990012_INSPECTIONS_20171231

rd i iA Fo rw-5
Facility;Numbem
01
'Division tifWa`ter Resource �!`� U
O Division of Soil and Water serval on �C�L
O Other Age rcy 7i O A M
Type of Visit: P Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: �6 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 01 ^nArrival Time:® DepartureTime:®County: 1 Region: 5KQ
Farm Name: S 1� o.J t�roVe- batry rTv)a Owner Email:
Owner Name: T } 1Nl C) 4 I ti - 3 70
Si1Q[,V C�tOJP_ 1>Qiru 1Lne. Phone: W [o99—S;2faZ
Mailing Address: 10 t{6 Hoot OI-A Ho 116 to I Ea5 + 19" 10 N G a 7 0 1 T
Physical Address: Nj4 o$ 54)&,y "& renue- Ch • 2d 'l Enos+ BeAetd.0 NC. 27019"
tt1 Facility Contact: &'U rIC& 5.17t i t _Irrr.� g &_4 Title: Phone: -11(0 4,— (9 Q S✓
Onsite Representative:�I I /�a ��� ��'h a�� Integrator:
Certified Operator: AaturiC P. cv JTy.I'' I V1 Q Certification Number:
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
I mt mon I 6ypste Z 5MI'4-l'ioWn ! L- side- 3 F4wy(p1tL riex- 11
05 H w & -1 Fa-1 r rowea L v . 2 far M L
n; i ;, t# Design
t�„} I9Swine}jtt�(( Y t Capacity
l t,. NJrNai#. ii1 F #:, l;.A}Stl
Current
iP.op.
1
I
Wet Poultry
ultt
Design Current
Gapac'i[y Pop.
� ►
.:
Cattle.
•5��4 -
Design Current
Capacity Pop.
�d
.1
Wean to Finish
La er
Dai Cow
OO
Wean to Feeder
No a er
Dai Calf
Feeder to Finish
¢
t
Dr. P.oultry,
:
Design
aei ..
Current
P,o P.
I
Dai Heifer
Farrow to Wean
D Cow
Farrow to Feeder
Non -Dairy
_.
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
{
$Ot�hr
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
a. Was the conveyance man-made?
M
w
wo nts o �S'(o I�1111�f 1�O Dritloo
(0b}p+� IA2[tPS gNo ❑ NA ❑ NEa'Yes
1 Yes
❑ Other:
b. Did the discharge reach waters of the State? (If yes, notify DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DW R)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
WNo
❑ NA
❑ NE
Ryes
❑ No
❑ NA
❑ NE
Page I of 3
21412015 Continued

Facili Number: - Date of Inspection: 7 781 WI-7
24. Did the facility fail to calibrate waste appltcation equipment as required by the permit? ❑ Yes Z"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. /0
❑ 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 I . No
❑ Yes j No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes IxNo ❑ NA ❑ NE
❑ Yes X No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes XNo
❑ NA
❑ NE
Yes ❑� No
❑ NA
❑ NE
❑ Yes D jrNo
�rTeKo
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
(Comments (refer to question #): Explain any YES answers anmor any aumtional recommenuations or any other comments. I
Use drawings of facility to better explain situations (use additional paces as necessary).
raa +&hk Rmo1-P-6m resiof&nce? ye5
dress e.5-V4-6jisheA on a.11 dQ M5 ? N.ead 9 ro,,,55 0 n I d >MaW
>"O_Y_- Soil +e5k5 r2$virej by 17131Izoll,0,ojL�eA lo16- dye aolSr- J
Ne-y.A C_L1ibraA-ion d,ve- 20va. Dr lire &Mi(oro..ke_6 Prior i7a ,)5e, ? lQ
wasi-t, plan revised %r IDso MI10-ows ? NC4-ye+, I)m0tc"naalti
3Pipe-Alb mta}eln {a
dell ,n r 4bw olu .q was+e �roivs o fi o (oo�r
manure, tYoxlSfer @ 0 4 (Neu louyar�.o�"A
3d?. P(XIv� 1 ( neeA5 +& 'rev 15eA Azm
rem &.qv be- - tb re,Go rJ
aL&O0n+4v Iver\s_� ejoctile4s
�rep_ln at3,rd b1 ua e.e y—
oZI g� —
�--�
DouJ 4 Z ova baan k iJv�e t� +, -t000 ill so
9 a 6b5orvv� 5lvdQet,�orun5 M *reAu" at _v'oSSl v1
DW R- }{a5 Vows+� 5 vc{une, D(an rerov-nalnsion. k,
M
�'.to I
Reviewer/Inspector Signature: vW B, tl bu tAC/ St a3
Page 3 of 3 > a
flRpl iCat�hon -F100 A
I
a. P leas e .�lvdt;
rl O a1� p U (1 Al :k' es vt
Phone__ 77(n 9 649
l a7'!. m SODate: I__�I I2TI I ZOI7
7.91 16,), N tgwb
Taal r1 4,11 A_6►.,jpb5+

Facility Number: 11 - I Z • Date of Inspection: 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I �pquStrYucture 2 �tructure 3 Structure 4 , StructureQ5 Structure 6 p-oo-re-ti P; {
Identifier: & rn4l J" Jan 7— N /VL W �Ai.X f IItJ'�Oi + �o W 1 rl y�+ t y�
Spillway?: �J C' S U L� S ���� t ��
ObservedFreeboard(in): %` —�_ Ot1CY2!
Observed Freeboard (in): � Wt rt1-O
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
P�
(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 DWR
7. Do any of the structures need maintenance or improvement? W'es ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Dfgo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) .ram
9. Does any part of the waste management system other than the waste structures require �ClXes ❑ No ❑ NA ❑ NE
maintenance or improvement? '7(
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Cq/No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes I JO No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.!)`
❑ PAN ❑ PAN> 10%or 10lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): v V
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes N(No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No CR'NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes A No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes J�No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [:!�'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes il"o ❑ NA [3 NE
the appropriate box. �T
❑ WUP ❑Checklists ❑ Design ❑/ Maps ❑ Lease Agreements ❑Other:
,2�1f.p�, /oes record keeping nee �P 'ZYes ❑ No ❑ NA ❑ NE
U aste Application Weekly Freeboard Waste Analysis it Analysis aste Transfers ❑ Weather Code
Rainfall Stocking ❑Crop Yield 20 Minute Inspections onthly and I" Rainfall Inspections2 om:c)-
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 14 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No % NA ❑ NE
Page 2 of 3 21412015 Continued

we-t(
for Visit: Od Routine
Referral
Other 0 Denied Access
0
Date of Visit: /nArrival Time: Departure Time: �.O.p •ounty: O O� ! /� Region: to5,Q
Farm Name: 0j8 r0 VC Nciry TyNb. Owner Email:
TlrAce I - 3-70
Owner Name: Lire IIL' o Phone:�U/ (p q q — Salo ,Z
Mailing Address: l o 4o Hpal d of 0110/,y t / _ Q S i nRe nd l, /\) C� A 7 0 I � c/
Physical Address: 4g o <e y�ji r O V 2 th U tic.) Kam • , / Q S ( 8uld AC-
Facility Contact: M-wrICe-SMk4e_krMQ11Titlle: q Phone: ,
Onsite Representative: p V S- PA17( I1A Q1 Z� `� J� / Integrator:�9r5 , 1 V 1431 / 15/
Certified Operator: M Q U r I Ge- 5nn , p t� M Q YI Certification Number:
Back-up Operator: L9i o Certification Number:
e GrAt�+own , ypsieo N SMv")town , c I
Location of Farm:d-3 AKLNb7j © boj-neu- Mill Laghtle: ,7j1oo / 3 h o2
°
Longitude: 103 1 V 6
()S y 6 % KI) F0. i r9 rovhdL, 5 rD ve- . `_{) . pl of
Four rh on /
Design Current
Swine Capacity Pop.
Design Current
Wet Poultry Capacity Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
0
Wean to Feeder
Non -La er
Dairy Calf
S
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Layers
Dry Cow61
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
qz
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any pan 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�Z(No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
(%No
❑ NA
❑ NE
❑ Yes
�KNo
❑ NA
❑ NE
Page I of 3
21412015 Continued

Facilit Number:qq1 • Date of Ins ection: yZ 1 o
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes WNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No X NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes �/No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes I XI No ❑ NA ❑ NE
Other Issues J��.,r
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 17Q No ❑ NA ❑ NE
and report mortality rates that were higher than normal? T
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes 1 M 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)
A.
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. tiryes FNo ❑ NA ❑ NE
[Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes X,No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
q v.Jas+e Cor\ t i nectl rear b o t n tit I? N o-+ ax, 0-on cau-n +o • o.y
S w s P 40-m- Vv 0 WeA )f pl I dol �tA ra.ss a aax- J'C�
� �o
50i l te-5 dve ao((�o �,201-5_9ey0¢-ont✓Joe, 1431/aol7,
d LatibOf
ra_�,-ior\ o F (D 000a ir,Jo0or-Q. due- 020110 e Nosec�ra ? LOW Qr
51'I r�q \J or bcxivt�
0 I r\e reds t•. q }0 108 ?'Tea:h feej&,Q,.5 owo�k, I \/ on W&v 5-� pl an
Pi pe- re-- inssi-allej td rn a:- C_h de51 n ? j0V- -F(ow Fr0A&- u� to lotue
AA e hvre. an54er a u y
%)ry couJ dossir\ re(�aa�ed/re-u�o���ed *5, -Mel V5
(o. ILI -J_ov,,, S{ora.ge tv� Fro_c- 4-*_-IY\ 1L . IC01 Frorv\ wet,i) 200' {romv-eStael�c
&onkOk-t ' ivl-{o on E6- l9- (?20-0r l5 O F slake, atn, outki-I 'OCC'-Fiot� of VvzanS�er
O� W&5 to A-M i-o_n 1_ , torr"Ntkq cDn1y il4l Cram tlovs�p_. 0%' Grow, \r llo d�
a 00l was 4-0-, fl Ian r
Nye Y- 0_a i b ra_4 a ►t due. a o 1 Y",q (.ol-I i bra l
.Prior -b use,.,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3of3 SM 0 j- n # PS�Q
KM _rVjV
to 5
krok-
'5 `t fie✓
Phone: 3Ta -77b — q k 9 of
Date: 9 /ZZ/ / &
21412015

kAl N i oG
Facility Number: 9LI - ob I Date of inspection:
Waste Collection &Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Ycs [:]No [_]NA [:]NE
a. If es, is w vel into t�ructural free? t/�qyL, v/des No NA NE
` y y ctinf c`ttG Ndef ❑ ❑ ❑
�5 �(x.�PF�h �� tructu Stru e0 Stru e g Str � 4 Str re ® Structure 6
t Identifier: Oj Oy (or OL rh � (+ f\ 'Z txJ () (�iL'u��41 1r (2 PI + Un -
Spillway?: l L �f (20VW64
Cor�Gr2{e
Designed Freeboard (in): F'hw5 I n'+0 Pad
Observed Freeboard (in): v e b�— <�5 n1 etyuPW Drai rrs F
\Aew
5. Are there any immediate threats to the integrity of any of the structures observedb ❑ Yes No ❑ NA Q NE P
(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? UJAIj y r, Olin �vv\-
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 I ]y No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 17.1 No ❑ NA ❑ NE
maintenance or improvement? `ice
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? Pk(
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes IYI 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 Types) rob n
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes fN
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? El Yes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes CONo ❑ 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 �!fNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑]—Other:
21. oes record keeping neV,wrt
rovement? If.3es reap y Yes S1Go ❑ NA ❑ NE
J�✓aste Applic wn ekly Freeboard Waste Analysis Soil Analysis Lr,�-�.1^'.aste Transfers ❑ Weather Code
Rainfall Stocking Crop Yield ❑ 120 Minute Inspections Monthly and I" Rainfall Inspections
22. Did the facilitp il�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 J NA ❑ NE
Page 2 of 3 21412015 Continued

for Visit: (A Routine
Referral
Other U Denied Access
Date of Visit: ��„ t� Arrival Time: Departure Time: County: &&�Wt7 Region: IIJ5A6
T
Farm Name: aC3L� 1'0 V4 1 1Q 1 Y'-U Owner Email:
_ Tivn 41 Lf -q 370
Owner Name: I IAl q- tk 1Jf (f e �f1n p ►y1 C}ryhone:yJ (p q Q - 5 b 7
Mailing Address,
Physical Address:
49 R sj rl=li. 3INOWWarr�
Ll "K Shad y 6roye Ch . Rd.. East Fennl ,/lJG A70/ S
Facility Contact: I auf icp �al7 Title:
Onsite Representative: / ik Se(.ff l iar ma.r� Integrator:
Phone: d_ 4 I y — 19 9 S
Certified Operator: Wow rice 5Ym t j ejr mo_lr) Certification Number:
Back-up Operator: lj {-per 11 vt ek 'Bo V Certification Number:
Location of Farm: Latitude:
3 l� 6131 S-a n
Longitude: / d 3 I' q6 11
f}u�y Q21 N,; UP, 6,06 more • 1 F6rbU5k/torhe11`u5 i2d , �- Botlfimore
O FIin+ 910 2d -, 0 *,O4-7 Dotiv rou L 5 Grove
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current arM e
Wet Poultry Capacity Pop. Cattle
I JLayer I Cow
esign Current
Capacity Pop.
4900 13
Wean to Feeder
I INon-Layer
I
Calf
S
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
IXT � 1105it Ca acit P,o
Layers
Dai Heifer
D Cow
-Dairy
Beef Stocker
(0 O
Gilts
Non -Layers
Beef Feeder
IBeef Brood Cow
Boars
Pullets
©[her
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
Stream Impacts
1. Is any.discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes eNo ❑ NA ❑ NE
❑ Yes ❑ No
[]Yes [—]No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
CyNo,
❑ NA
❑ NE
❑ Yes
%No
❑ NA
❑ NE
Page 1 of 3 21412014 Continued

Facility Number: - • Date of Inspection: $
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes YNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
1 a Q N Structurbo Structure 2 Structure 3 Structure 4 —4Structure 5 Structure 6 (} U t1
�] "� X,,e,
fi 10 f Barn 1 XV-A A%wUPPPr
2LU �04
PX f 1
Sp
04
w J
Designed Freeboard (in):
'CV
O Vet ow5
net"''
Df (k; m5
Observed Freeboard (in): (Q,'b &
o��
'Info
}o rk%
P
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ E
(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
Og"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?
XYes
❑ No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
OrNo ❑ 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
MYes
❑ No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
rNo ❑ NA
❑ NE
maintenance or improvement.
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes WNo ❑ 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 F] Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): Y
14. Do the receiving crops differ from those designated in the CAWMP? C64� 2
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?
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
LNY�o
❑ NA
❑ NE
[]Yes
[:]No
ZA
❑ NE
❑ Yes 0 No
❑ Yes A'No
❑ NA ❑ NE
❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ZYes [:]No ❑ NA ❑ NE
the appropriate box. Y P.!!�� he ?
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
2.11, Does record keeping need im rovement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
u ste Application Q ekly Freeboard ❑ Waste Analysis oil Analysis E3 ❑ Weather Code
Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections fonthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Wo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No Ej'5A ❑ NE
Page 1 of 3 21412014 Continued
1,

