970014_INSPECTIONS_20171231

for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: :O Departure Time: /6:30 County: VV L--S Region: W,5 a�
Farm Name: � ``l✓�'-6t_u'ae- She.vJ Fe-u-m Owner Email: s ke_t "--rm 4b, t.U1 ( LeS , n&
Owner Name: Clti.UAP_- t_ \f j C'V_ I t°_ S heUi (� Phone: (336) 9 $ t% — 3 3,3 y/
Mailing Address: q 5 S >� Y14 Q 1 V er N a$ (a 2
Physical Address: 5 a'm e—
Facility Contact: CA GLU a e— Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator:
Certification Number: R 1 q 3
Certification Number:
Latitude: 3(0 e ( I t 1'3 '' Longitude: V f o ,) a / az y I/
�vi+�oc_h adi t
u 5 4,71 N f-o Inl irld y 6ckp
�. ©r, 01a (00 1 ® Ike lIn-pfavie pld
Spe °Y iv r' h UK on
Swine
Wean to Finish
Design Current
CapacityWe[
Poultry
]Layer
Design Current
Capacity Pop.
Cattle
Dairy Cow
Design Current
Capacity Pop.
Wean to Feeder
]Non -Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr, P�oultry
Layers
Design Curren[
Ca acity Pao ,
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
5
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
TurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 J)� No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes .e No
❑ Yes IV No
NA ❑ NE
NA ❑ NE
IM NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

Facili Number: (- 1 • Date of Inspection: / 7
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
RI NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
T�
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 7❑� No ONA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) ,,,,����rrrr
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 0 No ❑ NA ❑ NE
maintenance or improvement? Ytttt"''
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [4 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
t" NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes IN No
❑ Yes [X No
❑ NA ❑ NE
❑NA ❑NE
❑WUP ❑Checklists ❑Design ❑Maps ❑LeaseAgreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes JA No ❑ NA ❑ NE
❑ Waste Application - - - ❑ Waste Analysis ❑ Soil Analysis aeafet's ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield E A4i r r rq ci. t�ioos [:]Monthly and V Rainfall Inspections E3�g=S==cy
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 Q-1A ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: —1 - J 1 Date of inspection: g t
24. Did the facility fail to calibrate waste *cation equipment as required by the permit?
❑ Yes
�j No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No F_,iNA ❑ 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
.0?'rNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
2�rNo ❑ 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
r,�
' Xl- No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
T�
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
A� No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
IN No ❑ NA ❑ NE
33. Did the Reviewerfinspector fail to discuss review/inspection with an on -site representative? ❑ Yes V No ❑ NA ❑ NE
Reviewer/Inspector Name: ic...� Phone: V6-a91a-41G95
Reviewer/Inspector Signature: &k6 _4� Date:
Page 3 of 3 (/ 21412015

I
Type of Visit: OCCompliance Inspection 0 Operation Review O Structure Evaluation p Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral 0 Emergency O Other O Denied Access
Date of Visit: Q
Arrival Time: BOO
Departure Time:
County: (aALjqcts Region: Wlko
Farm Name: 4,'g4106
5Kk3 PAN\
Owner Email:
�1{&t,j GRIA0 WIWZ63 ,xJGT
Owner Name: LAUD(.
)R
* V ICW S h6 0.)
Phone:
TU - 393 4
Mailing Address:
4(S
CZ) tJULAPLfwt- M
(zomt W k
RkvG,ei c a 6 CAI
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Certification Number: a 1113 6
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
We[ Poultry
Design
Capacity
Current
Pop..
Design Current
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
]Non -Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Ih, ] $Tutu..
Layers
Design
Ca act
Current
$o ,
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
TurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 X No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes No
KYes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
\ Page I of 3
21412015 Continued

- ( . jDate of Inspection $
Facility Number:
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: ARV S119[.K
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): - 1�-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
V3 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
g 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
rK No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
D4No
❑ 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
CKNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
Yes
�No
❑ NA
❑ NE
❑ Excessive Ponding Hydraulic Overload ❑ Frozen Ground Heavy Metals(Cu, Zn,etc.)
❑ PAN PAN > 10% or 10 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): 60W S tL,&rrt
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
[R No
❑ NA
❑ NE
[-]Yes
CKNo
❑ NA
❑ NE
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
S<No
❑ NA
❑ NE
❑ Yes
IN No
❑ NA
❑ NE
❑ Yes
W No
❑ NA
❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
��Vaste�tppitC3i7I5R'a- "tteebvad --e'VVaste Analyse r-Eg-&e sis ❑ Waste Transfers
...QAamfa* E Ss oc in op Id ,Q UaU P - --
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes XN
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ ILSI Yes N
Page 2 of 3
❑ NA ❑ NE
�i ED ade
❑ Sludge Survey
o ❑ NA ❑ NE
o ❑ NA ❑ NE
21412015 Continued

Facili Number: al 7- ( Ll Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Wr ❑ Yes k No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Cg No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [—]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes G No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes � No
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?
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Yes CK No ❑ NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ICI No ❑ NA ❑ NE
❑ Yes M No
❑ Yes 5g No
19 Yes [—]No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question q): 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).
6?6RP at tkoom ? b QvE T[ 7 cvt$
a0l S CaWr AbAlp1 �
Zu Gv L6VM3 --LAW-ic Ea.s—�o�:ia ctrytFt trtvb- cam as�u
soft -fss .-- -ram' b(b, Ouf rreaw ao�a.
P Cv ck M%ol'i r wc- -1e Ace Q LM-
S,tl,
3'30�16
Reviewer/Inspector Name:
Reviewer/Inspector Signatm
Page 3 of 3
CbuW COA&j QOWM
3
VID
avAIO
0_ . . .
Phone: 33 6. Lto& -Lk"1
Date: s s 1 16
21412015

Type of Visit: ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Arrival Time: ; 00 gat Departure Time: 1 Idva County: $� Region: LJ 510
Farm Name: (., /' /J goa/l/Nett/
cr✓�
Owner Email: �/r�W�o rMtSCwilkes, ne,�
Owner Name: C /baude
,f� k
t1,,k o'e S/{7eO✓
Phone: 3 3 @/� - 77y— 3 ?3 1MailingAddress:
/S5
d ella/21an-G
Physical Address: 5
Facility Contact: acroG(_ Title:
Onsite Representative: `
Certified Operator: J
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: �L/ it 3v
Certification Number:
Longitude:
SIZJ n/ fo lJin %� Q� on Ail-wo 4 /{ 0 B/J(s0"' 2
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Design
Capacity
Current
Pop.
Cattle
Design Current
Capacity Pop.
I
ILayer
Dai Cow
Wean to Feeder
I
INon-Layer
IDai
Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design t
D . P,oultr. Ca aci
Layers
Cow
Beef Stocker
Gilts
Non -Layers
Beef Feeder
LS 3
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[—]Yes �&No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [—]No
[—]Yes [—]No
[:]Yes DZ No
[:]Yes J'No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3
21412014 Continued

I'
FaciliNumber: 77 - 1( jDate of inspection: -1 7-
S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes §� No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: t Sac
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes jo 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 Z No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes ❑ No
tKNA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes 0,No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes JKJ No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes ]2 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): 1%ane_
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
JK No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
,1K No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
N No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
g] No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
jNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
'EZLWaste Application Weekly Freeboard Lj�aste Analysis ®Soil Analysis
rmrs m
Weather
Code
`Rainfall WStocking ❑ Crop Yield nj 440- "-' t _,._ - Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
ONo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
JK NA
❑ NE
Page 2 of
21412014 Continued

Facility Number: 7 - I Date of inspection: —/ 7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes tE;,No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
Other Issues
❑ NA ❑ NE
Eg-NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ZLNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [:]Yes ® No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes (a No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 40 No ❑ NA ❑ NE
Comments (refer to question#): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility tobetter explain situations (use additional pages as necessary).
I� Lic Aeej ZA,-f A y
Lajas}tun in Zola Pj�f, /`�J��/JdtAe-
//r" Zols.
f,4 zoly lw4- iot,?
y-/-),dis ,v, 7, 76 /4�4-K P, d
Reviewer/Inspector Name: 1 r�ta4 S tr
Reviewer/Inspector Signature:
Page 3 of 3
d-zsi/f//, ,
Phone: M- 77b — V77
Date: /—/7 — "/-5
21412014

Inspection
for Visit: 00 Routine
Referral
0 Other 0 Denied Access
Date of Visit: rrival Time: Departure Time: �County.w t l F-5J Region: 05P
Farm Name: Maude— S 6� f 4&X-r) Owner Email: / �
Owner Name: lit 0_UAe.7�.Tr. -+-y i (_VLl e./� S� hdAJ Phone: (� /,3 ,3 & )q Q, l -- 3 S 3 LZ
Mailing Address: q rJ J .� J � � IA"V 14n /C [t /Gl7Q !/ t l�l q / � / �1e � , A) a 8 6 6
Physical Address: W
Facility Contact: 0,10-U/4 e- Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
ne Capacity SwiPop.
Wean to Finish I
Wean to Feeder I
Wet Poulgyj Kc.
ILayer
INon-Layer
Design
pKc I t-M
I
I
Current
Pop.
Cattle
Dairy Cow
Dairy Calf
Design Current
Capacity Pop.
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
1) , P,oul
Layers
Design
Ga aci_
Current
P,o -
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
BoarsI
Pullets
I
lBeefBroodCow
Other
Other
Turkeys
Turke Pouets
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 �No ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes [:]No
❑ NA ❑ NE
❑NA ❑NE
[—]Yes
❑ No
❑ NA
❑ NE
[:]Yes
o
❑ NA
❑ NE
❑ Yes
\�
�No
❑ NA
❑ NE
Page I of 3
21412014 Continued

Facility Number: Date of Ins ection:
d
Waste Collection & Treatment
WNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[:]No
❑ NA
❑ NE
Structure2 Structure 3 Structure 4
Structure 5
Structure 6
'I 1,Structure
Identifier: r]� 1/ 1-ut
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
PNo
❑ 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 E ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes XNo ❑ 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 ���'�"'o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ANo ❑ NA ❑ NE
maintenance or improvement? �/
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes M No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) C
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes t No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
k�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑YesNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
n No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
MNo
❑ NA
❑ NE
the appropriate box.
TT
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvemen ❑ Yes 0
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 Inspectio oc'••a-�••
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 Q-NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: Date of Inspection: O y�
24. Did the facility fail to calibrate waste app ication equipment as required by the permit? ❑ Yes t No r❑-lNA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes J❑� No � X� NA ❑ NE
the appropriate box(es) below. T'
❑ 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 1 No ❑ NA ❑ NE
V 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 0 No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes / No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question N): 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. z(VxC- leweIS ? r(o 5� 61#1 ao1V Zn 131D
C°,u�aObd
'�• ROG Cali bra Now
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: -I -I l - S as
Date: tl ($ ;-0 l
2/4/ 014

Type of Visit: 1PCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Jr',J Departure Time: County: W 1 l Y,eS Region: W S RO
Farm Name: C1 &UA'P_ S hP .Q RLF- M Owner Email:
Owner Name: b fLUAte— Shaw., Sr,y- V I GIB te_ Phone: 3 3� , q
Mailing Address: I ±3S_
Physical Address: W
Facility Contact: C` A UckQ_ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
n4 R. v-ems, N)i✓ a $ to 6 q
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
02� '�"O W I
�Y
c
�Z✓
-
m�.
Design Current
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle
Capacity Pop.
Wean to Finish
La er
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Da' Heifer
Farrow to Wean
I)r.+P,ouI .+
Design
Ca aci +
k-m en
P,o,
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Non -Layers
Beef Stocker
Beef Feeder
5
Gilts
Boars
I
Pullets
lBeefBroodCow
Turke s
Other
TurkeyPoults
Other
Other
'
Discharges and Stream Impacts -
1. Is any discharge observed from any part of the operation?
❑ Yes
9No
❑ 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
CNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
N No
❑ NA
❑ NE
of the State other than from a discharge?
Page I 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 ONo ❑ 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: D nt 5+0-c.le'
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes j No ❑ NA ❑ NE
waste management or closure plan? T�
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? [:]Yes � No ,,❑_,/NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No I y.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 lyj No ❑ NA ❑ NE
maintenance or improvement? J�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [yNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes VNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes J�No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes PNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[!�,No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ONo
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes CWNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Pd No ❑ NA ❑ NE
the appropriate box. 7��"'
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other.
21. oes record keeping need improvement? e�ppre}niate :gMonthly
w. ❑ Yes �No ❑NA ❑ NE
L�0 aste Applic ion 0Waste Analysis oil Analysis dWeather Code
Rainfall Stocking Crop Yield l20 Minute Inspections and 1" Rainfall Inspections QSludg"u Way_
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 rainbreakers on irrigation equipment? ❑ Yes [:]No A NA ❑ NE
Page 2 of 21412011 Continued

Facility Number: - I Date of Inspection:
24. Did the facility fail to calibrate waste appin equipment as required by the permit? ❑ Yes IYI 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes D�No
❑ Yes am( No
❑ Yes ,I,,��/No
❑ Yes �j �s No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes 0jNo ❑ NA ❑ NE
❑ Yes 06No ❑ NA ❑ NE
❑ Yes . No
❑ Yes No
❑ Yes M'%Io
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. fi Use drawings of facility to better explain situations (use additional pages as necessary).
7�i nc 1"els U y > a 500 .-y7-h r
C° �ps�v l +r
13
�, FF ► ,•
i
AT
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: % -% I — j g 9 %
Date: 9 S
2/4/20 1

