number: d • Date of Inspection: 5—ty
is
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
® No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 1Gl g06'/t-
Spillway?: % 5
Designed Freeboard (in):
Observed Freeboard (in): ? O''
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
0 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
CQ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0 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
JED. No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
JK No
❑ NA
❑ NE
❑ Excessive Pending ❑ 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
Svc
12. Crop Type(s):
w� `41/041z7
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
151 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
allo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
allo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
53 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E[ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
2 No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes �o ❑ NA ❑ NE
Q'Waste Application 2weekly Freeboard e Waste Analysis ESSoil Analysis [ ' eather Code
.Rainfall Stocking /Crop Yield 21& Minute Inspections e1C4onthly and 1" Rainfall Inspections 051udge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes J�]_No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ;Z�No ❑ NA ❑ NE
Page 2 of 3
21412014 Continued

-
Facili Number: g( • Date of inspection: 5-1yAW
Wr
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes RNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes ®.No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PDA for sludge
levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes B 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 E&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 fa 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
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
jo No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Jallo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
El No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
I So%l Arse ,,, Zo/6V6dA ion an awnS1•,Oe s daw /L sI /oµt k«P
N Cal.1tJ"- C vc Zolf —/"a�/ v ZOIY: �
4 S/JgC 5""t"t7 done_�— J"e_ X01Y
_�—jo13
S-L-ts
g4
N-3.�o
P0.1
iaos
/Y,5
kta
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 336` 77d- 96V
Date: S' /7 7 "/ 5-
Page 3 of 3
21412014

K19
(Type of Visit: QD Compliance Inspection V Operation Review V Structure Evaluation V Iecnnical Assistance I
Reason for Visit: (Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: % (rArrivall Time: 1 _� Departure Time: j 1 County: U t�1r Region: (
Farm Name: ,ur\� I V� (A—fe X-- F Qrrv► Owner Email:
Owner Name: I
W1t� k _1OII1yye'o v) \ Phone:
3 1 � Sg -7&
nn
Mailing Address: Y0 Wg-96) �I�NCi a7ot�
Physical Address:
Facility Contact:
Onsite Representative: 6w] V� (? ' j✓ Vf'U-P:' Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
Layer
Design
CapacityA
Curcent
Design Current
Capacity Pop.
Dai Cow
Wean to Feeder
Non -Layer
Da' Calf
Feeder to Finish
Gq
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
1) . P,oul
Layers
—I n
C•_a acitTymP,o
ur en
,
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes C5�No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[-]Yes [XNo ❑ NA ❑ NE
❑ Yes [�(No ❑ NA ❑ NE
Page I of 3 214,12014 Continued

Facility Number: Vto Date of Inspection: -v--p E' 7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [A No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure 1 Structure 2
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ NA ❑ NE
❑NA ❑NE
Structure 3 Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
❑ Yes �ZNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? - ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes - No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:)Yes [A No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [—]Yes DNo ❑ NA ❑ NE
❑ Excessive Pending ❑ 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?
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
Q!(No
❑ NA
❑ I E
❑ Yes
UX No
❑ NA
❑ NE
❑ Yes
b�`No
❑ NA
❑ NE
❑ Yes Pg'�No
❑ Yes A No
❑ Yes [eNo
❑ Yes V� No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. oes record keeping need v' nprovement ❑ Yes 0 No ❑ ❑ NE
yyaste Applic ionu( eekly Freeboar ❑ Waste Analysis Soil Analysis �s Weather Code
Rainfall Stocking Crop Yield 120 Minute Inspections onthly and V Rainfall Inspections fudge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes tNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes VNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: • Date of Inspection: OI
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 TT''' No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 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 M"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?
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 X No ❑ NA ❑ NE
[—]Yes XNo ❑ NA ❑ NE
,
❑ Yes YNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Comments (refer to question #I): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional paves as necessary).::
(g ,sal {-es-ts d ue-0 l6
Ca1ib►0.iiav� due aO(S 51txl�e �vrvevr by pad o� a-olq,
1 - nL+on re, - -eSAcOAI%sheA ? /So. !�" tk - q,UIeh.a.Q
5 R-ye re- -dr%fled? cf-A.
3t l? / a-ol�( _
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
3.
b q
(b. s.
N/ t o0o tli-e
3.
75-1
b-s _
-
N/1 O00 t
Ke,l'kssa Roseb roc1L
Phone: -7 7 l - Sag I
Date: -1 1 All 020 l
21412014

Date of Visit: Arrival Time:u--t-1 `� Departure Time: County: / Region: NL15F—O
Farm Name: ��U l S� CI ree.1L t=Q.Y— M Owner Email:
Owner Name:
M i V_ A.
Toh n
s o rr
Phone: W. 7— S$ 7 (p
Mailing Address: Po Q O y�-'
a to .l
S 1�
O O_M l
/3%
I3 C/ a- 7 0 `l
Physical Address:
Facility Contact: 1 It e OY �L V e- r e. 4 Title:
Onsite Representative: MJ r-e—To"66 n
Certified Operator: L V 2Xe, 4' SO V1 h5�
Back-up Operator:
Location of Farm:
Phone:
Integrator: L a'
Certification Number:
Certification Number:
Latitude: 3 c 1 t 3S 1 Longitude: 6 351 1(„
they tool 1 NO,
Grew L 2d
Hvila
R ivF,r
s el
si �ocem
COpeta„
��i ,
&oor .)
Lon (bus
LDew e—
Tray l
Design
Current
Design Current
Desigtt Current
Swine Capacity
Pop.
WefPoultry
Capacity Pop.
Cattle
Capacity Pop.
Wean to Finish
Layer
Da Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
,
Dai Heifer
Farrow to Wean
F-BIX96urrent
D Cow
Farrow to Feeder
I) , $oult .
Ca acity P,o P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
LtherMM
ILurkeyPuults
01 Other I
IOther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
0 No
"``1III"''""""'"'
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[4 No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 21412011 Continued

Facility Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes A No
a. If yes, is waste level into the structural freeboard? [:]Yes YYY/'❑—] No
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2
e5
`�tl
3�
❑ NA ❑ NE
❑ NA ❑ NE
Structure 3 Structure 4 Structure 5 Structure 6
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.)
T`
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
'� Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Ua 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
1% No
❑ NA
❑ NE
maintenance or improvement?
Waste Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes IYI No ❑ NA
maintenance or improvement? "`fff"""���
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA
❑ 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?
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
❑ Yes
11
[—]Yes CR o
❑ Yes Wo
❑ Yes �No
❑ Yes No
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑WUP ❑Checklists ❑Design Maps
❑ Lease Agreements
❑Other:
21 Does record keeping need improvement? If----- - p-iaterbvx-betow-
❑ Yes
No ❑ NA ❑ NE
aste Applic tion UC Weekly Freeboard Waste Analysis Soil Analysis
�tocking
Brwla& T^^°f rc Weather Code
u �infall g Crop Yield D§ 120 Minute Inspections
Monthly and 1" Rainfall
Inspections
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑�.N�A ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,c iv
❑ No � A ❑ NE
y
Page 2 of 3
21412011 Continued

Facility Number: Date of Inspection: I
'qW
24. Did the facility fail to calibrate waste a cation 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
,,,No
❑ 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
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[—]Yes MrNo ❑ NA ❑ NE
❑ Yes 0j'No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes DdNo ❑ NA ❑ NE
❑ Yes [)(No
❑ Yes 0 No
❑ Yes D�r`No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Uornments (reter to question 4): Explain any YES answers and/or any additional recommendations or any Other COmment5..� T
Use drawings of facility to better explain situations (use additional pages as necessary). x
abl L6r 0-013 661( +s?c6l� 012
`I "(AI i b r- " on d je ® @moo b ex- R61
aS Sludge Survej due. Dece"ejr R61q.
d.d /XXt- c LAP P �1
111a�J1 _ �. 7 ((��91 a�I 13 1.
Reviewer/Inspector Name: �,(? fo5o. RZ6'01 rOCAL-
Reviewer/Inspector Signature:
Page 3 of 3
-6/Y/13= 3.a,
Phone:
Date: I a
21412011

for Visit: (25 Routine 0 Complaint 0 Follow-up 0 Referral
0 Other 0 Denied Access
Date of Visit: b -z Arrival Time: : 30 Departure Time: ' 30 County: S trr
Farm Name: 6tAAL 6we4 F—IrM Owner Email:
Owner Name: /•`rr,2 A, ,eillnf0rt Phone: (♦♦)�737`�-5_0%6
Mailing Address: F. Q ll oX 2-(0 S I GCi wt �i G Z/
Physical Address: LUn y ,D Lt 5 ttz / r' ,'
Facility Contact: M, R,c C r five I e Title:
M
Onsite Representative: 't 4E ✓err_ TJ a `i nj o n
Certified Operator: 15✓eie4 T �hSo�1
Back-up Operator:
Location of Farm:
Phone:
Integrator: L 4 f7
Certification Number:
Certification Number:
Region: W S O
Latitude: 36 / 7 3 S Longitude: '7O o 35-
�w7 (Col fj./ got 2(,f 15
R Cape_lrtid
54AOZI
ki,/ L bot,�Le CT
Design Current
Design
Current
Design C•uerent
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
IDai
Cow
Wean to Feeder
jiA
I INon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
&H I
esign
Dry Cow
Farrow to Feeder
Dm P,oult ,
Ca aci_
P,o P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
01 Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 P(I No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 21412011 Continued

Facili Number: JV. - • Date of inspection: O Z
Waste Collection & Treatment MW
�,_,(
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes *o ❑ 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: Iv=pl
Spillway?: �LI
Designed Freeboard (in): / Z
Observed Freeboard (in): LO ///
5. Are there any immediate threats to theintegrityof any of the structures observed? ❑ Yes gNo ❑ 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 p� I No ❑ NA ❑ NE
X waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes J�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?......���''���""'''""'''""```CCtCCt
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? ���"iiG"'
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes X 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): fie-r"_vG
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.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes XNo
❑ Yes XNo
❑ Yes 9No
❑ Yes A No
❑ Yes t—KrNo
❑ Yes No
❑ Yes 1No
❑Other:
❑NA
❑NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a min gauge? ❑ Yes 91No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ❑ No XNA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: 30 • Date of inspection: Z �,./
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑palYes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes JN(No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 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 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 lam( No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
J�
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes ANo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes o
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yeso
fNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comment§.
Use drawin¢s of facility to better explain situations (use additional pages as necessary).
flint%ys,s F 3 ZcMes :,AU rer ifwL�, "-,.p AJ&A,
2�%, Ctl,6.e��b� dw� O�Fdsc� 2a/2,tJrx�- Zoltf ,
il�i%i= 2•0 (bN
-71z3112, 2,z Ibn!
Z. = 3, s /6 At
Reviewer/Inspector Name: Fe jrick /vI%- l-w—II Phone: e317) 77/ SZV>
Reviewer/Inspector Signature: ��y�f" Date:
Page 3 of 3 21412011

Division of Water Quality -
Facility Ntitnber 3 Q Division of Soil and Water Conservation
Q Ottier Agency
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
0 Routine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: 171 �I tC 1 I I IArrival Time: Departure Time: (l D O County: 5 U r r 1 _ Region: LA'G Zd
Farm Name: `f (,� .'AAUt Q Q1 l k i Cree K— FGi r Owner Email: '
Owner Name: A _I 0 Ig --n n Phone:
Mailing Address: P O 8 Q 114
Physical Address: LO hQ 1) 7S It L0.h P t-
Facility Contact: 1 61�, 0 Ir 7P R� � Title: Phone No:
Onsite Representative: Wk\4-e— `I- T0k116 Yi Integrator:
Certified Operator.y'e�e' T6 h h 50 r, Operator Certification Number.
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = ' = Longitude: = o = ,
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 Lyl No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE %
❑ Yes WNo ❑ NA ❑ NE
Page I of 12128104 Continued

Facility Number: — • Date of Inspection 3 r Ij •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P(No ❑ 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. LA60V1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? El NA El NE
❑ Yes No
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No [INA ElNE
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 WNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes A 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 g No ❑ NA ❑ NE
maintenance or improvement?
Waste Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes D No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes On ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [:]Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) I
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes fiTNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ YesZ(No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes O No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes 0 No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes VNo ❑ NA ❑ NE
'Comments (refer to question #): Explain any YES answers and/or any recommendattons:or any otheycommen4
Use'drawings of facility io.bettec explain situations.j(use additional pages as necessary).-
­Reviewer/inspector Name I t O r F
Phone: %1 1—
Reviewer/Inspector Signature:
_
Date:44
Page 2 of 3 12128104 Continued

•j Facility Number. g — DAInspection � •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Dos record keeping need imprDvement? dyed-eb ❑ Yes No ❑ NA ❑ NE
Wa to A'plicati n L—tf"W/e ly Freeboard Waste Analysis S,o�il Analysis Waste Transfers
ainfall Stocking Crop Yield 120 Minute Inspections LET Monthly and 1" Rain Inspections 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
O NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
IqI No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
` (No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
{gyp, No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
19No
❑ NA
❑ NE
Otherlssues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
KNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[XNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
ElNA
El Ni
If yes, contact a regional Air Quality representative immediately
,�,,,r,`
31.
Did the facility fail to notify the regional office of emergency situations as required by
El Yes
�J No
❑ NA
[I NE
General Permit? (ie/ discharge, freeboard problems, over application)
`T�
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
Ad' ` ' a1 Comments'apd/or. Dr'awings:.. i' „, . ^ , ' * ` a .y.
a,S Ib5 NI loon alp$/il Waste�Ah��siS
010
!1-Lo co
Page 3 of 3 I2,28/04