Facility Number: - • Date of Inspection: I
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P(No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No 4 NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes Dg�No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes M'No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes XNo ❑ 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
ZNo
❑ 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
XNo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
�No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
PdYes
❑ 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
LkN_"'No
❑ NA
❑ NE
Comments (refer to question ft 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).
W0.5�2 ft°COrC�5 For F0.U�Sept•�l'�? •— e,.
I• I" IV) speC-+ions? RaAna-ini44aJs on eleck",'C LjeAhce ware ode
a Parr 1dr Free%oo.rd re -co rel s ? Notts Co-W tt RaL+ern I Pond'.' 2e eoti S
L rtib� Y__Mev�5 m o U_:eci ? Pleaz-, Goner nut: -�& rvio CO/5 FVX� / e5 5
a I Ne-y--� 5oi 10eal y s 15 �d u2016
a Cetti bra_.!�6ovl of (� t000�'t, b oo�U e (Sc.+6'0 . ao 16
�9 Please ins°lalI bcor-dj on, berm nec-r I t3L9-rr\ 4-b conlrittn tx.xa
PAN
1nO a2�1-S
Fall do)4
L-51)
Reviewer/Inspector Name:
iY7
?7= LsJ 3, 3(�= LSD �PleaSe ret�o1rI'K—
pr`l
C�oSs1if,
a, A).5& 6
Phone: 174 — U 49
+e
Reviewer/Inspector Signature:
Page 3 of(5 pk 7(_ A 1 u e L
Date: 5 1l I old 1 S
r-e_- i ns$aA I P'Ip2 L 2 i sa �� Fo M�4ch mr'(�i nc�i�4 �' igne Q

Visit: Sff Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: II Arrival Time:Ob Departure Time: County: Yvi d kM Region: 05KO
Farm Name: kdrSu 6tco2 Q60ry Owner Email: mllkm"U. (o3Z®9"t4t+/• e.'M
Owner Name: I ; ,t' /V lA N!i to SM . UWrvlrt rl Phone: LWi G yc�._ y� y
Mailing Address: f b
Physical Address:
Facility Contact: Mcjwti4W 5/'•1XItKArl Title:
Onsite Representative: ,57Gr I,% q _ pu� Integrator:
Phone: (G) �// — f 9 9
Certified Operator: Mo wrir« .S Certification Number:
Back-up Operator: S�cr� �t �, Certification Number:
Location of Farm: Latitude: 3(� " /3 SZ �r Longitude: g 8 0 �/ / 90 r/
♦+� Yzl / K irgt,+ n R , R �rbNstl�cork►IKs ice,/ L /fin ./ L Gl;;tf Hlil Cdi
�{I r 67 K .R7r 01i. LW4-,
Design
Swine Capacity
Current
Pop.
I esign Current
Wet Poultry Capacity Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish
Layer
DairyCow
o0 166
Wean to Feeder
Non -La er
Dairy Calf
J Q
Feeder to Finish
Design Current
I)r, P.pultr.+ Ca tacit + P,oP.
La ers
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D Cow
Non -Dairy
Beef Stocker
0 dl7
Gilts
Non -La ers
Beef Feeder
Boars
I Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure Cl 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 xNo
❑ Yes ❑ No
[—]Yes [:]No
❑ Yes ❑ No
❑ Yes �No
❑ Yes XNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 21412011 Continued

Facili Number: Z. • Date of inspection: 23
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? � ❑ Yes ZNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ati� I ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 7V tiStructure tel Structure 4 J Structure 5 Structure 6 p / Un "Kkj
Identifier: At 1y r 011 0.1 `` old d Z N ,/�� Ne.l Lowv 6GJ 7,'T Pik '
Spillway?: / / / t yes � _
Designed Freeboard (in):
Observed Freeboard (in): 2_ 8
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes No ❑ NA ❑ NE p
A
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes I XI No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yesit No ❑ NA ❑ NE MS
(not applicable to roofed pits, dry stacks, and/or wet stacks) 1
C
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? 0
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): CBS i� M tt / S fafh !tliY/aiDyG
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yeso
f
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yeso
❑ 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
RNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes o ❑ NA ❑ NE
26. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes tNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑]OOtther: gyp"
21. Does record keeping need improvement? If yes, check the appropriate box below. IXI Yes Ig�tvo ❑ NA ❑ NE
❑ Waste Application Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections to Monthly and V Rainfall Inspections 'E481 d'gesm—.ey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes NNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No *A ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: 119 - y • jDate of Inspection: L3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes /(�No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ❑ No NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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 I�j No ❑ NA ❑ NE
Other Issues +, t}��
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes I X 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?
❑ Yes
1 1 { No
[3 NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
77 ��
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
;VNo
❑ 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 #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
z 7/ bPa 000'5j J.,,, V
lxr 2-01 ,
An4�ysD 2l, I�A)k 41P(rcorg1.6f r>?�1�. lkn J <�P. elvew�I flak 1„4 fle4) y,'�II ���rx��
2). RCr -& 14At] bef+ode mth GWeii� >1"4 SLIA IA,S�citm, ,(j4fk&4,ref 111a �Ivne..
21. )rfnj {��bakrd heorris 04 4e, Pq,lor Wcth_Po,tJ,
*dew s��k �' � � �., �rn#� L ^ k,r, Am cor,Plad{1. GC' '
� 4 e_'f� 0, 96-n "ti 1,AJ 1.. rYIred, Gem,
Wh3rr�3 .
1`3.7196J, 2=y60rl
6.99 f6d
81U13 = q,5LI IW
Reviewer/Inspector Name: FA T! t uk Phone: (536 ) 771 —SZQS
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412011

9
,i
Type of Visit: �orgpliance Inspection V Operation Review U Structure Evaluation O Technical Assistance
isit: RI
Reason for Voutine O Complaint 0 Follow-up O Referral Q Emergency O Other Q Denied Access
Date of Visit: D bl Arrival Time: �(M Departure Time: !� t p
1 /' � P '3da+� County: q �71 Region: WS�O
Farm Name: �j 6t� G nviii b Atv u Owner E ail: &;1'tl rho.►
Owner Name: ► i M �L IA' I � �MALf1'Mq yj Phone: t"lnl 6 �% — 5 Z 6 Z
Mailing Address: i o ,ii Root owl �il`ow , Cyl- l—n1 f 0G 270 IT
Physical Address: `fy0� rS�a1a Gminei �., t'
ty �� v/y- l99 s Facility Contact: M0.t^��GQ sMr ft:,Aq Title: Phone: �
Onsite Representative: �.7 Integrator: p ((�
Certified Operator: f Certification Number: aN+/ S I M
Back-up Operator: 54f'1rvl DDy �M3Ci1�//11ii/i Certification Number: o_4j,� /!&/�7,YO/7—
Location of Farm: V Latitude: �(� l 3 / SZ„ Longitude: O J 3 O ff
L AF11i L_
s eo"lli MI, a•, u.4.
Desigp i tM
Swine Capacity Pop.
Wean to Finish
WetPoulgry
I I Layer
esign Curren[
Capacity Pop.
Cattle
ai Cow
Design
Capacity
Q
Current
Pop.
F O
Wean to Feeder
I INon-Layer
I
airy Calf
S
7
Feeder to Finish
Farrow to Wean
I)t. P,oultr.
La ers
Design Current
Ca acit P,oP .
Dairy Heifer
Dry Cow
O
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
I
Turke s
Turke Ponits
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
IN No
%%%% """����
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
XNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Yes
❑ No
❑ NA
❑ NE
of the State other than from a discharge?
Pagel of 21412011 Continued

• Facility Number: el 47 Date of Inspection: ( 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes ❑ No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ NA ❑ NE
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
arlcr (�1J+��1 Old�'A2 I&� ��1�-r�
�N
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
33
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
2-11
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
i
ti
If any of questions 4-6 were answered yes, and the situation poses an immediate public heath or environmental threat, notify DWQ (T-
7. Do any of the structures need maintenance or improvement? XYes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes �KNo ❑ 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 )KNo ❑ 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): 61-A �L fXA// 0" rt .
13. Soil Type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP []Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Applications ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ WasteAransfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections E8lndge-&�
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ❑ No XNA ❑ NE
Page 2 of 3 21412011 Continued

• Facility Number: Cj 12,10 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
No
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No
❑ Yes No
❑ NA ❑ NE
X NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ YesIN
\No ❑ NA ❑ NE
No
❑ Yes
No ❑ NA ❑ NE
b[I Yes
❑ No ❑ NA ❑ NE
❑ Yes IXI No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?. ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any,additional recommendations or any other; comments.:
Use drawings of facility to better explain situations (use additional pages as necessary)..
{la✓Ie 9P0 MX - Zt[ d�fA4,fe
�[3, Co ��rr n� ;til"rl.��iO�Z ao�eLr ryAh; M +or t lg/rk ov/erROJ,�ADA-0- 171Ano9':
0-3 (o/d */r4- 1O1I nZ°) �ilG /tOiV�y iu��l lgna_6// �J�GtfiA 1 kbrtf�
�- Q�13 wsZ, ,ta�A1
-f irn2 /11a rc /et*--/ or a eAll
�,� �•�
i-t,ta
� /�rrR� Fto! IA�CiI rnn`Y/cd1�N/�� C� /U✓ �/'���
--C.V'f/i i" or" �u1� � �.�s➢^9-� �rrTzh i� %i+,� � u/�ar"r er (.�
��//� `✓✓ L mil, �f�q 41"14 ellel"
k4ezr AVALYJi,
- —9
7�1D! 3 ,dd 3 = S,77 )6A1
111202.- .1=532AIV, 2=6.GOIdN,3=10,10i6d
1_ �l-I
ReviewerMspectorName: �lq'Iy �� tTLhGPhone: (7. 7 / SZg
Reviewer/Inspector Signature: / Date: 10D 1 )-%(-3
Page 3 of 3 214/1011

FIELD INSPECTION
Waste Storages Ji411 any nvcrt(•v �� Sind Gia. by s�,.
Waste Pond(s)
a Observed Freeboard(s):
-----� a Vegetated, Free of Woody Plants, No burrow
O No Erosion, Slumping, or Seeping?
Waste Lagoon(s)
o Observed Freeboard(s):
O Vegetated, Free of Woody Plants, No burrow
C No Erosion, Slumping, or Seeping?
* Waste Piles
Dry Stacks .
c Roof intact?
e Rainwater excluded?
o Leaks in block/wooden walls?
Wet Stacks
o Roof intact?
o Rainwater excluded?
a Leaks in block/wooden walls?
Discharges or Surface Water Impacts
•--�> * Structure (leaking walls, seeping, etc.)
a� Bn��l lFwca�s d c a•hy o^ w,Itr
i
----------------
6M Cfr
* Drains and Ditches
Pasture/Stock Lanes (stream crossings, water holes, etc.)
* Application Fields
* Irrigation Supply
7� Silage Facilities
Were discharge conveyances man-made? 0 Yes
Ne 11��(civni/ Wwc
u6 MKZ
El No O N/A

5'"0.
0 I0)DOAM
INSPECTION OF RECORDS & DOCUMENTS
* Verify current contact information.
19) Permit? M(es ❑ No
19) Certificate of coverage? es ❑ No
26) Operator Certification? Yes ❑ No
20) Waste Management -Plan Availabi le?
21) Weekly Freeboard Records? ❑Yes
Hours needed?
Yes ❑ No
❑ No
21) Precipitation Records (with initials by>1" event)?
22) Rain Gauge on site? WYes ❑ No
21) Animal stocking records? Yes ❑ No
* Current Population (including poorly vegetated lots)?
Record details on inspection form
Yes ❑ No
or DHI for.Dairy
29) How are dead animals disposed of (within 24 hours)?
,��� 21) Soil Analysis Results? Yes ❑ No _ pH 5.5 - 7.0
Cu: < 60ppm OR NCDA < 3,000 Zn: < 120 ppm OR NCDA < 3,000
21) Waste Analysis Results? Yes ❑ No Dates: 0"i - M'- "YAW
Within 60 days of applications (multiple test)? N Levels: Beast: Irrgt:
21) Waste Application Records (with weather code)? Yes ❑ No
Applications within window for,crops?
Were there any commercial fertilizers or other sources used? ❑ Yes ❑ No
What was the N levels applied?
Does the total PAN match up with WMP? ❑ Yes ❑ No
21) What crops are being grown (are they in the WMP)?
Are they harvested? ❑ Yes ❑ No
21) Crop yield records? Yes ❑No ❑ N/A
—� 24) Has waste application equipment. been calibrated? lderY9
es ❑ No ❑ N/A
Are gauges & equipment in good repair and working
31) Were there any emergency situations that need discussion (date occurred)?
13 Yes 10 No

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 990012 Facility Status: Active Permit: AWC990012 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Follow-up County: Yadkin Region: Winston-Salem
Date of Visit: 05/11/2012 Entry Time: 03:00 PM Exit Time: 04:00 PM Incident #:
Farm Name: Shady Grove Dairy Owner Email:
Owner: Tim A Smitherman Phone: [phone]
Aalling Address: 1.1 Hoot Owl Hollow .al• NG 27018
Physical Address: 4408 Shady Grove Church Rd East Bend NC 27018
Facility Status: 0 Compliant ❑ Not Compliant
Location of Farm:
Integrator:
Latitude: 36'13'59" Longitude: 80"31'33"
US Hwy 421 north to Baltimore Rd. exit. Left at top of ramp (north). Right onto Forbush/Comelius Rd. Left onto Baltimore Rd. Left onto
Flint Hill Rd. left onto NC Hwy. 67. Right onto Fairground Rd. Right onto Shady Grove Road. Farm is on left.
Question Areas:
W Dischrge & Stream Impacts Records and Documents
Certified Operator: Maurice W Smitherman Operator Certification Number: 21958
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Maurice Smitherman Phone: [phone]
On -site representative Maurice Smitherman Phone: [phone]
Primary Inspector: Patrick Mitchell Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Sterling Smitherman submitted the following via email for DWQ review:
- 2012 Calibration Sheets for the "Pull Spreader" and the "Truck Spreader". Next due by May 2014.
- 2011 Crop Yield Records.
- Precipitation Records for September 2011 through April 2012.
- Waste Application Records with Weather Codes through March 30, 2012.
- Photo of the repair & cleanup at the sand lane.
- Photo of the repair & cleanup at the stock trail between the Maternity Barn & Barn #1.
Page: 1

0
1
•
Permit: AWC990012 Owner - Facility: Tim A Smitherman
Inspection Date: 0511112012 Inspection Type: Compliance Inspection
Facility Number: 990012
Reason for Visit: Follow-up
Waste Structures
Deal nod Observed
Tvoe Identifier Closed Date Start Data Freeboard Freeboard
Neste Pit
OLD ROOFED PIT
12/31/03
9.60
Neste Pond
NEW LOWER #4
27.60
MEMEME
Neste Pond
NEW UPPER #3
27.60
MEMEMEM
Neste Pond
OLD #1
27.60
Waste Pond
OLD #2
24.00
Waste Pond
PARLOR WSP
16.00
Page: 2

0
• 0
Permit: AWC990012 Owner -Facility: Tim A Smithernan Facility Number: 990012
Inspection Date: 05/11/2012 Inspection Type: Compliance Inspection Reason for Visit: Follow-up
Discharges & Stream Impacts Yes No NA NE
1. Is any discharge observed from any part of the operation? ❑ ■ ❑ ❑
Discharge originated at
Structure ❑
Application Field ❑
Other ❑
a. Was conveyance man-made?
b. Did discharge reach Waters of the Slate? (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 observable adverse impacts or potential adverse impacts to Waters of the State other than
❑
■
❑
❑
from a discharge?
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?
❑
Lease Agreements?
❑
Other?
If Other, please specify
21. Does record keeping need improvement?
110110
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Page: 3

Permit: AWC990012 Owner -Facility: TimASmithennan
Inspection Date: 05/1112012 Inspection Type: Compliance Inspection
Facility Number: 990012
Reason for Visit: Follow-up
Records and Documents yes No NA
NE
Weather code?
❑
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■ ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑ ■
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■ ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 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?
❑
■ ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■ ❑
❑
Page: 4

nwv,
f
Ni
w\
a'yT�V
v,
/1
r
/r r
J!. _,i• �/ _ _ :asp'
V

Mitchell, Patrick
From:
Sterling Smitherma [milkman [e-mail]]
Sent:
Thursday, May 10, 2012 9:11 AM
To:
Mitchell, Patrick
Subject:
From sterling Smitherman Shady Grove Dairy inc
Attachments:
image.jpeg; image.jpeg; image.jpeg; image.jpeg; image.jpeg; image.jpeg; image.jpeg;
image.jpeg; ATT00001.c; image.jpeg; ATT00002.c