M.1+�tCCC_
II ype of visit: 9Q Vmphance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: 51�1 Routine O Complaint O Follow-up O Referral O Emer¢encv O Other O Denied Access
Date of Visit: ►.Z O rrival Time: Departure Time: County: L S Region: �-C iW
Farm Name: ��I(Il)A Owner Email: jhQLo-FQrM LJI l �LP_Se
1 i� net
Owner Name: 0 ,16t A R S 61pa,J Tr- Phone: 33 (p _ Q rS 4, 3 73 V
Mailing Address:
Physical Address:
Facility Contact: C l cw 32 Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
CliI'd ma11
2d.� 0
oI c}
l (t ,�
l�� �49 D7 P llo_pla--ne--
Current
Swine
Wean to Finish
Wean to Feeder
Design
Capacity Pop.
Wet Poultry
La er
Non -La er
Desigtt
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Da' Cow
DairyCalf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
I. , + P,oul , +
Layers
Design
Ca aci +
Current
P,o ,
Dry Cow
Non-Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
lBeefBroodCow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
No
1. Is any discharge observed from any part of the operation?
❑ Yes
[
❑ 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
O;7o
❑ NA
❑ NE
3. Were [here any observable adverse impacts of potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page I of
21412011 Continued

Facility Number: CA• Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes O�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes V 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 Q�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 I�.f No
7YY❑`CCC
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No
[�J'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 ONo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Wo
❑ NA
❑ NE
maintenance or improvement?
,`�,/�
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes h XI No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) C
❑ 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 [�fNo
❑ Yes F No
❑ Yes [:]No
[—]Yes `�o
❑ Yes M'No
[� Yes 777❑�D No
[:]Yes WNo
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
�021. es record keeping need improvement? 1€ 3 es, three ate box bel
aste Applic 'on ��eelf�tll / Waste Analysis Soil
Rainfall Stocking Crop Yield L,`�/20 Minute Inspections Monthl
22. Did the facility fail to install and maintain a rain gauge?
❑ NA
❑ NE
❑ NA
❑ NE
�NA
❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes No IX: ❑ NE
Analysis rera— �LI Weather Code
y and V Rainfall Inspections
edge. Suwey
❑ Yes IA I No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 4'NA ❑ NE
Page 2 of 3 21412011 Condnued

Facility Number: • Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes lNoo NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ 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 4 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes XI I No ❑ NA ❑ NE
Other Issues ❑ `Yy'' /
❑
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document Yes I y�No ❑ NA NE
and report mortality rates that were higher than normal? ..P
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes PNo ❑ 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 J� 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
ANo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
4% No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Io
❑ NA
❑ NE
Comments (refer to question #): Explain.any YES answers and/or any additional recommendationsor any other comments. -
Use dr wings of facility to better explain situations (use additional pages as necessary).
ra- orb Glue- Rol3.
PA i\1 --t7a A. 2 NIA .
bO v-I ed — 5`fkg,4in� {odo
a► I -A VV C- vt° IS v e.�r � In i � �� a coo — C o� wLi n Q�l'i o n
m
bt?4-
sS4
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
-4w V l Si ¢)
Phone: ? I -S 0 l7 q
Date: i ✓ a6
21412011

Reason for Visit:
Date of Visit: C
Farm Name
Owner Name:
Mailing Address:
Routine 0
Arrival Time:
Operation Review Q Structure Evaluation Q Technical Assistance
0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Departure Time: ® County: Region: LQS
Owner Email: to
�_KrisoLht lKes , Y►e`J
Phone: Q; II _ � a -
RN
Physical Address:
y
Facility Contact: (C ( Title: Phone: RS%-716 0
Onsite Representative: Integrator: 010't ,
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
w� li of N
--7-7.
T)-- t12
tad N� ( O
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Cattle
Da' Cow
Design Current
Capacity Pop.
Wean to Feeder
Non -La er
Da' Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
La ers
Design
city
Current
P,o ,
D Cow
Non -Da
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I
jBeefBmodCow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
[:]Yes ❑ No
[—]Yes [-]No
❑ Yes ❑ No
❑ Yes No
❑ Yes �f No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ONE
6
Page 1 of 3 21412011 Continued

Facie Number: - Date of inspection: aQ /
Waste Collection & Treatment �/
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes I Y{"No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ...777❑"'��� No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes X No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [, No ❑ NA ❑ 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 ZNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No r,!S�NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) �f
9. Does any part of the waste management system other than the waste structures require ❑ Yes I )(I No ❑ NA ❑ NE
maintenance or improvement? 7�
Waste Application �%
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes I �d" No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P'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):
2
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
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
NA
❑ NE
acres determination?
to
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
o
❑ NA
❑ NE
Required Records & Documents
�S
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
Fa/No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists '8 E)c� ❑ Maps ❑ Lease Agreements ❑Other:
21. oes record keeping need improvement? If yes, check t e appropriate box b Yes ❑ No ❑ NA ❑ NE
y to Applicaf n w -'•'� -- Vwt ante Analysis oil Analy� s� [ Weather Code
Rainfa ErstockingEj Crop Yield ❑ 120 Minute Inspections onthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes dNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [-]No PRf NA ❑ NE
Page 2 of 3 21412011 Condnued

Facili Number; - I I Date of Inspection:
24. Did the facility fail to calibrate waste app*on 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 [XNA ❑ NE
the appropriate box(es) below. �ttt`'""
❑ 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 VNo ❑ NA ❑ NE
Other Issues /
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes I ]i'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 XNo ❑ NA ❑ NE
❑ Yes I WNo ❑ NA ❑ NE
[:]Yes [.d o ❑ NA ❑ NE
❑ Yes e,,N'o
,.s
❑ Yes I 0
[:]Yes CVNo
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
s ummems trerer to question oI: c xpiam any if Lb answers anmor any aaattronat recommendations or any other comments z„
Use.drawings of facility to better explain situations (use additional pages as necessary).E-
o�u.e
4 Co- 0-f—
L
N? p �1LeL t� t
OJ_A_0, /lam tstp,D
9 rVQA -zi;- 6N�4upj�
ReviewerlInspector Name:
r
Reviewer/Inspector Signature:
0
13Ay
Phone: Sa $
Date: 3 db I I
40
Page 3 of 3
21412011

Type of Visit WCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit A Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 0 0 Arrival Time: 0 JO aM Departure Time: County:
kjSK 0
Farm Name: 4k iS t^Y'M Owner Email: \122' 9" q 2 5_5 UL4. t tccs , rw r
Owner Name: CIA �t jt 5 J f • Phone: t--'fJ9 gt/ -3
/�e
Mailing Address: 5s- (��gpt'gnt Rd, �n�11A, RNet ANC 2-do�G�
Physical Address: I r J% I_En
Facility Contact: GI �4dC JAe4.✓�" J- �� Title: Phone No(-� 7 s% -7/6 0
Onsite Representative: c b-ttn dP tt/, Tr. Integrator:
u' /Gr ute 0
Certified Operator: S� Zrr' Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: ° © ® Longitude: ®/ ° © ®
Jf,,V 2
277/ A„h of
(Z ,� t_ 0/cl G (oQ/
-
Design
Current Destgn Current
;._
wDgestgn. �,@brrent
Swore M i
,,.,.... WetPoul
Capacity 1'opulatton try Capacty Population
arty a.__
Capacttypulation
rr.
FCattle „
::
❑ Wean to Finishµ❑
Layer
❑
Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
I
Dairy Calf
❑ Feeder to Finish
- - , ft ❑ Dairy Heifer
'. ❑Farrow to Wean
Dry Ptultry "-« ❑ Dry Cow
`% ❑ Farrow to Feeder
, ElNon-Dai
❑ Farrow to Finish
❑ Layers
Beef Stocker 2•i
❑ Gilts
❑ Non -Layers
Beef Feeder
El Boars
❑Pullets
❑ Beef Brood Co
Other
, ❑ Turkeys
❑ Turkey Poults
,.,. Ra� S]j�GK
❑ Other
L„ ❑Other
Number�tructures:.,.,•�
Discharges & Stream Impacts
1. Is any discharge observed from any pan 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 ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
El Yes
El NA El NE
❑ Yes *No ❑ NA ❑ NE
Page I of 3 12128104 Continued

FaciBty Number: (� 7 — • Date of Inspection (j(/D?//0 I •
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): _1%i;1 f rt7c , u.744,
❑ Yes �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �'J No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) '.,/
6. Are there structures on -site which are not properly addressed and/or managed [I Yes ICI No
❑ NA El NE
through a waste management or closure plan? /
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental) threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No
.IXI
❑.,/NA El NE
8. Do any of the stuctures lack adequate markets as required by the permit? El Yes "❑ No
Jdl NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
jjjjjj������
9. Does any part of the waste management system other than the waste structures require El Yes )No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes XNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ElFrozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or ] 0 lbs [:]Total Phosphorus [:]Failure to Incorporate Manure/Sludge into Bare Soil
[:]Outside of Acceptable Crop Window [:]Evidence of Wind Drift [IApplication Outside of Area
12. Crop type(s) LG/A -, / ram
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ YejD No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
��y�1
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes /❑\ NoX
NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes 0yNo
[I NA
[I NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes yJ No
❑ NA
❑ NE
'Cominents"(refer to question #):"-Explain any YES answers and/or -any recommendahons or any othe comments �x �
Use drawings of facility to better'explaimsituations. (use additional -pages 'as necessary) r4r y;
IReviewer[Inspector Name jy 21� ll/� i tZhQ:�1 ' �t ' 'T] Phone: 6�30 7'7/—S7-2 r-S-- I
Reviewer/Inspector Signature: /f % Date: / J /02/ 20 O
Page 2 of 3

Facility Number: — % Date of Inspection •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
TTTDdYes ,❑,/No
❑l Yes f 4 No
❑ NA ❑ NE
El NA ❑NE
21. Does re rd keeping need improvement? eli XYes ❑ No ❑ NA ❑ NE
Was Application Waste Analysis Soil A i E3 Fast, Tymes&rs.. maai 2etti�aaaeo•
Rainfall Stocking Crop Yield P H0 2diziaWiwspections onthly and V Rain Inspections Bather e
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes kNo ❑,/NA El NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No Ik1 NA [I NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No '"❑ NA El NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No k'NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? El Yes �o JJJJJJ❑��l NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes �No ❑ NA ❑ NE
Otherlssues /
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes Y�OfNo
/A3J
❑ NA
[I NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes )(No
❑ 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 JVNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ..�(No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes 'kNo
❑ NA
❑ NE
Addtbonal Gommentsran0 rhDrawin gs ' aes
2y, 61,'bfgk„ n1e,-
2/. �rcc /eve /j
4�1!�t/L , Na - b C�.cc e_� /v�l CAn[i'Py i Lov�
CpcoJm wr�d� Lodz /i
Page 3 of 3 12128104

SU
Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
§ Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: %Q� Arrival Time: ® Departure Time: t t u r �J County: 1 I ILES Region: t��L
Farm Name: S�Oli) Farm Owner Email/: e-brISO-nd.je55kw�i
Owner Name: IQUA Q. S ba, ) I Tr- Phone: T[r) 4 q q — 3 2 3 y
Mailing Address: �SS De_11"IQ.t!)P Rd qP'l ye IVL 2gtokq
Physical Address:
Facility Contact: a, la,%)A 6 etil .,-Tr - Title:
�t
Onsite Representative: l ,10 t Ae. 5 6e,..0 'Tr
Certified Operator: &a_Ude.. SheA D I .j f .
Phone No: 9 5- 7- 7 1(o V'
Integrator: (Er(' IL. NLpS
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes N No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
[I No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: — l • Date of Inspection _�Q __ •
f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0
No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
,
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
Wo ❑ 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)
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
threat,
No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
❑ No VNA ❑ 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
�,/
J[Y,No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
XNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ 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
Py No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
DR�&o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑lNo
,'NAElNE
17. Does the facility lack adequate acreage for land application?
❑ Yes
o
tNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
.� ...a:
Comments (refer to question #): Explain any YES ansviers and/or„any recommendations or,,.any, other, inents,�.
t.
Use drawings of facilityao b tter explain situations (use additional'pages as necessary)
vZor,
of l }eS+ L0M*1e+'ecal? C0'�C
bre_-tior\ to"leted ?
0
Reviewer/Inspector Name I r Phone:
Reviewer/inspectorSignature: Date: io
12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ,Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA [INE
the appropriate box. El WL[p [IChecklists ElDesig
n El Maps ❑Other
21. Does record keeping need improvement? lil Yes No ❑ NA
LV❑ NE
Waste Application Waste Analysis Soil'alysis [�p!lh�� ��snn�nal-r +iF •:--
LytCalnfall tocking Ekerop Yield 20 Minute Inspections Ly Monthly and I" Rain Inspections L4feather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes N(No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No tjfNA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes el9j'No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No ZNA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes WNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes VNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ko
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
JN
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
(fNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
IX No
❑ NA
❑ NE
0
A•
oil
� � J
I WIN 1
1 �
t[
0
i
12/18104

2-b/osW-�
Q Division of Water Quali-
Facility Number 1 p o Division of Soil and Water Conservati
0 Other Agency
Type of Visit to Cympliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 9t Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: a-�Arrival Time: Departure Time: County: Jil A re—S Region: " --O
Farm Name: 5he1•J Farm Owner Email: Cc55ta W 1 1���5
Owner Name: qsS l�la'll.�lax12 ltt F•IYet'IpCi, d.�tpb�'
Mailing Address: �Aaude Jhet ) ram• 3
Physical Address:
Facility Contact: OA&kAZ ShetA) I T! . Title: T
Onsite Representative: / �/1.� Q UC�S.r fW�j S(•
CI�
Certified Operator: tQUd� SbU3 t -TV--
Back-up Operator:
Location of Farm:
� (tiHu j (p0 I t
Swine
Feeder
Wean
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
G Latitude: ®o © � Longitude: ®o O� 21"
IF �Ione W ir.d�loap a-�-urh r�h • Le-r-F onto
Design - Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
DDairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
D.Non-Dairy
Beef Stocket
/ oZ
Ll Beef Feeder
❑ Beef Brood Cc
c. What is the estimated volume that reached waters of the State (gallons)?
-bry 5+o_c1--r
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 � No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
b No
❑ NA
❑ NE
❑ Yes O No ❑ NA ❑ NE
❑ Yes 4No ❑ NA ❑ NE
12128104 Continued