Facility Number
Division of Water Quality,—
Division of Soil and Water Conservation
Other Agency
IType of Visit tP Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 116 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I _7 I �,111 / ()I
Arrival Time:
Departure Time: 1= County:
a9f Ll� Region:
Farm Name: i(` I I b
1
Owner Email:
Owner Name:
TO h 56r)
Phone: 1
`
?J� I ' Sy1l'0
n
Mailing Address:. Y
r\
y
(�
[.J a(D I 1 1 A�
1 (t. fit},
Physical Address:
rQl
oQ N�
Facility Contact:
r— f15 on
Title:
Phone No:
Onsite Representative:
�" Integrator: [*�
Certified Operator: we ynl' As TO Vln.`5on Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: �o ©' �'�� Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
}' ❑ Non -Layer
Dry Poultry
❑ La ers
❑ 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 Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑'Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
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?
a
❑ Yes O(No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Condnued

Facility Number: — J() • Date of Inspection 0 •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 1 oZ i 1 a
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
*No ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[<Io ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
ONo ❑ 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
J
LLI No ❑ NA
❑ NE
maintenance or improvement?
1
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA
ElNE
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.)
[]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) 3mw 1 Q r/.i t Vl .P. Se,I )P ti 17
C�v� 1
1 .Ie
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[Vo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
biryes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
[A No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
YesNo
P Ni{
❑ 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):
5 Small rat(n hob be p re,-Plan-l-J wp id q{ VYV_5
d%'e- +anew �re;'P-z.2. T5 CoWnj 4 u100.
Reviewer/Inspector Name 1 p( � Phone: i- s as 9
Reviewer/Inspector Signature: Date: O
12/28/04 Continued

Facility Number: — 178[e of Inspection I '7 /.t. I I U •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �(No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. is record keeping need i rovement? ❑ Yes ,"No ❑ NA ❑ NE
as[e�JLEA Weekly Freeboard XWaste Analysis Soil alysis �-,-�taasfccs � tion—
infall pd Stocking Crop Yield -A120 Minute Inspections Monthly and I" Rain Inspections Weather Code
22.
Did the facility fail to install and maintain a min gauge?
❑ Yes
*o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�(No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
JXNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
KNo
❑ 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?
io
❑ NA
[I NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
11Yes
l Yes
A 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
LldNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
�t
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
W 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?
ElYes
,0
p/ No
❑ NA
❑ NE
Additionali Drawings:
• OI
• C • I _ �'
• C2 Qot 0, r
o • •
ed
is- ta
` ` 1
i / coo 6'
1
�i p / I �.
�. (; /�
Awl iv�rrr;'
�1

oaoFwAr�9oc Incident Report
`
ReportNumber. 201001657 (�01l� a.olo PCB �5 Q to
Incident Type: Non -Compliance Reporting
Category: APS- Animal
Incident.Started:_01 /25/2010
County: Surry
City: Siloam
Farm #: 086-0030
Responsible Party:
Owner:
Permit:N AWS860030
Facility: Cundiff Creek Farm
First Name: Mike
Middle Name: A
Last Name: Johnson
Address PO Box 26
City/State/Zip: Siloam NC 27047
Phone:
Material Category: Estimated City: UOM
DD:MM:SS Decimal
Latitude
Longitude:
Location of Incident
Address:
City/State/Zip
Cundiff Crcek Farm
On -Site Contact:
First/Mid/Last Name:
Company Name:
Phone:
Pager/Mobile Phone: /
Reported By:
FirstlMid/Last Name:
Company Name:
Address:
City/State/Zip:
Phone:
Pager/Mobile Phone: I
Chemical Name Reportable City. lbs. Reportable City. kgs.
Position Method:
Position Accuracy:
Position Datum:
Report Created 05/14/10 01:28 PM Page I

Cause/Observation:
Action Taken:
Incident Questions:
Did the Material reach the Surface Water? Unknown
Surface Water Name?
Did the Spill result in a Fish Kill? Unknown
If the Spill was from a storage tank indicate type.
Containment? Unknown
Cleanup Complete? Unknown
Directions:
Comments:
Water Supply Wells within 1500ft : Unknown
Access to Farm Animal Population
Structure Questions
Conveyance:
Estimated Number offish?
(Above Ground or Under Ground)
Groundwater Impacted : Unknown
Spray Availability
Report Created 05/14/10 01:28 PM Page 2

•
C�
Access to Farm
Farm accessible from the main road?
Animal Population
Confined?
Depop?
Feed Available?
Mortality?
Spray Availability
Pumping equipment?
Available Fields?
Structure Questions
Breached?
Inundated?
Overtopped?
Water on outside wall?
Poor dike conditions?
Waste Structure Type Waste Structure Identi inches
Lagoon LAGOON 18.00
Event Type
Incident closed
Requested Additional Information
Report Received
Referred to Regional Office - Primary Contact
Report Entered
Incident Start
Event Date
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA ❑ NE
❑ Yes
[IN,
❑ NA ❑ NE
Plan Due Date Plan Recteved Date Level OK Date
2010-05-11 01:22:03
2010-01-25 08:00:00
Due Date Comment
Report Created 05/14/10 01:28 PM Page 3

Standard Agencies Notified:
Agency Name Phone First Name M.I. Last Name Contact Date
Other Agencies Notified:
Agency Name Phone First Name M.I. Last Name Contact Date
DWQ Information
Report Taken By: Report Entered By: Regional Contact:
Melissa Rosebrock
Phone:
Datelrime: 2010-05-11 01:22:03 PM
Referred Via:
Did DWQ request an additional written report?
If yes, What additional information is needed?
Report Created 05/14/10 01:28 PM Page 4

Y
(Type of Visit 7tCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 4 Routine 0—Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: $ 0 Arrival Time: 43—' ] Departure Time: County: Ui Region: tosk
Farm Name: �o l t V1 // j i p C "_P_ ��Q,r m Owner Email:
Owner Name: D, I`l e— A • Toh t 5(' h Phone: 3 7 7 S� �0
Mailing Address: Po '✓ �X, a 6 . S In C, a 7 0 `( 7
Physical Address:
Facility Contact: y�-
Onsite Representative- , - 1 h oP Cy E vex , l 1
Certified Operator: GyleXe, " i4, Vc,65n%)
Back-up Operator:
Location of Farm:
.. 7C. tt6w,dLrAl- S�a-I[�
Integrator: _
Operator Certification Number:
Back-up Certification Number:
Latitude: [Mo [jj] ' F57ZT, Longitude: ®o ©��
Design Current
Design Current
Design Current
Swipe Capacity Populafion
We[ Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
10 Layer 1
❑ Dairy Cow
❑ Wean to Feeder
JLJ Non -Layer 1
❑ Dairy Calf
Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Non -Dairy
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Laers
El Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ TurkeyPuuets
Number of Structures
❑ Other ❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes 1111110
No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ YesJ No
❑ Yes p/J No
12128104
El NA ❑NE
❑ NA ❑ NE
❑NA ONE
Continued
\

� v •Facility Number: $ — • Date of Inspection 020
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
I a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
(/ Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(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 l%jI No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes [)(No ❑ NA ❑ NE
❑ Yes to No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes � No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes V No ❑ 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 Ldl No ❑ NA ❑ NE
maintenance or improvement? 0
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes gNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) / -
❑ PAN ❑ PAN > 10% or 10 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
ONo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? 1 '
❑ Yes
1e31 No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
15�No
❑ NA
❑ NE
Comments (refen to question #)
u+
; Explain.any YES answers and/or any rec mmendatton for any It comments'"
h
Use drawings of facility to better
explain situations. (use additional pages as necessary)
Reviewer/inspector Name I
_._' Phone:
Reviewer/Inspector Signatur
Date:
12128104 Continued

Facility Number: — d II —ate of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
•
❑ Yes 141 o, ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Doe
record keeping need ' rovemem: re----- ❑ Yes No ❑ NA ❑ NE
WV aste Applica 'on V eekly Freeboard Waste Analysis Soil, alysis /
LVJ Rainfall Stocking Crop Yield 120 Minute Inspections L�dMonthly and I" Rain Inspections (] Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
O-No
❑ NA
❑ NE
❑ Yes
A NA
❑ NE
❑ Yes
,❑No
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ YesW,No
❑ NA
❑ NE
❑ Yes
[1 No
'!
❑ NA
❑ NE
❑ Yes
No
ElNA
❑ NE
❑ Yes
[�t No
❑ NA
❑ NE
❑ Yes
t�2y/No
/Llf-
El NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
1 ,No
❑ NA
❑ NE
• � � � b � (1 1 � I t 1 J �, l i � � � t
two h . ,
)jjq 10 vj ia� -e* e iqq
o
)y
12128104

RDivision of Water Quali
Number 3d 10 Division of Soil and Water-onservation r p rn
-- - - r
- Q.Other Agency
of Visit (,Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ,Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Arrival Time:
r+ri
Date of Visit: j A(iv
P 3� Departure Time:
a' - O County:
<"
Su r r Region: L 1
Farm Name: CU n3I
t i" Cmeg. Hir m
Owner Email:
Owner Name:
IA t Yve
1Y/�•
f0 hn5o r)
Phone: �
H �
� 1 ti — S a
Mailing Address:
Po
& 4
J (ka
m/
N a 70 q 7
Physical Address:
Q
0
h U 1ra I I
I 15I I oa m F
NC —
Facility Contact: I
0riio
n Title:
Phone/ No:
Onsite Representative: •
" t.
lz,,P- I
Fi %e
Integrator:
`_
L - N � orCCnn � LB
Certified Operator:Eklefe-A N . So h n,son Operator Certification Number:
Back-up Operator:
Location of Farm:
J Wean to Finish
] Wean to Feeder
Feeder to Finish
] Farrow to Wean
] Farrow to Feedei
] Farrow to Finish
] Gilts
] Boars
Back-up Certification Number:
Latitude: MO ©, 1�" Longitude: ®° Q ®��
Design Current Design Current
Capacity Population Wet Poultry Capacity Population `'Cault
❑ Layer ❑ Dai
❑ Non -Layer I ❑ Dai
---- ❑ Dai
Dry Poultry ElDry 1-❑ N
❑ 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)
Cow
Calf
Heifer
Cow
on -..a„
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structi
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?
•es..:ELI
❑ Yes XNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
[]No
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
❑ Yes t eNo ❑ NA ❑ NE
Page 1 of 12128104 Continued

Facility Number: — Q • Date of Inspection `
Waste Collection & Treatment
,,��,,..//
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
N
El Yes C� o
``No
❑ NA
El NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑//
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: LQIbon
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes YNo
p
❑ NA
El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
Cl Yes ;<No
[]NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes )� No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Wo ❑ 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 ElNA ❑ NE
maintenance or improvement? 111
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 L�yNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ 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 M No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes )6 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes K No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes NfNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes tNo ❑ NA ❑ NE
Comments (refer to question il): Explain any YES answers and/or any recommendations or any other,comments „
Usedrawings of facility to better explain situations. (use additional pages as necessary):
a
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone:)
Date: 5 Q
Page 2 of L ' r 12128104 Continued

Facility Number: — Wate of Inspection at!Ew 0
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 El Yes LJd NO ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Doe record keeping need un 'rove ment? v.•-� ❑ Yes No ❑ NA ❑ NE
Zante App�lic/rytion Wee y Freeboard Waste Analysis Soil alysis ❑ V'act��srsfery—❑
in all I!d Stocking Crop Yield 120 Minute Inspections Monthly and 1"Rain Inspections CeWeather 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?
Otherlssues
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?
jAdditional Comments and/or Drawings: f/
���►��o� = a ss = a
❑ Yes
�(No
❑ NA
❑ NE
❑ Yes
ONO
<NA
❑ NE
❑ Yes
lyl
N
❑ NA
❑ NE
❑ Yes
❑ Yes
UXN
L No
El NA
❑ NA
❑ NE
❑ NE
❑ Yes roNo ❑ NA ❑ NE
OYes ❑ No
❑ Yes �No
❑ Yes XNo
❑ Yes L�J No
❑ Yes X
❑ Yes :Zo
i
0 ,
❑ NA ❑ NE
DNA ONE
El NA El NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 3 of 3 12128104

Division of Water Quality=
Facility Number ® 3O Division of Soil and Water onservation I
O Other Agency
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
Q Technical Assistance
Reason for Visit
Routine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: 3 �Arrival
�L!l�R�I Time: parture Time: County: / �+ Region: C)
Farm Name: C U n d t r C-1reey- Farm Owner Email:
Owner Name: Y"t 1 kI n Phone:
*Mailing Address: Po UOX Jdoo_m 1 n L a -7o it %
Physical Address: lkok Lbnq U S I I o4.M
Facility Contact: E- Title: Phone No:
Onsite Representative: 11 11 -t-
Certified Operator: l i V �e %f el O h r,. O y)
Back-up Operator:
Location of Farm:
Swine
Other
❑ Other
Latitude: t�1tn1°
Integrator: L`F
Operator Certification Number:
Back-up Certification Number:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
Pal
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)
Longitude: ®° [0, ©
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
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 bi(No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
El No
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes KNo ❑ NA ❑ NE
12128104 Confinued