Mitchell, Patrick
From: Mitchell, Patrick
Sent: Friday, May 11, 2012 5:20 PM
To: 'Sterling Smitherma'
Subject: RE: From sterling Smitherman Shady Grove Dairy inc
Sterling,
Thanks for making the repairs and cleanups as requested during the May 1st inspection. Tell
Maurice thanks for submitting the missing records. I hope to review those next week.
Thanks again,
Patrick
Patrick L. Mitchell, LSS
NC DENR - DWQ
Aquifer Protection Section
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
Phone: [phone]
FAX: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.
-----Original Message -----
From: Sterling Smitherma [mailto:milkman1032(@gmail.com]
Sent: Thursday, May 10, 2012 9:11 AM
To: Mitchell, Patrick
Subject: From sterling Smitherman Shady Grove Dairy inc
1

Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 9P Routine U Complaint U Follow-up U Referral U Emergency U Other U Denied Access
Date of Visit: To'1117, /'Arrival Time: C m Departure Time: :4f7 County: t ,AJ1</ 1 Region: �%� [7
Farm Name: ��q Grovy- Dale Owner Email: Mi�!<M0.�11D32®qMq �. eoM
.1
Owner Name: �IM `/ molur"c.G 2 Mi,Tf( pta„ Phone:
Mailing Address: /I / D 4010 Q.J/ t-tolle1j, 1AJA &d', tj G 27Q1 f3
Physical Address:
Facility Contact: I I M Ott Mottjr(ce_ Title:
Onsite Representative: / iM Si+ 1�//fikgn
Certified Operator: M0,grlI« sM;ti.erMAf1
Back-up Operator: 5k�11:44 go.,
E—,,J
Integrator:
Certification Number:
.cN&_d 611", ey
Certification Number: I Z 3/� ZOl z-
Location of Farm: Latitude: 36� / 3 1 5If e 2 Longitude: 5 0 31 / 'V-O "
w7 Z1 N., $x%'I On Jam+!% r�/� tJ,� Qom. t`vrbusl/LorKlrui A.r L- PAN-IMOrc Kd. j
►- F1t,+411 Q. t, Nu G7 F, r�fr rek-d J�L s Aa �ro�� Kul., or te><f—,
Swine
Design Current
Capacity Pop.
Design
Wet Poultry Capacity
Current
Pop.
Design Current
Cattle 0 ' Capacity Pop.
Wean to Finish
[Layer
Dai Cow
140
Wean to Feeder
Non -La er 1
75—
p,
Feeder to Finish
Dai Heifer
1M
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design
Dr, P.oult .+ Ca aci
La ers
Current
P,o P.
D Cow
on- airy
Beef Stocker
Q W
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
jBeefBroodCow
11
Other
Other
Turke s
Turke Pouets
Other
�O
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
XYes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
N
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No '5�rNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? Yes ❑ No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: 01 q Date of Ins ection: S y
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes gNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2
Structure 3
4
Structure 5 Structure 6
Identifier:
mr 10r 0Id lr2
61d *-t
^Sttfructure
IVew c*,r
Oew toww ,w P14—
Spillway?: ry 0 N 0
W 0
Yt1
C y —
Designed Freeboard (in): Is
2
2 %, (0
27,
Observed Freeboard (in): I Zb a %b rr
141/
7-4 rl
f Z 0
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes lXI 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 p(I 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 N6A ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? Yes 7777++++❑����RCCC No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application �/
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes IXI No ❑ NA ❑ NE
maintenance or improvement? !�T/
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes I YI 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): G6 rt 4- stk4l l i rain
v v
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yeso
k1l
❑ 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
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need i rovement?.des; e}fe pelsbetEbsir i. Yes ❑ No NA ❑ NE
U✓ Waste Application E elw Freeboard Waste Analysis �il Analysis aste Transfers Weather Code
Rainfall Stocking9Crop Yield 120 Minute Inspections Amonthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes )�No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No NA ❑ NE
Page 2 of 3 21412011 Continued

1FaciIAy Number: q q I 2 • Date of Inspection: S D .�J
• 24. Did the facility fail to calibrate waste application equipment as required by the permit? I �G Yes ❑ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check E] Yes ❑ No NA ❑ NE
the appropriate box(es) below. Pr
❑ 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 IXI Yes [:]No ❑ NA ❑ NE
and report mortality rates that were higher than normal? f l
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
X 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
XNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
kYes
❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
ZI{.✓C a j;G�a tiJ OL1 ZoI � C:v ola � ? � %e 4X"-Cl %o WSKO,
9• G� b -�,xc/j I •ti 6er., of/ ryry�no,fl,?1
2,1" l D(�4?'M5 h 1 (2COfdf b�ood �W�v� 200, �e(y li/GKs✓ Wi �l°co��I dhil'7L
D / 7/b
Or (ecor c1 0,. ir•�% (aF�Il PNeit�r
� �rntis, �
20, 'Z 4j y
1 4"d OA 4-orvivf
21.1A)o tObs� Code recd/ �J r� a,,,l 9a�rlkrtpOvt•
✓moo/ /he � n4oi�
2(0. (a%owt' nak/e>�� //�O7 I z131/201 Z
Z� 7i.wl� jar 7�� of A � W tUj�_ MgAkt-c i3 Ie4
( A,+
(J�� l�1 r(al
j. o
Noy s4de � jaar� "1 at I� 2 Lack. MaRMK rs orcr�lo,
�;Ae j1 l31c� �1atit.r l � fen d oyek rei- Kyo&ptpe,-a'� 6agrliOfc�
4� FKvcAV
ni QVer ow, L(rnn tiP S�%)'lac /r Nrli to (O�a7f .
f✓gs/e! %L Y/ia/WI;L— f2 )7,7 3 = 19.1 Ite1 o /d, 7 n �OP��
Reviewer/Inspector Name: �sI kRil` Ivl fjLCPhone: 6330 P77/".5y'9-5—
Reviewer/Inspector Signature: / Date: O S D I ZZO 1 Z
Page 3 of 3 21412011

611 OL)
�a�/�n. �k,,,4� .�,/,1 � 1AG�✓ti�- �� /ePl,�n� n�/1�^, 1 / I-,�_,,Q/
/ "'L.%�L �Y�'��ArK i''� `S O✓I l.%�1J �C �QYI�S S�f�`7 �faS,diLP�� ✓�`-�"f
�-- 44 cam
I
5G ubeS�
V61
�,k y

for Visit: (3 Routine 0
Date of Visit: Arrival Timer
Farm Name:<►nA%I(',► r
Owner Name: T� �.�U f IC 2 1M F(ylQi'1
Mailing Address:
Physical Address:
Referral 0
0 Other 0 Denied Access
Departure Time: County: YOA16 Region: 11�Q 0
9Mat
Owner Email: NI I M 10�21 E--l- It
Facility Contact: ryt p r �L1 rl G� Title:
Onsite Representative: 'I V� 4 Integrator: "�
Certitied0 erator: *New hrS, by
P (1LU( 1 PJl M Certification Number: 1
Back-up Operator: I Certification Number: p
Location of Farm: Latitude: 3 (O 13 Longitude: 3
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 21412011 Continued

Facili Number: Date of Inspection:
Waste e e t Collection & Tr atm nt
��((
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes I `fX1 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes T❑''' No ❑ NA ❑ NE
5 Structure 1 Structure 2 Stru re 3 Structure 4 cture 5 Structure 6
�Identi5er: &rler t) Id -+a- O .� Nel.� ,)0 le LP
Spillway): I
Designed Freeboard (in):
Observed Freeboard (in): � �� to !1
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.) y�
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes I Jrl 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?
0 Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
MNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
7
9. Does any part of the waste management system other than the waste structures require
Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
,,
I p No
❑ NA
❑ NE
maintenance or improvement?
T-
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, 2 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
th appropriate box.
❑ Yes [gNo
❑ Yes RNo
❑ Yes ''gNo
❑ Yes No
❑ Yes 4No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑WUP ❑Checklists ❑Design ❑Maps ❑Lease greements ❑I Other:
JRaInfallesrecord keeping need improvement?��I- J❑YesNo ❑ A ❑ NE
steAppli anon eekly Freebo rd Waste Analysis Soil Analysis [JJ Waste Transfers Weather Code
[Stocking [Crop Yield 120 Minute Inspections Monthly and V Rainfall Inspections Elfndge$nw
22. Did the facility fail to install and maintain a min gauge? ❑ Yes %No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes [—]No. X NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection:
24. Did the facility fail to calibrate waste app tion equipment as required by the permit? ❑ Yes 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 PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ NA ❑ NE
1WNA ❑ NE
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
Yes
o
❑ NA
❑ NE
and report mortality rates that were higher than normal'?
T�
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
������//////
�No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ 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
dNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YESanswersand/or any additional. recommendations or any other comments. r + t
Us rawings of facility to better explain situations (use additional pages as necessary). r °
=rrtja-t-Loh wuP- 4��g/xo/l U�wAed5f> 11(, aol/ se'd-bu5W land
IJ�ar k ea-s 52-i e� bl�� olc-r Dt.� need Cop ley .
. Wh tlt� 6i-OCA-41(t.
�. tali br"cins Joe. ec+..2otl.
O
-'SJ����OS� QirlOr
2 �loSure
9 l �qu s �n berm o� j4I bam(t)C' SId J
e�' FlX W4 ASAP. 5te �oFyet'Insheaiw
I — cowl d rA 10 e�� e, Mar er o tv �d to tip e
3a C6�1.s11^�P cde5!� h Ya(urne �r 5
o rn 2Xj3"Qn5 ion . or\e 51 nCe Id- was re_CbRS+'ruF6 r-
03/129h = 4_5 �+ z =.z. 3-ia. - � _ .b 45=15. Y
A �t
vs is s Sm Gp
wer/Inspector Name: t: Phone:
Reviewer/Inspector Signature: Date: '93 %
Page 3 of 3 N "A Mo W% S P r� y 214/1011
,Toe, 3/30`90i 1 w S P 5 1 es p- irers 0 n 4 5J

lg6-O
I''ll GHQ„
lr='t � is u
�ktUL-4-1
Me� t 4,

J
Facility Number ®�
Division of Water Quality • •/
Divis_ion of Soil a_ nd Water Conservation q A m
ii0ther Agencv
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
M
Date of Visit: F61 Il I I U 1 Arrival Time: Departure Time: �� County: XjQA KI, Yl Region: Q s 20
Farm Name:s r r j-Owner Email:
Owner Name: �t YVt •1 11U11t C2 PX 0. nPhone: t W 6qq -S `01/—
Mailing Address: 1040 OOL 11001 bl) po. FQ/n�S+ C)einel t niL a 3 01 a c>
Physical Address: L14 01 'C 1h M lD rove- (�h, I� • t d N �— a % 0 � d
Facility Contact: T—1M0 iXTLJ rC ?� Title: Phone No:(c r— I
I- 3 70
�Onsite Representative: u+< erl"Inq
Certified Operator:Anurie— ) t + .t—
p4(4
Integrator:
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
7e
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
A No
❑ NA
El NE'
Discharge originated at: [IStructure ElApplication Field ElOther
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
0
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
xNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
Yes
❑ No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: — • Date of Inspection "`� " T •
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 111❑��- No ❑ NA ❑ NE
tructure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: &.Y Or o1a Z t7 MeU-) NQ U)
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.) T'
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? I Yes ❑ No ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? rj•Q ❑ Yes % No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 1
9. Does any part of the waste management system other than the waste structures require ❑ Yes %kNo ❑ 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 El NA El NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.) 11
❑ 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) V
14. Do the receiving crops differ from those designated in the CAWMP?
El Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ es§
Nc
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
;KNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
'Io
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other,,comments;,i • ;
Use drawings of facility to better explain situations. (useaddntonal pagesias necessary)
E.t VQx^Cthq VleIowJ I0.S'- WS P
I_mte vtJ is v eke •l-ated o v1 n �w wS P ? Imor-Ir-A=OR de5lsn updc_{-ed TT-,34Aj F-It t4w-, tent ukLext 'ror last wsP? NDtiAUJ 3 Cle-4.0t
+
Reviewer/Inspector Name -" L "0J Phone: 11 — 5a p9
Reviewer/Inspector Signature 1' d ; A4 0 1 h A' Date: $ I )1 116
11
Page 2 of 3 12128104 Continued
I�. .2- 0 ems= Y• I

E
Ell
Facility Number: qq — 1 a. l9of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ��(No El NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes �Q No ❑ NA ❑ NE
El❑ Design El ❑ Other
the appropriate box. WUP ❑ Checklists ,-
21. D�oessrr3�'ord keeping need iimiprovement? - XeYes ❑ No ❑ NA ❑ NE
L to AppI' E Weekl Freeboard Waste Analysis S=ly
is Waste Transfers fieu..
ainfall Stockin Crop Yield 120 Minute Inspections and 1" Rain Inspections Weather Cdde
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 minbreakers on irrigation equipment? ❑ Yes tANo d 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 �(NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Otherlssues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes $ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document '300/ ❑ 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 O(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 XNo ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes *o ❑ NA ❑ NE
33. Does facility require a follow-up visit by sat gency? Yes ❑ No ❑ NA ❑ NE
_ `mom
►.i /- ... Y:�• ., !
_ - - �:- -- - _ _11__ �� �
'
.III
ON.`'
v �'..
�..V / /, + / �` /✓ 1 , �Y �. �. �/�
A /
I
C
Page of 3 ,1104
�R(I�-P o�oll Coca-.) Tr'"L',,Solidtligui4

I;'
- >- 9 3as PAJJ ?
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
0 Technical Assistance
Reason for Visit
(Routine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: LI Region:. W 520
Farm Name:1l�p rAUQ. 1nl rS4 T Owner Email:
Owner Name: _ r i Ce Sm ty"P/}F.1rm G_n Phone: \Ai (D 9 9
Mailing Address: �aA
Physical Address: a4l&A Ca/�
M Ve— l iLl U r
a� t r- 41 -9 3-10
Facility Contact: :T--1 . a w i- i C QI'itle: Phone No:
_ Onsite Representative: -1j im -I,- M 'pUturtLf Integrator: �5
Certified Operator: MI&A- 1 SMW2 tr IM 4 Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: ® U © I 1� Longitude: ®e ® '
x,
Swore , h7
❑ Wean to Finish
❑ Wean to Feeder
Dectrk
ow
C�apactty
b@ur'rent
P-opulation
y • Design Csprrent t
Wet Poo"ultry Cap�ac ry� P�opulatt�on C�at�tle
❑ La er DairyCow
k ❑Non -La et Dairy Calf
Deign
Cap cciiry
QOO
@urrent
Population
i
.
El Feeder to Finish
- nt,
i
Dry Poultry
s
'
s !
DairyHeifei
.
El Farrow to Wean
D Cow
Q
❑ Farrow to Feeder
Farrow to Finish
El Farrow
Non -Dairy
Beef Stocker
Reef Feeder
D
Layers
El
❑ Non -Layers
El pallets
-" ❑ Turkeys
El
El Gilts
❑ Boars
❑
Beef Brood Cow
'
~ O e
"tttr d �
r +
;
_� ?ii
IrZ -
�'
, .
Number of Structures: m
`
❑Turkey Ponits
❑ Other
El Other
k•.
s211111111W 4;rr r s
C Rkw3tUF�F&
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
�No
❑ NA
ElNE
ElYes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
❑ No
❑ NA
❑ NE
❑ Yes H No ❑ NA ❑ NE
�I Yes ❑ No ❑ NA ❑ NE
I 12128104 Continued