Facility Number: — . Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 ,j Structure 2 Structure 3 Structure 4
Identifier:fm ('A/L_
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes ANo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ yes
4 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
�../
LVI No
❑ NA ❑ NE
through a waste management or closure plan?
�i
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
0 No
El NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
❑ No
)(NA ElNE
(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
L41 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
l7�
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ yes
�,�(
IN No
El NA El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
�T.(�,
�(,J No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
No
❑,/NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
/�❑��',,No
L�/NA
❑ NE
17. Does the facility lack adequate acreage for land application? El Yes
LJ//No
El NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes VrNo ❑ NA ❑ NE
IComments (refer to question ft Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name 4ZA'Phone:
Reviewer/Inspector Signature: ���Lk ,�_ Date:
12128104

Facility Number: — loate of Inspection oZ Q •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �,C1 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes TYJ` No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists 6 ❑ Design El Maps El Other
21. Doe record keeping need improvement? IPyCsrl ,..,� Yes ❑ No ❑ NA ❑ NE
plic tion aV12(
Waste Analysis Soil alysis L7Waste Transfers �satien
Rainf Wtocking Crop Yield Minute InspectionsL�{Monthly and 1" Rain Inspections eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes A No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No X NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes )0 No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No [VNA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes D�No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes b(No ❑ NA ❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M_, NNo
❑ NA
El NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[I Yes
P 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
Io
❑ 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
�,/
p� 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?
ElYes
I,YNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
34/0
❑ NA
❑ NE
Additional Comments and/or Drawings:
9f. Due agog -
aL aob% 4Z�St oa okon 0- fie}
a1_ '�:Foc_V-iln t10-t u`Ire� vw it iyo u h6we (9-a*20
in aM-7 on do0-s Okt c.omwemi
a[_
12128104

$� Division of Water Qualit_ I
Facility Number g 1 '0 Division of Soil and Water onservation
0 Other Agency k PH
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit (Routine o Complaint 0 Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: l l c10 O Arrival Time: I I /X Y ] Departure Time: County: Region: 05P
Farm Name: For m 5 h r w I 1 (&15 . net
Owner Emails
Owner Name: C 1 Q_LAe__ s%1e�) —Tr-. p Phone: �4� 1 9 8 4 - 3 ?3 ¢
Mailing Address:
Physical Address:/V4P 1
Facility Contact � I Q IVAP , hTitle: Phone No:
OnsiteRepresentative: 0
,1a,1 Ae SI1e Q Integrator:
Certified Operator: V' lat)Je_ `) h VAJ Operator Certification Number: a'
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: 36 u 1 i ` �` Longitude: ° L� �F` ®`
us 4P-1 ► v- rh
Swine
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
�I ❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
El Non-Dairy
Beef Stocker
Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: U
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
/❑
El NA
El NE
El Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes o ElNA ❑ NE
❑ Yes tNo ❑ 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? ❑ 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:. I r4 St9Y n.V-
Spillway?: "� �""`""`
Designed Freeboard (in):
Observed Freeboard (in): / iJ ( —JK /
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 f 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? El Yes /❑ No NA [I NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) Ili
❑ 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)
uP
14. Do the receiving crops differ from those designated in the CAMP?
❑ Yes
14 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? ❑ yes
t
VNA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
N No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
OdNo
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
Reviewer/Inspector Signal
Phone: 7 ") I _ SZ S{ 9
Date: It In n /A —1

Facility Number: — •e of Inspection ) 02O % •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �W(No ❑ NA El NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check El Yes I]� No ❑ NA ❑ NE
ElEl❑ Design ❑Maps El the appropirate box. WUP Checklists t 21.D.,o�es/rj�ord keeping need improvement? If yes, check t appropriate box bel [I Yes No ❑ NA ❑ NE
I]ef W Ste Application ,,_, ante Analysis o�ilJ�jnalysis Waste Transfers eafien-
ainfall Stocking` Crop Yield Lid'120 Minute Inspections L�J Monthly and 1" Rain Inspections M4eeather Code
22. Did the facility fail to install and maintain a min gauge?
❑ Yes
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
24. Did the facility fail to calibrate waste application equipment as required by the permit? &-F 10$ ❑ Yes
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
❑ Yes
❑ Yes
No
El NA
[I NE
❑ No
P NA
❑ NE
�KNo
❑ NA
❑ NE
❑..,,((No
VNA
El NE
,,
ONo
❑ NA
❑ NE
WNo
❑ NA
❑ NE
❑ Yes No
❑ Yes No
❑ Yes 1ANo
❑ Yes INo
❑ Yes *
❑ Yes t�No
❑NA El NE
❑ NA ❑ NE
El NA ❑NE
El NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
tlonal Comments and/ Drawings:
Oc-ILtn notr
�ycz Qq� V n J
S. `� 0 vh �S+c�� k nA
VeAA
n��` e
few aoo (o- �+.� e 11�
W1
12128104

Division of Water Quality
n Division of Soil and Water Conservation
❑ Other Agency rr1I
Facility Number: 970014 Facility Status: Active Permit: AWC970014 Denied Access
Inspection Type: Comoliance Inspection Inactive or Closed Date:
Reason for Visit: Follow-up County: Wlkes Region: Winston-Salem
Date of Visit: 12/19/2006 Entry Time: 10:30 AM Exit Time: 02,00 PM
Farts Name: Claude Shaw Farm
Owner: Claude Shew
Incident #:
Owner Email:
Phone: [phone]
M,. r - r :. - r r • :tQ�l.[aTi:Sld;+�
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farts: Latitude: 36'11'18" Longitude: 81.02'24"
Hwy 421 north, dght on Clingman Rd. Left onto old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right, farm is at the end of the
road.
Question Areas:
W Records and Documents
Certified Operator: Claude E Shew
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative, Claude Shew
24 hour contact name Claude Shew
Primary Inspector: Melissa Rosebrock
Inspector Signature:
Secondary Inspector(s):
Operator Certification Number. 21436
Title
Phone:
Phone:
Phone:
Date:
Phone
Inspection Summary:
21. The purpose of today's inspection was to follow-up on deficiencies in record keeping noted during previous DWQ compliance
inspection. Ron Howard (NRCS), Clayton Porter (paid record keeper), and Kate Canpau (DSWC)and myself met with Claude Shew to
discuss waste plan revisions and how the new waste plan in to correlate into record keeping for both his poultry and beef operations.
Mr. Shew decided to keep poultry and beef waste plans separate. Fields located at the farts are to be reserved for beef waste if he
should have cattle again since these fields do not need anymore litter applied. There are some new fields located at this farts, and
these fields are to be put into the revised poultry plan. Kate is working on waste plan.
Page: 1

40
Permit: AWC970014 Owner - Facility: Claude Shaw
Inspection Date: 12/19/2006 Inspection Type: Compliance Inspection
Facility Number : 970014
Reason for Vie it: Follow-up
Regulated Operations Design Capacity Current Population
Cattle
O Cattle - Beef Feeder 125 0
Total Design Capacity: 125
Total SSLW: 100,000
Waste Structures
Type Identifier Closed Date Star Date Designed FMDOard VDserV20 rreeDearo
ry Stadc DRY STACK
Page: 2

Permit: AWC970014 Owner- Facility: Claude Shew
Inspection Date: 12/1912006 Inspection Type: Compliance Inspection
Facility Number: 970014
Reason for Visit: Follow-up
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?
Cl ■
❑
❑
If yes, check the appropriate box below.
'
WUP?
❑
Checklists?
Cl
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application? _
0
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 Fonn (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑
■
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
a
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑
0
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■
❑
❑
Page: 3

r1
L
Permit: AWC970014
Inspection Date: 12/19/2006
Owner -Facility: Claude Shew
Inspection Type: Compliance Inspection
Facility Number: 970014
Reason for Visit: Follow-up
Page:4

E Division of Water Quality
Fj Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 970014 Facility Status: Active Permit: AWC970014 ❑ Denied Access
Inspection Type: Comoliance Inspection
Reason for Visit:
Inactive or Closed Date:
County: Wilkes Region: Winston-Salem
Date of Visit: 09/20/2006 Entry Time: 10:00 AM Exit Time: 12,00 PM
Farm Name: Claude Shaw Farm
Owner: Claude Shaw
Incident #:
Owner Email:
Phone: [phone]
Mailing Address: 955 Dellao Ln Rd Roarino River NC 28669
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°11'l8" Longitude: 81°02'24"
Hwy 421 north, right on Clingman Rd. Left onto old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right, farm is at the end of the
road.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Claude E Shaw
Secondary OIC(s):
Operator Certification Number. 21436
On -Site Representative(s): Name
Title Phone
On -site representative Claude Shaw
Phone:
24 hour contact name Claude Shaw
Phone:
Primary Inspector: Melissa Rosebrock
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
3. Vegetation on dam of new freshwater pond looks great.
11. Cannot evaluate from records. No beef waste applied in 2006, only poultry litter.
15. & 21. Several fields have copper levels >2000 and some are low in pH. Are to be limed this year.
21. Must keep monthly stocking, daily rainfall, and crop yield records.
21. Must be able to match fields in waste plan with fields in records to document PAN.
33. DWQ to re -check records in Dec. 2006.
Page: 1

9
Permit: AWC970014 Owner • Facility: Claude Shaw Facility Number: 970014
Inspection Date: 09/20/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity
Current Population
Cattle
O Cattle - Beef Feeder 125 0
Total Design Capacity: 125
Total SSLW: 100,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
ry Stack DRY STACK 48.00
Page:2

Permit: AWC970014 Owner- Facility: Claude Shaw Facility Number: 970014
Inspection Date: 09202006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No
NA
NE
1. Is any discharge observed from any part of the operation?
❑
■
0
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
01311
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)
❑
■
Cl
Cl
2. Is there evidence of a past discharge from any part of the operation?
❑
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State 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 (l.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 ❑
■
❑
Cl
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 altematives 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: AWC970014 Owner -Facility: Claude Shaw
Inspection Date: 09/20/2006 Inspection Type: Compliance Inspection
Facility Number: 970014
Reason for Visit: Routine
Waste Application
Yes No NA NE
PAN?
❑
Is PAN > 10%/10 lbs.?
n
Total P205?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
Cl
Application outside of application area?
❑
Crop Type 1
Corn (Silage)
Crop Type 2
Small Grain (Wheat,
Badey, Oats)
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
—
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management
❑
■
❑
❑
Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
■
Cl
❑
❑
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: AWC970014 Owner -Facility: Claude Shew Facility Number: 970014
Inspection Date: 09202006 - Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents Yes No NA NE
Checklists? ❑
Design? ❑
Maps? ❑
Other? ❑
21. Does record keeping need improvement? ❑ ❑ ❑
If yes, check the appropriate box below
Waste Applidation?
120 Minute inspections? ❑
Weather code? ❑
Weekly Freeboard? - ❑
Transfers? ❑
Rainfall? - E
Inspections after> 1 inch rainfall & monthly? ❑
Waste Analysis? ❑
Annual soil analysis? ❑
Crop yields?
E
Stocking? -
M
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑
■
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
m
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑
M
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
■
❑
Other Issues
Yes
No
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
M
❑
❑
29. Did the facility fail to properly dispose of dead animals vothin 24 hours and/or document and report those
❑
■
❑
❑
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air
❑
■
❑
❑
Quality representative immediately.
Page: 5

rI
L
Permit: AWC970014 Owner -Facility: Claude Shaw
Facility Number: 970014
Inspection Date: 09/20/2006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Other Issues
Yes
No
NA
NE
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
m
Q
Q
32. Did ReviewerAnspector fail to discuss review/inspection with on -site representative?
❑
M
Q
❑
33. Does facility require a follow-up visit by same agency?
■
❑
❑
❑
Page:6

Type of Visit N Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit (Routine O Complaint Q Follow up Q Referral o Emergency 0 Other ❑ Denied Access
Date of Visit: �t" 4---i"=�� Arrival Time: �� Departure Time: County: W 1 lSe.S Region:
Farm Name: C i �(�vut? 5 �1Px7 FQf 1h Owner Email: �/ /
Owner Name: �.�t7UXl G Phone: (� $ T — 3 $ 3`f'
Mailing Address: qSS be l f Q p n e— Pd . t kww l nq aj V'f- j NC a 96 b
Physical Address: fpa Me—
Facility Contact: e 1a.ud.e Title:
OnsiteRepresentative: 0-112L.)de .5yl J
Certified Operator:y-/ � e-. E - 5h4&jI, —ar
Back-up Operator:
Location of Farm:
Phone No: e/5 7-7166
Integrator: Tv 500 !
Operator Certification Number: °Q 143
3
Back-up Certification Number:
Latitude: [W —IT, �Longitude: laf o 1rO1, 1W
uS al N tb Loin at-P oLh Ch 'k Zl7 -i- }urn rig L*.
��+ one 016 Nw j bo �� . onto Li�lt'a Plat-ne V
_
Design Current Design
Current
Design Current
Swine
Capacity Population Wet Poultry Capacity
Population
Cattle Capacity Population
❑ Wean to Finish
10 Layer
❑ Dairy Cow
❑ Wean to Feeder
ILI Non -Layer I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
El❑
❑ Gilts
❑ Boars
Dry Poultry
Laers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑Pry Cow
on -Dairy 107 SS
Beef Stocker
❑Beef Feeder
❑ Beef Brood Cowl
Other
ElTurke Poults
Number of Structures:
❑ Other ❑ 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)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes 4 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
D(No
❑ NA
❑ NE
❑ Yes
WNo
❑ NA
❑ NE
12128104 Continued