` Facility Number: — •
Date of Inspection
,it
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: L bon
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
El Yes
�p�J,/�
r%No [I NA El NE
through a waste management or closure plan?
ll
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 stucmres lack adequate markers as required by the permit?
❑ Yes
*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 ElNA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
�,,,(�L
INo ❑ NA ❑ NE
❑ Excessive Pending ❑ 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 Drifi ❑ 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
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
b(,(
El NA
El NE
17. Does the facility lack adequate acreage for land application?
El Yes
,No
l]U No
El NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector NameIYI S
ro
Phone: —
Reviewer/Inspector Signatur
Date:
pp
I
'1 12128104 Condnued

V
Facility Number: — ,3 0 •ate of InspectionU J / •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes VNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes La,No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need imp vement? If yes, c,_heccf the appropriate be elow. ❑ Yes WNo ❑ NA ❑ NE
❑ Wa e Applica Don Week "Freeboard ;:Waste Analysis �il lysis ��-i`�.,ie-iransfers �r
ainfall Stocking Crop Yield 120 Minute Inspections Monthly and l" Rain Inspections Bather 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 o El NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes tNo
M No ElNA ElNE
25. Did the facility fail to conduct a sludge survey as required by the permit?ElYes o [INA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ElYes ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes jNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes NrNo ❑ NA ❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
XNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
/
9 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
NrNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
�/
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
ICI No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
gNo
❑ NA
❑ NE
Ad 'fional Comments and/or Drawings:
3 I
waste SahuPle 1tO� = 3 •S 1b5. N/laoo
3/,;2-3107 = y-O Ib5-N //000AaQ.
U�
12128104

C1
•
Division of Water Quality
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 860030 Facility Status: Active Permit: NCA286030 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Sum Region: Winston-Salem
Dateof Visit: 11/03/2006 Entry Time: 11:25 AM Exit Time: 12:15 PM Incident#:
Farm Name: Cundiff Creek Farts Owner Email:
u. r
Phone: [phone]
Mailing Address: PO Box 29 Siloam NC 27047
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant
Location of Farm:
Integrator:
Latitude:36.17'35" Longitude: 80'35'11 "
Hwy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn right onto fans
road. Operation located 1/2 mile on fans road.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Everett H Johnson
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative Mike Johnson
24 hour contact name Mike Johnson
Operator Certification Number: 19794
Title Phone
Phone: [phone]
Phone: [phone]
Primary Inspector: Mepss Rosekrock Phone:
Inspector Signature: _ o Date: 11 4-3I Ow
Secondary Inspector(s):
Inspection Summary:
Rocords look good.
24. Will need to determine a uniformity co -efficient for next year's calibration.
7/10/06 waste analysis= 3.7 lbs. N/1000 gal.
Page: 1

Permit: NCA286030 Owner - Facility: Mike A Johnson
Facility Number: 8E
Inspection Date: 11/03/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity
Current Population
Swine
O Swine - Feeder to Finish 7,650 6,430
Total Design Capacity: 7,650
Total SSLW: 1,032,750
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
agoon 1 24.00 37.00
Page: 2

n
u
n
L�
Permit: NCA286030 Owner - Facility: Mike A Johnson
Inspection Date: 11/03/2006 Inspection Type: Compliance Inspection
Facility Number: 860030
Reason for Visit: Routine
Discharges &Stream Impacts
Yes
No
NA
NE
1. Is any discharge observed from any part of the operation?
1101111
Discharge originated at:
Structure
❑
Application Field
Cl
Other
❑
a. Was conveyance man-made?
❑
■
Cl
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■
Cl
Cl
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
■
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
❑
■
❑
❑
discharge?
Waste Collection, Storage & Treatment Yes
No
NA
NE
4. Is storage capacity less than adequate?
❑
■
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large trees, severe
❑
■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not property 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 aitematives 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: NCA286030 Owner - Facility: Mike A Johnson
Inspection Date: 11/03/2006 Inspection Type: Compliance Inspection
Facility Number: 860030
Reason for Visit: Routine
Waste Ap Ilcp ation
Yes No
NA
NE
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
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
Fescue
(Hay, Pasture)
Crop Type 2
Small Grain
Cover
Crop Type 3
Millet
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 NCA286030 Owner - Facility: Mike A Johnson Facility Number:
860030
Inspection Date: 11/03/2006 Inspection Type: Compliance Inspection Reason for vtslt: Routine
Records and Documents
Yes No
NA
NE
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑
0
❑
Cl
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?
❑
N
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■
❑
❑
24. Did the fadlity fail to calibrate waste application equipment as required by the permit?
❑
E
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
N
❑
❑
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 noncompliance of the Permit or CAWMP?
❑
0
❑
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those
❑
■
❑
❑
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concem? If yes, contact a regional Air
❑
■
❑
❑
Quality representative immediately.
Page: 5

permit: NCA286030 Owner - Facility: Mike A Johnson
Facility Number: 860030
Inspection Date: 1110312006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other Msues Yes No NA NE
31. Did the facility fail to notify regional DWO 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?
N
❑i•❑❑
Page:6

Division of Water Quality =I
Facility Number Q Division of Soil and Water onservation
-- - E --_ - O Other Agency
Type of Visit
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
�Coompliance
UC Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other El Denied Access
Date of Visit: Arrijv+a(l'fTim/et: WZ Departure Time: County: _ Region!-� 1w
Farm Name: at tl(� ,,//I��;Y t 1 rTp-T'P^��'rtA ('Y�i "`����"`OOwwwnnner Email: I' L
Owner Name: 1� `�?_ A • ��6�n na Y� Phone:
1 CI 3 ,36 - 9 7 `/ J 8 7(o
Mailing Address: l P 60)C 3-9 '51 1 0 AAA N L 2 _7 6 L I
Physical Address: 9 1.oy�# V )ln
Facility Contact: I ��� �Tn h h SO h ��Tllitle:
'/
Onsite Representative: If l I ),q T
Certified Operator: vex- e-4+ Z-A pSL
Back-up Operator:
Location of Farm:
Design
Other
Latitude: P11Ao
Phone No:
Integrator: __ L* 11
Operator Certification Number:
Back-up Certification Number:
Design Current `
Wetlioultry Capacity .Population
Dry Poultry
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?
Longitude: Io
!�'4 CapacityP.opulatioii
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures dI
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes To ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104
Continued

Facility Number: — • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
' Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(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
El Yes ] No
Structure 5
❑NA El NE
[I NA ❑NE
Structure 6
❑ Yes ��p[[Q No [I NA [I NE
El Yes //I�No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ����/// No El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes Lip No ❑ NA El 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 No ❑ NA ❑ 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.)
❑ 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
D(No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
L74No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
A No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
AIo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
1ANo
❑ NA
❑ NE
Comments (refer to question tt): 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 r6 Phone: — 2g
Reviewer/Inspector Signatur Date:
Page 2 of 3 1 '1, 1 1, - - - 12128104 'Continued

Facility Number: — Ste of Inspection •
Reauired Records & Documents yam/
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,L�J N ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ yes / o ElNA ❑ NE
the appropriate box. ❑ WUP ElChecklists ElDesign ElMaps ❑ Other
21. Does cord keeping need im ovement? If yes, check a appropriate bo�SOIIICA
w. ❑ Yes ANo ❑ NA ❑ NE
Wto Applicaf n eekl Freeboard aste Analysis ipsis raasfecc.. I Certification
ain Stocking rop Yield [9 120 Minute Inspections L1d'Monthly and V Rain Inspection������,s,,,,,,������(((( Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes l No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes //❑ No *A ❑ NE
24. Did the facility fail to calibrate waste application equipment as required bbv the permit? ❑ Yes No ❑ NA El NE
25. Did the facility fail to conduct a sludge survey as required by the pernut 01 ❑ Yes �,../No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes No ���❑NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No Il(I NA ❑ NE
Other Issues r `
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes OK
KNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes WSJ No ❑ NA ❑ NE
and report the mortality rates that were higher than normal? ( ,
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes o ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes �(No ❑ NA ❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12,,28/04

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 860030 Facility Status: Active Permit: NCA286030 ❑ Denied Access
Inspection Type: Compliance Inspection
Reason for Visit:
Inactive or Closed Date:
County: Sunv Region: Winston-Salem
Date of Visit: 03/10/2005 Entry riime:09Q5 AM Exit Time: 11:30 AM Incident #:
Farm Name: Cundiff Creek Farm Owner Email:
Owner. Mike A Johnson
Phone: [phone]
Mailing Address: PO Box 29 Siloam NC 27047
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant
Location of Farm:
Integrator: L & H Farms
Latitude: 36'17'35" Longitude: 80'35'11"
Hwy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn right onto
fans road. Operation located 1/2 mile on farm road.
Question Areas:
0 Discharges & Stream Impacts
0 Records and Documents
Certified Operator: Everett H Johnson
Secondary OIC(s):
Waste Collection & Treatment 0 Waste Application
Other Issues
Operator Certification Number. 19794
On -Site Representative(s): Name Title Phone
On -site representative Mike Johnson Phone: [phone]
24 hour contact name Mike Johnson Phone: [phone]
Primary Inspector: M1pis�sa M Rosebroc /,, Phone: [phone]
Inspector Signature-,-
1 ,�d A A'Ail ht � �(c / Date: Ext.383 3110 l oS
ib
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary:
18. 1 checked many of the hydrants and all the sprinklers. Look good.
21. Records are perfect!
25. Sludge survey not due again until 12131/07.
1/13/05 waste analysis=3.0 lbs. N/1000 gal.
Page: 1

Permit: NCA286030 Owner- Facility: Mike A Johnson Facility Number: 860030
Inspection Date: 03110/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current Population
Swine
0 Swine - Feeder to Finish 7,650 4,468
Total Design Capacity: 7,650
Total SSLW: 1,032.750
Waste Structures
Tvoe Identifier Closed Data Start Date Desiened Freeboard Observed Freeboard
lagoon 1 24.00 40.00
Page: 2

•
n
u
Permit: NCA286030 Owner- Facility: Mike A Johnson
Facility Number: 860030
Inspection Date: 03/102005 inspection Type: Compliance Inspection Reason for Visit: Routine
Disrhame5 & Stream lmnncfs Yes No NA NF
1. Is any discharge observed from any part of the operation? ❑ 0 ❑ ❑
Discharge originated at:
Structure
❑
Application Feld
❑
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0 ❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
N ❑
❑
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?
❑
Von
0 ❑
No NA
❑
NF
Waste Collection. Storage & Treatment
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 (Le./ large trees, severe erosion,
❑
E ❑
❑
seepage, etc.)?
6. Are there structures on -site that are not property addressed and/or managed through a waste management or
❑
❑
❑
closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the peril? (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?
Ves
No NA
NE
Wast -Application
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
E ❑
❑
11. Is then: evidence of incorrect application?
❑
0 ❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total P2O5?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Fescue (Hay)
Crop Type 2
Corn (Silage)
Crop Type 3
Millet
Crop Type 4
Crop Type 5
Page: 3

Permit: NCA286030 Owner- Faclllty: Mike A Johnson
Facility Number: 860030
Inspection Date: 03110/2005 Inspection Type: Compliance Inspection
Reason for Visit: Routine
WngtP. Annlination
Crop Type 6
Yes
No NA
NE
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)? ❑
E ❑
❑
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑
0 ❑
❑
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
Yes
N ❑
No NA
❑
N
Rernrds and Dnrnmen}s
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?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑
E ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Tmnsfers?
❑
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 rein gauge?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a minbreaker on irrigation equipment (NPDES only)?
❑
0 ❑
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
0 ❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Page: 4

Permit: NCA286030 Owner - Facility: Mike A Johnson
Facility Number: 860030
Inspection Date: 0311012005 Inspection Type: Compliance Inspection Reason for Vlsit: Routine
Other Issues Vas No NA NF
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? ❑ 0 ❑ ❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those modality ❑ 0 ❑ ❑
rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air Quality
representative immediately.
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewerlinspector fail to discuss review(nspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
An -Imp
Page: 5

IType of Visit 51� pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit (1rX`/Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 4 6 d Arriivvall Time:: ,, n V {Departure Time: ® County: �Urr Region: LOJ
Farm Name: IM,12 nX 1 T i"/� 1 +.irCTx- -- f o-r—D, Owner Email:
Owner Name: 1 f 1pI V, � A p-J O hny5O_Q Phone: �J �J in • ,3 7 V , S 9 7 G�
Mailing Address: 1 O lb0 7 a I l 5 i 100' m t lN) c OL 1 0 43
Physical Address:
Facility Contact:
Onsite Representative: 1 1 I 1
'1
Certified Operator: G VIC
Back-up Operator:
Location of Farm:
') r\— Title: iPh11one No:
�—( Integrator: �''� n Farm 5
' -) O b h ,-:Po Operator Certification Number:
Back-up Certification Number:
Latitude: no al • ©' Longitude: gb o m�r V ••
Design Current
Swine Capacity Population
Design Current
Wet Poultry Capacity Population Cattle
Design Current
Capacity Population
❑ Wean to Finish
` ❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
Feeder to Finish 7
❑ Dairy Heifer
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Dry Poultry ❑ Dry Cow
❑ Non-Dai
❑ La ers
El Stocker
Non -Layers ❑ Beef Feeder
❑ Pullets
❑ Beef Brood Cow
❑ Boars
❑ Turkeys
Othe
❑ Other
10 Turkey Poults
❑ Other
rn
Number of Structures: LIMMI
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 ANo [INA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: — Q • Date of Inspection .3 0 •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ijej No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: '
Spillway?:
Designed Freeboard (in): ^
Observed Freeboard (in): ���q (j
5. Are there any immediate threats "" to the integrity of any of the structures observed? ❑ Yes �No El NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes / `` �No ❑ NA ElNE
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 _'4No ❑ 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 [INE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ` No El ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ! `
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination` ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
QQ No
�
El NA
El NE
l
o
❑ NA
❑ NE
No
❑ NA
❑ NE
4[o
El NA
❑ NE
�
pd No
❑ NA
❑ NE
Reviewer/Inspector Name j lco 10 ro CVPhone:171.LNOM L' ZIV
Reviewer/Inspector Signat*e; a I Q141 4 It& IQ���� Date:

Facility Number -WI)— *f Inspection 2pqKiT•.
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 CA WMP readily available? If yes, check ❑ Yes /bSI`No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Do s record keeping need improvement? If yes, the the appropriate be
❑ Yes �No ❑ NA ❑ NE
Waste Application 12 Weekly Freeboard Waste Analysis L� Soil Analysis D Annual Certification
R1 Rainfall pd Stocking IS/Crop Yield 120 Minute Inspections LI✓ Monthly and l" Rain Inspections 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 NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? El Yes I� No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes .�No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes )?j[[I No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? El Yes &No ❑ NA El NE
Other Issues ((
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP? ❑ Yes -KNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes No ❑ NA ElNE
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 ElNE
If yes, contact a regional Air Quality representative immediately 0
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 �< ❑ NA El NE
33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE
Additional Comments and/or Drawings: -
�5. 4WAA2 - d4q It 0/3 (/07 .
13/05 = 3°0 (1;,. N/J000 y
@ fi"".� d'q /
12,128104

Assistance Site Visit
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 86 - 30 Date: 10/12/04 Time: 9:40 Time On Farm: 90 I WSRO
Farm Name Cundiff Creek Farm County Surry Phone: [phone]
Mailing Address PO Box 29
Siloam NC 27047
Onsite
Representative Mike & Everett Johnson Integrator Premium Standard Farms
Type Of Visit
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ Operating below threshold
IN Swine ❑ Poultry ❑ Cattle ❑ Horse
Design Current
❑ Wean to Feeder
® Feeder to Finish 7650 4029
❑ 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
❑ 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 Lagoon
Level (Inches) 1 32 11
CROP TYPES Fescue -hay j IMillet (overseeded)
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Dairy
❑ Non -Dairy
❑ 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 Lagoon
Level (Inches) 1 32 11
CROP TYPES Fescue -hay j IMillet (overseeded)
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ 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 Lagoon
Level (Inches) 1 32 11
CROP TYPES Fescue -hay j IMillet (overseeded)
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

Facility Number 86 - 30 Date:
10/12/04
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
❑
❑
[110. Level in structural freeboard
Plan
❑
❑
❑ 11. Level in storm storage
26. Waste Conditional Amendment
27. Review or Evaluate Waste Plan w/producer
❑
❑
❑ 12. Waste structure integrity compromised
28. Forms Need (list in comment section)
❑
[113. Waste structure needs maintenance
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
❑
❑
[115. Over application < 10% or < 10 lbs.
30. 21-11.0200 recertification
❑ 16. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
❑ 17. Deficient irrigation records
32. Irrigation record keeping assistance
❑
❑
❑ 18. Late/missing waste analysis
33. Organize/computerization of records
❑
❑
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. 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
[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
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
❑
❑
The facility has calibrated the solid set irrigation
1
47. Evaluate WAD certification/rechecks
❑
❑
. system.
48. Crop evaluation/recommendations
❑
❑
2. The facility has completed the PLAT
49. Drainage workievaluation
❑
❑
requirements with no fields rated high.
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stornwater 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
❑
❑
2 03/10/03

Facility Number 86 30 Date; F 10/12/04
Waste analysis: 8/26/04 ALS 4.5 Ibs.N/1000 gals. I, 6/09/04 ALS 4.1
Soil samples dated 3/23/04 and 9/08/04.
1 provided Mr. Johnson with some application and crop yield forms.
I discussed the NPDES permit requirements with Mr. Johnson.
The facility and records look good overall. Good farm.
TECHNICAL SPECIALIST lRocky Durham rony Davis
SIGNATURE
Date Entered: 10/15/04 Entered By: lRocky Durham
3 03/10/03

Facility Number 86 3� Date of Visit: 4/7/2004 Time: 0945
Not Operational A Below Threshold
® Permitted ® Certified E3 Conditionally Certified E3 Registered Date Last Operated or Above Threshold_ ___ __ __ ____ __
Farm Name: Q.umd(ff.C.r=kTarm............................................................. County: 511rXy ..................................... WSR.Q......
Owner Name: Alike A .___--.---_---._ JQbnsuu--------------------------- Phone No: (33(t137.45871.-.---•-.-------------.-.---
MailingAddress: FO.HpX 2.4............................................................................................... Silitam...NC.............................................................. 77.0.4.7 ..............
Facility Contact: Mike.J9bQstin....................................Title:............................................... Phone No:......................................
OnsiteRepresentative: Mi1m&ndEysxcttJDhDSUA------------------------- Integrator:]
Certified Operator:Excreft.H............................. jollum ............................................ Operator Certification Number: 19.79.4.............................
Location of Farm: _
wy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn
right onto farm road. Operation located 1/2 mile on farm road. �
® Swine []Poultry ❑ Cattle ❑ Horse Latitude 36 • 17 35 Longitude 80 • 35 11 u
Design _ Current
Swine - Cnnseity-Ponulation.
❑ Wean to Feeder
® Feeder to Finish
7650
6080
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 1
Discharpes & Stream Impacts
Design Current- Design Current
-Poultry Capacity Population CattleaiCapa -Po uI tion
❑ Layer OD
ry
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity 7,650
Total SSLW 1 1,032,750
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: ........Lagcum....... ........................... ...... ------------•-------.----__...................................... ...........................
Freeboard (inches): 32
12112103 Continued

Facility Number: 86-30 Date of Inspection 4/7/2004
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/S, severe erosion,
❑ Yes
M No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
M 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
M 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
M No
elevation markings?
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
M No
11.
Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
M No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12.
Crop type Fescue (Hay) Small Grain Overseed
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
M No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
M No
b) Does the facility need a wettable acre determination?
❑ Yes
M No
c) This facility is pended for a wettable acre determination?
❑ Yes
M No
15.
Does the receiving crop need improvement?
❑ Yes
M No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
M 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
M No
19.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
M 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
M No
Air Quality representative immediately.
Comment§ (refer to_question t�:-Explain any YES'answers and/or apy recomniendatiops or any;other comments =
Use drawings of facility to better explain situations (use additional pages as necessary) --'[]—Field Copy M Final Notes -
7. Operator is to apply insecticide to control grubs on the lagoon embankment.
3. 2004 soil test results are back and look ok.
3. Conducted 2/25/04. Next one is due April 2005.
4. Don't forget to document calibration in writing.
5. Records look real good!
25/04 waste analysis = 3.3 lbs. N/1000 gal.
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signature: Date: In

Facility Numof Inspection 4/7/1004 •
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 IN No
❑ Yes ® No
❑ Yes ®No
❑ Yes ®No
❑ Yes ® No
12112103

(Type of Visit V. Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit )i Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: � Time:
0 Not Operational O Below Threshold
0 Permitted 0 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: -------
.........
Farm Name Lu��'...._�'ree l� - �ar- ...-_...._._.._-- _.._. County:
I, c p M t'
Owner Name:...n..tlQ.,_....:........Q_C.T�...�i......_......_./_�...,............. Phone No:.._.�.�....:_... ._1.... J..,07.....!!.l � F�
Mailing Address: ..r�....A1��...i..... ...111.0f.M../...'.v.�............... .2.70%........._...._..._....._
........ ............._.
..........
Facility Contact: _Il.!.!(h.._.1.��2�---------- Title: ... .................................... _._.__._. Phone No:
Onsite Representative: _3-_!!,1 K e c{ E Ve ne Lt So �)11
Operator Certification Number:. ........ ...... ... ............... ....
Location of Farm:
d, Swine []Poultry ❑ Cattle ❑ Horse Latitude ®• ©' ©" Longitude ®• ®' I--L-l- ]l
Dm@n ;Current `- Ilevgn `Cgmnt
5wme Ca as '. Po ulahoa' Poultry`�__Ca'sa <Po-ulation :Cable _
N
an to Feeder ❑ Layer Dairy
er to Finish I ❑Non -Layer ow to Wean
❑ Farrow to Feeder 10 Other
Farrow to Finish
Total DestgnCapatiti
Ej Gilts-
JEI Boars Total SSLW
Discharges & Stream Impacts ��JJ
I. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field El Other / `
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/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 l [' 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? lEl Spillway ❑ Yes N0
r Structure 1 Structure 2 Structure 3 111 ��` Structure 4 Structure 5 Structure
Identifier: ........._ ............%......_..............._................ ............ ............. ....... ................................... ...... ....... ............ ...... ............ _.....................
Freeboard (inches):z _
12112103 Continued

Facility Number: _ Ike of Inspection 1 V / 7 / Cfyt •
Required Records & Documents • "'f ��
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/ WIT, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ aste 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. oes record keeping for NPDES required forms need im�re��the propriate box below
✓ ❑Stocking Form ❑ Crop Yield Form ❑ Rainf ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes i No
❑ Yes No
ElYes P
No
❑ Yes No
❑ Yes o
❑ Yes No
❑ Yes 6
❑ Yes Sro
❑ Yes `` NO
AYes ❑No
❑ Yes JKNo
❑ Yes ) No
❑ Yes No
❑ Yes No
❑ Yes o
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit
1 . 0 � ?Leo
*m/ 04 U_)0 -e 3.3
I lgs N I I �a U
Ce-►� �as� O�qt aQ0.s
,3
..�

Facility Number: — Date of Inspection
•
5.
Are there any immediate threats to theogrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yeslo
seepage, etc.)
/
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
Io
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
XNo
9.
Do any stuctures lack adequate, gauged markets 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 ❑ PAN ❑ Hydraulic Overlloffad ❑ Frozen Ground Copper and/or Zinc
jjP��oo'nding
J❑
12.
Crop type iOs(",UP, n'l IP mver-5 lJ
13.
Do the receiving crops differ with those tgnated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
Nc&o
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
ANo
Odor Issues
17.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
El Yus--f
[.IQ —
liquid level of lagoon or storage pond with no agitation?
18.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
KNo
19.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
roads, building structure, and/or public property)
tXNo
20.
At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
No
Air Quality representative immediately.
Comments (refer to question i#) Explain any i ES answeis and/or any,recomniendatwns or }°y�thcr rnmmenic
Use drawings of facrhty to better explain sttuatiops (use'addt6ona! page as necessary) spry Fteld Copy ❑Final Notes _
I�
° C)k h'5 X_ C&-'�-06k1 oL farrn1 e red l-��
Reviewer/InspectorName '' y,_;z
Reviewer/Inspector Signature. Date:
12112103 Continued

/ - jechnical Assistance Site Visit Rep.
ID ion of Soil and Water Conservatio -
O Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number 86 - 30 Date: 9/11/03 Time: 9:00 Time On Farm: F 130-1 WSRO
Farm Name Cundiff Creek Farm County Surry Phone: [phone]
Mailing Address PO Box 29 Siloam NC 27047
Onsite
Representative Mike and Everett Johnson Integrator L & H Farms
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operat
❑ Operating below
® Swine ❑ Poultry ❑ Cattle ❑ Horse
Design Current
Capacity Population
❑ Wean to Feeder
10 Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
7650
6415
Purpose Of Visit
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Po ulation
❑ Layer
❑ Non Layer
❑ Dairy
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes N no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes S no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes N no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes N no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes S no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes S no
Structural Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level(Inches)l 25
CROP TYPES Fescue -hay Millet (overseeded)
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Dairy
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes N no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes S no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes N no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes N no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes S no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes S no
Structural Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level(Inches)l 25
CROP TYPES Fescue -hay Millet (overseeded)
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes N no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes S no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes N no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes N no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes S no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes S no
Structural Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level(Inches)l 25
CROP TYPES Fescue -hay Millet (overseeded)
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

Facility Number 86 - 30 Date:
9/11/03
PARAMETER
O 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
Conditional
❑
❑
❑ 11.
Level in storm storage
26. Waste Plan Amendment
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.
El
El15.
Over application < 10% or < 10 lbs.
30.2Hre-certification reertification
❑ 16.
Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
❑ 17.
Deficient irrigation records
32. Irrigation record keeping assistance
❑
❑
[118.
Late/missing waste analysis
33. Organize/computerization of records
❑
❑
❑ 19.
Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
[120. Late/missing soils analysis
❑ 21.
Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22.
Crop inconsistent with waste plan
36. Sludge removal/closure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
❑ 24.
Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker checklcalibration
❑
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
design/installation
ElElElOther...
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 evaluationlrecommendations
❑
❑
2.
49. Drainage work/evaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
$
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
5.
66. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