Ss►���t-VV't���:��
Facility Number: �q — I � • Date of Inspection i y / 7/p J �
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes KNo ❑ NA ❑ NE
a. If yes, is wastefjQu4 into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Q S c11 1 l+�Y Structure Structure to r Structure 4 Structure 5 cture 6
Identifier. 'i� � 4/QV
Spillway?: l i fl
Designed Freeboard (in):
Observed Freeboard (in): Y(J Q O
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes P�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 XNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate iu: hoalth or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? "Mh Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes NrNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Zo ❑ 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. Croptype(s) i 1 470 JJ , A/YIAA_U a'tA ✓ ;>�
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
VNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
q(No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Dd
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
(tn Vleede�i �la� sh-��m, lO� k�w l2si knew_e50 w(t5t--4?_ Jbil
I!� _V'ri90.fi'°17 �!51'54 hf<ec15 +o be,utre-4�lec- L- h
Phone: 1 I (—
Date: V .7 1

Facility Number: — Inspection •
1e of
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ yes
�o
No
❑ NA
❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21.
s record keeping need inlprovement?*1 Je ' epee t�pptvpra .befex—+
Waste Application [—�]'/Weekly Freeboard Waste Analysis Soil�nalysis Waste
❑Yes
Transfers
❑ No
❑ NA
❑ NE
,�/.
�
Rainfall ❑ Stocking ❑ Crop Yield 120 Minute Inspections h0 Monthly and I" Rain
Inspections
L9d
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
�6A
❑ NE
24.
o c+. 1
Did the facility fail to calibrate waste application equipment as required by the permit? < CJ 07
❑ Yes
;ZNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
XNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
0 NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
9,No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
iNo
❑ 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
KNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
Yes
❑ No
❑ NA
❑ NE
General Permit'? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
'�No
❑ NA
❑ NE
Additional`Commentsand/or -Drawings:
el 1 C lose(( ��es— v
Noj---�,j e `I . NeeA A 5A-P .
121. aMot Sod +es- 5
NO
a l 26
a ? QQ4_ c
-AJ 60
_
011
/k,t,m
Page 3 of 3 3 try ( s �i - '� • D :Ha.J = ltl2/28/gf�: rf-

Type of Visit 1& Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit � Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of visit: �Q[
Farm Name: �.
Owner Name:
Mailing Address:
Physical Address:
Time: eparture'fime: J
O oun[}':
J-t V1
Region: SJ�21L�1%
Owner Email:
MRA
Facility Contact:
,� I ' A y- YF Q)AC t C e Title:
OnsiteRep—es�kive: Up.iime_ SJ i9jejrYV>an
Certified Operator: t���i II�n=1042 a
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Latitude:
0
_y' 1 Phone:
;ast 3
arch
Integrator:.
W 1,2����07
?d .,East 3c� a�918
Phone N JC) T— y 14 — 43'10
99S
Operator Certification Number:
Back-up Certification Number:
IMF U81014ME 141
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -La et'i
Dry Poultry
❑ Layers
❑ 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?
vA
o ej
Design
Current
Cattle Capacity
Population
Dairy Cow
g0
Dairy Calf
Dairy Heifei
Dry Cow
Non -Dairy
❑ Beef Stocker
S
El Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
e. 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 )( ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
C°
❑ NA
❑ NE
❑ Yes
t2q No
❑ NA
❑ NE
11/18104 Continued

Facility Number: — • Date of Inspection O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?/,' ❑Yes TTTTTT❑ No ❑ NA ❑ NE
Structure 1 Structure 2�li") Structure —� Structure 4 yj Structure 5 Structure 6
Identifier: 60 9 l old 9 Z PUX 5 lOY ("P i���! k,30
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 31)
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ElNA ElNE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
XNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
Yes
❑ No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
/
9. Does any part of the waste management system other than the waste structures require
❑ yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
XNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
,No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
PNo
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
jKNo
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination %yes
//I7❑77tt
No
17.
Does the facility lack adequate acreage for land application? Yes
No
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
No
❑NA ❑NE
❑NA El NE
El NA ❑NE
❑NA El NE
El NA ❑NE
to . New was{e Ponds 3+4 oer�vv
fl-ed ? \,jo Pp well c(aSed
10 �o +i lotr �nond Closed No s� ciaj�s{ to send1u�n�tzkovl
3. Erosion on we-Sf side
e
Reviewer/Inspector Name jO,evrYr ` Phone:
Reviewer/Inspector Signature. V fil I I 11l4L4t tadd L A Date: 02

Facility Number: — aI Bate of Inspection �(Q� •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes X,No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes > No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need imErovement? Yes ❑No ❑NA ❑NE
❑ ste Applicationeboard *ante Analysis ❑ SVAnalysis ❑ �ste Transfers
❑ ainfall ❑ �ing eld n Un ^"' --Y—❑ Vnthly and I" Rain Inspections ❑ Nt�ather Code
DµI t-
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'?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
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 tail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector tail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
kNo
❑ Yes
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
gNo
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
�(No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
9 No
❑ NA
❑ NE
❑ Yes
ON
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
IgNo
❑ NA
❑ NE
❑ Yes
[�(No
❑ NA
❑ NE
Additional Comments and/or Drawings:
�` ?-To berev +pr c'eons(rvC{ioV�,S
�Cove - crop CL&a wu � • C04ke_F w- WvP '15 updated o
oZ T ry 130+ov>, Aes(� inq- specs u paaL.�eA 7To be re- v i sea CcRe t•
�ons�-�c�-;oh eot�;plz+esio
a l aoo1
�01f LA3 &0 = 1 /� = 16.7 U 3- 6. Jj
a a°Mt �?N)kk IS Ss AA_T�NOq.
a1 Somer wee, Kl LOC.5fe. [en/e ( C.t1eC145 acre Wll5S [ n� .
a tax / ab
)1
12128104

n Division of Water Quality
Facility Number q -I a- 0 Division of Soil and Water onservation yt yyt
0 Other Agency
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: Arrival Timer-`�;�{�- Departure Time: �. 0 County: aol_
Farm Name: k � V 0 rOV LL hcX ► ICAJ Owner Email:
Owner Name: 1-I wh au r l c,,P- J`r i-doze- m aq) Phone:
Mailing Address:
Region:IA.),S C
0
Physical Address: A�[J6 /�/`�1 U CDt (�1�� �h�KrA (?J - � iL &,#-,d,n)e- a�o�
Facility Contact: �1 (Wnt or- Mat l t i rp C Title: Pho to No: a F
Onsite Representative: IV IQ% U(1 C ei Sm W Integrator: C
QQ �/ 'l445
Certified Operator: �aurl CO J M t 1'VIPX rna✓) Operator Certific on Number:
Back-up Operator:
Location of Farm:
Swine
Wean to.Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
❑ Other
Back-up Certification Number: _
Latitude: ®o ®� Q Longitude: ® o
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
m
Design Current
Cattle Capacity Population
❑ Dai Cow
qOO
❑ Dairy Calf
1 -7
❑ Dairy Heifei
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: Ell
Discharges & Stream Impacts I et -�. p
1. is any discharge observed from any part of the operation? V /I F/❑ Yes Vo ❑ NA ❑ NE
Discharge originated at: ❑Structure El Application Field ❑Other
T'" 1
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? 0
d. Does discharge bypass the waste management system? (If yes, notify DWQ) [I Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes DNo ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State DO Yes El No [I NA El NE
K
other than from a discharge'? „ , „ t u j
a Gi 12/2 04 Continued
3, Neust ► �t� Fm hole. ivy Ick ea.ztc c-6xs-+ o�

acility Number: — . Date of Inspection 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes go ❑ NA ❑ NE
ly/�
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
5 ' Identifier: 014 44 ( 2_ tx r pr
/0 � lb& C)ASuI
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
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes .(No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit'? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ yes VNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes VNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes )(No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
• o
12.
Crop type(s)
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP? El,, Yes
<o
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement?
9No
❑ NA ❑ NE
16.
������.....❑Yes
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? Yes
❑ No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
)<No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
VNo
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
on
u
r�e.e� � � v�g t�� tva�t-i� I ✓1 �j'I�e.m •
5U_-) �fO"^ 5 t�lo m uSt cl lso be� GloSe d
Parforwatul wspmust lop. C'\v
C,0"[O4;v✓l n�r npA�J 4)0(
e, cer-H i--I e.q not- t
vJavzir- s`' jPkxj WykI to
w/in one 1eairof
ia-4.
IReviewer/Inspector Name ( roc_Phone: 1, I
Reviewer/Inspector Signature: _Q� _ Ap J Date: 1 1
LS Sc1e- l eI� �OJ1/2 h 4h ZIhC o JV�gest no Qi�ll/ha1aiooaStet;o,,,isdyear.

0"
0
J
Facility Number: q — Pate of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
0
❑ Yes �No ❑ NA ❑ NE
20. Does the facility fail to have components of the CAW eadily available? If yes, check Yes o ❑ NA ❑ NE
WU
the appropirate box. ❑ Checklists Desig ❑ Maps [--]Other
��JJ���JJJ"'
t
21. Does record a ing need improvement? Yes ❑ No ❑ NA ❑ NE
isle Appli do eekl Freeboard Waste Analysis Soil alysis ❑ aste Trans s ties
Rainfall Stocking Crop Yield 120 Minute Inspections Monthly and V Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes ❑ No 1ANA ❑ NE
❑ Yes N(No ❑ NA ❑ NE
❑ Yes
❑ No
%NA
❑ NE
❑ Yes
�y No
❑ NA
❑ NE
❑ Yes
L161 No
❑ NA
❑ NE
❑ Yes
N(No
❑ NA
❑ NE
❑ Yes
19(No
❑ NA
❑ NE
❑ Yes
%No
❑ NA
❑ NE
❑ Yes
)�No
❑ NA
❑ NE
❑ Yes
�dNo
❑ NA
❑ NE
❑ Yes
15(No
❑ NA
❑ NE
al Comments and/or Drawings:
Ad itOPP
r0 O O
ck
II //
l c1lU cJ I
S�t 1 co V
CFe 5 - `6-
ao. o�
M"Ui h Aw-�.5►�P�6
lo 5N' { Fowra�bt000
celb
LA �o a itsf.
tie
as �Co ve r—L* ► rvL v s
6A�6Lfjr
l
TAAc ial5tm PAN i 5
$ Severna/Fie Id►S I', 5ieA t�i oe for SaYv�e- crop
3 S Jj M Pit Con'h'o l m ~? 4 Sp re 5 loo lL cJ. cry e
A Pip 11'ea Oom�(
-
I
o r\ U,X6-60 5 al4# leU to CD"V ie ne. co o-d So

• 0
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 990012 Facility Status: Alive Permit: AWC990012 ❑ Denied Access
Inspection Type: Comoliance Inspection
Reason for Visit:
Inactive or Closed Date:
County: Yadkin Region: Winston-Salem
Date of Visit: 03/03/2006 Entry Time: 10,10 AM Exit Time: 12:00 PM Incident #:
Farm Name: Shady Grove Dairy Owner Email:
Owner: Tim A Smitherman Phone: [phone]
Mailing Address: 1040 Hoot Owl Hollow - vm;= -II&F411111
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°13'59" Longitude: 80°31'33"
US Hwy 421 north to Baltimore Rd. exit. Left at top of ramp (north). Right onto Forbush/Comelius Rd. Left onto Baltimore Rd. Left onto
Flint Hill Rd. left onto NC Hwy. 67. Right onto Fairground Rd. Right onto Shady Grove Road. Farm is on left.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Maurice W Smitherman
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative Maurice Smitherman
24 hour contact name Tim Smitherman
Operator Certification Number: 21958
Title . Phone
Phone: [phone]
Phone:
Primary Inspector: Melissa Rosebrock Phone:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
3. & 9. Must keep cattle out of buffers and re -vegetate to control run-off.
28, CAWMP for 700 cattle? Need to update WUP to include confined dry or heifers.
28. T-3915 F-5 received irrigated waste. WUP states that it is to be broadcast.
31. Remember to contact DWQ if waste level rises above maximum liquid mark.
33. Re -check buffers near calf barn.
2/23106 waste analyses:
#1=2.9, #2=7.3, #3=4.9, and #4=9.1 lbs. N/1000 gal.
Date:
Page:1

• 1 0
Permit: AWC990012 Owner - Facility: Tim A Smithennan Facility Number: 990012
Inspection Date: 03/03/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
O Cattle -Milk Cow 600 600
Total Design Capacity: 600
Total SSLW: 840,000
Waste Structures
TvP9 Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
Neste Pit
ROOFED PIT
24.00
Neste Pond
PARLOR WSP 1
18.00
36.00
Waste Pond
WSP 2
18.00
30.00
este Pond
WSP 3
- 24.00
36.00
Page:2

Permit: AWC990012 Owner - Facility: Tim A Smitherman Facility Number: 990012
Inspection Date: 03/03/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No
NA
NE
1. Is any discharge observed from any part of the operation?
❑
m
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0
❑
❑
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)
❑
0
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
Cl
M
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
■
❑
❑
❑
discharge?
Waste Collection, Storage & Treatment
Yea
No
NA
NE
4. Is storage capacity less than adequate?
❑
0
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large trees, severe
❑
■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management ❑
■
❑
❑
or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits,
❑
■
❑
❑
dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
■
❑
❑
❑
improvement?
Waste Application
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or
❑
■
❑
❑
improvement? -
11. Is there evidence of incorrect application?
❑
m
❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
Page:3

• I •
Permit: AWC990012 Owner- Facility: Tim A Smilherman
Facility Number: 990012
Inspection Date: 03/03/2006 Inspection Type: Compliance Inspection
Reason for Melt: Routine
Waste Ap licp ation
Yes No NA NE
PAN?
❑
Is PAN > 10°/u/10 lbs.?
❑
Total P205?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Com (Silage)
Crop Type 2
Small Grain (Wheat,
Barley, Oats)
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5 1
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management
Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Records and Documents
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available?
If yes, check the appropriate box below.
WUP?
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
Yes No NA NE
❑ ■ ❑ ❑
❑ ■ ❑ ❑
701
Page:4

Permit: AWC990012 Owner - Facility: Tim A Smilherman Facility Number: 990012
Inspection Date: 03/03/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents Yes No NA NE
Checklists? ❑
Design? ❑
Maps? ❑
Other? ❑
21. Does record keeping need improvement? ❑ 0 ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after> 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■ ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑ ■
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑ 0
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■ ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑ ■
❑
Otherlssues
Yes
No NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
■
❑ ❑
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those
❑
■ ❑
❑
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air
❑
■ ❑
❑
Quality representative immediately.
Page: 5

Penult: AWC990012 Owner - Facility: Tim A Smithennan
Facility Number:
990012
Inspection Date: 03/03/2006 Inspection Type:l'Compliance Inspection
Reason for Visit: Routine
Otherlssues
Yes
No
NA
NE
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
■
32. Did ReviewerAnspector fail to discuss review/inspection with on -site representative?
❑
■
El
11
33. Does facility require a follow-up visit by same agency?
■
❑
❑
Page: 6