Facility Number: �] — I (9 Date of Inspection .20
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 l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes I
❑ Yes No
Structure 5
El NA ❑NE
❑ NA ❑ NE
Structure 6
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
o
❑ NA
❑ NE
through a waste management or closure plan?
(ram
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
*o
[I NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
[I No
����❑,,,,,,,,,,,,////NA
LAVA
❑ 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 El Yes IINo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA NE
❑ Excessive 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 CropWindow [:]Evidence of Wind Drift El Application Outside of Area
tb
12. Croptype(s) ('j)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CA WMP? ,❑,,/Yes
15. Does the receiving crop and/or land application site need improvement? IL�I 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
❑ NA ❑ NE
❑ No ❑ NA ❑ NE
❑ No )� NA ❑ NE
IN(No ❑ NA ❑ NE
$No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments
Us drawings of facility to better explain situations. (use additional pages as necessary):
3 �nei14 c r\ on cU^
of sh w�ex- pond ?
qJA-�t /
N@ Lt MtJ4
0
Reviewer/Inspector Name
( —�
one: 171 Sa.Bg
Reviewer/Inspector Signatur
Date: a0
Page 2 of .$ V • V ' V 12129104 Continued

14 0"
Facility Number. — Rate of Inspection Y"�— •
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes L{Igvo El NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes/ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps [:]Other
21. Does rec need im rovement? If yes, check the appropriate box elow. Yes ❑ No ❑ NA ❑ NE
Waste Application Weekly Freeboard U-Waste Analysis ; Soil lysis M'Glraste Transfers n A An-1 r@4gf4AAti
❑ Rainfall Stocking Crop Yield 8 N 11 c_,Q ^esHens Monthly and 1" Rain Inspections ❑ Weather Code
22. Di e facility fail to install and maintain a rain gauge? ❑ Yes TTTTTT �No El NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes
❑'''"'No NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes T,No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? a� C ❑ Yes ❑ No VNA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes lNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No KNA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes VNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes �<No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes [ No ❑ 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 ❑ YesNo El 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 XNo ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? Yes ❑ No ❑ NA ❑ NE
Additional Comments and/or Drawings:
91000
vw P U0(� trca
a�' �" rvto.rtkhl� 5imc-Kiv,� i dots rainrilCrop ieI
VIA, Uju� IJ/ _fV+
bi er Say.�le: e-C) creel 46 YVt.a hbuj[.
Page 3 of 3
1/ 12128104

I
J
�a
•

E Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 970014
Facility Status: Active Permit: AWC970014 ❑ Denied Access
Inspection Type: Compliance Inspection
Inactive or Closed Date:
Reason for Visit: Routine
County: Wilkes Region: Winston-Salem
Date of Visit: 10/06/2005
Entry Time:09,45 AM Exit Time: 10:55 AM Incident #:
Farm Name: Claude Shaw Farm Owner Email:
Owner: Claude Shew
Phone: [phone]
Mailing Address: 955 Dellap Ln
Rd Roadno River NC 28669
Physical Address:
Facility Status: ❑ Compliant
❑ Not Compliant Integrator:
Location of Farm:
Latitude: 36°11'18" Longitude: 81°02'24"
Hwy 421 north, right on Clingman Rd. Leftonto old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right, fans is at the end of the
road.
Question Areas:
'
Discharges & Stream Impacts
Waste Collection& Treatment Waste Application
Records and Documents
Other Issues
Certified Operator: Claude E Shaw Operator Certification Number: 21436
Secondary OIC(s):
On -Site Representative(s): Name
Title
24 hour contact name Claude Shaw Phone:
On -site representative Claude Shaw Phone:
Phone
Primary Inspector: M lissa Rosebrock Phone: [phone]
Inspector Signature. j Xn � Ext.383 l �k.1b Date: D D S
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary:
22. Operator to re -install rain gauge.
27. SWCD/NRCS office is currently working on PLAT.
28. Operator has recently completed land -disturbing activities near river. Need to establish permanent vegetation on area as soon as
possible.
Mr. Shaw received an emergency phone call involving a family member and had to leave prior to the completion of the
inspection.Check PAN balances next visit.
Page: 1
/I

a
Permit: AWC970014 Owner -Facility: Claude Shaw
Facility Number: 970014
Inspection Data: 10/06/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current Population
Cattle
O Cattle - Beef Feeder 125 0
Total Design Capacity: 125
Total SSLW: 100,000
Waste Structures
Type Identifier Closed Date Start Data Designed Freeboard Observed Freeboard
ry Stack DRY STACK 48.00
Page: 2

Permit AWC970014 Owner- Facility: Claude Shaw Facility Number: 970014
Inspection Date: 10/06/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges &Stream Impacts Yes No NA NE
1. Is any discharge observed from any part of the operation? ❑ ■ ❑ ❑
Discharge originated at:
Structure
❑
Application Field
❑
Othei
❑
a. Was conveyance man-made?
❑
■
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■
❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
■
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a discharge?
❑
■
❑
❑
Waste Collection, Storage & Treatment
Yes
No
NA
NE
4. Is storage capacity less than adequate?
❑
■
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led large trees, severe erosion,
❑
■
Cl❑
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 slacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑ ■ ❑ ❑
improvement?
Waste Application
Yes No NA NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑ ■ ❑ ❑
11. Is there evidence of incorrect applicebon?
❑ ■ ❑ ❑
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, Pasture)
Crop Type 2
Com (Silage)
Crop Type 3
Small Grain (Wheat,
Barley, Oats)
Crop Type 4
Page: 3
/I

Permit: AWC970014 Owner -Facility: Claude Shaw Facility Number: 970014
Inspection Date: 10/06/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No NA NE
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?
❑
■
❑
Cl
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 property 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?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑ ■ ❑ ❑
If yes, check the appropriate box below
Waste Application?
Cl
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)?
Cl
22. Did the facility fail to install and maintain a rein gauge?
❑
■
. ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■
❑
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
Page:4

Permit: AWC970014 Owner- Facility: Claude Shaw
Inspection Date: 10/06/2005 Inspection Type: Compliance Inspection
Records and Documents
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
Othpr ISSI IPC
Facility Number: 970014
Reason for Malt: Routine
28. Were any additional problems noted which cause noncompliance of the Permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concem? 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 reviewlnspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Yes No NA NE
❑ ■ ❑ ❑
Ype Mn NA MP
■ ❑ 0 ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
Page: 5
/I

Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: p� 'Arrival Time: roqzl:�M Departure Time: • 5j County: W 1 1 KCS Region: V�lS Ra
Farm Name: Mti,,,,Udesho tp—Farno Owner Email: C% ¢
Owner Name:�yle- 5 h eA . J Tr . Phone: ` ^ J ✓ 7'
Mailing Address:9-` S 7 �110 l O I� 1Zd •, (Zo�r i ,�; F i uP r, N L a �P9
Physical Address:
Facility Contact ry 1� 1S �1 �� Title:
Onsite Representative:
�t t i1. tl� C �GG j1�
Certified Operator: �` OL U� -- ,.J� Tr .
Back-up Operator:
4
Phone No: C - 9 .S 7 - 716d
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ©° ®•. Longitude: ®° ••
05 4ol l N +a) w i a An tlOC h Ch • PJ - e-X }Urrn r-)
Le-P -ovlto dLA 14-t.o 4 (o0 . R+-. Onto beA I eLP L&-Yx4L . U
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ Layer
❑ Wean to Feeder JLJ Non -La et
[]Feeder to Finish
i
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
E]Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
Non -Dairy
Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: FT- i
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
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 II Structure 2 Structure 3 Structure 4
Identifier: � STI LC
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes o
❑ Yes No
Structure 5
El NA ❑NE
❑ NA ❑ NE
Structure 6
❑ Yes L��/No ❑ NA ❑ NE
El Yes LYNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental treat, notify DWQ
` 7. Do any of the structures need maintenance or improvement? ❑ Yes jiyNo s❑l/NA [I NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes ❑ No LL1NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) TT
9. Does any part of the waste management system other than the waste structures require ❑ Yes L� No El NA ❑ NE
maintenance or improvement? //,,
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes LyJ 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 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Wi dw ❑ Evidence of Wind Drill ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ Yes No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination., ❑ Yes �O No
17. Does the facility lack adequate acreage for land application? El Yes Q No
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA ❑ NE
El NA El NE
XNA ❑ NE
El NA El NE
❑NA ❑NE
IReviewer/Inspector Name I -1 (,L. �b r�, 'I Phone: I I I—'t(0 V`6 Y— ,j)U
Reviewer/InspectorSignatur / 1�ddA_ /� /�di0 it I% Date: 10 % /'O:C:
Continued

Facility Number: — M D#Inspection �'—
•
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other �`LL
21. Does cord keeping need improvement? If yes, check a appropriate box blow. ❑ Yes �J No ❑ NA ❑ NE
Waste Applicati ante Analysis `��7S/oil A lysis aste Transfer `inrAmnanFC-e�ifitete5er
Rainfall Stocking Crop Yield Monthly and 1" 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
❑ No
NA
❑ NE
24.
t
Did the facility fail to calibrate waste application equipment as required by the permit? OrA 011❑ Yes
No
❑ NA
❑ NE
25.
fail to conduct a sludge surveyas required b the permit? ❑ Yes
Did the facility g q Y
No
NA
�
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
X No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
p(No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�,/
L]!L No
El NA
❑ NE
If yes, contact a regional Air Quality representative immediately
Did the facility fail to notify the regional office of emergency situations as required by
ffi
ElL,g Yes
��!//�
No
El31. 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
gNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
XNo
❑ NA
❑ NE
lAdditional Comments and/or Drawings: Comments and/or Drawings:
/ / I
�P
,
t
. r
a 1,3 l las- N�-� Corr

Facility Number 97 14 Date of Visit: 6/15/2004 Time: 1230
O Not Operational i♦ Below Threshold
® Permitted ® Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: V111.497........
Farm Name: Claude.Sleetf:Y.U.M..................................................... :............................... County: WJIMs ............................................... WS13Q........
OwnerName: Maude .................................... Sbew.dr..................................................... Phone No: 33.6.9114.3.834 ..........................................................
Mailing Address: 9S.S.DkIcaIa,O.e-lid................................................................................ RQ8)rjazRiy.rr..N.0 .............................................. 28.6.6.9 .............
Facility Contact: Lila..ude.Shm..................................................Title:................................................................ Phone No: C.33695.7...7.160....................
Onsite Representative: ClAt de..S.h.cm.............................................................................. Integrator:......................................................................................
Certified Operator:Claude-E ............................... Shvm.,l[............................................ Operator Certification Number: 21436.............................
Location of Farm:
Hwy 421 north, right on Clingman Rd. Left onto old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right, farm is at th
:nd of the road.
❑ Swine ❑ Poultry ® Cattle [I Horse Latitude 36 • 11 I8 Longitude 81 • 02 24 u
Design Current
Swine C'anacity Ponulation Poultry
❑ Wean to Feeder
❑ Layer
❑ Feeder to Finish
10
Non -Layer
❑ Farrow to Wean
'
❑ Other
❑ Farrow to Feeder
Total Desi
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 0 0
Cattle
;n Capacity
'otal SSLW
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)
a If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
125 1 0 j
125
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
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: .......Dry...stack ........ ................................... ......................................................................................................... J Freeboard (inches): empty
12112103 Continued \

Facility Number: 97-14 Date of Inspection 6/15/2004
5. Are there any immediate threats to th*tegrity of any of the structures observed? (ie/ es, severe erosion, ❑ Yes ®No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes OR No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No
elevation markings?
Waste Aoolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ®No
[]Excessive Ponding []PAN []Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Fescue (Graze) Fescue (Hay) Corn (Silage & Grain)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ®No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement? ❑ Yes ® No
16. Is there a lack of adequate waste application equipment? ❑ Yes ®No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? - - ❑ Yes ®No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ®No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ®No
Air Quality representative immediately.
Comments.,(refer to question tl) Explain any YES inswers and/or any recommendations of -any other comments _
Use drawings of facility tiibetter explatu"situations I(use additiouei pages as necessary) Meld Copy ®Final Notes
3.No cattle waste applied in the last year. No application records required.
POULTRY
5/19/04 waste analyses: SLB 25.1, 23.6, 24.7 lbs. N/ton.
Poultry records look great.
Reviewer/inspector Name Meft Rose
brock
Reviewer/Inspector Signatu Date: 42
1211210 t onrrnuea

Facility Number: 97-14 >of Inspection 6/15/2004 •
Required
Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
®No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
®No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
®No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
®No
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
29.
Were any additional problems noted which cause noncompliance of the Certified A WMP?
❑ Yes
®No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
® No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

(Type of Visit f9LCompliance 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:.l /pT D Time:
0 Not Operational Melow Threshold
} Permitted E3
//Certified E3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:..�.�.j.�
Farm Name: .... 1`.j.4�14r.._...t?.L1K.....1.i��i!i._............................... _... County: _Y.V..1_�.L�Q5...............
Owner Name:
Mailing Address:
0
Facility Contact: ..! .1_...........__ _. ._._._Title; ... ...... _._ .
Onsite Representative:._.. ...._....__._.... .......
Certified Operator:..6.t0j.14 ._._&...:....a_ ? If :.............
Location of Farm:
4a I nw-th to to
AMEMISU
Phone No:
Phone No: L. A,!MZe_7166
Integrator: __._ ....... ..... _........... ..... ....... _......_......L..
Operator Certification Number..
?a.'C�
❑ Swine ❑ Poultry Cattle ❑ Horse Latitude ®• ' �" Longitude ®' �' °
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? t
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)
S
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3Structure 4 Structure 5
Identifier:r... -..(........................ _.... _.............._.........._..._......._ ...._....... _.............. ........ _.................. _..... .......
Freeboard (inches): _
12112103
[]Yes �No
Yes ❑ No
❑ Yes ❑ No
Yes
❑ No
[]Yes
VNo
❑ Yes
ANo
❑ Yes
No
Structure 6
Continued