C�
Facility Number 86 - 30 Datc; F 9/11/03
Waste analysis: 7-29-03 ALS 5.3 Ibs.N/1000 gals. 1
4-03-03 ALS 4.0 " "
Soil analysis dated 4-17-03 has two samples calling for more than one ton of lime.
Provided Mr. Johnson with some freeboard forms.
Facility and records look good.
Discussed some of the requirements of the new NPDES permit and went over some of
e new forms and record keeping requirements with Mr. Johnson. Provided Mr. Johnson
ith some DWQ forms that were created by different integrators and approved by the
TECHNICAL SPECIALIST lRocky Durham I rony Davis lCameron Pardue
SIGNATURE
Date Entered: 9/17/03 Entered By: lRocky Durham
3 03/10/03

vision of Water Quality •
ision of Soil and Water Conservation
O Other Agency
(Type of Visit O• 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 86 30 Date of Visit: Ol/15/2003 'Time: 0945
O Not Operational O Below Threshold
® Permitted ® Certified Q Conditionally Certified Q Registered Date Last Operated or Above Threshold: ... ..................
Farm Name: C.madilf -Cre.ek.Farm.................................................................................. County: S.urry ................................................. W..SRQ........
Owner Name: rWke.A.................................. dRhntsRn...................................................... Phone No: (3.3.61.31475.816.Alikc ...........................................
MailingAddress: P.Q.13.9%29................................................................................................ 5119.am..N.0 ............................................................. 2.7.0.4.7 ..............
Facility Contact: lY.iilic1ol law................................................Title:................................................................ Phone No: fax..33.6„3714893................
Onsite Representative: klike..anti.E.V.e[E.t1.d.Rb uS.Rn.................................................. Integrator: L.s&.U.Eajrjw.........................................................
Certified Operator:Exerett.M............................3.O.I=.Q.a........................................... Operator Certification Number:19.79.4 .............................
Location of Farm:
wy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn �'
right onto farm road. Operation located 1/2 mile on farm road.
®Swine []Poultry []Cattle []Horse Latitude 36 OF 17 35 Longitude F 80 • 35 11
Swine
7650 6504
Design Current Design Current
Capacity Population Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑
Wean to Feeder
®
Feeder to Finish
❑
Number of Lagoons
Holding Ponds / Solid Traps
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity 7,650
Total SSLW 1,032,750
Field Area
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge origniated at: ❑ Lagoon [ISpray 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: ..........Lagoon.........................................................................................................................................................................................
Freeboard (inches): 24
05103101 W 7 73 Continued

Facility Number: 86-30 • Date of Inspection O1/15/2003 ., .
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees�vere erosion, ❑ Yes M 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
S.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
M No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
M No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
M No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
M No
12.
Crop type Fescue/millet/rye (Hay)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
®No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
M No
b) Does the facility need a wettable acre determination?
❑ Yes
M No
c) This facility is pended for a wettable acre determination?
❑ Yes
M No
15.
Does the receiving crop need improvement?
❑ Yes
M No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
M No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
M 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
M No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
M No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
M No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
M No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
M No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
M No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
M No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
M No
IN 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 M Final Notes
6. Facility is in process of obtaining a closure plan for an onsite inactive waste storage pond.
19. Recordkeeping and farm looks great!
27. facility to install incinerator onsite to dispose of mortality. Just need to add to mortality checklist once installed.
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: 86-30 D — I Inspection O1/15/2003
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Not applicable.
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
J
O5103101

IType of Visit PQ Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit jK Routine 0 Complaint Q Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number (late of Visit: Time: =K1
Not Operational OBelowThreshold
OPermitted ❑ Certified 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold:
Farm Name: �L-�nd i i'i' (Lee K- FQ r M County: Surry' L �,t
Owner Name: m((��EQi T4�:COn Phone No: 33(a• 377•527L Ir dje'
Mailing Address: n,Y �1' -C]�%� '21 . _ ) i lod m i NL j
Facility Contact: h I I ILA jb h n.5o' n Title: PhoneNo: Fax 3336. 3 %4/• 4",
,
Onsite Representative: 4yV6t-S
e �Integrator: LA H Farft
Certified Operator: E V er P A H • _TO k nu r) Operator Certification Number: 1, 9�_
Location of Farm:
XSwine ❑ Poultry ❑ Cattle ❑Horse Latitude ®• L.1/J. ®- Longitude ®• �$ ®-
_ -Design:;. .'Current, -
swine
❑ Wean to Feeder
Feeder to Finish
�j _
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Facts
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? h(J Spillway
Structure I Structure 2 Structure 3 /` Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes p(1 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑.�( No
❑ Yes
liyNo
❑ Yes
No
❑ Yes
XNo
Structure 6
Continued

Facility Number: — • Date of Inspections •
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes L�No
seepage, etc.) /
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes 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 Pon ing ❑ P ❑ Hydraulic Overload El Yes No
12. Crop type
13. Do the receiving c ps differ with those designated in the C rtified mal Waste agement Plan (CAWMP)? ❑Yes [No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes
b) Does the facility need a wettable acre determination? ❑ Yesc) This facility is pended for a wettable acre determination? ElYes15. Does the receiving crop need improvement? ElYes16. Is there a lack of adequate waste application equipment? ElYes
Required Records & Documents ,,��,,,//
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes *0
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? ///
(ie/ WUP, checklists, design, maps, etc.) V/ V/ �-- ❑ Yes o
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil ample reports) ❑ Yes XNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes XNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ANo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes XNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes j�����,,,,,,,[[,(((No
24. Does facility require a follow-up visit by same agency? El Yes qd rvo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? El Yes �JjNo
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Comments (refer to question #) Eaplmn any YES answers and/or anv=i=ecommendahons or any other�eo`' mmentsi4Y
Use drawings of facility to better, explain situations (use additional ppik' as ne"`teessiiry) �' w
., �., �— Field COPY El Final Notes
,.
(Q• W liYv/NCZiI�/—_ " _ t� C��C'r lttti`C
Reviewer/Inspector Name L ." '
Reviewer/Inspector Signature: Date:
05103101
. L
Continued

Facility Number: q1te of Inspection
Oda- Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below - n—� wes— ,
liquid level of lagoon or storage pond with no agitation?
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 Z 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?
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 permanentitemporary cover? ❑ Yes [XNo
t
_ o
O5103101

Facility Number 86 30 Date of Visit: 6J27/2002 Time: 9:40
Not Operational C Below Threshold
M Permitted ■ Certified 0 Conditionally Certified E3Registered Date Last Operated or Above Threshold: .........................
Farm Name: CUt1dtH.Qtcek..i'4x=.................................................................................. County: S.urjry .................................................. WSHQ........
Owner Name: 5like.A................................... dohomll...................................................... Phone No:(,3341.3.7.4.-5.&74........................................................
MailingAddress: P.Q.B.o.X29.............................................................................................. SilA0U1..B.C............................................................. 2,.7.QA7...............
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Onsite Representative: Aike...Iohmon............................................................................ Integrator: LA.H.Farms.........................................................
Certified Operator:EY.eltetl.H.............................. 7A41111 01,........................................... Operator Certification Number: 19.79.4 .............................
Location of Farm:
3wy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn
fight onto farm road. Operation located 1/2 mite on farm road.
N Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ®• 17 35 k Longitude 80 • 35 11 u
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Capacity Population
Wean to Feeder
❑ Layer
Dairy
Feeder to Finish
7650
10 Non -Layer
1
10 Non -Dairy
Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
7,650
Gilts
Total SSLW
1,032,750
Boars
Number of Lagoons I I I IU Subsurface Drah
Holding Ponds / Solid Traps = ❑uidW
DischarM & 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)
I
[]Yes N No
[]Yes ❑ No
[]Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes N No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes N No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? N Spillway ❑ Yes N No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...................................
Freeboard (inches): 35
05103101
Continued

Facility Number, 86-30 is Date of Inspection 6/27/2002
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 maintenancelimprovement?
❑ Yes
® No
9.
Do any strictures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12.
Crop type Fescue (Hay,Graze) Pearl Millet (overseeded)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application? -
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
®No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQof emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments refer to uestion # : Explain any answers and/or any ommendations or any other comments
Use drawings of facility to better explain situations. use additional pages as necessary ❑ Field Copy ❑Final Notes
Facility and records are in compliance.
Reviewer/Inspector Name lRocky Durham
Reviewer/Inspector Signature: Date:
O5103101 Continued

Facility Number: 86-30 0te of Inspection 6/27/2002 40
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: 6-25-02 ALS 6.0 Ibs.N/1000 gals. I
4-10-02 ALS 4.2 " "
05103101

Facility Number 86 30 Date of Visit: 1 1/17/2002 Time: 0940
0 Not Operational Q Below Threshold
M Permitted ■ Certified ❑ Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Quadiff.Qceek.Eum.................................................................................. County: S.urjry .................................................. W..S.RQ........
OwnerName: MCA ........... :....................... John"a...................................................... Phone No: Q.3.61.3.7.4-5.876 .......................................................
MailingAddress: PQ.D.9%29.............................................................................................. SM.Q.0M.AC .............................................................. 2.7.0.47...............
Facility Contact: Mike.JAIM01t..........:.....................................Title:................................................................ Phone No: F.U.3,36..3.7.4 4843..............
Onsite Representative: Mike..8Ud.E.vert:tl.Job:tISQM.................................................. Integrator: LA.HX.'3rXM .........................................................
Certified Operator: EyeFett.Il .............................. JA.hilmn............................................ Operator Certification Number: 14.794.............................
Location of Farm:
3wy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn A
fight onto farm road. Operation located 1/2 mile on farm road
IN Swine [I Poultry [I Cattle ❑ Horse Latitude 36 • 17 ' 35 " Longitude 80 • 35 11
tY4�YAY•..
Destgn
?i2rre3C5'iII `�., tt .� +z ,x R'M1:W;.i C.}As;3"M
Correa[ ' � � ,De"sign - Garrent � Destgn � Current
Swme
Ca aci .
P,o ulation Poultry Ca aci P,o ulation [Sapaci P,o Mahon
❑ Wean to Feeder
❑Layer
❑Dairy
x
® Feeder to Finish
7650
7320
❑Non -Layer
❑Non -Dairy
_
❑ Farrow to Wean
❑Other ;
❑ Farrow to Feeder
t s :� z Total Design Capacity 7,650
❑ Farrow to Finish
❑ Guts"
❑ Boars
� r
'
,.. Number,of L f ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
Holding 0 ❑ No Liquid Waste Management System
M
Discharges 8& Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes M 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:..........Lagoan.......... ................................... .................................... ....................
Freeboard (inches): 31 -
05103/01 Continued

Facility Number: 86-30 • Date of Inspection 1/17/2002 •
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 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 Fescue (Hay) Rye (hay) Millet (hay)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
®No
c) This facility is pended for a wettable acre determination?
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
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Comments refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of acility to better explain si atioM use additional pages as necessary : ❑ Field Copy ® Final Notes
Facility looks great. Newly re -seeded fields and lagoon dam now have vegetation established.
Suggest obtaining calibration documentation from Johnson and Co. for yearly calibration check. May want to keep records in ink, also.
26. Not applicable.
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signature?-� Date:
05103101 t Continued

Facility Number: *of Inspection I/17/2002 •
Odor Issues -
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
J
05103101

Facility Number Date of Visit: i ZTime: KEM=
10 Not O erational 0 Below Threshold
,o PermittedCertified(1 O��+Cyy onditionally Certified 0 Registered
Farm Name: CUm,Rlat'y-lroxy)
Owner Name: M 1 �LL �. �1 r 5 on
U (�
Mailing Address: P. • 1J6.x a 9 , S'(I ca m i �-
Facility Contact: " f ���/��/� �b�/I (1s 1 I Title:
+1 Onsite Representative: I r'I �`� � �1°T6Yn'sCn
ri Certified Operator: e4 -IJQ�Vl y1t(�
Location of Farm:
Date Last Operated or Above Threshold:
County: f r14 o
Phone No: 3 ?)� .3
a7 047
Phone No: Eax Y�6 - 31 T ' 4� 13
integrator: L T I1 Farm-5
Operator Certification Number: _
*Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =' 0` =- Longitude =' =` =
Design
Gurrent> Design - Curreui
Design Current
Swine Ca aci
Eo ulation Poultry Ca aci P,o ulation Cattle
Ca aci P.o rulation
❑ can to Feeder
❑ Layer
, ❑ Dairy
Feeder to Finish
_
.,, ❑ Non -La er ;, ,., ❑ Non -Dairy
❑ Other
Farrow to Wean..°
❑ Farrow to Feeder
❑ Farrow to Finish
Total. Zn,!a pacity
Q
❑ Gilts
❑ Boars
Total SSLW
of % S0
Number of Lagoons ❑Subsurface Drains Present ❑ La pop Area
❑ Spray Field Area
Holding Ponds / Solid Traps
®�❑ No Li..id Waste Management S stem
Discharges & Stream Impacts
1. Is any discharge observed from any pan 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
���ttt
❑ Yes o No
'
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: La.Gcon
Freeboard (inches):���
05103101
Continued

•
Facility Number: — 3 Date of Inspection I l� dl
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
No
seepage, etc.)
IN
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
0. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of over applica ' n? ❑ Excessive Pointing ❑ PAN ❑ Hydraulic Overload
❑ Yes
j�i7p)`No
c
12. Crop typeasc. V
13. Do the receiving crops differ with those 9signated in the Certified Animal Caste Manage ent Plan (CA )?
❑ 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
LAI No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
_)�No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
*No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
.N 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
J<No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
ElYes
No
!!!O
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
ElYes
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 violations or deficiencies were noted durine this visit. You will receive no further correspondence about this visit
I
Reviewer/Inspector Name
Reviewer/Inspector Signature:
05103101
Field Copy W Final Notes
Date: 01
Continued