Division of Water Quality -
Number Z Division of Soil and Water Conservation
O Other Agency .
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
(Routine Q Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Ep/a Arrival Time: Q Departure Time: Hlo—cD County: 1 Region: k)5 Q O
Farm Name: !AdAX4 I% U IN V-f- bt3t� Ir U Owner Email:
Owner Name: TIVA4- M(ivt1LZ CMi-11i e.V-Me-1t�,0 Phone: ZIb.9Q-19i3(e V4 Iv94-3l1.7
Mailing Address: l �%y D � OW 1 P6 Q O U-3 figs+ Reid I N L 2 1 0 l5
Physical Address: LO C_ur Z.-yl Fat
-t-
Facility Contact: l t rn o r m(J�
,>�Y'1 e-Title::
OnsiteRepresentative:�f 1 M&-JI1C.P 5004-Fe-CMQ1I Integrator:
Phone No: ID 4 Q. - 39 0-
Certified Operator: !_I OLV r « 'F; M&'e_'mQn Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: No ®. [ALongitude: rMo ©,
u5 4 N 1. ' nrort - ex:t4. e�4 fi-tout rah Cnor+, R-i K+ On+0 h r b ue h
Cornelius Lei} on}o 0al-hmore_ M. ��t onto F31+ l) 2�a Le
or%'o Mb iktx.,�6 + O +0 Fdir f'0�;a drove
Design Current Design Current Design Current
Swine CapacityPopulation Wet Poultry Capacity Population Cattle Capacity Popu—lation
❑ Wean to Finish I ❑ Laver DairyCow 00 400
1❑ Wean to Wean to Feeder I 1 1; ❑ Non -Layer I I Ell JEJ Dairy Calf
U Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullet
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
U Be f St cker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: F-41'
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 KNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
El No
❑NA
❑NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
t7D Yes
I`
XNo El NA
*No [I NA
777���
�
El NE
El NE
12128104
Continued

VI
Number: 1— 1.1 • 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?
❑ Yes XNo
❑ Yes ❑ No
❑NA ONE
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: M thUarhA• EnegSiaLV Lb E'rrn5t(! %Iia Sinc-14-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?? ❑ Yes IjgNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) /
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 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? Yens No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes IRXo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require *Yes ❑ No El NA ❑ NE
maintenance or improvement? IT``
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes I ❑ NA ❑ NE
maintenance/improvement? ���...///
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes L�Q No El NA El NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground El 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 5�No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes /KNo []NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes I��tN....,I// No ❑ NA 10 NE
17. Does the facility lack adequate acreage for land application? ❑ Yes TL No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes '(No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
r
3 cAbF✓ le oui.t-S`
�� - Ve e`ia��e
Reviewer/Inspector Name I rJ . f0 L
Phone: 11 S a$
Reviewer/Inspector Signatur
Date: 3
Page 2 of 3
12128104 Continued

Facility Number: qq — I ; Dgte of Inspection Q 40
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ANo ❑ 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 I ❑ Design El Maps ❑Other
21. DoeWrecord keeping need improvement? ❑ Yes XNo ❑ NA ❑ NE
L�1 WW/aste Application D Weekly Freeboard D-waste Analysis ail A lysis [Waste Transfers /
Ly'Rainfall Stocking rop Yield Monthly and 1" Rain Inspections a4ather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
'ONO
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment``?''
El Yes
El No
24.
Did the facility fail to calibrate waste application equipment as required by the permit?l: 4 `V &
❑ Yes
%No
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
9(No
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
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?
Comments and/or
`d • Fan mo_rl�,e.r
K • Pre.Ssure_ On 4un ,
9. Berm d n eas+ Side 6f FS by 413 LoS P
aa. YLatn (%0. 10v' ►-epowred ? co-t
rites ❑ No
❑ Yes JXNo
❑ Yes ,No
❑ NA ❑ NE
*A ❑ NE
❑NA ❑NE
�fNA ❑ NE
❑ NA ❑ NE
ONA ❑ NE
El NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes D(No ❑ NA ❑ NE
❑ Yes )�No ❑ NA ❑ NE
C4 Yes ❑ No ❑ NA ❑ NE
L la y I.t_a ei W-Gr)
al Qai1v� ra44\CdLkt ? 1n1Mk w t ondi4-iohs7 6roP lrid?q�
cbUDQ t6 U
� ®T 39 I S F— 5 �� ✓�u�"
Page 3 of 3 12128104

0
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 990012 Facility Status: Active Permit: AWC990012 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Yadkin Region: Winston-Salem
Date of Visit: 09/21/2005 Entry Time:09,35 AM Exit Time: 11:20 AM Incident #:
Farm Name: Shady Grove Dairy _ Owner Email:
• m A Smitherman3366998136OR37
Malling, Address: East Bend NC 27018
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°13'59" Longitude: 80°31'33"
US Hwy 421 north to Baltimore Rd. exit. Left at lop of ramp (north). Right onto Forbush/Cornelius Rd. Left onto Baltimore Rd. Left
onto Flint Hill Rd. left onto NC Hwy. 67. Right onto Fairground Rd. Right onto Shady Grove Road. Farm is on left.
Question Areas:
0 Discharges & Stream Impacts 0 Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Maurice W Smitherman
Secondary OIC(s):
On -Site Representative(s): Name
24 hour contact name Maurice Smitherman
On -site representative Tim Smitherman
Primary Inspector: Melissa Rosebrock
Inspector Signature: —
Secondary Inspector(s):
Operator Certification Number: 21958
Title Phone
Phone: [phone]
Phone:
Phone: [phone]
Ext.383
Date:
Phone:
Phone:
Page: 1

Permit: AWC990012 Owner- Facility: 'Tim A Smitherman Facility Number: 990012
Inspection Date: 09121/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Inspection Summary:
7. Continue efforts to mow embankments, especially; outside corners.
8. Need to repair marker for right freestall WSP.
9. Need to remove stockpiled waste from from stocktrail.
'•9. Must install a taller concrete or wooden berm on the east side of the left freestall barn near the water trough. Waste is washing
down the hill to a freshwater ditch.
9. Manure is entering ditch from barn near calf hutches/old parlor barn.
16. Still need pressure gauge for irrigation gun.
"21. New permit requires you to keep daily rainfall records, and document weather conditions on IRR1 and SLUR1 for the days
when waste is applied. Initial rainfall events of 1" or greater. Don't forget to record crop yields for land that receives animal waste.
22. Rain gauge is onsite... just need to repair.
28. Owner wants to go to 700 cattle in the near future. Is working with SWCD/NRCS for plan revision.
32.Operator was cutting silage and instructed inspector to review records in office and complete inspection in their absence. Tim
Smitherman was onsite part of the time.
Waste was being hauled today.
Page: 2

Permit: AWC990012 Owner- Facility: Tim A Smithennan Facility Number: 990012
Inspection Date: 09/21/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current Population
Cattle
IN Cattle - Milk Cow 600 575
Total Design Capacity: 600
Total SSLW: 840,000
Waste Structures
Tvoe Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
Waste Pit
ROOFED PIT
24.00
Waste Pond
PARLOR WSP
18.00
30.00
Waste Pond
WSP 2
18.00
24.00
Waste Pond
WSP 3
24.00
18.00
Page: 3

• 1'
Permit: AWC990012 Owner - Facility: ITim A Smithennan Facility Number: 990012
Inspection Date: 0921/2005 Inspection Type: ,Compliance Inspection Reason for Visit: Routine
Discharcipm & Stream Imnacte
1. Is any discharge observed from any part of the operation?
Yee No NA
❑ moo
NE
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑ ■ ❑
Cl
b. Did discharge reach Waters of the State? (if yes, notify DWO)
❑ 0 ❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWO)
❑ 0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑ 0 ❑
❑
3. Were there any adverse Impacts or potential adverse Impacts to Waters of the State other than from a discharge?
❑ 0 ❑
Yes No NA
❑
NF
Waste Collection Stnrage & Treatment
4. Is storage capacity less than adequate?
❑ 0 ❑
❑
If yes, is waste level Into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large trees, severe erosion,
❑ ❑
❑
seepage, etc.)? I
6. Are there structures on -site that are not properly addressed and/or managed through a waste management or
❑ M ❑
❑
closure plan?
7. Do any of the structures need maintenance or improvement?
❑ ❑
❑
8. Do any of the structures lack adequate markers asrequired 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?
Yec No NA
NE
Waste Applinatinn
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or Improvement?
❑ 0 ❑
❑
11. Is there evidence of incorrect application?
❑ M ❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload? �� i.
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
Cl
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
Com (Silage)
Crop Type 2
Fescue (Hey)
Crop Type 3
Small Grain (Wheat,
Barley, Oats)
Crop Type 4
Crop Type 5
Page: 4

Permit: AWC990012 Owner - Facility: Tim A Smithennan
Inspection Dale: 09/21/2005 Inspection Type: Compliance Inspection
Facility Number: 990012
Reason for Visit: Routine
Wa%tP. Application
Crop Type 6
Vee
No NA
NF
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)? ❑
n ❑
❑
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the Irrigation design or wettable acre determination?
❑
E ❑
❑
17. Does the facility lack adequate acreage for lend application?
❑
N ❑
❑
18. Is there a lack of properly operating waste application equipment?
0
Yes
❑ ❑
No NA
❑
NF
Records and Documents
19. Did the facility fall to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
N ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
0
❑ ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
0
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
Inspections after> 1 inch rainfall & monthly?
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
E
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fall to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on inlgaton equipment (NPDES only)?
❑
❑ 0
❑
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑ 0
❑
26. Did the facility fall to have an actively certified operator In charge?
❑
N ❑
❑
27, Did the facility fall to secure a phosphorous loss assessment (PLAT) certification?
❑
❑ 0
❑
Page: 5

• I •
Permit: AWC990012 Owner -Facility: TIm A Smithennan Facility Number:
990012
Inspection Dale: 09/21/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other ISsupg
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
Vas
❑
No
NA
❑
NF
❑
29. Did the facility fall to properly dispose of dead animals withln 24 hours and/or document and report those mortality
❑
❑
❑
rates that exceed normal rates?
30. At the Ume of the inspection did the facility pose an air quality concern? If yes, contact a regional Air Quality
❑
❑
❑
representative immediately.
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
33. Does facility require a follow-up visit by same agency?
❑
❑
❑
Page: 6

Type of Visit 0 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 ❑ Denied Access
Date of Visit: zl 0 Arrival Time: '� Departure Time: County: UQ� Region:
a
Farm Name:-tS-h0.A V U r0 V 2 �Q \ y-U Owner Email•
Owner Name: 1 ylnn rnLl Ulf:IC42 . SD01-9, _MQ-A Phone: 1)&A 1A9 -213G 1(QT? 3319
Mailing Address: 10 `k) dimt C,A) l H O IIOt �Ea6t fiend , NG a� 01Z
Physical Address: S h�u Co rom h . R d • f GQS�&,,n li
r
Facility Contact: Tn!�l OP- I , Ian IQ Uf- lGe_ Title: Phone No: (2 Of 9 - �;a as
Onsite Representative: Tim S�YI PrmC�2�� Integrator:
Certified Operator: J r �/�Q V y l C-P— SV\A I1+ PJi MQ-n Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: L�jv �atitude: L ' S Longitude: g� o 0
US t o Mores . eu.+, I n�0� a+ -a�p O'F
COV Y1e�tUs 2d• (rf,4 0✓l+0 &t-hYY1or-e I (V ✓lt� ��� Leo-
( N� I
)v ntl A R-+ +• onto G h ,_�
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Non -Layer... _..
II 1 Furrow to Feeder I I
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
Dairy Cow
6O
Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
❑ Yes L)9,No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? 0
d. Does discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 777777���///No [I NA El NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State El Yes L]9��`"`No El NA ❑ NE
other than from a discharge? , `
L+7
12128104 Continued /A

Facility Number: q — Z • Date of Inspection 1-I O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �(No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. fly PreA?,S+&Jj W&j6 Wy:=
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 0_
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.) ,,..J
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes I�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? tg Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? IXl yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) l///'����
9. Does any part of the waste management system other than the waste structures require es ❑ No ElNA [INE
maintenance or improvement? ROY
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o [I NA ❑ NE
maintenance/improvement? ;k<
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Wo ❑ 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 Drifi ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
l,No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
XNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, ❑ Yes
�(No
❑ NA
❑ NE
17.'Does the facility lack adequate acreage for land application? ❑ Yes
0No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? 19 Yes
❑ No
❑ NA
❑ NE
��` y ..[5t wi1b5':IP`Nk`�ksd. ,. ti��'i '
;omments�(refer to question #): Exph in any YES answers;and/or;any,recommeudations or any otper co�mm�epts.
fSik"F24kig7e+— 1. It , /w;4ah. 9�S dk:.�s'4 Xr9°.ulsss2cr¢g9mN I
cmot..we� ? (�- n yee, '�osespeM&r1)e.r5 visiWeo�0.�r# oZ W1a'rrrt e.Aq p YJft�-VWv/nit 1,.Y�8fD�lgr,? a.mo ��acn7��/ija"`=___9,3 w jb 5
Reviewer/Inspector Name
Reviewer/Inspector Signal
Phone:
Date:
7.t
2-2I 1
Continued
r5. C(I3bv
M vs� i r15�t.\� �ber-m (tAn�re+e, wood �,,ller on PAs-�12128104
S d� c�

Facility Number: — 2 D1f Inspection o11 D •
C' i
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �!CNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes >No ❑ NA ❑ NE
the appropirate box. ❑ W UP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes check the appropriate box below. /
EJ Yes
❑ No
❑ NA
❑ NE
a to Applicaf ❑ Weekl Freeboard El Waste Analysis ❑Soil Anal iy ❑ Waste`T`ransfers✓
Rainfall ❑ Stocki17 Crop Yield ❑ 120 Minute Inspecvns Monthly and I" Rain Inspections
Y
Weather
On
Code L
n;ti�
22. Did the facility fail to install and maintain a rain gauge?
n MeclSur
o
NA
eq,���
❑ NE' /1,
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
I(NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
Yes
$No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit'?
❑ Yes
❑ No
0NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
IgNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
tgNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�(No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑YesNo
El NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
X Yes
❑ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency'?
❑ Yes
�j(No
❑ NA
❑ NE
Additional Comments and/or Drawings:
a 0t_..)ne_r1 op11'z+._-i-orS I v2r� �uLTI 51 �a q� �i I YlS Eru���d I hSPeC.{�
v re- vIeU-DreC-0C5 +-4011lV�{L lvtis ty✓t In`(�let of
T w _ S m ►` &&14 ten. U)0s On 'bAgo-4- " o-F
5 on s i 4-e — J u,5+ needs 46 be- ne ► re4
al New pecrhl+ t-2g�Itres �ou+p Keep d4IL,rci►m�e�l� 1'2c ord
y 6LC-U �,ti{ wea`�Pnex
,
Cove c ,o hs oh Stu R I
ilex ys 'ihal- t,t5te t5 P r n t$ i al rc�i Y'SOLI 0M2 �
r
I
m e � or more, bovjA -FOVI -6 re -Cord crop
Leld for bond `s rOA I YM9
le
(�.h�r2i5 9�� � ��ul�-o d��� �row� iparn Icy ea�h.rl:c�es�o �otx
JA� Lke AUA—.J
0 nee,
r6q