Facility Number:. 1 —.' 1� Date of Inspection 0
5.
Are there any' immediate threats to the in egnty of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes )r No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes ,] No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes No
8.
Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes o
9.
Do any smctures lack adequate, gauged markers with required maximum and minimum liquid level
motes—R 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 o
❑ Excessive Ponding PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12.
Crop type
13.
Do the receiving crops differ wi those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes o
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes l Io
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 /XNo
Odor Issues
17.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
-n&Y�go
liquid level of lagoon or storage pond with no agitation?
18.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes o
19.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes )ANo
)A
roads, building structure, and/or public property)
``
20.
At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes No
Air Quality representative immediately.
Comments (refer to question fl) `EScphua any YFS attswets and/or any recommendahons;greny otlec comments.
Use drawings of facility to better explain sttuatioas (use adrhtional pages as necessary) Field
�. V_ o Copy ❑ Final Notes
a
5imoe led aS Y501
cSbl =a-3o(� csoa = A9.7
Reviewer/InspectorName , 1`J ~ __ _ ,.e
Reviewer/Inspector Signaturet,I%IA /A 1> Date: �} '

--
Facility Number: Cn _ F, of Inspection Ip •
�T
Required Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes AN'o
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
�
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes X `ro
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes JR�o
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes No
25.
Did the facility fail to have a actively certified operator in charge?
❑Yes o
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes No
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes No
28.
Does facility require a follow-up visit by same agency?
❑ Yes No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes �eo
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)es$lVtf
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes ❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes ❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall []Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Fort
No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
A dinnnaI-C di meritcandfiirirknZii, _
�0 yin .—/d�✓w_cez
a
I7y,ocb Poem/�ry
12112103
nt

Assistance Site Visit
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 97 - 14 Date: /24/04 Time: 13:00 Time On Farm: F 70 1 WSRO
Farm Name Claude Shew Farm County Wilkes Phone: [phone]
Mailing Address 955 Deleplane Rd Roaring River NC 28669
Onsite
Representative Claude Shew Integrator
Type Of Visit Purpose Of Visit
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Routine
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Po ulation
❑ Layer
❑ Non -Layer
❑ Dairy
® Non -Dairy
Routine
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Po ulation
❑ Layer
❑ Non -Layer
❑ Dairy
® Non -Dairy
❑ Dairy
® Non -Dairy
tzs
o
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes ®no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ® no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ®no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier Dry -stack
Level (Inches) 24
CROP TYPES lCom, Silage Ismail grain silage Fescue -hay
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

Facility Number 97 - 14 Date:
3/24/04
PARAMETER
pp 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
Amendment
❑
❑
❑ 11.
Level in storm storage
26. Waste Plan Conditional
27. Review or Evaluate Waste Plan w/producer
❑
❑
❑ 12.
Waste structure integrity compromised
28. Forms Need (list in comment section)
El
❑
[113.
Waste structure needs maintenance
❑
❑
29. Missing Components (list in comments)
[114.
Over application >= 10% & 10 lbs.
❑
❑
❑ 15.
Over application < 10% or < 10 lbs.
30. 21-1.0200 recertification
[116.
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
❑ 24.
Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker check/calibration
❑
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
Other...
43. Irrigation system design/installation
El
El
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2
49. Drainage workievaluation
❑
❑
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'
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

1]
Facility Number 97 - 14 Date: 3/24/04
SLB (CS01) 14.4 Ibs.N/ton B, SLB (CS02) 12.6
SLB (VS01) 14.5 " "
No cattle in confinement. No cattle waste applications since the last inspection.
Mr. Shew has waste analysis and application records for the poultry operation.
Good farm.
TECHNICAL SPECIALIST IRocky Durham
SIGNATURE
Date Entered: 3/26/04
Entered By: lRocky Durham
03/10/03

Facility Number 97 14 Date of Visit: 06/17/2003 Time: 1300
0 Not Operational 0 Below Threshold
® Permitted ® Certified ❑ Conditionally Certified 0 Registered Date Last Operated or Above Threshold: U9101/.1."I.
Farm Name: Claude.Shew.Ealaut..................................................................................... County:WAkC5 ............................................... W..SR.........
OwnerName: Claude .................................... Shew.lir. ..................................................... Phone No: 33.6 9.q'3834...........................................................
Mailing Address: 9S.S.1?lllaplaue..Rd.............................................................................. Ktta1rjng. y.9r..NC.............................................. 2W9..............
Facility Contact: Claude.Shew..................................................Title:................................................................ Phone No: c:33.0.57...7.16(1....................
OnsiteRepresentative: CIRl1td.e.,Ske.W.............................................................................. Integrator:......................................................................................
Certified Operator:Cl2tude..E ............................... SIM.W.d[,,.......................................... Operator Certification Number:Zl436 ..............................
Location of Farm:
Hwy 421 north, right on Clingman Rd. Left onto old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right, farm is at th
end of the road.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude ®• 11 18 " Longitude 81 • 02 ' 4
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)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge.
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ....... 1]cy.Stack.......
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
®No
❑ Yes
® No
❑ Yes
® No
Structure 6
Freeboard (inches):
05103101
Continued

Facility Number. 97-14 • Date of Inspection 06/17/2003 •
1
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 4-6was 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 Corn (Silage & Grain) Fescue (Hay) Fescue (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15. Does the receiving crop need improvement?
❑ Yes
® No
16. Is there a lack of adequate waste application equipment?
❑ Yes
® No
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
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments refer to question #p Exphtin any YES answersand/or any recommendations or any other rnmments
Use drawings of facility to better explain situations (use additional pages as necessary : ❑ Field Copy ® Final Notes
19. No cattle on site in the last year. No soil or waste analyses or application records required.
Farm # 2 is ok.
Poultu
Waste analyses range 24.2 - 24.8 lbs. N/ton
Waste plan for poultry needs to match what operator is actually doing (ex. change application windows for fescue hay). Records look
good.
Reviewer/Inspector Name Mel' Rosebrock
Reviewer/Inspector Signature: Date: Q
OSIO3101 r v Continued

FacidlityNumber: 97-14 Do Inspection 06/17/2003 •
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?
left blank are not applicable to this facility at this time.
❑ Yes
❑ No
❑ Yes
® No
❑ Yes
® No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
05103101

2PM
Type of Visit JQ Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine 0 Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time: wMal
Permitted 0 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:`
Farm Name: /� %ela ud tg. S lA Farm County- W 1 / Ite-.5 p z
Owner Name: 0,10 t Ap. ��r Phon o: 3 0 ' qO i ' 3 U 3
Mailing Address: �1 / /�j)��'�e /C,IJ G a 166 y
Facility Contact: ('f 1 Aa `) httoTitle: T one No, cell Y 4� 7. 7 �6 0
OnsiteRepresentative: 61 1214SPIJ - A�\J Integrator: ! VSON' Poyi' y
Certified Operator: Claude, E . S60,1.11, -_T r. Operator Certification Number, o2/ 3&
Location of Farm:
Qo/ 2o►-Ih . � f4en-k i17 Man , e on a -
1 miles bei gpiye� 'M-cf 4urn rioh-f F 'f-M 4{ „d afr
❑Swine Poultry Cattle ❑Horse Latitude ••®� ongitude �•�•-
Design_:. Current :�Desrgn . ".Current - .Design Current
Swine _ '- Ca acitv_Po ulation Pout Ga acrty_ Po ulation :.Cattle„ Ca achy ,Po ulaLon
❑ Wean to Feeder Dairy
.m ❑ Feeder to Finish ❑Non -La er Non -Da' �--s
❑ Fatrow to Wean-
;.w) ❑ Farrow to Feeder ❑Other
_
❑ Farrow to Finish Total Deli Ce act
❑ Gilts t 7.
P=
❑soars Total35LW_ /00 QOQ
�...
Nn`mber ofLagoons ®; ❑ Subsurface Drains Present ❑ La pop Ares 1'
_ ❑ S ray Field Area
Holding"Popds /Solid Traps �-Ek<o Liquid Waste Management System t -
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
a 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. 2. Is there evidence of past discharge from any part of the operation? ❑ Yes Lg No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �{/j'No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes �(No
$tructuT 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): U
05103101
Continued

Facility Number: — Date of Inspection {1-p
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any smctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? -
❑ Yes ®No
❑ Yes )(No
❑ yes No
❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? Excessive Pondin ❑ PAN Hydraulic Overload
12. Crop type
❑ Yes
❑ Yes
�o
o
13.
Do the receiving crops differ with those d gnated in the Certified Anim ante Amagement Plan (CAWMP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
o
b) Does the facility need a wettable acre determination?
❑ Yeso
c) This facility is pended for a wettable acre determination?
El Yeso
jNo
15.
Does the receiving crop need improvement?
❑ Yeso
16.
Is there a lack of adequate waste application equipment? - -
❑ Yes
Renuired Records & Documents
17. Fail to have Certificate Coverage General
of & 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
6t
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis 80sample reports)
❑ Yes
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
KNo
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
�,/�
(ie/ discharge, freeboard problems, over application)
El 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?
ElYes
No
25?Were any additional problems noted which cause noncompliance of the Certified AWMP?
ElYes
INO
No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit
.Comments(refer to question #): Ephun aay YFS apswefssnd/or any recotttmendations o_r. any er comments.
Use drawings of facility to,better explain situations. (dse addtuonal pages as necessary) �~
Field Corm �z ._ - -- _ ❑ Final Notes 1
Iq .AJ6 �. _ aA,41) 02
UAA02
a►�t�w -Ha,— a
Reviewer/Inspector Name
Reviewer/Inspector Signature Date:
O5103101 1.
` . r
Continued

Facility number: — of inspection •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ya,
liquid level of lagoon or storage pond with no agitation?
27. Are there anv 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? ---E ^Q u
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.) ETTM -B�
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 pennanent/temporary cover?
Additional Comments and/or -Drawings: - -- - s -� -:-- -
Ajolltz
r
05103101

Facility Number 97 14 Date of Visit: 10222002 Time: 11:30
0 Not Operational 0 Below Threshold
® Permitted ® Certified E3 Conditionally Certified Q Registered Date Last Operated or Above Threshold: .........................
Farm Name: Claude.Sl ew-Eam................................ :.................................................... County:Wghgs ................................................ IYSBQ........
OwnerName: Claude .................................... Slxetv..dr...................................................... Phone No: 33.6,9.84z3.83.4 ..........................................................
Mailing Address: 9S.S.11eleplaute.l{.d............................... :........ :....................................... &9.adug. firer..NC.............................................. 2W9 .............
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
OnsiteRepresentative: ............................................................................................................. Integrator:......................................................................................
Certified Operator:.ClRlRdg. ............................... Slte)X.d¢.............................. .............. Operator Certification Number: 2l436.............................
Location of Farm:
3wy 421 north, right on Clingman Rd.. At stop sign go left on old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right,
arm is at the end of the road.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude ®- 11 IS " Longitude 81 • 02 ' ®"
ti? Des.
Current
Design C'•u'rren;t Destgu; ,Current;r a
Swine actt
P,o ula
Poultry Ca aci P,o ula 'on Cattle Ca acif ,', Po ulation
❑ Wean to Feeder
*
10 Layer I❑Dairy
tk
t"
�
❑ Feeder to Finish
10Non-Layer
I®Non-Dairy
125
0
❑ Farrow to Wean
_
'•"°„,,._
°.,f.�.
_
❑Other
-.
❑ Farrow to Feeder
n:
❑ Farrow to Finish
Total Design Capacity 125
e
❑ Gilts
Boars
Total SSLW lOQ,000
to
x Number of Lagoons
❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
4Holdrng{P,onds / Solid.Traps
0 ®No Liquid Waste Management System s,
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 IN No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway _ ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101
Continued

Facility Number: 97-14 Date of Inspection 10/22/2002 •
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 Aoulication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Com (Silage & Grain) Fescue (Graze) Fescue (Hay)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination?
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
Q No violations or deficiencies were noted during this visit You will receive no further correspondence about this visiL
Comments (refer to question tt): Explain any YES answers and/or any recommendations or any other comments
Use drawings of facility to better explain sifoatioas use additional pages as necessary : ❑ Field Copy ® Final Notes
o cattle waste applied this year to date.
Poultry waste plan and application records were on site.
Facility seems to be in compliance.
Keep an eye on the copper levels of some fields.
u-I @ 2000-3000 warning track, Cu-I @ 3000 or more: no animal waste applications recommended.
Reviewer/Inspector Name !Rocky Durham
Reviewer/Inspector Signature: Date:
05103101 Continued

FacililjtJumber: 97-14 1 Da0Inspection 10l22/2002 •
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
05103101

1 - ton of Water Quality
00,ion of Soil and Water Conservation
0 Other Agency
(Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 97 14 Date of Visit: 6/12/2002 Time: 1315
0 Not Operational 40 Below Threshold
0 Permitted ® Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Claude.Show....Fa.1:DA..................................................................................... County: \'.ki tes................................................1'.E'SRQ........
OwnerName:Claxide.................................... SllewIx................................. .................. :.. Phone No: 336-9. U.8]9...........................................................
Mailing Address: 9S.S.i)ellsPlane.l3d.............................................................................. RQRrjUgR1yRr.XC .............................................. 2B.6.6.9 .............
Facility Contact:Cla.ude............................................................... Title:................................................................ Phone No: ce11.336.951 I16U...............
Onsite Representative: C1ai dP.S.h¢..w............................................................................... Integrator:......................................................................................
Certified Operator:Cl,2ude.Z .............................. Sbx.N.k............................................ Operator Certification Number: Zl'136.............................
Location of Farm:
Hwy 421 north, right on Clingman Rd.. At stop sign go left on old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right,
farm is at the end of the road.
❑ Swine ❑ Poultry 19 Cattle ❑ Horse Latitude 36 • 11 18 Longitude 81 • 02 24
Design Current
Swine CapaeitV Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons I
Holding Ponds / Solid Traps C
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer 10 Dairy
❑ Non -Layer ® Non -Dairy 125 1 0
❑ Other
Total Design Capacity 125
Total SSLW L
Subsurface Drains Present I ❑ Lagoon Area
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No .
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......Dry.Stack.......................................................................................................................................................................................
Freeboard (inches):
05103101 6O8 / Continued