Facility Number: —,3Q Date of Inspection U
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
--E3-YrTr-a'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
1z 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
'hHCt 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/temporaryElry cover?
Yes
,,,__p
pNo
Additional Comments and/orDrawings:
�
O5103101

Type of Visit O Compliance Inspection 0. Operation Review O lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 86 30 Date of Visit: 9202001 Time: 9:30
0 Not Operational 0 Below Threshold
■ Permitted E Certified [:1 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
Farm Name: QuadiH.C=k1am ......................................... :........................................ County: 5.urry .................................................. H'SRO........
Owner Name: lY.tike.A.................................. joklmon ...................................................... Phone No: Q.3.60.7.4-S.S7b........................................................
MailingAddress: PQ.R.9%29.............................................................................................. SjI.Q.RM..N.0 ............................................................. 2.7.0.47...............
FacilityContact: ..............................................................................Title:................................................................ Phone No:...................................................
Onsite Representative: lYlike..attd.E.vetg.11.J.obu nn.................................................. Integrator:LAX1.8= .........................................................
Certified Operator: Eyt rxtt................................... .1ol GSA.u............................................ Operator Certification Number: ].9.7.9.4.............................
Location of Farm:
Hwy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn
right onto farm road. Operation located 1/2 mile on farm road.
®Swine []Poultry []Cattle []Horse Latitude ®• 17 35 Longitude 80 • 35 11
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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..................................................................................................................................................................................................................
Freeboard (inches): . 26 - -
05/03/01 Continued

Facility Number: 86-3o • Date of Inspection 9/20/2001
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees,• re erosion,
❑ Yes
® No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
® No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
® No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste
Application -
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crop type Fescue (Hay) Pearl millet ( overseeded)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement? ❑ Yes ® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/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
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
•omments Wfe ues 'on air an a e an or an ommenda 'o or o e co er .
cawings of facility to tter ex lain atio a additio pages as ❑ Field Copy ®Final Notes
Overall facility looks good and is in compliance.
Reviewer/Inspector Name IRocky Durham
Reviewer/Inspector Signature: Date:
05103101 Conliaued

Facility Number—:—. 86-30 a of Inspection 9/20/2001 .
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
analysis: 3-12-01 ALS 6.0lbs.N/1000 gals. I
7-13-01 ALS 4.6" "
9-13-01 ALS 3.6" "
v
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
[]Yes ® No
❑ Yes ® No
[]Yes ® No
❑ Yes ❑ No
J
05103101

(Type of Visit U compliance inspection U operation Heview U lagoon evaluation I
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 86 30 Date or Vint: 3/20/2001 Time: 0910
Not Operational 0 Below Threshold
N Permitted N Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ...............
Farm Name: Cnndilf7..C.EnUarm.................................................................................. County: Sin-ry................................................... 1Y.SRO.......
OwnerName:l.!'IIkiCA.................................. .IA.tttwn...................................................... Phone No: I3,36).337A:.S87k.......................................................
MailingAddress:P.O.B.M."...........................................................................:................... Sifo,ZltA-NIC............................................................. Z7.0.4.7 ..............
Facility Contact: Mike.191twon.................................................Title:............................................................... Phone No: fax.336...3.7A 459,3................
Onsite Representative: )fver9ll.8Atd.Mike.dohA"Xk................................................. Integrator: LARF,Anwi..........................................................
Certified Operator: Eyer ll.................................. lobv"13............................................ Operator Certification Number:19.79.4 ............................
Location of Farm:
wy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn
fright onto farm road. Operation located 1/2 mile on farm road.
N Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ®• 17 35 °, Longitude 80 35 11
Design
Current
Design Current Deign C'urrrentU
Swine Ca aci
P,o ulatfon
Poultry Ga aci P,o ulation Cattle Ca aci P,o elation
Wean to Feeder
❑Layer
❑Dairy
Feeder to Finish 7650
7335
❑Non -Layer
❑Non -Dairy.
Farrow to Wean
y
Farrow to Feeder
❑Other
T019hDCS1� Capacity 7,650
Farrow to Finish
Gilts
�sv
TotaltSSLW 1,032,750
Boars
Number oilLagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area ,
Holding Ponds / Solid Traps 0� ❑ No Liquid Waste Management Svstem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes N 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 N No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes N No
01/01/0l / Continued
7�

Facility Number: 86-30 • Date of Inspection 3/20/2001 •
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: ..........LijP>09m.................................................................................................................... .
Freeboard(inches): ................ 17 ............... .................................... ................................... .................................... .................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? -
❑ Yes
® No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
®No
11.
Is there evidence of over application? []Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
®No
12.
Crop type Fescue (Hay) Pearl millet overseed
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
Required 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
19 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 19 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
01/01/01 Continued

Facility'Number: 86-30 to of Inspection 3/20/2001
30. Is there any evidence of wind drift d1•
g land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
printed on: 3/23/2001
❑ Yes ® No
❑ Yes IN 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.
Commen refer to qv o E lain an. F5 ans ers a or an mmendatio o any other rnmments
dra gs of fac ' be r explain i tions. a ditional ages as necessary ❑Field Copy ®Final Notes
. Try again to establish vegetation on interior of lagoon. Exterior looks great.
. May want to add "spillway" to marker.
15. A few places are sparse, should fill in this spring.
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signature. Date: a a
u
01/01/01

9AM
�r m
F Divlsron of Water tZoa>ity y
E
Division of SoB and watei Co,tservattonI
t
Ofher Agency>
o4a #
4
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
Facility Number Date of Visit: Time:
Q Not Operational Q Below Threshold
P Permitted // Certified r0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name- ..L.uriaiff...... ..e.AY ......Fa .. County: ....... .J�...Qr......
.........................................._......
Owner Name:.J.!!. J... C-.e...1._y...:...y��l..}A�Yvtl%G1n�m............................................... Phone No:..aJ.. �Y'..r...._ S..T..!..6.....�./t7�7
Facility Contact: �..JJ. _,I..SiL.!_!_!id.!'.vi �aX 33(0, 3?�• 7Q.t3
Q......Q........ Q ..............Title:................................e............................... Phone No:............-..7.....................................
MailingAddress:...J....'..��_...5/.%......._!............................................................ _`�..�.%. �.:..1......�...N................fr.�..7...7.......:.....
// � c
Onsite Representative: , ✓,� °V-- F/�, ()1�,�on Integrator:.... Fa r&ir i
Certified Operator:...\K Qr�f_.._,�..__g7 h.nSor).......................... Operator Certification Number:...,;�,,,�,�,�.�,
Location of Farm:
y 26B -h 5i(oairt K4•) 5otslh,69 Kier Kit. Ta.Y Kivet-P-d-3 rni
Swine ❑ Poultry ❑ Cattle ❑ Horse La
Design - Current
Swine r.,...,.::w. u.....a..r.....
�nnlation Cattle
❑ Wean to Feeder ❑ Layer " ❑ Dairy
s,
_ Feeder to Finish ❑ Non -Layer I Non -Dairy
.` Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity 7.65 ,
❑ Gilts
❑ Boars Total SSLW h 03 �2 SQ
- Number of Lagoons :. ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area `:
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System -
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
��//
j�No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
j(No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
)i o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? 1A Spillway
❑ Yes
kNo
Structure I Structure Structure 3 Structure 4 Structure 5
Structure 6
Identifier: loy, oo ....................................
Freeboard (inches): (�
.
5/00
Continued
on back

FaciiitY Number: — Date of Inspection IJ/L(I/per Printed on: 1/9/2001
5.
Are there any immediate threats to Otegrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
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?
KYes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
Aldo
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
XNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
�o
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
*o
12.
Crop type e6e Ue h gu l poar l-1),) ll e j /f i/ r SPPd
13.
Do the receiving crops differ with the -e designatedin the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
VNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
["Io
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
15.
Does the receiving crop need improvement?
❑ Yes
��No
./
� No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
XNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes '-"No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? IN '
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes , WNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ���J ```No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes p}-�vo
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 o
24. Does facility require a follow-up visit by same agency? ❑ Yesro
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 'boo
i Yi9tr;tiorjs;ojr ilgticiencie$ wgre note Ol Kirig this;visit Yoil wiii•iecgipe qti fui4�Qr: •: :
:•:•curies deitce:aboukthisvisit::•:•:•:::::•:•:•:::•:•:•::-:•:•:•::::•:•:•:•::•:•:•:•::•:•:
Comments (refer to question#): Explain any YES answers and/or any recommendations or any otlier com`menffi
Use drawinp of faciti_ty to better explain situations. (use additional
.Pages as n N
ecessary)•
�. TrV 0nee k Ol1►1 q4 P_5k l� rays on in��10ro�' _
I� non. t4tV-io►' 100V_ .
q M 9 to 4o add 11� car
°"� Ski � �-✓�l
►s. �e� I a�ees re s c rs� . Slm(,Id � i 4i S
Reviewer/Inspector Name Q _
Reviewer/lnspector Signature. Date: 3 S/170

Faeilily Number:
Odor Issues X10_1ate of Inspection Printed on: 1/9/2001
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 KNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yesflo
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"KNo
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? ❑ Yes ANo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ,�No
Additional omments and/orDrawings:-
Noso*12,1' Fr Orr, SPil�wou' `ht �p o�ma�C•lt��Id ILVe� .
ne wv P, Df' of eP0S. I-o r QelolS
5100

c ' ' ion of Water Quality
' ion of Soil and Water Conservation
0 Other Agency
(Type of Visit O Compliance Inspection * 0. Operation Review 0 Lagoon Evaluation I
Reason Tor Visit *Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 86 30 Date of Visit: 9/28/2000 Time 9:40 Printed on: 2/22/2001
0 Not Operational 0 Below Threshold
0 Permitted E Certified 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: ......................
Farm Name: C.uttd1&Cmk.Farm.................................................................................. County: Sur y.................................................. W,SICQ........
Owner Name: Mke.A.................................. daftvM11...................................................... Phone No: UM1.3.7.4r5.8.7.6 .......................................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
MailingAddress: PQ.0oX.29.............................................................................................. Si1.oam1..1N.C............................................................. 2.7.9.47...............
Onsite Representative: JYlitle..attsl.Everett.1.alxvSalu.................................................. Integrator: ls&li.FAnm............................................................
Certified Operator:EXeCett.kt,. ............................ J.Q.Iww
................................ Operator Certification Number:.j9794.............................
Location of Farm:
wy 268 to Siloam Rd. South; Siloam Rd South to River Road. Take River road approx. 3 miles to Cundiff House. Turn
right onto farm road. Operation located 1/2 mile on farm road.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ®• 17 35 Longitude ®• 35 11 11
Design Current
to f
rto
V to
V to
V to
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattie Capacity Population
❑ Layer I i 10 Dairy
❑ Non -Layer 1 10 Non -Dairy
❑ Other
Total Design Capacity 7,650
Total SSLW 1,032,750
❑ 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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................................... :.................................... ................................... .................................... ..................... ............... ....................................
Freeboard (inches): 17
5100 Continued on back

Facility Number, 86-30 Date of Inspection 9/28/2000 � �
� 0 � Printed on: 2/22/2001
5. Are there any immediate threats to the�flfeerity of any of the structures observed? (ie/ t 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?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Fescue (Hay) pearl millet overseeded
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Reouired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ "P, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0' Ntj yiolatitjds or de' iciencies were noted :dui•ingthis visit::Yoit:wiIt iecei've fib ftirther
corresnorideitce. aboitt 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
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
(and records looked good.
ard recordings will show 12" from spillway to top of the max. liquid level marker after today. This was verified from the lagoon
data. The district tech. will check the marker with a level to make sure it is set correctly.
analysis: 3/31/00 ALS 6.0lbs N/1000 gals.1, 6/09/00 ALS 5.8 Ibs N/1000 gals. I, 8/31/00 ALS 6.8 lbs. N/1000 gals.
Reviewer/Inspector Name iRocky Durham
Reviewer/Inspector Signature: Date: 5100

Facility Number. 86-30 D*f Inspection 9/28/2000 • Printed on: 2/22/2001
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
5100

Facility Number 86 30
Dale of Visil 4/10l2000 Printed on: 4/17/2000
Q Not Operational Q Below Threshold
S Permitted N Certified E3 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Guadik[.Cxm. k.Form.................................................................................. County: S.urjry .................................................. WISHQ........
OwnerName: lY.til e.e1.................................. dQlttxsaxt...................................................... Phone No: 0.361.314.-.5.87.6 .......................................................
Facility Contact: 1411 clohna m................................................ Title:................................................................ Phone No: &.f8x1 R..4 4B.93..........
MailingAddress: P..9.7j.29.............................................................................................. S110tam..N.0 ............................................................. 2.7.QA7...............
Onsite Representative: 1�'l11{P..aud.$Y.RICRIL..1.RiAlISAIA.................................................. Integrator: L&H.Earms ............................................................
Certified Operator: Ey.py.Rtt.H.............................. JQ.IW 0.0..............._........................... Operator Certification Number:1,9.7.9')..
...........................
Location of Farm:
®Swine ❑ Poultry []Cattle ❑ Hor.Latitude ®• 17 35 Longitude 80 • 35 11
J; Desrgo
Swine Ca aci
❑ Wean to Feeder
® Feeder to Finish 7650
Current
Po u1aGon
6540
Destgn - Current L,, t{.
Poultry Ca Tacit P,o rulation Caere
❑Layer ❑Dairy
❑Non -Layer ❑Non -Dairy
Destgn Current;;)
C��a as i P,o ulahon
❑ Farrow to Wean
-.' ❑Other
":
❑ Farrow to Feeder
Total Design Capacity
Total SS LW
7,650?
❑ Farrow to Finish
. ❑ Gilts
❑ Boars
1,032,750
Number of Lagoons
Holding Ponds /Solid Traps
0=0 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area ,
❑ No Liquid Waste Management System
Discharges R Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................................................................................................................................................
Freeboard (inches): 14
Continued on back

Facility Number: 86-30 Date of Inspection 1 4/10/2000 Printed on: 4/17/2000
5. Are [here any immediate threats [o [he _ grity of any of the structures observed? (ie/ A , 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?
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?
12. Crop type Fescue
❑ Excessive Pending ❑ PAN
No till millet
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
No violations or deticiencies were noted :during -this: visi . Y' 6* u:wiIi receive no furth'e;
correspondence about this.visit... .
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
4. Owner/operators were under imprmion from SWCD that top was 18 inches -per Tony Davis. Spillway and dam heights do not
1997 letter from Tommy Burchette. Surry county SWCD to re -shoot spillway depth and re -check marker.
Te v15t?d
0
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signature: W111AQ Date.