(Type of Visit O• Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Facility Number 99 12 Dale of Visit: ll/30/2004 Time: 0950
Not Operational 0 Below Threshold
® Permitted ® Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: S.hadY.GxuYR.A?,aitw..................................................................................... County: X,adk a.:............................................ WS.13Q........
Owner Name: Tim..&.1.!'laurite.................. Smitliefatan............................................. Phone No: (Dad).te9Acda b..Ox.CFt�.k99,3.7.Q9....................
Mailing Address: IQ9.O..k1U.U1.Qtt'i.HQ..IlUat:.................................................................... EaS1.B.Cild...N.C...................................................... VAL& .............
Facility Contact: Tiu1.UX..IYaauGice.Sm111ARICmaU................Title:................................................................ Phone No: 699.,39,25..(l AILr.iS.e,kl)....
Onsite Representative: MauirICE mithl:. an............................................................. Integrator:......................................................................................
Certified Operator: MAU.Cigr..W..-..r........................ SanRM..0ama................................... Operator Certificaatttiion Nuntber:2,19fl S.............................
Location of Farm: 1114 4-1 I YloMn C, M . rdi.S% pi Pr%A N% 9-70 � 15
US Hwy 421 north to Baltimore Rd. exit. Left at top of ramp (north). Right onto Forbush/Cornelius Rd. Left onto Baltimore) -
Rd. Left onto Flint Hill Rd. left onto NC Hwy. 67. Right onto Fairground Rd. Right onto Shady Grove Road. Farm is on left
❑ Swine ❑ Poultry 0 Cattle ❑ Horse Latitude F 36 • 13 59 11, Longitude 80 • F_311 F 33 11
Swine
Design
Capacity
Current
Population
Design Current Design Current
Poultry Ca It Po ulation Cattle Capacity Population
❑ Wean to Feeder
i
❑ Layer
I
I[] Dairy
600
550
❑ Feeder to Finish
10 Non -Layer
I
❑ Non -Dairy
❑ Farrow to Wean
❑Other
Total Design Capacity `` 600
Total SSLW 840,000
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
I Number of Lagoons - u I II I I I
a I
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 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: .......Milk.Barn ....... ...... [ iL.fracstall...... ...... .1 t..freestall...............W.etstack..............................................................................
Freeboard (inches): 24 48 18 18
12112103 Continued

Facility Number: 99-12 1 • Date of Inspection 11/30/2004 • F .
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes N No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes N 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? N 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? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc > 3000
12. Crop type Com (Silage & Grain) Fescue (Hay) Small Grain (Wheat, Barley,
❑ Yes
❑ Yes
❑ Yes
N No
N No
N No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
N No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
N No
b) Does the facility need a wettable acre determination?
❑ Yes
N No
c) This facility is pended for a wettable acre determination?
❑ Yes
N No
15. Does the receiving crop need improvement?
❑ Yes
N No
16. Is there a lack of adequate waste application equipment?
N Yes
❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
N No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
N No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
N No
Air Quality representative immediately.
Comments (refer to question #):' Explain any YES answers and/or,any recommendations or any other comments
d '
�i 1 Iii '
Use drawings�oflfacility to better explain situations. (use additional pages as necessaryp�„3! N Field Copy ❑ Final
Notes
yl (�
3. and 8. Leachate from bedding/old silage stockpiled near the silos is washing downhill into a surface drain and ditch. Waste was
followed to where it discharged into surface waters. Operator to move stockpile immediately. Waste is to be land -applied.
7.Observed burrow hole in comer of left freestall waste pond. Need to spray/mow briars to discourage burrowing animals.
16. Must install pressure gauge prior to next use.
looked good.
over new permitting requirements with operator.
Reviewer/Inspector Name Melis a Rosebrock
Reviewer/Inspector Signature: Date:
12112103 Continued

Facility Number: 99-12 DIof Inspection 11/30/2004 .
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.
❑ YesANo
❑ 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?
❑ Yes ®No
(ie/ discharge, freeboard problems, over application)
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ®No
28.
Does facility require a follow-up visit by same agency?
® Yes ❑ No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ®No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes ®No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes ❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes ❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections []Annual Certification Form
12112103

(Type of Visit %Compliance Inspection O Operation Review O Lagoon Evaluation
for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
11Faotcility Number Date of Visit: 1 , Time:
�[ ; NOperational O Below Threshold
® Permitted 0 Certified 0 Conditionally Certified ❑ Registered Date Last Operated or Above Tbreshold:..___..._.__..
I�
Farm Name: ...S.h�A _.�.I-O.U2�,„��_'„t�r ._._._.__....__.___.___..__._ County: _. ___...._.___.____.__.__._.__
Owner Name: �_Lfi1_.�/' LT III ._�. �/_ _._._._....__.__ _.. Phone No: _-)3 t q_
q___�%� �M 6 tYt
Mailing Address: .I Q! 9._._l% ..Q l_.�!o11..o__.SfYI i . N_...._.... '�_. �_C� I �...... _
Facility Contact: M1%'1.oT...1.!./.Q13.f 1C � Stu i e��/YJa 11 ____.._._..._._..._. .......... Pk?a No: 3 6 q q ' 37 9
Onsite Representative:
Certified
r: _.9.1�,111J_�er .1t�1 i vt FT V_W_4_'_rjj?Lj____ Operator Certification Number:—..---_--_.
Location of Farm: I#I & q 1 , ,Iq
t& W I m i�, . -e.x 4 iz f- 0-+ 01rkLN.- oVTF oC u,
VVIO r-11on+a> N6 Hw o TL+ 14I II
It
❑ Swine [3Poultry Cattle [3iore ahtu a �' 0' S� Longitude �•
'Swine
rFmrow
o Feeder
to Finish
to Wean
to Feede
to Finisl
uai
Dischames & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field 40ther
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 gallmin?
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: L11 [LV f1_. _re
Freeboard (inches):�-
12112103
cn'Fo" A 6 d
7a�u
XYes ❑ No
❑Yes No
VYes ❑ No
Yes ❑ No
❑ Yes ro
o
❑ Yes
❑ Yes% No
Structure
Continued

Facilitylyumber: — Date of Inspections pt]
5.
Are there any immediate threats to the inn ty of any of the structures observed? (ie/ trews Fevere erosion,
❑ Yes
No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
No
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
'AYes
7.
Do any of the structures need maintenance/improvement?
❑ No
8.
Does any part of the waste management system other than waste structures require maintenancelimprovement?
El Yes
No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
N0
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11.
Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground E;C per and/or Zinc
12.
Cror -,pe
'
13.
Do the receiving crops differ with those delIgnafed in the Certified A al Waste Management lan (CAWMP)?
Yes
CVN6
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
0(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
to
1
Odor Issues 3 t0 V_ -7, �C Fye�S Lf v
!'
Y'
17.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
E j*e,—E^,
, o—
liquid level of lagoon or storage pond with no agitation?
18.
19.
Are there any dead animals not disposed of properly within 24 hours?
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ Yes
�_ /o
O
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
XNo
Air Quality representative immediately.
Feld Copy ❑ Final Notes
C� hs -red roe �,d Ina by rrol J hole- n o n for. n e>r
2a� � �lru �Jr fp-v:5 °� ci iS �o U r0.sj �. o" � �O�J `i
an�lVlL V
My
Reviewer/Inspector Name I 1„ ¢ - , r c,7L17A TIMSUMM, SM RM
Reviewer r Signatu ! , / � Date: r� 0
11/12/03 Usf�l�ls t4`(I �%� lJl� L? Q �f�UE� il�x� continued
USP_9

i
echnical Assistance Site Visit R�epoj r
D on of Soil and Water Conservation
O Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number
99 12
Date: 1017/04
Time: 10:00
Time On Farm: = WSRO
Farm Name
Shady Grove Dairy
County Yadkin
Phone: [phone]
Mailing Address 1040 Hoot Owl Hollow East Bend NC
Onsite
Representative Tim & Maurice Smitherman Integrator
Type 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
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 uI tion
❑ Layer
❑ Non Layer
® Dairy
❑ Non -Dairy
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Po uI tion
❑ Layer
❑ Non Layer
® Dairy
❑ Non -Dairy
® Dairy
❑ Non -Dairy
1 600
1 600
❑ Other
27018
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 Ono
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes Ono
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 Ono
Structural Structure 2 Structure 3 Structure 4 Structure 5
Identifier Parlor WSP RT. Back Freestall LT. Back Freestall I Small covered pit
Level (inches) 1 28 21 1 19 32
CROP TYPES jCom, Silage Ismail grain silage 10rchard Grass ha
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

Facility Number 99 - 12 Date:
10/7/04
PARAMETER
p 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
❑
El
10.
Level in structural freeboard
Conditional Amendment
❑
❑
❑ 11.
Level in storm storage
26. Waste Plan
27. Review or Evaluate Waste Plan w/producer
❑
❑
❑ 12.
Waste structure integrity compromised
28. Forms Need (list in comment section)
El
❑
® 13.
Waste structure needs maintenance
❑
❑
29. Missing Components (list In comments)
[114.
Over application >= 10% & 10 lbs.
El
❑
El15.
Over application < 10% or < 10 lbs.
30. 2H.0200 re -certification
[116.
Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
[117.
Deficient irrigation records
32. Irrigation record keeping assistance
❑
❑
❑ 18.
Late/missing waste analysis
33. Organize/computerization of records
❑
❑
019.
Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
[121.
Crop needs improvement
35. Sludge or Closure Plan
❑
❑
[122.
Crop inconsistent with waste plan
36. Sludge removal/closure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
❑ 24.
Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker check/calibration
❑
❑
Reaulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
El❑
El Other...
43. Irrigation system design/installation
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2.
49. Drainage work/evaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, storrnwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5'
56. Operation & maintenance education
❑
❑
57. Record keeping education .
❑
❑
6
68. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

Facility Number 99 12 Date: 10/7/04
7/20/04 ALD (1) 2.7 Ibs.N/1000 gals. I, ALD (2) 9.0 Ibs.N/1000 gals. B,
ALD (3) 15.9
ALD (4) 9.7 " "
FCD (5) 6.3 Ibs.N/ton B
9/17/04 LSD (1) 3.1 Ibs.N/1000 gals. I, LSD (2) 7.3 Ibs.N/1000 gals. B
LSD (3) 4.4 " "
LSD (4) 5.7 " "
FCD (5),4.9 Ibs.N/ton B
Soil samples dated 4/06/04 had one field calling for a ton or more of lime per acre.
# 13. The waste storage ponds need to be mowed.
# 19. The freeboard readings need to be done weekly.
* Need to get a copy of the New certificate of coverage and permit to keep on site.
*.Need to begin using new application forms and recording rainfall, monthly stocking rate, crop yields,
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 10/8/04 Entered By: lRocky Durham
3 03/10/03

(Type of Visit O• Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 99 12 Date of Visit: I l/24/2003 Time: 1000
0 Not Operational O Below Threshold
Permitted 0 Certified 0 Conditionally Certified Registered Date Last Operated or Above Threshold_
Farm Name: Shady GXQX&A)airY................................................................ County: YA.& tt................................... Y. SB.Q......
Owner Name: Tim---------------•---._ Smithe[auau---------------------- Phone No: (33Si1b92=813Q11uRm1--------------------
Mailing Address: .1.04Q..kl.RA.tS?»I..k1RIAA.»..................................................................... ERS(ARAd... NG....................................................... Z7.0.10 ..............
Facility Contact:.T.im.Rt'.maurice.Sulithexman.............Title:............................................... Phone No: 3ab.b94,3799..................
Onsite Representative: TJro.at[dMalUCICP.SAU.ihCl[tlL7DIntegrator:•_•_-_____-_•_•_•_•_•_•_•_•_•___-_-_•_•_•_•,
Certified Operator: MAur.icc..W........................... SwillIer><roan.................................... Operator Certification Number: Z.1.9SA.............................
Location of Farm:
From WSRO: US Hwy 421 north to Baltimore Rd. exit. Left at top of ramp (north). Right onto Forbush/Cornelius Rd. Left
onto Baltimore Rd. Left onto Flint Hill Rd. left onto NC Hwy. 67. Right onto Fairground Road (labeled "AIRGR"). Right
[]Swine []Poultry ®Cattle []Horse Latitude 36 • 13 59 " Longitude 80 •
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:__.SmallestN!SP.... ...... 1WLkbarn..... ....Rt..freestall___ .... eft.fteestall.... ....... Wrustack...... ...........................
Freeboard (inches): closed 30 72 27 24
05103101 7 Continued
PKI

Facility Number: 99-12 Date of Inspection 11/24/2003
*ity
5.
Are there any immediate threats to the of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
®No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
® Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement'?
® Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
® No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
® Yes
❑ No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12.
Crop type Small Grain ( Wheat, Barley, Corn (Silage & Grain)
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
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Field Conv ® Final Notes
Suggest moving feed trough for small calves since some run-off is being observed.
Need berm along lower wall of calf barn to keep waste out of the surface drain.
Must keep cattle out of buffer near calving barn to control run-off of soil and waste into ditch.
Need to fence off lower corner of the dry pasture to establish some vegetation.
Facility needs a heavy use area next to the milk parlor WSP as soon as possible. Some waste was observed washing down the hill
wards the freshwater ditch.
Small WSP closed. Looks good.
1**6. and 9. Still need marker on wet stack. Engineer is working on adding wet stack certification to CAWMP.
Reviewer/Inspector Name
Reviewer/Inspector Signal
Date:
05103101 Continued

Facility Number: 99_12 1) of Inspection I1/24/2003 •
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
Need to cut small trees on waste pond dams.
17. Operator called Raleigh today to request copy of COC and permit.
19. 2003 soils look ok.
19. Records look much better this year.
19. Must keep freeboard weekly rather than monthly per permit.
19. Need to record field numbers on recordkeeping forms.
Some Spring 2003 waste application events May were outside of the application window of March but otherwise ok.
05103101

SM+h rm&.a+ �P aoI& cot)
16PM
I Divission of Water Quality
• Division of Soil and Water Conservation
t'J Other Agency
Type of Visit IR Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint Q Follow up 0 Emergency Notification 0 Other
Date of Visit: I a Time:
Facility Number Iw
! v Permitted 0 Certified O Conditionally Certifed 0 Registered
Farm Name: an rbcokw CY
Owner Name: E M 0Mr iYl )
Mailing Address:
Facility Contact:
Onsite Representative: i n 4ur i c e jMrtVwwLLn
Certified Operator: n ,D, an
Location of Farm:
0
W
mor2lzcl 4-
❑ Denied Access
Date Last Operated or Above Threshold:
County:)kj 1
Phone No: 3I
S+Rem, NC "AIR
�13 tPh/one No:: Q
Integrator: � 70 • (0 q 9 • 3- �t I / Q
Operator Certification Number: ;� I _I S O
A
E:TiI 1�71 �i ]
Design Current
YDesign Current
Design -Current
Swine Capacity Po dlatlon '
Poultr
Capacity Population Cattle
Ca acit Po mlatiob
❑ Wean to Feeder
❑ La er
Dai
❑ Feeder to Finish
Layer
JLJ Non -Dairy
i`-
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
p
❑ Gilts
❑ Boars
Total SSLW
Traps 10 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?
❑ Yes �?<o
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes El No
❑ Yes *0
3. Were there any adverse impacts or potential a_ dvp=ctc to the Waters of the State other than from a discharge? Yes El
Waste Collection && Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes N<o
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 tructure 6
Identifier. (M14 �,( 5 C'
Freeboard (inches):
05/03/01 (�, Continued
lab

Facility Number: — Z Date of Inspection W203
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
>No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
,
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
Yes
El No
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
)0 Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
MNo
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
XNo
11.
Is there evidence of over application? ,0 Excessive Ponding El PAN [I Hydraulic Overload
❑ Yes
rNNo
12.
A
Crop type u, fJ L; d tQ_ , & .0
13.
Do the receiving crops differ with th a designated in the Certified Animal Wa Management Plan (CAWMP)?
❑ Yes
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
'�$,�,.�'N"o
(,}}�,,,''No
b) Does the facility need a wettable acre determination?
❑ Yes
�NNo
c) This facility is pended for a wettable acre determination?
❑ Yes
WIN,
15.
Does the receiving crop need improvement?
❑ Yes
0
16.
Is there a lack of adequate waste application equipment?
❑ Yes
1( No
Reauired
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
YNNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
Xy 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
*1110
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
ANo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
ElYes
o
24.
Does facility require a follow-up visit by same agency?
❑ Yes
o
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
WNo
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ramments(rel>3r to tjuestion Exlln�'any Y-ES answers�hntl/or ahyxeeommen"r�a�ions or aoy other comments. "W l
Userdrawings of facility to better�explain situations (use ad litionaltpages es necessary) , t, �� Field Copv
..,.a, r... W
❑Final Notes
Reviewer/InspectorName
Reviewer/Inspector Signature: Date:
05103101 jolaq n Q Continued
i 11C 3. t ALA) �� `% L . S. 1, 5ktZ 7 •-7
11ry 4-a