Facilit Number: 97-14 Date of Inspection 6/12/2002 •
5. ATddpm9 Qp}t�tirRBtfit�hitlelkb a>pfl l>RI of the structures observed? (ie/ trees, severe,, • ®No
seepage, et
Gavilmhare not properly addressed and/or managed through a waste m3���Aes-
��
G. R cAVilki tano s Sec eta ® No
p (11 any o€quess ions 4-6 was answered yes, and the situation poses an N C D E
Charles H. ( iapeWt#iq�e itggvironmental threat, notify DWQ)
7. Dg�mygfabe fkglOgdSpieed maintenance/improvement? WINSTON-SALEM REGIONAL[grf qqE®No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application -
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
12. Crop type Corn (Silage & Grain) Fescue (Graze) Small Grain (Wheat, Barley,
❑ Yes
❑ Yes
❑ Yes
❑ No
®No
®No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
®No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination? - _ _ -
- _ 0 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
IXI 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
l3 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): E]Field Copy ® Final Notes
15. Continue to.monitor copperfromsoil-analysis-reports as -field CS710 was at 2822: Discussed with operator that he could not use a
+
eld far animal waste application once copper or zinc reached 3000.
19. No cattle waste applied in 2001 or so far in 2002. No waste or application records required. Also checked poultry records.
Operator may need to add some fields to the WIT.
5. Add `landfill' to mortality checklist.
Also checked farm#2ionlnnorth sides of highway 60 near Clingman. looked ok.
Reviewer/Inspector Name AiLVs 2Aigkt 2kStreet Winston-Salem North Carolina 27107
- - - - Phone 33Customer Service - i-
Reviewer/Inspector Signature: ate:
05103101 _ U Continued

Facility Number: 97-14 DaInspection 6/12/2002
Odor�ss�ie rtment of Environment anaNatural • t� •
26. I`��,�e �;pd &�onf nement building to the storage pond or lagoon fail to this � ❑ No
�itlP ail f�ogoe r sto�ae pond with no agitation?
any
ass, animals
NCDEHR
27. Are there any dead animals not disposed of properly within 24 hours? ®No
Caries H. Crrdne, P..C�. L'F� �
28. Is any e e ce o wm 8nffdiirmg Irapplication? (i.e. residue on neighboringtgpgg)jp��g)VpjR_GioNnt fl3t'dE ®No
rD�ai$n MR, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments and/orDrawings:.'!""' �, i'e=
r
585 Waughtown Street, Winston-Salem, North Carolina 27107
Irtione azCustomer Service 1-877-623-6748
An Equal Opportunity/ Affirmative Action Employer
05103101 _

/dz" / 3opm
IType of Visit N compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit y Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: Time:
Not Operational 0 Below Threshold
Permitted $0 Certified Q CConnd_it�ionnally Certified D Registered Date Last Operate�d or Above Threshold: 9 Z
Farm Name: IA�IQIudQ _IIetZ Irarm County: IQ 1 I yp'ps
Owner Name: C�0.1)At- apo I 7r' Phone No: � ' l S 3 83 V
Mailing Address: S S D el��pnla In 2. %�aari rx� Iye�r-� Jy� a. g 6 6
Facility Contact: I Qv Jp— Title: Phone No: q5- 7 � 7 I� 10
OnsiteRepresentative: r,IQ/l49 Integrator:
Certified Operator: GI QA-)��. -tJ Operator Certification Number,
Location of Farm: _
t>s " o erM
d.
on fa o r -
❑ Swine ❑ Poultry Cattle ❑ Horse Latitude IJ ®' ®- Longitude
Design
Current` �` - Design
Current''"'- '�"
Design Cunrept
':,c,Ca aci
P,o ulafion P�oultr,,y Ca aci
Reputation Cattle
Ca achy P,o ulafion
n to Feeder
❑ La erder
to FinishNon-La
erow
to Weanow
rrC3Farrow
to FeederOther
to Fi❑ish
Total Desin Caacit
I asrs
rN
Tota1SSLW
Qd O00
Number of Lagoons
® ❑ Subsurface Drains Present ❑ La o0a Area IQ Spray Field Area
Holding Ponds /Solid Traps
® No Li uid Waste Mana ement Svstem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structur Structure 2 Structure 3 Structure 4 Structure S
Identifier: I
Freeboard (inches): /�ff)WL-& _
05103101
❑ Yes ;(No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0, No
El Yes ixNo
v^— Y�
Structure 6
Continued

Facility Numb • Date of Inspection bz •
er. 7 — I /D// 7-/ O
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? 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 o
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ElYes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? - ❑ Yes )P'No
11. Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑//H�ydraulic Overload \ El Yes
12. Crop type Al �✓, -<,a n Q D An AL [AA. - �Jn AJ4JAP IAA A . 0 1
13.
Do the receiving crops differ with those designated in the Cc fied Animal Waste Iv ttagement Plan�AWM*)?K
❑ Yes No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
WNo
b) Does the facility need a wettable acre determination?
❑ Yes
B No
c) This facility is pended for a wettable acre determination?
❑ Yes
X No
15.
Does the receiving crop need improvement?
❑ Yes
)<No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
)SrNo
Reouired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
KNo
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
A No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
o
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
El Yes
JNO
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yeso
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
_�,//
(ie/ discharge, freeboard problems, over application)
❑ Yes
Jen4,No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
W'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
R1 No
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
.. n " a, P a � 1v 39 e .§4 i" ;'..xi -Mi3 {: 4, a .'°4` $i .i ?rL �. .'ss�: Z -p&' �, j ti
Comments:(refer to question # Explain any YES answeis�and/or any,recommendations orr any other comments. ' ` ' 5%i
Use drawings�of facility better situations. (use additionallpagesras necessary) Field Copy ❑ Final Notes
�1
Uwe ROO
0
Reviewer/Inspector Name Effijpll'
Reviewer/Inspector Signature: Date: 01--
05103101 Continued

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

vision of Water Quality '�?
rsion of Soil and Water Conservation v.
Q Other Agency
(Type of Visit O Compliance Inspection 0. Operation Review O Lagoon Evaluation
for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 97 14 Date of Visit: 11/1/2001 Time: 11:20
0 Not Operational O Below Threshold
® Permitted ® Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: Claude.Shew.Faetu..................................................................................... County:\'.F'.i►1CeS................................................ W..SRQ........
Owner Name: Claude .................................... ShearIT...................................................... Phone No: 336-9.83-3.539...........................................................
Mailing Address: 9S.S.D9lepla:ne.lid................................................................................ R9.ajrjvzRxycK.XC .............................................. N.6.6.9 ..............
Facility Contact:
Title:
Onsite Representative: Clatade..Shen'............................................................................... Integrator:
Phone No:
Certified Operator:Cladde.Z.............................. Slmw.Jr............................................ Operator Certification Number:2.1.43.6 .............................
Location of Farm:
wy 421 north, right on Clingman Rd.. At stop sign go left on old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right,
arm is at the end of the road.
❑ Swine ❑ Poultry ® Cattle [I Horse Latitude 36 • ll 18 Longitude 81 • 02
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
Number of Lagoons 0
Holding Ponds / Solid Traps ,E:=
Design Current
Cattle Capacity Population
❑ Dairy
® Non-Dairy1 125 1 15
Total Design Capacity 125
Total SSLW 100,000
Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
No Liquid Waste
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ®No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:........Drystack.................................................................................................................. ......................................................................
Freeboard (inches): 48
05103101 Continued

Facility Number: 97-14 Date of Inspection 11/1/2001
{
5.
Are immediate to the integrity
there any threats of any of the structures observed? (ie/ tree*ere erosion,
❑ Yes
N No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
-
closure plan?
El Yes
N 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
N No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
N No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
N No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
N No
12.
Crop type Corn (Silage & Grain) Timothy, Orchard, &
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
N No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
N 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
N No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
N No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
N 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
N No
21.
Did the facility fad to have a actively certified operator in charge?
❑ Yes
N No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
N No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question ft 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 N Final Notes
r. Shew has not applied beef waste to date. There were only 15 calves that could come up to the barn to eat and were able to return to
pasture. Not confined. Poultry waste plan was on site.
r. Shew has a poultry litter structure that the beef waste can be stared in until it would need to be applied.
Reviewer/Inspector Name :Rocky Durham
Reviewer/Inspector Signature: Date:
05103101 Continued

Pacilit}Number: 97-14 D6f Inspection 11/1/2001
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
WD37LIA

Facility Number 97 14 Date of Visit: 620/2001 Time: 1115 Printed on: 6/21/2001
O Not Operational 0 Below Threshold
0 Permitted E Certified 0 Conditionally Certified ❑ Registered Date Lust Operated or Above Threshold: 911119.92 .......
Farm Name: Claude.5liew.Falaat..................................................................................... County: Wags !' .SRQ........
OwnerName: Claude .................................... 5ttew.ls...................................................... Phone No: 33b-9...$4-3.83.4...........................................................
Mailing Address: 955.Aelevlaae.lid................................................................................ RQ.4AV9Xiy.rr.XC .............................................. ?5b69..............
Facility Contact: Claude.5hew.................................................. Title:................................................................ Phone No: ceB.RlAoue.9.S.7.-7.1b0.........
Onsite Representative: C.Laudg-SlIm.............................................................................. Integrator: Tys.alt-F9.Wjry............................................ ............
Certified Operator: I7Audi................................... Sllcn:.................................................. Operator Certification Number:21436.............................
Location of Farm:
Hwy 421 north, right on Clingman Rd.. At stop sign go left on old Hwy 60 and go 2.1 miles to Dellaplane Rd. and tun right,
farm is at the end of the road.
[ISwine ❑ Poultry ® Cattle ❑ Horse Latitude ®• F 11 18 Longitude F 81 • 02
Des gn
Swine Ca tacit
Gur'rent
P,o Is on
v. Design Current
Poultry Ga aci P,o ulation
Desi�Current
Cattle Ca aci P,o ulat'on
❑ Wean to Feeder
❑Layer
❑Dairy
❑ Feeder to Finish
❑Non -Layer
®Non -Dairy 125 7
❑ Farrow to Wean
❑ Other < t
Total. Design Capacity 125
Until Ss .2 1110,000 .
— -- -- -- sue.
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 0 ❑ Subsurface Drains Present o❑ ❑ Lagoon Area Spray Field Area
Holding Ponds / Solid Traps 0� IN No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or 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: .Dry..stack-.empty.................................... .................................... ................................... ......................................................................
Freeboard (inches): 48
05103101 ontinued

Facility Number: 97-14 Date of Inspection 6/20/2001 • Printed on: 6/21/2001
•
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
12. Crop type Corn (Silage & Grain) Fescue (Hay)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
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
❑ 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 an YFS answers an or an recon mm lions or an other comments.
se drawings of facility to better explain situations use ad 'tin pages as necessary ❑ Field Copy ®Final Notes
19. This facility has never had over 100 cattle. Have not applied any beef waste. No soil or waste analysis required.
27. Any dead cattle are taken to landfill. If cattle are ever buried onsite, the site was confirmed to be > 300 feet from any waters oIthe
State.
Poultry:
Ian written by Clayton Porter. Could not dtermine how much PAN has been applied and PAN balance determined for each field. Could
of produce 2000 soil analysis results.
Reviewer/Inspector Name !Meli Rosebrock
Reviewer/Inspector Signatur . Date: Q
05103101 1 1 r Continued

Facility Number: 97_14 0•f Inspection 6/20/2001 • Printed on: 6/21/2001
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
05103101

n
Type of Visit P Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit iRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number I Date of Visit:
13 Permitted #Ceefrti�fited 13 Conditionally Certified 13 Registered
Farm Name: ........dn.�1.`7. de...; .i``Feil...�.....................................
Owner Name:......! G.�_A_udt�.......S h'& ,..... r:..................................
Facility Contact: ......Cla.. L'4f�..........5 ...........Title :.........................
Mailing Address:
Onsite Representative:
Certified Operator
Location of Farm:
u
❑ Swine Poultry
,me
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedc
Farrow to Finist
7
Cattle ❑ Horse
Design Cum
Date Last Operated or Above Threshold: UZ.J� .�9.'
County:......o1....1.
Phone No: ............ `....{.A...-�._l� .Iop_1....__.......__�./.__.
....................................... Phone Nbe1e;.k'....kc..�._11.60
x).L.ri.n�........R.1 me�r.......0 c..... a S/ 6�
Integrator: i1.1 .... ...: Tys.io1..._22..............
Operator Certification Number:,,_.... V „�%�,,,_....
.�} 5-top l 5Is1�1 i
Plane- to
Longitude ® • ®°
_ Desiga ' . Current �11
.cattl¢'.. ['ananly Pnnnlafinn .``-.
-� _o oh f4t-►Y►
Total'Design Capacity
Total.SSLW
Number of Lagoons -. ® .. ❑Subsurface Drains Present ❑ Lagooa Area ❑ Spny Freld Area
Holding Ponds / Solid Taps- ® No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes �o
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If 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 WNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
-t�Structure 1 .Structure.2 Structure 3 Structure 4
Identifier:..b.ri.sAae u..........................................................................
Freeboard (inches): E +- C('�
5100 '��`�' I
❑ Yes *0
Structure 5 Structure 6
Continued on back