N6RTH CAROLINA ,
DEPARTMENT OF
ENVIRONMENT AND
NATURAL RESOURCES
WINSTON-SALEM REGIONAL OFFICE
FAX TRANSMITTAL.
Division of Water Quality
585 Waughtown Street
Winston-Salem, N.C. 27107
Phone:[phone]
we
FAX NUMBER:
FROM:
DATE: v uv
Number of pages (including cover page):
COMMENTS:
H Ll `
Fax:[phone]

Division of q&ter Quality
MEMO From:&krw &�ate 0�(�T�7e
To:CIKB .lohn6cn Subject: D 60 6f7
fyi P A� 'Other ❑ Denied Access
"r 4/10/2000 Printed on: 4/17/2000
I Operational 0 Below Threshold
)perated or Above Threshold: ................. .......
�' - 1.y: Suriov................................................ FWSRO ........
a: L3].G).7.7.4-58.7.b........................................................
ter• .............. Phone No: t9 JaX.336.3.7.4.,4H.93..........
�. ..................
2-7.0.4.7 ...........
or: L&HYArras............................................................
r Certification Number:),4Z94.............................
atox...3.miles-to_Cuudiii.Hnuse...T.urn......_ �
...........................................1=
Longitude 80 • 35 11
Design Current
"`''r��'WW ��/ �'"Y� (%t•[l� in Cattle Ca ac tv o ulation
❑ Dairy
❑Non -Dairy
�* � sign Capacity 7,650
'c-6t-C-� Total SSLW :.. 1,032,750 L�C�J
tent ❑ Lagoon Area 10 Spray Field Area
gemen[ System
NCDENR❑Yes ®No
North Carolina Department of Environment and Natural Resources
585 Waughtown Street, Winston-Salem, NC 27107 ❑ Yes ❑ No
Telephone [phone] f es notify Dw 1 / , >' >' Q ❑Yes � No
.... �_... ......-- — -.-.. nin't
d. Does discharge bypass a lagoon system? (It )es. notify DWQ) - ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway
Structure I Structure 2 Structure 3 Structure 4
Identifier: .....................
Frechoard (inches): 14
❑ Yes ® No
Structure 5 Structure 6
Continued on back

rsion of Water Quality
ion of Soil and Water Conservation •
C Other Agency
Type of Visit *Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 86 30 Date of Visit 4/1On000 Printed on: 4/14/2000
rO Not Operational O Below Threshold
■ Permitted E Certified E3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: ........................
Farm Name: Cutdilf:.Cmk.Fgaant.................................................................................. County: S.urn............ ...................................... WX.S11Q........
Owner Name: N&C.t1................................... johosuet...................................................... Phone No:03.61.314.187.6 .......................................................
Facility Contact: 111Ae.J.QIIWatt................................................ Title:................................................................ Phone No: &.[U136.3.7.4,,4893..........
Mailing Address: PQ.B.Q.&29.............................................................................................. SilogM..Nll............................................................. 2.7.Q47...............
Onsite Representative: 1!'x1Act;..glUd.F...v.R[Ett.dQlxus.Rla.................................................. Integrator: ln&W!.at7JUS............................................................
Certified Operator:lAyer.t tt.&............................ J.QhAS.Q.R ........................................... Operator Certification Number: a.9.7.94.............................
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ HorLatitude 36 • 17 35 Longitude 80 • 35 11
Design Current
Swine CanaClty Population
❑ Wean to Feeder
N Feeder to Finish
7650
6540
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Design Current
Poultry
Capacity Po ulation Cattle
Capacity Population
❑ Layer
❑ Dairy
❑ Non -Layer
I
I[] Non -Dairy
❑
Other
Total Design Capacity
7,650
Total SSLW
1,032,750
Number of Lagoons 0 ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ 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? N Spillway N Yes No
Structure I, Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................................................................................................................................................
Freeboard (inches): 14
Continued on back

Facility Number: 86-30 Date of Inspection 4/10/2000 Printed on: 4/14/2000 LL•
5. Are there any immediate threats to the9oty of any of the structures observed? (ie/ trrosevere 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 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 ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes ® No
12. Crop type Fescue (Hay) Orchardgrass No till millet
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 & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
�' No violations:oe deficieneie$ were _noted :during this: 0sit::Y6U'* ll ieceive no fdrthei : :
correspondence: 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
Owner/operators wer under impreesion from SWCD that top was 18 inches -per Tony Davis. Spillway and dam heights do not
I7 letter from Tommy Burchette. Surry county SWCD to re -shoot spillway depth and re -check marker.
Reviewer/Inspector Name jMelissa Rosebrock
Reviewer/Inspector Signature ,(41/7 OJZ4/ _ Date: Q N t DU

' Facility Number: 8f~30 D�f Inspection 4/10/2000 • Printed on: 4/14/2000
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
J

JVKoutme O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
Facility Number Date of Inspection 10V&dp
Time of Inspection 24 hr. (hh:mm)
13 Permitted XCertifled [3 Conditionally Certified ❑ Registered 0 Not O erational Date Last Operated:
Farm Name: ... . FQrMCounty:
nty...:.................. .....�5) .r......_....................._ ........................... .. .......................
Owner Name:...............TDh-.fjjAr) ......................................... Phone No: .33x.T...
r17....................
Facility Contact: r... �!H.YSo........... Title:............................................. P�o{{NO .3-14 3
MailingAddress...........•..-.....en.......�n......................................................... D.1.../O!C1.VG ... a7oY
/
Onsite Representative: 1._�E�'�
.....VO Integrator: ........ ....... .Q.E�.........�. ..........................
.................................. ,,,,,...1Yi
Certified Operator: ... 1�,e'!�- .........,hl',,,,,,,_.._........__,.., Operator Certification Nnmber:,..,,.,f�;...................................... ..... ..... ... ..........
Location of Farm:
Latitude Longitude ®• F3s-1• ©.. u ' _
an
Design ij Currents:" Desigri;
. .., Capacity -Population Poultry Capacity.
❑ Wean to Feeder
Feeder to Finish 6
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Number
Holding Pon,
❑ Layer
i' ❑ Dairy
❑ Non -Layer
I
1 ❑ Non -Dairy
ether
Total Msign.Ca
TOW 11;
.. � - `. ❑Subsurface Drai
ps F-77P71" ❑ No Liquid Waste
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
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? X
Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): ...................,............
❑ Yes m No
❑ Yes 1❑` No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �f No
❑ Yes /LjP/P_o
Yes ❑ No
Stiucture 5
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.) / `
3/23/99 Continued on back

Facility Number: — �3 O of Inspection
6. Are there structures on -site which are no roperly addressed and/or managed through a Oce management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
M
13. Do the receiving crops differ with those desigUted in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
fe/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? fe/ 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?
iVq•yiol'a�iggs:oi• ilQfciencies were itO(je ilitritither
correspondence. about. this visit:
recommendations or -any other comet
Reviewer/Inspector Name
❑ Yes No
❑ Yes No
❑Yes tHNo
❑ Yes o
ElYes lo
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes A) No
❑ Yes XNo
❑ Yes INo
No
ElYesNo
El Yes
❑ Yes JKNO
❑ Yes A No
❑ Yes fNO
o
Yeso
Yes
Reviewer/Inspector Signatu kAMP—TY" h AdA 1~jO./lyYV1v Date:

Facility Number: — l�rf Inspection 0 �B •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage. Pend or lagoon fail to discharge attor below No
liquid level of lagoon or storage pond with no agitation? — m l a-t b
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? 0 M I T aOCO
-der$-No
6F &A� cicafe Of
U h resol 1ieJ a.lppre aJ Sfczf u S
1199 - 6+L3 4 WdR-Kt4 -Free- , d reaAM S.
F-t5cu42- haH 6V4, 5geded w/M;l/e7
Fscue -Jan �¢Prli ate. �C
'� M +.0 oP rv�X . �11c�r-k�'+o $P'i II
0 w h of / i!> Perc-for5 c tie re uric- iM�f 255 on -Ft75� ►'�
� UrC,�.
�JLM

Re: cundiff creek, mike johns n #86-30
Subject: Re: cundiff creek, mike johnson #86-30
Date: Sun, 09 Apr 2000 19:43:41 -0400
From: Sonya Avant <[e-mail]>
To: Melissa Rosebrock <[e-mail]>
Please let him know that his facility is ok now. I did receive his
paperwork. I tried calling him but could never get a hold of anyone.
Melissa Rosebrock wrote:
> doing his inspection monday and going over files now. noticed that
> you sent him a letter in january regarding unresolved conditional
> approval status. what info are you still lacking from him? anything
> i can check on during the inspection??
> thanks....... TGIF.... melissa
> Melissa Rosebrock
> NC DENR Winston-Salem Regional Office
> Division of Water Quality, Water Quality Section
> 585 Waughtown Street
> Winston-Salem, NC 27107
> Voice: [phone] ext 265
> FAX: [phone]
1 of 1 4/10/2000 8:27 AM

le tcontine p Conpmmt p rouow-up of uvvy inspection p ronow-up of vSwL review C vtuer
Facility Number ;late of Inspecnnu
I r Time of Inspection 24 hr. (hh:mm)
M Permitted g Certified p Conditionally Certified p Registered G i of peratmna Date Last Operated:
Farm Name: Mike.A_dnhnsnn.Farm............................................................................. County: Surry WSRO
OwnerName: Mikr-A_................................. dnhnsaa..................................................... Phone No: 9.1A- UnM7.ti..........................................................
Facility Contact:
Title:
Phone No:
i'vlailin2 Address: P.O.Roz.29............................................................................................... Siloam..N1C............................................................. 27.04.7 ..............
Onsile Representative.
nterratur: L&11..Ear.ins............................................................
Certified Operator:EvercIUL ............................ lohnsou ............................................ Operator Certification Number: 19.79.4.............................
Location of Farm:
Latitude ®• ©• ©" Lmfginndc ®0 ©• ©•.
Swine Capacity -Population
-
E3 Wean to Feeder
® ee er to tins
E3 arrow to can
13arrow to ee er
p Farrow to Finis
p Gilts
p Boars
Poultry Capacity Population Cattle Capacity .Population
E3 Layer 13 Dairy
E3 Non -Layer p on- atry
p Other
Total Design Capacity 7,650
Total SSLW 1,032,750
I Number,of Lagoons - 'Jp Subsurface Drains Present Ilp Lagoon Area Ip Spray Nield Area I I
Holding Ponds /'Solid Traps , O No Liquid Waste Management System
Is any discharge observed from any part of the operation? p Yes ® No
Discharse originated at: p Lagoon p Spray Field p Other
a. If discharge is observed. was the conveyance man-made? ❑ Yes ❑ No
h. If discharge is observed did it reach Water of the State? (If yes. notify D WQ) p Yes p No
c. If discharee is observed. what is the estimated tlow in -al/min?
d. Does discharge bypass a lagoon system? (If ves. notify DWQ) p Yes p 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? ® Spillway p Yes ® No
Structure 1 Su ucture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .................1.................
Ficebomd (inches): ............ 2.1eet............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
1 /6/99
p Yes ® No
Continued on back A�

act8-3w,v s t6. re there structureon-site ch. f,•�� Impccriur.
are not properly addressed and/or managed through a waste management or
closure plan? p 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? p Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? p Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
p Yes
® No
Waste
Anolication
10.
Are there any buffers that need maintenance/improvement?
p Yes
a No
11.
Is there evidence of over application? p Excessive Ponding p PAN
p Yes
® No
12.
Crop type...Titnathy.,.Omhard,.&.R.ye.................... F.escue.i(Hay.)................ ...................................................................................................................
Grass
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
p Yes
®No
14.
a) Does the facility lack adequate acreage for land application?
p Yes
®No
b) Does the facility need a wettable acre determination?
p Yes
®No
15.
Does the receiving crop need improvement?
p Yes
®No
16.
Is there a lack of adequate waste application equipment?
p Yes
®No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
®No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
p Yes
®No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
p Yes
®No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
®No
21.
Did the facility fail to have a actively certified operator in charge?
p Yes
®No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
O Yes
®No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
®No
24.
Does facility require a follow-up visit by same agency?
p Yes
®No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? 0 Yes ® No