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 allor 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(sl 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?
s
O5103101 .
lq Q' ✓i�uoz� �� G��-ea�Go a-�-J

Assistance Site Visit
• Di7gon of Soil and Water ConservatiorRr
O Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number 99 - 12 Date: 5/15/03 Time: 9:50 Time On Farm: F 150 WSRO
Farm Name Shady Grove Dairy County Yadkin
Phone: [phone]
Mailing Address 1040 Hoot Owl Hollow East Bend NC 27018
Onsite
Representative Tim Smitherman
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Design Current
Caoacitv Pooulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Integrator
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 Pooulation
❑ Layer
❑ Non -Layer
® Dairy
❑ Non -Dairy
Integrator
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 Pooulation
❑ Layer
❑ Non -Layer
® Dairy
❑ Non -Dairy
® Dairy
❑ Non -Dairy
400
470
❑ 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
Ono
surface waters or wetlands?
I
Does any problem pose an immediate threat to the integrity of the waste structure (large trees,
❑ yes
Ono
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 Milk barn WSP
Free -stall RT.
Free -stall LT.
Roofed wet -stack j
Small WSP
Level (Inches) 18
15
2
30 11
24
CROP TYPES
hmall grain silage
Icorn, Silage
Fescue -graze
jOrchard Grass ha
Rye grass Graze
SPRAYFIELD
SOIL TYPES CfB2
Lc133
Cp
WkC3
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

E
Facility Number 99 - 12 Date:
5/15/03
PARAMETER
Q No assistance provided/requested
❑ 8.
Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9.
Waste spill contained on site
® 10.
Level in structural freeboard
25. Waste Plan Revision or Amendment
®
❑
N 11.
Level in storm storage
26. Waste Plan Conditional Amendment
❑
❑
27. Review or Evaluate Waste Plan wlproducer
❑
❑
[112.
❑ 13.
Waste structure integrity compromised
Waste structure needs maintenance
28. Forms Need (list in comment section)
❑
29. Missing Components (list in comments)
❑
❑
[114.
Over application >= 10% & 10 lbs.
30.21-1.0200
❑
❑
[115.
Over application < 10% or < 10 lbs.
re -certification
❑ 16.
Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
®
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
❑ 18.
Late/missing waste analysis
33. Organize/computerization of records
❑
❑
❑ 19.
Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
® 20. Late/missing soils analysis
❑ 21.
Crop needs improvement
35. Sludge or Closure Plan
❑
❑
N 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: 5/16/2003
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
43. Irrigation design/installation
El
El
❑ Other...
system
Date'
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2.
49. Drainage work/evaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5'
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

0
Facility Number 99 - 12 Date: 5/15/03
s: 5-07-03 ALD (1) 2.3 Ibs.N/1000 gals. I, ALD (2) 7.3 Ibs.N/1000 gals. B, ALD (3) 11.6 It
ALD (4) 5.5 Ibs.N/1000 gals. B, ALD (5) 0.28
12-30-02 ALD (1) 2.8 Ibs.N/1000 gals. I, ALD (2) 5.0 " ", ALD (3) 7.7 "
ALD (4) 11.6 " ", ALD (5) 0.92 " ALD (5656) 4.5 "
Soil analysis dated 3-06-03
The left back waste storage pond is within the structural freeboard level at approximately two inches below the top of dam.
he facility will have to be referred to the division of water quality as required by law. A five and a thirty day plan of action will
ost likely be required for lowering the two back waste ponds to the maximum liquid level. Contact your technical specialist
it help with these plans.
Could not locate the 2002 soil analysis. The 12-30-02 waste analysis could not be located with the other waste analyses.
ome of the Fall waste applications had the wrong waste analysis used. Fields 2,3,and 4 of tract 4580 are Fescue and rye
*ass pasture, the waste plan lists small grain and corn silage. Could not locate a maximum liquid level marker in any waste
orage pond. The waste storage pond embankments need to be mowed for easy visual inspection and to deter vectors.
Facility has a certification for 600 head now.
Provided Mr. Smitherman with some Slurr I and Slurr II forms.
TECHNICAL SPECIALIST IRocky Durham
SIGNATURE
Date Entered: 5/16/03
Entered By: lRocky Durham
03/10/03

vision of Water Quality
ision of Soil and Water Conservation
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
d
Facility Number 99 12 Date of Visit: 12/4/2002 Time: 1000
O Not -Operational O Below Threshold
E3 Permitted ■ Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
FarmName: ShAdy..GraxeDairy................... :................ :................................................ County: Y>adkitt.............................................. WS.HQ........
Owner Name: Lot .......................................... Sutttherimix............................................. Phone No: (, 3Q..699r.0j3.6.jMoJ)........................................
Mailing Address: 1Q4Q.HAut.Qetl.HAllRtt.....:.............................................................. EAstJkIxd..NC ...................................................... 2.7.018 .............
Facility Contact: Tim.S. Wthet:11x0A.......................................... Title:................................................................ Phone No: 3J.6,.69.9.J299......ry
ps.......
Onsite Representative::tan.15mithcrmut...................................................................... Integrator:......................................................................................
Certified Operator:MO.urAt:e...W.......................... SbAber.num ................................... Operator Certification Number: 2,j9.j$.............................
Location of Farm:
From WSRO: US Hwy 421 north to Baltimore Rd. exit. Left at top of ramp (north). Right onto Forbush/Cornelius Rd. Left
into Baltimore Rd. Left onto Flint Hill Rd. left onto NC Hwy. 67. Right onto Fairground Road (labeled "AIRGIV ). Right
❑ Swine [I Poultry ® Cattle ❑ Horse Latitude 36 • 13 59 Longitude 80 • 31 33
Design Current
Swine Capacity Population
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Design Current Design Current
Poultry Capacity Population Cattle Ca tacit Po ulation
❑ Layer ® Dairy 400 465
❑ Non-LayerI I ❑ Non -Dairy
❑ Other
Total Design Capacity 400
Total SSLW 560,000
Number of Lagoons
10 Subsurface Drains Present 110 Lagoon Area
10 Spray Field Area
❑ No Liquid Waste Management System
Holding Ponds / Solid Traps ®
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
I 2. Is there evidence of past discharge from any part of the operation?
❑ Yes
® No
i. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
® No
NAak Collection _& Treatment
I. 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: ...... Small.W. SP...... ....... Milk.Baru....... ... Right.F.ceesmll... .... LeftFreestall.... Rnofed.Wemack...................................
eeboard (inches): 0 26 24 16 18
I05103101
Continued

Facility Number: 99-12
Date of Inspection 12/4/2002
5.
I
Are there any immediate threats to the iOft ity of anyiof the structures observed? (ie/ trees, severe erosion,
❑ Yes
® No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
® Yes
❑ No
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
® No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
® No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
® Yes
❑ No
Waste
Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12.
Crop type Small Grain (Wheat, Barley, 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?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No.
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
® Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
® Yes ❑ No
® Yes ❑ No
IE3 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Field Copy ® Final Notes
1. and 4. Discharge from smallest WSP was observed overflowing dam. Discharge had not yet reached surface waters. WSP is for lot _
run-off only. No waste is pushed into WSP. Send NOV.
6. and 25. CAWMP only lists three waste structures, Facility now has five (milk parlor, right and left freestall, small pond and roofed wet
stack). These need to be certified and included in CAWMP. See Yadkin SWCD, Co-op. Ext., or Tommy Burchette for assistance.
9. No maximum liquid markers were on the small WSP, roofed wet stack, or right freestall. Facility has closure plan dated 5/15/02 for
small WSP. �\
11. Facility had no records to document the Fall 2002 applications of waste. DWQ cannot verify over/under application. In future,
annlications need to at least be recorded. PAN balance can be calculated after waste analvsis results are received.
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector SignatureV 11/M161 /p_,4 /h Date:
r
05103101 Continued

Facility Number: 99-12 Def Inspection 12/4/2002 .
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 611'pipe or a permanent/temporary cover?
❑ Yes
❑ No
16. Due to construction of new milk parlor, operator does not have access to small WSP to pump it out conventionally. Operator
instructed to borrow a portable pump and pump small WSP down immediately to stop the discharge. Operator is to transfer the v
using a portable pump into a honey wagon.
19. Need to obtain waste analysis for Fall 2002 and soil analysis by 12/31/02. Small WSP has closure plan signed by Tommy
Burchette on 5/12/02.
Need to re -check smallest WSP once it's been pumped down at least two feet.
Facility has not yet been issued general permit or certificate of coverage. DWQ did not receive notice of freeboard problems
rc to the date of this inspection.
Facility has WUP for 600.
Smitherman called 1216102 and left message that one, 4000 gal. load had been transferred from the overflowing WSP into the
t freestall WSP. Another 4000 gal. was being held in the honey wagon tank due to snow/ice conditions. 30-day plan of action
is were received by DWQ stating that waste had been transferred to another WSP and was being held in the tank since weather
did not permit the application of the waste onto a receiving crop.
05103101

l�gm
t
i�'.":
Division o[ Water Quality
�t
Division ofSoiLand WaterlConservation
si
'1 i ay', u!'�
v 1 i �ti
t . a e :I' '
0 Other ,. .
1 �'
,
,}
, d
t
4
kq i...
1 i.•
Agency ..
c
i
J
Type of Visit ACompliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 9YRoutine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
•• Facility Number I-7f'7J—L..1-�-�—I
la /_r'—I4L_J
Date of Visit: Time:
10 Not Operational 011dowThreshold
0 Permitted Certified 0 Conditionally Certified
0 Registered Date Last Operated_ or Above Threshold:
Farm Name:
Jt� County: d 1 n ,
Name:
PhoneNo:
/S)Owner
Mailing Address: 6,1.1l
Q t G^� /a.ST &0"1 a
Facility Contact: T�I t l
%�Q l�,
Title: Phone No: .33j0 . & 9
1
�/��
Onsite Represen[ative:T jn 5(�
/+
Integrator: l 11
Certified Operator: M
aI J 6 �e. ZA 7 .
�/
�� 1 / YI��or Certification Number:
rows ": usyal North to (fit;lei nroro, pd9 Q.XIt + ivrn �t Aor-fh) Zi one a •
Forbush/L'orhelit>tqq /p�'{ aonin (9 I�inti,rP]Pti. Le nnfaFlitlik%t I IR�
SwiNe,ikr ❑Poultry C; Is Horse La ud L n�hude ®� �• �
Design ,, Current; 5 r. 'Design t`I`,Current . - : " Design", 1 Cui•i•ent
Swine 'Canacitv Pnnuintinn "Poultry :"CnnnAty _`Dnnulnlinu Cattle .`Cnner:t.. Pnn6leNn...
El Wean to Feeder
};:,
❑ La er
I
❑ Feeder to Finish
j -'
❑ Non -Layer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
pr ., Total De5ig
❑ Gilts
❑ Boars<<
otaIISSLW ��;i s�n' �
Discharses & Stream Impacts
1. Is any discharge observed from any part o,,,f,,, the operation? 'XYes El No
yd Discharge originated at: Lagoon ❑ Spray Field ElOther
a. If discharge Is observed, was the conveyance man-made? ❑ Yes XNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes jN�qo
c. If discharge is observed, what is the estimated flow in gal/min? OW V(Q
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}• WSpiliway XYes ❑ No
Struc e I Structure 2 Structure
3 _ Structure 4 �- �-f•
Identifier:
Freeboard (inches):
19 °li°t3i/0
h �i ��t�i��^•a ri'
s
A • •

I Facility Number: — Date of Inspection„•
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
XNo
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
>Kes
❑ No
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
, klo
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ YesX�No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Yes
❑ No
Waste Aoolication
10.
Are there any buffers that need maintenance//imprrovepmeenntl'? f•FQ L I
N61
❑ Yes
11.
Is there evidence of over application? 4c,&'ivC l onling �] PAN y'fdraulic Overload
Yes
12.
a
Crop type 1.�i6 E 42 a,L6.% i)1 /I % .o C i li lid !% �l l%
13.
Do the receiving crops differ with t ose designated in the Certified Animal Was Manage ent Plan (CAWMP)?
❑ Yeso
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
15.
Does the receiving crop need improvement?
ElYes
Z;(
16.
Is there a lack of adequate waste application equipment?
Yes
❑ No
Reouired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
-93*es-49-No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan rea ityy available?
(ie/ WUP, checklists, design, maps, etc.) r 6A� 'B� 1j,I31(10
❑ Yes
XNo
19.
Does record keeping need improvement? (ie/ irrigation,Srea4eatd, aste nalysis & soi ample reports)]
Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
���❑tit
yyNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
KNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑
fre
(ie/ discharge, eboard problems, over application)
,KYes
No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
;EZNo
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(retertoqueshon�#) Ex'plelnanyiYESanswers,andlortany,; eeommendatiousor,anvofher�comments.�'�;�s
Use drawings of facility toitietter,explain situations (use additional pages as necessary) G' i Field Conv Final Notes
cvsPu-�
a
M'
R4er/Inspector NameISM,�Q
Reviewer/Inspector Signature: Date: O
W-

Sox 30y? 1ao c P,
Facility Number: — to of Inspection ��d/y/Q�.. •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below
.liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes o
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes 4'o
31. Do the animals feed storage bins fail to have appropriate cover?o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporaty cover?;;_.�.;:�_
Pr�.-�n5pec�Fion I�eS„
Additional Ce�nirnents and/or Drawings:,
/
0111
'r I
/ � I
i
� ritr
1L
� ///
l�JJF7 �JI

(Type of Visit O Compliance Inspection 0. 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 99 12 Date of Visit: 6/12/2002 Time: 9:45
10 Not Operational O Below Threshold
Permitted e Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
FarmName: ShAdY.Gsuxe.D.8it'.X..................................................................................... County: YmdUFL.............................................. W.S.RQ........
Owner Name: Tim .......................................... Switherma ............................................. Phone No: G3aG1.b9.9.-AU.or...3.7.99......................................
Mailing Address: AU4Q.Iinat.QA.N9.I1QW.................................................................... East.8vid-KC ...................................................... 279M .............
FacilityContact: ..............................................................................Title:................................................................ Phone No:...................................................
Onsite Representative: 1! amrice.A.Tim.StlAillitaman..............................................Integrator:......................................................................................
Certified Operator:Maurice-W. ......................... SAWOLU.Man ................................... Operator Certification Number: 219.5A .............................
Location of Farm:
From Winston-Salem, travel Hwy. 67 West/Busisness 67 into East Bend; turn right onto Fairground Road (labeled A
`AIRGR") ; then right on Shady Grove Road. Farm is on Shady Grove Rd.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 13 59 " Longitude 80 • F 31 33 "
> t (D tr° C ei g1� 6 x D g.m C°rFrrene} d Desrgn i Current*
g *€+ k t �,
Swmeq 4Ca acit1P,0 mlahon, P.+o�ItFY1 .3 . Ga racrt .;:P,o ulatton 'Cattle ,iCa acit'" 2$0"" ulation
❑ Wean to Feeder M10 Layer I , ®Dairy 400 380
❑ Feeder to Finish ❑ Non Layer ❑Non Dairy
i.. ❑ Farrow to Wean , +^�'t3" �" 'kra^�w3'ra.ia I °,+i,•'.s ^E r ,: s .
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish 1� Tio l`D gtt Capacity, 400
[j Gilts
❑ Boars p �,(` {t Tofal`SSLW 560,000
..>., ,..�_,.-_q_.....,. .*y.b+.x�gl f
n Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Ficld Area
. Hold nil Ponds / SSjglid Traps 5� ❑ No Liquid Waste Management System `
Discharges R&, Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
❑ Yes
❑ No
b. If discharge is observed, did it reach Water of the State? (If yes,
notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
® Yes
❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
® No
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: ...... Smali.N SP..............Milkharn.............Fxeestall.RT...........F.teestall.LT...............dxystack............................................
Freeboard (inches): 48 28 60 36
60
05103101
Continued