Facility.Nurn r: —� .• Date of Inspection I(e I
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ treetsevere erosion, ❑ Yes *0
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes I�] 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 stuclures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? N A_ _8� r—`T�
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? ❑ Excessive P//oon-nding ❑ PAN ❑ Hydraulic Overload ❑ Yes "� No
12. Crop type 0 (A .51) a /lw , P— <� r oit, K /J .. r
13. Do the receiving crops differ with tkQ,ie designated in the Certified Animal Waste
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Plan (CAWMP)? ❑ Yes
1p No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
1
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? E i'es--1Nv
18. Dces [he fa ' ' 1 to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklist design, maps, etc.), Yes
,No
19. Does record eepmg need improvement? (ie/ irrigation, freeboard, waste analysis soil ample 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 Rl 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
�!Iq-yio1atiogs'ojr• d$fclepcie * *re pote$• Iltrt itag this:vpspt; •You wjti•�ec4iye tjq WOO
:: corresuoridence abouEthis visit::::: ....... ................. .
l� . New �0 CrLc G@ odorn6eC4-
ReviewerQnspector Name
NIP 1% tic) P - cam.
611P P_114cl UXpo
�fl� .rt �a� l � it .,.y �y t �✓{
Reviewer/Inspector Signahlce!II III A I I r Ai A) — U.J19tn I I A7y0 Date: O/ 5100

Facility Number: — *f Inspection •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below •$N6
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 ;VNo
❑ Yes )(No
❑ Yes ` No
❑ Yes No
nNo/
ona t_ , omments an or ra ngs: , k, , _,
Ci�e�9e1�si5 �mer�eney �1OLr)?
`
�100 �r'toll' to 611*1 7N°.00 be-160 M)M&A-5/06YYle
o ff' 1 S4 ? Na
too
1q. �� P
Ai z ( 44;6 ���e � � /V /V)
-�
c2oo
5/00

(Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit 0 Routine O Complaint O Follow up 0 Emergency Notification O Other ❑ Denied Access
Facility Number j
Date of Visit: 12/4/2000 Time: 8:30
0 Not O erational O Below Threshold
0 Permitted 0 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Claude.Sheet:.Fam..................................................................................... County:WAUs ............................................... IY.SRO........
Owner Name: Claude .................................... Siren:. Lr..................................................... Phone No: 33.6_9.84.-M.3.4 ..........................................................
Facility Contact:
Title:
Phone No:
Mailing Address: 95.5.Dglephate.lid................................................................................ R.aaxulgR1y.et:.NC.............................................. Me. ..............
Onsite Representative:
Integrator:
Certified Operator: Claude....................................$1111M .................................................. Operator Certification Number: 21Q36.............................
Location of Farm:
Hwy 421 north, right on Red, White & Blue Rd. At stop sign go left on old Hwy 60 and go 2.1 miles to Dellaplane Rd., right �
to farm at the end of the road.
❑ Swine ❑ Poultry 0 Cattle ❑ Horse Latitude ®• 11 18 Longitude 81 • 02 ' ®"
Design Currents
Swine •'�-,� .,fi �, -
Ca act cl'o Wation
; tee. -sa -, r 'xc —saa �w �vrs
+p ;,Design-t C.'WW '< Deslgn Current3�'
..Pool[`. '' , •�: - Cattle" - "' s. -..q.
rY Ca act dA Wation Ga act tfP,o Wation
❑ Wean to Feeder
10 Layer I 1❑Dairy
❑ Feeder to Finish
❑ Non -Layer
®Non -Dairy
125 7
❑ Farrow to Wean
❑ Other
7-*
❑ Farrow to Feeder-
Total Design Gapactty
"
125
❑ Farrow to Finish
� ❑Gilts
(] Boars?
�x � t.� �`
; b Total SSLW
100,000
Number of Lagoons
0 ❑ Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
Holding Ponds / Solid Traps
®No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or 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:..........d[ystack......... ..................................... ................................... .................................... .................................... ....................................
Freeboard (inches):
5/00 Continued on back

Facili NuDate of Inspection 12/4/21100
5. Arember: 97-14 here any immediate threats to theOgrity of any of the structures observed? (ie/ V severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markets with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
J ,
1.
[]Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
[]Yes ® No
❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload []Yes ® No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0' Nq-Yiotatioris;or' :deticiencies were noted :dufiittg this visi'L`Yoa''Will' iecerve hd furth'e't•
corresilotidefi& about this:visit.. .................... ..... ... .
waste is being collected as animals only on lot long enough to eat part of the time.
❑ 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
k.
Reviewer/Inspector Name Daphne Cartner
Reviewer/Inspector Signature: Date: 5/00

Fa'c[lity Number: 97-14 D f Inspection 12/4/2000 •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt.
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
S/00

Facility Number 97 14 Date of Visit: 7/17J2000 Time: 1000 Printed on: 7/12/2000
0 Not Operational O Below Threshold
E3 Permitted N Certified 0 Conditionally Certified [3 Registered ..
Farm Name: Claude.SlAe\Y.lam.....................................................................................
OwnerName: Claude .................................... Shew.lr. .....................................................
Facility Contact: M4ude.5I1R1v,.JX..........................................Title:.........................
Date Last Operated or Above Threshold:
County: \l7kCS..................... ..... ......................
..5RO........
Phone No: 33Gr9.$4.:3&a9...........................................................
Phone No:
Mailing Address: 95.S..i2elt:plztttt:.lid................................................................................ RQ.ajrj1MRiy.rr.N.0 .............................................. 20.09 .............
Onsite Representative: Cl;tud.¢..S.heK..Lr........................................................................ Integrator:
Certified Operator:l~.laade.E ............................... Shm.d[........................................... Operator Certification Number: Al4�b. A1.4M .............................
Location of Farm:
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude ®• 11 1S Longitude 81 • 02 24
Design Current
Design Current Design' , Current
Swine Ca acit P,o ulatioa
Poultry Ga aci P,o ulation Cattle Ca tacit P,o ulation
❑ Wean to Feeder
❑ Layer
❑ Dairy
❑ Feeder to Finish
Irl Non -Layer
®Non -Dairy
125
7
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity 125
❑ Gilts
❑ Boars
Total SSLW [00,000
Number of Lagoons
0
❑ Subsurface Drains Present ❑Lagoon Area I[] 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? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .1y.Slack.Only. ......................................................................................................................................................................................
Freeboard (inches):3a,s7
Continued on back

Facility Number: 97-14 Date of Inspection 7/12/2000 Printed on: 7/12/2000
5. Are there any immediate threats to the Verity of any of the structures observed? (ie/ treoevere 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 Corn (Silage & Grain)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
IN No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) 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 readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0` 4
¢-violati6its:o deficiencies &emoted :d iiih9 this: visit; Xtiu:will deceive ttuaftirther
corresnondencetibouf this.vtsit .................. .
❑ 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
No checklists or emergency plain. Mr. Shew will ask Wilkes SWCD to include in his new, combined, cow/poultry plan.
Cows only on pasture currently. No waste applied this year. No waste/soil records for cows.
0
Reviewer/Inspector Signature:
Reviewer/Inspector Name !Melissa Rosebrock _ —
Date:

Facility Number. 97-14 D�of Inspection 7/17J2000 • Printed on: 7/1212000
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

aa�outine Q Complaint 0 Follow-up of DWQ inspection 0 Fo I Ilow-up of DSWC review O Other
Facility Number Date of Inspection D7
[Time of Inspection 24 hr. (hh:mm)
0 Permitted JrCertified O CConditio`nally Certified [3 Registered 0 Not O erational Date Last Operated: ..........................
Farm Name: .._5,r��.pp�t Q....... �..1.�em).._Farm................................................. County:.....�.)...�..�Le�......................1. �.......................
Owner Name: .... s%..I.o-...... S 1a......................................... Phone No:...336 t 48..E ._38 37
�s ..........TTr� ........ .............................................
Facility Contact: ...C'.La-Uj.0 . .�e_ j... I..r..:..Tiptle�:................................................................ Phone No: ...................................................
Mailing Address:.... 5L E......hede pan.e.........A`. !........................... Lr...l.:.. Q.....1. � Ile r CZ p P.. ? ..................... ...........
Onsite Representative:
Integrator:
Certified Operator:... tQ e,,.,.;, ........ i ..J. ..J'T t ....................... Operator Certification Number:
Location of Farm: _ _ . , _ - _ I
Is
Latitude =•=' =" Longitude =• =` =" �O'
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes )6No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ycs, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes )V<o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes*o
Structure t Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: �) (�
Freeboard(inches): ............ !.-JA.\...... .................................... ................................... .................................... .................................... ...............................1... `/
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

k'acility Number: Ll I — 1 Ote of Inspection db
6. Are there structures on -site 'which are0properly addressed and/or managed through a waste management or '—'T-•T�
closure plan? ❑ Yes Iwo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? - ❑ Yes o
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level .
elevation markings? ❑ Yes >Io
Waste Application ]],�..
10. Are there any buffers that need maintenance/improvement? ❑ Yes A,No
11. _ Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes �00
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yesh<No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes CNo
b) Does the facility need a wettable acre determination? ❑ Yes 4�No
c) This facility is pended for a wettable acre determination? ❑ Yes AWO
15. Does the receiving crop need improvement? ❑ Yes A No
16. Is there a lack of adequate waste application equipment? ❑ Yes Ago
Reouired Records & Documents
IT.
Fail to have Certificate of Coverage & General Permit readily available? N JA
❑ Yes ❑ No
18.
Does the fa - - to have all components of the Certified Animal Waste Management Plan readily available?
WUP hecklisls design,
)6Yes ❑ No
(ie/ maps, etc.)
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
o
❑ Yes to
20,
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes RNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes AN0
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes -k,�,r'lgo
24.
Does facility require a follow-up visit by same agency?
❑ Yes No
[g
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes �Vo
iVo •vigl�(i¢ris;or• defcieuc+es were itgtet} tretig this:visit; Yoit will•ieceive n' fui thor
::
coriespondeitce: abotit his visit: :::::............................ .
��. No CV1ecK 1iSES ore-m"encj pon. Rr. 51J will czS1�
Wil1[es Sw"V fin, �r�clud- IVY {1iSU12�J CcWlbtv�eci�
© h lk, ® h pas +u re
ctPplte � s �eb.t-. No U)45+-e jSoi r� oro�s For co
Reviewer/InspectorName
Reviewer/Inspector Signatur / j71f,Q I t Date:

Facility Number: — & of Inspection • "
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
940r-�
liquid level of lagoon or storage pond with no agitation? - Qrn I T yZbOd
27. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes X-1 o
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes )No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? N/P
❑ 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 100
31. Do the animals feed storage bins fail to have appropriate cover?
❑ Yes X<O
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ON I Taboo
o *es--�
1[O'Outmeots O[,.rav�tngS _. i•e-',,, '�-� .' -�'.>'_ -,... _ is , ,y.s="-3-=�^' .,.,--

.4
Facility Number Date of Inspection -
[Time of Inspection 20 24 hr. (hh:mm)
Q Permitted III certified 0 Conditionally 'CetiZed Q Registered Not O erational Date Last Operated:
Farm Name: .... L./L'iqvO.------- .,I.facW........ NRnZ.....................-..T.............................. Cuunty:............W1.41s:ES.............................. _INSQD....
OwnerName: ...... Jf. % L..Q. ....................... .... sy.e✓................N...�C,......................... Phone No:..... ,3.�a...'..` . �i.-..3 3.y...............................
Facility Contact: ... Li14R12E......... SHE.IA/...... TY3.......p.Title: ...........4.L✓N 1( ............................... Phone No: .......... $. .ti£........................
Mailing Address:......gt. ..�5........ ELEpGIiNF.......... ii& ............................... ..........
OnsiteRepresentative:........................................................................................................... Integrator:......................................................................................
Certified Operator: ..... C1-.4.V..n.F................... ..... ........ s}fEW............. T&%................. Operator Certification Number: .... Z Z.L.36
.........................
Location of Farm:
..._L'..:.....:. .�e ....../�.t-......Y......... ... ............:/ .:.....:!]^`t.:: ._ ........ ..........'�^`.. ...._ :...:..f.::.:!tt..rut..h�-.........M...f.:.:�r..........................
Latitude ©• �/ 19' Longitude Irl • Fee 2y '°
.. ,.- ,. 'Design - n Current: = Design '- - ,. go gn Current _ Design. Current
_ Capacity Population:.: poultry -+Ca acity Population :Cattle Capacity Population,
❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer on -Dairy j p
>; ❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Dest Ca acit
g�. P „ .Y �2s
❑ Gilts,
❑ Boars Total SSLW I DOS 000 i
'Dumber of Lagoons Subsurface Drains Present _❑ Lagoon Area IDSpray FZeld Area -
Holding 'Ponds / Solid Traps E::=- ` ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: []Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: %%yy��
Freeboard(inches): ....... .N./A—..................................................................................................................... ............................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes UIKO
❑ Yes
9? o
❑ Yes
t6J1140
N %
❑ Yes
Mqlo
❑ Yes
9146
❑ Yes
Q3, o
❑ Yes [0,N'o
Structure 6
t
❑ Yes [ G4
Continued on back ,tt�-

Facility Number: 97 — :� •te of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes VIT�o
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes K�C�o
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [j o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? []Yes [a No
Waste Application /
10. Are there any buffers that need maintenance/improvement? ❑ Yes 2 No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes LI}'No
12. Crop type r-;0 ac- C
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [j*No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes 92'Slo
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?
❑ Yes [RIIo
❑ Yes R1`Io
❑ Yes 01-Ko
❑ Yes ZKo
[-]Yes [D Ko
❑ Yes tldKo
❑ Yes ��, /o
❑ Yes 6'1vo
Cl Yes2�o
❑ Yes N40
❑ Yes M4410
❑ Yes Vo
❑ Yes [ Vo
3/23/99