Division of Soil an ter conservation operation xev_Few. _ -
p Division oGSoil an ter Conservation 'Cothpiiance lns`pectio'
Division nf'Water Quality Compliance4t spechon e
p Otber Agency = Operation Review
le Routine p Complaint p o ow -up of DWQ inspection p o ow -up of DSWC review C Other
Facility Number Date of lospection
Tung of Inspection 24 hr. (hh:mm)
p Registered 0 Certified p Applied for Permit 0 Permitted in Not Operational Date Last Operated:
Farm Name: Mike.A.,JahnsaR.Farm............................................................................. Countv: Sorry WSRO
Owner Nanic: Mike.A_................................. Johnson..................................................... Phone No: 9.10-U.41-5876 ..........................................................
FacilityContact: ...............................................................................Title:............................................................... Phone No:....................................................
MailingAddress: P.O..Rox.24............................................................................................... Siloam..NC ............................................................. 27114.7 ..............
Onsite Representative:
it teg ra to r: L&R.Far.ins............................................................
Certified Operator:Evcreft.H............................. Johnson ............................................ Operator Certification Number: 19.79.4.............................
Location of Farm:
Latitude ®• ©` ©" Longitude
Swine Capacity Population
p Wean to Feeder
® Feeder to Finish
p Farrow to Wean
p Farrow to Feeder
p Farrow to Finish
p Gilts
p Boars
Number of Lagoons / Holding
Poultry Capacity Population Cattle Capacity Population
p Layer Ip Dairy
p Non -Layer 1 p on- airy
p Other
Total Design Capacity 7,650
Total SSLW
General
I. 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. I I'd ischarg e is observed, was the conveyance man-made?
O Yes
p No
b. If discharge is observed. did it reach Surface Water? (If yes, notifv DWQ)
p Yes
p No
c. If discharue is observed, what is the estimated flow in gal/niin?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
p Yes
❑ 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

aci ii um er: 86_30 Date
.is ection
8. Are there lagoons or storage ponds on s�wh ch need to be properly closed? p Yes M No
Structures ( Lagomts.lioldine Ponds. Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? p Yes ® No
Structure I Suvcmte 2 Structure 3 Structure 4 Structure 5 Stnteture 6
Identifier: I
Freeboard((I): ..............6..0................................................ ...............................
.......................................................................................................... .
10. Is seepage observed from any of the structures? I7 Yes ® No
11. Is erosion, or any other threats to the integrity of any of the structures observed? p Yes ® No
12. Do any of the structures need maintenance/improvement?
p Yes
N No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
p Yes
® No
Waste Application -
14. Is there physical evidence of over application?
p Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .... Timoxhy..Qrchard..&.Ayr»....................................................................................................................................................................................
rass
16. Do the receiving crops di er with those designated in the Animal Waste Management Plan (A WMP)?
p Yes
®No
17. Does the facility have a lack of adequate acreage for land application?
p Yes
®No
18. Does the receiving crop need improvement?
E3 Yes
®No
19. Is there a lack of available waste application equipment?
p Yes
®No
20. Does facility require a follow-up visit by same agency?
p Yes
®No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
®No
22. Does record keeping need improvement?
p Yes
®No
For Certified or Permitted Facilities Ouly
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
p Yes
®No
24. Were any additional problems noted which cause noncompliance of the Certified A WMP?
p Yes
®No
25. Were any additional problems noted which cause noncompliance of the Permit?
p Yes
®No
R..ovia tions.or iciencies-were.note unngt is visit:. ou.will-receivena further
.:.:..... s...e.. ....:t...visit:.•.•.•.•.•.•.•.....•.•.•........................
Comments (refer to question #):, Explain anyYES"answers and/or.any,recommendations,or'anyothercomments
Use drawings of facility to better explain situation's. (use additional pages as necessary):
Reviewer/Inspector Name Jenn'yRankin
Reviewer/Inspector Signature: n p MmA ^ �C Date:
ry 1 (— Zc —
q�q _:-

6. Is facility not in compliance with any al&bie setback criteria?
❑ Yes lgNd'.,t ;
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)?
p Yes ® No
S. Are there lagoons or storage ponds on site which need to be properly closed?
p Yes
®No
Structures (Lagoons and/or Holding Ponds)
9. Is structural freeboard less than adequate?
p Yes
® No
Freeboard (ft): Lagoon I Lagoon 2 Lagoon 3
Lagoon 4
5ft
10. Is seepage observed from any of the structures?
p Yes
® No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
p Yes
® No
12. Do any of the structures need maintenance/improvement?
p Yes
® No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
p Yes
® No
Waste Application
14. Is there physical evidence of over application?
p Yes
13 No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ............................. .F.escue................................... Timothy-.Ozchard.&.R.ye.lirass....
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
p Yes
® No
17. Does the facility have a lack of adequate acreage for land application?
p Yes
® No
18. Does the cover crop need improvement?
p Yes
p No
19. Is there a lack of available irrigation equipment?
p Yes
®No
For Certified Facilities Only
-
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
p Yes
®No
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
p Yes
®No
22. Does record keeping need improvement?
p Yes
®No
23. Does facility require a follow-up visit by same agency?
p Yes
®No
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
13 Yes
®No

State of North Carol0a
Department of Environment,
Health and Natural Resources 1 •
Winston-Salem Regional Office _
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary EDE H N R
DIVISION OF WATER QUALITY
May 21, 1997
Mr. Mike Johnson
P.O. Box 29
Siloam, NC 27047
SUBJECT: Animal Feedlot Operations Inspection
Mike A. Johnson Farm
Facility No. 86-30
Surry County
Dear Mr. Johnson:
An Animal Feedlot Operation Inspection was performed on the Mike A. Johnson
Farm by Mike Mickey and Jenny Rankin of this office on May 8, 1997. Greg Goings and
Tony Davis from the Surry County SWCD as well as yourself were present for the
inspection.
The inspection found your waste management system to be well maintained. No
water quality concerns were noted. Enclosed is the inspection sheet which was completed
during the visit.
Please contact the Winston-Salem Regional Office if you should have any questions.
Sincerely,
Jenny Rankin
Environmental Technician
cc: Tony Davis, Surry Co. SWCD
WSRO
585 Woughtown Street. wl FAX [phone]
Winston-Salem, North Carolina 27107-2241 N%q C An Equal Opportunity/Affirmative Action Employer
Voice910-771-4600 ps,79P."M 50% recycled/ 10% post -consumer paper

FacilityNumber
Farm Status: Certified
Date of Inspection
Time of Inspection
24 hr. (hh:mm)
(es:1.25 for 1 hr 15 min)) Spent on Review
or Inspection (includes travel and processing)
Farm Name: MikeA.JuImsanF.arm.................. _............................... _.............. ........... County: Sorry
WSRO
Owner Name: Mike.A................................. Johnson ............................. ...... _................. Phone No: 910n3.7.4=5816 ..........................................................
MailingAddress: I'I1.Bnr.29................... ...._._....... _.................. _............................. Siloam...N.0......... _._............................................... 2.7047 .............
Onsite Representative: MikeJahnson........... ___._...................................... _................. Integrator: L&H.Earms ...........................................................
Certified Operator: Exerect.11............................. Johnson ............................................ Operator Certification Number: 19Z94.............................
Location of Farm:
Latitude ®• ©' ©" Longitude =o ©' ©"
in Not Operationa Date Last Operated: ........................................................................... . ..
Type of Operation and Design Capacity
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
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?
p Yes ® No
p Yes Is No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes ® No
p Yes N No
p Yes N No
5,1 P`i

6.
Is facility not in compliance with any able setback criteria? •
p Yes
H Nd
7.
Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)?
p Yes
® No
8.
Are there lagoons or storage ponds on site which need to be properly closed?
p Yes
® No
Structures (Lagoons and/or Holding Ponds)
9.
Is structural freeboard less than adequate?
p Yes
® No
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
Lagoon 4
5ft
10.
Is seepage observed from any of the structures?
p Yes
® No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
p Yes
® No
12.
Do any of the structures need maintenance/improvement?
p Yes
® No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adquate markers to identify start and stop pumping levels?
p Yes
N No
Waste Application
14.
Is there physical evidence of over application?
p Yes
p No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type .............................. F.e=...................................T.imnthy-.Drchard..&..Lye.f rass....
16.
Do the active crops differ with those designated in the Animal Waste Management Plan?
p Yes
10 No
17.
Does the facility have a lack of adequate acreage for land application?
13 Yes
® No
18.
Does the cover crop need improvement?
p Yes
p No
19.
Is there a lack of available irrigation equipment?
p Yes
®No
For Certified Facilities Only
-
20.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
p Yes
®No
21.
Does the facility fail to comply with the Animal Waste Management Plan in any way?
p Yes
®No
22.
Does record keeping need improvement?
p Yes
N No
23.
Does facility require a follow-up visit by same agency?
p Yes
®No
24. Did Reviewerlinspector fail to discuss review/inspection with owner or operator in charge? p Yes N No

>ti i.-is9s sstsa VROM Tf iERla '�
• able Rovir" i'ait Aetc
Faeiliey No.
ANII4AL nMl p G U AnO TSsih vM iim REt70RD
JDAM N V if _ 199s
s Brc 4 5 . t
F PAt> a c ex 2�i S l e N C 2 704
blDvww- ,TV I �Yl ( ll 13119 - t Yr 1(f rwmt -
on Site tative: m;K< �nitn _�� - 1J. C . ( Coo) tM3 Ofk-f-
plsyeiwAddre0Ac&tloss:_'K,oer S,lonm
Tyr of pptxa+aom awioe ✓ pottlt�' -- Cole
of Aaimsls ce Site
• De°�' wry: DDI Catifit:aaon Numbs ACNEW. --
DEM Number. ACfi 4o • 3y ` y3 8levatioa:__meet
3-ici-15-15 C*C1eYes orNo
r. A... Animal Waste I490on hivc cuS dent f:wung of 1 Foot + 25 you 24 boor etarm eat
(vproe=wiy 1 Foot + 7 inches) �f* or No Amin) Rvcbosrd: ) L Inches
Wg nay awpage obsayed from the Ltgooa(S)? Yes M& Was say cmdon obsa'vod? Ya 0161
Is §equ►te laud enable tan tspa+l'!C�
Or No Is the nova Crop
Yes a No
Qvp(s) bang vn'l M
Does the facility meet SCS minimum setback Crl= a? 300 Fat fr WCU5 4f%-Ar a
I00 Feet � wed?�� No
USGS Blue Idao Swam? Yes ar 6
No
L �ims1 wasm tto 41led within 100thFat of
-' b animal waste land applied a spay ixtigand within 25 Feet of a USGS Map Blue line?
L animal w asu discharged into wafers of the state by waa-made ditch6 flushing gym= a O&W
�dmIIar man-made devices? Yes or o If Yes, Fkase F.apldu.
Does Ste facility maintain wSc4um wasu tmaftneat records (volu»xS of Mann. bmd appliod.
W„y;tr;pwd ots ttpccif c irseage with cova gaup)? Yes or No
- It,...,+ elr,o6 6r,.4 tf,yE nrs no r�rr
5 oem wG wsao
ttmc '
Yes w69>
Use Attarhwents if Nader

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RRTIONS BRANCH ` WQ Fa.x:919-715-6048
Jul 19 '95 14:51 -R.12/15
Site taIvitt�'ivaatdiatc Attanticn
111cair,
s'.'% vLSI �'.i+'lI4N RF,�4Itr.
1995
Owner, M lQ C.1L FarmlterrG�t,N<nAlS 8ot.(�!s FARM
County:
Agent Visiting Sit��Iy�;s . GA;4L
Ol:crecor. M:ka snl{A/S/]A[�_ phone: 371 S$76
Cn Slit Reprm=tadve: PhoIIc:
Mys[cs! Address: _ kzver Qoam_
.��lea..t, 1LC �96Y`J
,Vailin& Addte;_l: P o & r.
`z-lnarc.lye a70Yo
Te P f u
/P o ,;—+4'_oatry Cultic _ -4 1
Design Cs; xity, Number of Animals as Site: O
Latimc, 3(0 _o 1-7 �� Lot�teda 8U o
rye' c P:rsv:;ca: Cr::ured +�_ rtSCfla1
Circle yi-a Cyr NC
CCs ti'',e A:an'2,l Wasiy LIP= �'ave ;UCM cnC f --zI:c r'•'. of 1 : Cot T �S ye=24 cur, o�'tt'!
(<Ippre-Tisnitely 1 Foot or Vo Actual O Isa
Fcz fuitities WILL .More C4= r_;e'agr:on, pl=o addres: the cd:et lsgcaca' i'46=bcud under the
cvent::cetts a: a;ioa.
tis any :.eepap 0bsme'd 2f—:_. Ii' j or Rio '%.Vgz I!:Cm ctcajoC d=?: YW or Nj{C
sdwva:a !anti av�9cble for:3r d 3ppticalicr.? Xes Cr tia 4 :hc a:vc-omp edeca=�? Yes er \'o
Sit v:,ai Cor.:meact:e&aj�!
2�Gp—hngS.�d_.ip¢n,, t'Ic..s fo_P�cn.�.-i� c✓,n� � c.- ;