Facility Number: �7—e of Inspection •
i
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes t-rvo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ttd'tvo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes R<0
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 P'<o
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 lq<o
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes EKo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes
3/23/99

ssu zaxz..
Q Divtston of S nd Water Conservation ❑ Othlency
Division of Water Quality
® Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review O Other
Date of Inspection
Facility Number Time of Inspection Ib ' U 24 hr.
to o ar 3/Gy
0 Registered ® Certified 0 Applied for Permit 0 Permitted 10 Not Operational Date Last Operated:
Farm Name: ....... �t,.Gn2c,�'c....... ... /l`.. �.................................. County:..... .✓*� �r1..............................�✓s.2..Q....
Owner Name: ...... l d/�:s_...................... [c r.........0 '........................ Phone No:......3.r� err.-.. .Y..... '.3.�%.......................
Facility Contact:.!, YAtx....... zo(�o......................�...../Title: .........
tl i1 . ./..�1.........................../�Phune No:... ......... ........................
Mailing Address: ....... 7.. >..��4".................................... ...alLeRN.+..._-dls?^r4:................................ .2.i...6... ...
Onsite Representative:
r......................................................�.....p............................................ Integrator:......................................................................................
Certified Operator:....... n........................... ... ...........
�- _.:.............. Operator Certification Number, ...... 2 / y..3fe...............
Location of Farm:
Latitude®* FTFT F 1 L' Longitude $'/ • OZ 2-U
Design,.. Current Design_. Current Design Current'
m _ .
`Swine Capacity' Population Poultry Capacity Population Cattle a_. - Capacity"Population'
❑ Wean to Feeder ID Layer I ❑ Dairy
❑ Feeder to Finish ILI Non -Layer I IN Non-Dairy1 Z
' ❑ Farrow to Wean
❑Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity : 2
El Gilts .��.
❑ Boars Total SSLW l 00 ODO 1
Number' of Lagoons`t Holding P`imds`'.❑ Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area r
�� �'. -, > . = ❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
13'Id0
2. Is any discharge observed from any part of the operation?
❑ Yes
U P<
Discharge originated at ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
01W
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
9'158
c. If discharge is observed, what is the estimated Flow in gal/min?
/Vn
d. Does discharge bypass a lagoon system? (If yes, notifv DWQ)
❑ Yes
09, o
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
L1-'o
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
[VX0
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
M-Ko
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
��
LVINo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7/25/97

Facility Number: q — f y •� .
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
W" "'
Structures (LaEoons.HoldinE Ponds. Flush Pits. etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
ID'No
Struct%re I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: /.1/ C.
Freeboard(h)............ N.lL.............................................................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
[Dwo
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
mho
12.
Do any of the structures need maintenance/improvement?
❑ Yes
ZKO
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
tU'tvo
Waste Application
14.
Is there physical evidence of over application?
El Yes
�
040
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15.
Crop type ..... .[Y5-..1...........................................................................................................................................................................................
16.
Do the receiving crops differwiththose designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
0
Iry,
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
v ,
D,n<oo
18.
Does the receiving crop need improvement?
❑ Yes
,t
[9-1<0
19.
Is there a lack of available waste application equipment?
❑ Yes
11-10
20.
Does facility require a follow-up visit by same agency?
❑ Yes
j-, i��Qo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
E o
22.
Does record keeping need improvement?
❑ Yes
P4"0
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
��
EKO
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
El, o
25.
7pre any additional problems noted which cause noncompliance of the Permit?
❑ Yes
IU-No
No.viWfititihi or de566166.were noted during this:visit. You:will reeeive uo furi ei-.
correspoudeiteeaboutthis:visit:-:.::::.:.:.:.::::::
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature:.__'�„Jf Date: Q —Jr - .j k

Division of SZTand Water Conservation ❑ Other
Division of Water Quality
of DS%VC
Date of Inspection 11013i /97
v'v,oFaciIityNumber 7 /
Time of Inspection /b : Ss 24 hr. (hh:mm)
13 Registered 0 Certified [3 Applied for Permit E3 Permitted Q Not Operational Date Last Operated:...._ ....................
Farm Name:......1-.Gn.II.:Giv1�L�.....-c ..D.[�cr.'.....•�L..G!?^:!...................................._ County:....... N..«9............................. ..1�✓..$..!�.Q......
Owner Name: ...... r Q.4SA......................: t ... ................. Phone No:......(.0..-...`%i�X.-.3.Fi'..3.y.............................
,/p .�.........
Facility Contact:..1,X/�r :S .....r c:......�......./...... Title: ........ ./.p....,�...At.................................../Pghone�N'o:...................................................
Mailing Address: .......7..:?.. .... -:Pi ?`.:......f1..!+......................................�fiRN...... ........ 1Lt'r`t' ,2ft'66%
OnsiteRepresentative: ........................................................................................... ............... Integrator:.......................................................................................
Certified Operator;.... .........................- il!-Lel......... '............... Operator Certification Number: ...... C �.y. .6.............
Location f Farm:
.......................O ....... .. .. .. ....... ...!...............................................................................................................................................................................
..........................................................................................................................................................................................................................................................................
Latitude®— ©' 1®" Longitude ®• F-0-2 1` 0"
Design .-,Current=_ - ' Deign%, , Current - Design- = Current"�,.'..
Swine Capacity' Population,; Poultry Capacity Population Cattle Capacity Population f;
illr; ❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish 10 Non -Layer , `, Non -Dairy
`. `. ❑ Farrow to Wean y
[I Farrow to Feeder ❑Other
ISO
❑Farrow to Finish Total Design Capacity': (2S
❑ Gilts
' ❑ Boars Total SSLW ADO p00
NumberW,Cag000s / Holding�Ptiud ID Subsurface Drains Present I0 Lagoon Area 10 Spray Field Area
_ ❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. 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 Surface Water? (If yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'! (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes No
❑ Yes ® No
❑ Yes R1 No
❑ Yes ® No
❑ Yes 14 No
❑ Yes M No
❑ Yes 1N No
❑ Yes 10 No
❑ Yes No
❑ Yes No
Continued on back

1
y l
11 Facility Number: %-% -) •
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
9 No
Structures (La2oons.Holdine Ponds. Flush Pits. etc.)
9.
1s storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
K No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:...................................................................................................................................................................................................................
Freeboard (fr)
_
..............
10.
Is seepage observed from any of the structures?
❑ Yes
RNo
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
W No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
R No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes]
No
(If in excess of WMP, runoff entering waters of the State, notify DWQ)
15.
/or
Crop type .... Ltd ..1....},............................................. ...... _......._.......__............. _................. ............................
.............
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the receiving crop need improvement?
❑ Yes
PO No
19.
Is there a lack of available waste application equipment?
❑ Yes
No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
P No
22.
Does record keeping need improvement?
❑ Yes
No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
QQ No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
(R No
No.violitioits or deftcieitcies. were noted duffing this:visit. You will receive iloft rther :
correspondence about this:visit:

4
G Division of Jo d Water Uonservation
p Division of W Quality
19 nouttne p t-ompiamt p ronow-up of uwtl inspection p ronow-up of uswt: review p tuner
Date of Inspection
Facility Number
Time of Inspection 24 he (hh:mm)
p Registered 0 Certified p Applied for Permit p Permitted in Not Operational. I Date Last Operated:
Farm Name: ChuLdt.Shtw.Farm.........................................................:............................ County: Wilkes WSRO
Owner Name: Claude ................................... Shr-w.dr_.................................................... Phone No: 9.111-A.U-3834 ..........................................................
FacilityContact: ...............................................................................Title:............................................................... Phone No:....................................................
Mailing Address: 05.Deleplane.Rd................................................................................ Roaring.Ri(PrAC.............................................. Z8669 ..............
OnsiteRepresentative: .............................. ........................................................................... Integrator:.......................................................................................
Certified Operator:................................................................................................................ Operator Certification Number:.........................................
Location of Farm: -
Latitude Longitude
estgn -; Current —Design
77
ag _urren -
Swine- _ r-.-,Capacity'Population= Poultry:-
Capacity- Population^ - Cattle
Capacity Populstion .e
p Wean to Feeder
mts
p arrow to can
p Farrow to ee er
p Farrow to Fims
p Gilts
p Boars
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
2. Is any discharge observed from any part of the operation? I] Yes N No
Discharge originated at: p Lagoon p Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? p Yes ®No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) p Yes ®No
c. If discharge is observed, what is the estimated flow in galhnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ®No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
4. Were there any adverse impacts to the waters of the State other than from a discharge? p Yes ®No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ®No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ®No
7. Did the facility fail to have a certified operator in responsible charge? p Yes ❑ No
725/97
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
2. Is any discharge observed from any part of the operation? I] Yes N No
Discharge originated at: p Lagoon p Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? p Yes ®No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) p Yes ®No
c. If discharge is observed, what is the estimated flow in galhnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ®No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
4. Were there any adverse impacts to the waters of the State other than from a discharge? p Yes ®No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ®No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ®No
7. Did the facility fail to have a certified operator in responsible charge? p Yes ❑ No
725/97

;p. ace t y Num er: 97_14
8. Are there lagoons or storage ponds on site which need to be properly closed?
p Yes ® No
Structures (La2oons,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3
Identifier:
Freeboard (tt):
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Anulication
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
p Yes p No
Structure 5 Structure 6
p Yes ® No
p Yes ® No
p Yes ® No
p Yes p No
p Yes Ia No
15. Crop type.......C.mnkSilaga.&.&ain)....... Small.Gmin�.(Wheat,.Barley,...........................................................................................................
16. Do the receiving crops differ with those designated m the Animal Waste Management Plan (AWMP)? 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?
p Yes
®No
19.
Is there a lack of available waste application equipment?
p Yes
p No
20.
Does facility require a follow-up visit by same agency?
p Yes
p No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
p No
22.
Does record keeping need improvement?
Yes
p No
For Certified or Permitted Facilities Only
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 AWMP?
❑ Yes
p No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
p No
Q ..
p.via ions.or icrencies"were.note unng t is vlslt:. oa wt .receive nsfurther...
. ..
. . . . . . . .¢. . .i►[). . .t. . . .s.. ......... ............ . . .......•................,....•.•.•.•,•;..
Comments (refer to:question #):, Explain:aiiy YES answers an_d/oeany recomiuendations:orany otfier comments -- -
[Ise drawinis of facility, to better explain.situations.'(use,additional:pages as�uecessary);
yet given in the area.
9: Not applicable
13: Not applicable
19: Not applicable
s: The Operation is in good condition. No cattle were on the farm the day.of the visit. The only minor problem was
that needs repairing. This, however, does not impair the structure of will cause any.discharge from the operation.
7/25/97
Reviewer/Inspector Name )MtchaeIW Pardue
Reviewer/Inspector Signature: Date:

Site Regahu Attendo�
Facility No. Y 7
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANWAL FEEDLOT OPERATIONS STTE VISITATION RECORD
DAM NOV 9 .1995
'I M: 2 go am
Farm
Mail
Q,uty: INI(t:�J
Integrator: GsO�Gt
On Site Representative:
Physical Address/I. =dcn:
phone: 9;o- 77/-y600
Phone: 9/0 - y FY - 3 8.3 y
Type of Operation: Swine poultry _ ()stele -Y ,
Design Capacity: 12.5 Number of Animals on Site: O
DEM Ccrdfication Number: ACE DEM Certification Number: ACNEW
Latitude• _.,.L—' —IL. -I% Longitude: �' Elevation: `meet
Chile Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) X-er"bivIA A=alFreebowd: _mac Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes OCRs)
Is adequate land available for spray? V4s-=.No k/q Is the cover crop adequate? Ye No
Cop(s) being utilimd: J 1 L 448_ y l-k ua g Lj rTe r I t Efe vr^
Does the facility meet SCS miniamm setback criteria? 200 Feet from
0
100 Feet from We1is?0 of .NO
is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes arto
Is animal waste land applied or spray inigated within 25 Feet of a USGS Map Blue line? Yes o"9)
Is animal waste discharged into waters of the state by man-made ditch. flushing syste&, or other
sinular man-made devices? Yes orS-) if Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray krigated on specific acreage with cover crop)? �te or No
Additional Comments:
Inspector Name
cc- Facility Assessment Unit Use Attachments if Needcd.

Site Requires Attention
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANMAL FEEDLOT OPERATIONS STTE VISITATION RECORD
DATE: Nov0 ,1995
Time: , Y O
FarmNamUOwncr 1 �i_qunE �HL�w
bbiiAgAddress: 9.5.s- DFUR PL>4uE ROwR;uc- kiVQQ 2SbGy
On Site Representative: C
Physical Address(l ovation:
phone: %1G- 77/, `/bUL�
phone: 91G- M- 39?Ll
Type of Operation: Swine ` poultry _ cattle -),,,
Design Capacity; -� 0 D Number of Animals on Site: 12 O
DEM Certification Number: ACE DEM Oa ification Number. ACNEW
Latitude: -3-L- Longitude:' ` '.y" Elevation: --Y;eet
Chile Yes or No
Does the Animal Waste Lagoon have sufficient frxboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) V*"r--No i+/i4 Actual Freeboard: _--FL Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
h adequate land available for gray? Yes or No Is the cover crop adequate? Yes or No
Ctiop(s) being utilimd: FESCu�
Does the facility meet SCS miniamm setback criteria? 200 Few from Dwellings? ey of so
100 Feet from Wells? 6 Rc,
Is the animal Waste Stockpiled within 100 Feet of USGS Blue Litz Stream? Yes or W
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes No
Is animal waste discharged into waters of the state by man-made ditch, flushing Systefir, or other
sh n7ar man-made devices? Yes or lR If Yes, please Explain.
Does tie facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? (S� or No
Additional Comments:
Inspectcr Nam
oc: Facility Assessment Unit
Use Attachments if Needed.