Facility Number: 99-12 • Date of Inspection 6/12/2002
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ treesopere erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Small Grain (Wheat, Barley, Corn (Silage & Grain)
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.) 1
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
comments refer to u lion # : Explain an fanswersiand/or any recommendations or any other comments.
Use rawings of f lcilit to better explain situations. u additional pages as necessary : ❑ Field Copy ® Final Notes
The dry -stack needs to be included in the waste plan (storage volume, days storage, etc.).
_
3. Cattle are in the creek and livestock exclusion area behind and on the side of the free -stall barns, because of the lack of water. Need
to construct a stream crossing (for water) and remove cattle from the creek. Mr. Smitherman has a well-fed water tank near the lower
Cream crossing, but he is hesitant to use it due to the possibility of a malfunction which could deplete his well.
The facility has a waste utilization plan for 600 head total. The certification needs to be redone for 600 head as well.
7. Need to mow around the waste storage ponds.
Records looked better this time.
Reviewer/Inspector Name Rocky Durham
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: 99-12 a of Inspection 6/12/2002 •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes ❑ No
tt onla ruwtngs: t2
Waste analysis: 3-25-02 ALD (1) 2.3 Ibs.N/1000 gals. I, ALD (2) 9.6 lbs.N/1000 gals. B, ALD (3) 13.O Ibs.N/1000 gals. B
ALD (4) 0.71 ` " B, FCD (5) 3.0lbs.N/ton B
11-9-01 ALD (1) 2.8lbs.N/1000 gals. I, ALD (2) 15.0lbs.N/1000 gals. B, ALD (3) 9.3 Ibs.N/1000 gals. B
ALD (4) 2.2 " " B, FCD (5) 4.9 Ibs.N/ton B
Soil samples dated 4-4-01: A couple of fields are calling for one ton of lime per acre.
05103101

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 99 12 Date of Visit: 112/2001 Time: f1940 Printed on: 11/5/2001
O Not Operational O Below Threshold
E3Permitted 0 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
FarmName: SbA dy..Gru.e.Uaia.................................................................................... County: Ytl..........M................................ WSRO........
Owner Name: JIM.......................................... SutlthCrj=IA............................................. Phone No: 3.799.Poo&.......................
Mailing Address: 1Q4A.. A.Rt.QltA.1T9IlQlY..................................................................... EIk$1.JkIxd.,NC ...................................................... Z7.018 .............
Facility Contact: TiM.SlWdA¢ydlitn..........................................Title:................................................................ Phone No:...................................................
Onsite Representative: Tina.Snutbermix...................................................................... Integrator:......................................................................................
Certified Operator: l! &urin¢..W ......................... SlWaLgMan ................................... Operator Certification Number: 7IQ$$.............................
Location of Farm:
From Winston-Salem, travel Hwy. 67 West/Busisness 67 into East Bend; turn right onto Fairground Road (labeled A,
�'AIRGR") ; then right on Shady Grove Road. Farm is on Shady Grove Rd.
❑ Swine ❑ Poultry 0 Cattle ❑ Horse Latitude 36 • 13 59 Longitude 80 • 31 33
Discharees 4& 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 ¢t 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: ......Small WSP..............Milk.Bam...........Left.F.teestall......Right.Frees[all.........................................................................
Freeboard (inches): 72 24 28 36
05103101 6-6 Q 4 'Continued

Facility Number: 99-12 Dale of Inspection 11/2/2001
Printed on; 11/5/2001 �
5. Are there any immediate threats to the inte my of any of the structures observed? (ie/ treesPere 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? ® Yps ❑ No
Waste Agplicalion
10. Are there any, buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? []Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Small Grain (Wheat, Barley, Corn (Silage & Grain)
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? j
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 seItback 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
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
n1111t an.
1 M
[I Field Copy ® Final Notes
11111ME
6. Dry stack must be added to waste plan prior to storing waste.
7. Must keep cattle of dam o4mallest waste storage pond permanently. South side of dam is eroding. Suggest repairing and reseeding.
Structure #4 has several groundhog holes that need to be repaired. Keeping vegetation shorter will help to discourage groundhogs.
8. Facility has constructed earthen berm to divert parlor waste into PVC pipe to waste storage pond. Suggest concreting berm or ditch for
permanent containment.
9. Need to call SWCD to install marker on structure #1 since waste is pumped down now.
11. Can't verify that there was no overapplication sinccla PAN balance has not been calculated for any waste application fields.
Reviewer/Inspector Name Meli, a Rosebrock /)
Reviewer/Inspector Signatur / Date: I Ls Z6
05103101 Continued

Facility Number: 99_12 6e of Inspection 11/2/2001 . Printed on: 11/5/2001
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
9. PAN balance is not being maintained for any fields this year. Need to complete IRR-2, SLR-2, and SLD-2 forms. Records need
use the "usable acres" from waste utilization plan in calculations. Need to label SLR -I form with which waste pond the waste
ame from so that waste sample results can be matched -up. Need to obtain waste result records for 10/2001 applications. Also, Tract
018 is not listed in waste plan "Solids Application." Need to revise this.
5. Cattle have been in the fenced, buffered, area again. Per owner, cattle were allowed in buffer area after well pipe broke and well
tent dry. Repairs have been made and well is functioning. Need to keep cattle out now. Owner would like to install another creek
ccess for cattle. Suggested that he contact the Yadkin SWCD.
rMIOMOTA

90030
(Type of Visit .6Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit VRoutlne O Complaint, O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Dale of Visit: �" d Time:
Q Not Operational Q Below Threshold
13 Permitted f Certified [3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: . hl :a4.....001..0.i/.e-JDQI......................................... Connty:.... !� F!..!....................................................
...
Owner Name:...... T.!.m....... sm.l..`..1t 1 YY1,QY1............................................... Phone 3� »629.: `!/�6......,�13 799
y. .. ............. ...........................
Facility Contact: .... ..............'Title:................................................................ Phone No: ............
............... .................
''II Ll // Imo,.../......
Mailing Address:......1..(].`t;� NObf... �....l...r..�.G(.QG) 2, Q NG .-.76. d
Onsite Representative:.... !...1�%L.. S.Ml. L!! a fi......................................... Integrator:.....................................................................
Certified Operator:.... S.(}'I f IZ}(YjQi7............................ Operator Certification Number:.....................
Location of Farm:
Fr61r) tJ5 - q�_[►YI�%� �i
❑ Swi ❑ porU C �d rA"�" "r�.a�uc eN • �` rr�,—Lon tude ®• t ^�--i, �•<
ry ]� Cattle Horse I I
Design , Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design . Current
VYIIiY{
rrat%IP
=6900
MIYOM
Capacity
Total SSLW
Number of Lagoons ; I —,U—J < -,1❑ Subsurface Drains Present 110 Lagoon Area I❑ Spray Field Area r
Holding Ponds / Sohd Traps' ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes fA No
Discharge originated at: [3 Lagoon ❑ Spray Field [I Other
7�
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) 1 ❑ 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 0 No
Structure�7 I �f Strtrjuctur 2 StEucturc I Structure 4n Structure 5 Structure 6
Identifier: x:.....C...?..........1!i.�?:.t�t...t1�I�I .........................................
Freeboard (inches): , Z 4 3
5/00 1 —0 3 L Continued on back

Facility Number: — lol Date of Inspection / d 0
5. Are there any immediate threats to the egrity of any of the structures observed? (ie/ tr• 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 KNo
(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? XYes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ AM
Poondiing ❑ PAN ❑ Hydraulic Overload ❑ Yes [I No
12. Crop type AMUi].0 /r �, I I.M AL, h�lX
13. Do the receiving crops diffev'with those designated in the Certified'Animal Waste Management Plan (CAWMP)? ❑ Yes IX No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
P.No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
10
gNo
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
9No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
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 KNo
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
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes ;KNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes A No
24.
Does facility require a follow-up visit by same agency?
❑ Yes KNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
9Yes ❑ No
1R Yivta4i4�ls;o� il$fcpejttie$ •w rc P#� �St1 igtg tjtjs;vpspt; •Yoh wpti•Keeoite 00
itiirisuotideitce:about:thisvisit:.:•:•:•:•:•:.:•:•:•:•:•:•:.:•:•:.:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•.....
1- Ilti,
I
(NCie
Reviewer/Inspector Name • : r
Reviewer/Inspector Signature. Q /a%Al JO-eO A,417 Date: I a s 0 5100

Facility Number: Oate of Inspection (i I •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ^� G.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 XNo
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? .-94es— 3-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 ANo
31. Do the animals feed storage bins fail to have appropriate cover? ^��^Q-No
32. Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover?—QX4&—Q.No-
D?�!3 ✓
Ty
s F�0 F av`3
Iq.zrd ✓tit ? d061
/

A'i
OPERATIONS
%, IV wU Ua:
BRANCH - WQ Fax:[phone]
is 'U'a�0/a JVJO
Ju.1 19 '95
J,.J 1Lluuinia�
14:49 P..U2/15
5�1e raqui:iS:mmedlare :earAQ1
FacilSy ncm.v
SITE VISITATION RECORD
Date: J-cT-� 1995
Owner. Shbf move — T.T S. Ar+,� Faun `lame: slL lirora a rv_ -- f
Count,/:—k I{: —
Agent Visitlng Slte: U�,
Operator. : :i er.i� Phone:glo-�4,9,3799
On.4ite Representative: Phone:
h
Physical ?dress:
Mailing Adcrss:
,ems c+ -VZ v A rv_t1 - a7o 18
Tyce of SWne
ceslgn capacty: 1 �2o
LWWr e:
3� 13 5_
Type of Irsec5on;und _ Aerial
Circle Yes or No
Poultry Cale
Nurr.ber of Animals on Site: _--Lf� v
LongiPJde: SG C,
Dees the .=;.inal'h'asw Lagccn have Sufc:ent frfaet card cf 1 Feet 25 year 24 acur s:cr~ event
arprozimaia; Fcct t 7 inches) Yes or Vo
`Oat �,_ inCheS
Fc� recui',ies with more than one la;ocn, ple2se addraea to oti'ar lageans ;;m card un ert e
cc�,.c,enis sectlCn.
was any seepage cxserve- (hem 'ne lageoa(s)?
Yes
or
'h'Es Ihere erosion of the dal?
ti;-,:S:7
cr
No
Is StEcuz'a !a-,d ava82alefcr lard application?
es
or
1140
s the CC":er Crcp a Uate r
Yes
vo
A a; n'^P^T e•+t �rs+5 .� YiG d
iq
PC�^y7 �i.,��`fw; �'�•'l"
tS i
0

Facility Number
Date of Visit: 6/11/2001 Time: 13:45 Printed on: 10/25/2001
99 12
Q Not Operational Q Below Threshold
0 Permitted N Certified 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold:
Farm Name: Shady..Girare.Dairy..................................................................................... County: Ymtlain............................................... W..S.R0........
Owner Name: Tim .......................................... smithcruma ............................................. Phone No:L3.JG1.699.:.13.k.ac...3.7.99.....................................
Mailing Address: 1Q4Q.klnat.Qw. LUnllaet'..................................................................... Eas.t.Rcud-NC ...................................................... 2 ZI$..............
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Onsite Representative:.Tim.s&.Mmarice.Smithe[maa............................................. Integrator:...............................................................................:
Certified Operator: Maurice ................................. &Wtha.man ................................... Operator Certification Number: 219Sfl.............................
Location of Farm:
From Winston-Salem, travel Hwy. 67 West/Busisness 67 into East Bend; turn right onto Fairground Road (labeled
"AIRGR") ; then right on Shady Grove Road. Farm is on Shady Grove Rd.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • =IE 59 « Longitude = • =1 =11
DischargesgStream 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 &t 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: ... SmaIL.H SP..#.4... .... Milk.bam.A1..... ...Frcestall.Lt.A.2.....F.rsestalLRt_.#3........................................................................
Freeboard (inches): 48 24 20 30
05103101 Continued

Facility Number: 99-12 Datcofscetio10/25/2001 -
5.
Are there any immediate threats to the igrity of any of the structures observed? (ie/ tre evere erosion,
❑ Yes
® No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
® No
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
® Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
® Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
® Yes
❑ No
Waste
Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12.
Crop type Small Grain (Wheat, Barley, Corn (Silage & Grain)
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
la n. om n ti s o a t o n
tt ai t 'ti a nee a ❑ Field Copy ® Final Notes
M
hree of the four waste ponds are full and need to be pumped as soon as possible. Applications have already been done to corn crop.
rNot'
ure if storage capacity is not adequate because there are no max. liquid markers.
eed to mow around all waste ponds for easy visual inspection. Ge[ rid of groundhogs on [he # 3 waste pond.
0 Fields 2 & 3 are in pasture or partially in pasture. Need to figure irrigation on wetted acres of corn.
9. Need to have graduated markers ( every six inches ), with top of dam and max. liquid level indicated, installed on all waste storage
ponds.
8. Still need to construct the berm, and keep calves off, to divert parlor water into the PVC pipe which goes to the waste pond at the
milk barn.
Reviewer/Inspector Name Rocky Durham i
Reviewer/Inspector Signature: Date:
05103101 Continued

Number: 99-12 1)) a Inspection 6/11/2001 • Printed on: 10/25/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
see any records of solids being applied from the lounging barns. Talked to the OIC and he said he had some with the
tion and slurry records.
analysis: 3/23/01 1.) ALD 1.2 I 2.) ALD 2.6 B 3.) ALD 1.8 B 4.) ALD 1.2 B 5.) FCD 5.3 B
05103101

• NORTH ROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
WINSTON-SALEM REGIONAL OFFICE
DIVISION OF WATER QUALITY
January 5, 2000
Mr. Tim Smitherman
1040 Hoot Owl Hollow
East Bend, NC 27018
SUBJECT: Follow-up Compliance Inspection
Shady Grove Dairy #99-12
Yadkin County
Dear Mr. Smitherman:
On December 21, 2000, Abner Braddy, of the Division of Water Quality from
the Winston-Salem Regional Office performed a follow-up compliance inspection on
your farm. Enclosed is the inspection sheet which was completed during the inspection.
If you have any questions concerning this report, please call the Winston-Salem
Regional Office at 336-771-4600.
Sincerely,
Larry D. Coble
Water Quality Supervisor
cc: Yadkin County NRCS/SWCD
Central Files
CWS'RO F,a ilitly Files
585 WAUGMTOWN STREET, WINSTON-SALEM, NORTH CAROLINA 27107
PHONE [phone] FAX [phone]
PENR CUSTOMER SERVICE CENTER 1.877-623-6746
AN EQUAL OPPORTUNITY / AFFIRMATIVE EMPLOYER - 50% RECYCLED/10% POST -CONSUMER PAPER

Facility Number 99 12 Date of Visit: 12/21/2000 Time: E= Printed on: 1/4/2001
0 Not Operational O Below Threshold
0 Permitted ■ Certified [3 Conditionally Certified ❑ Registered Date Last Operated or Above Threshold: .........................
Farm Name: S.hAft..GfaX.k.x?rY...................................................................................... County: YAdkia...... :........... :........................... WS.RQ........
Owner Name: Titn........................................... Smitktermix............................................. Phone No: 013.0.6.99A.1a6..at'... 3.7.94.....................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Mailing Address: 1114Q.111ta1.Qtvl.11nllaxt..................................................................... EA$1rrxd..NC...................................................... 27.018 .............
OnsiteRepresentative: ........................................................................................................... Integrator:......................................................................................
Certified Operator:Miturlce................................. S.faith¢. mu................................... Operator Certification Number:219.5.S .............................
Location of Farm:
?rom Winston-Salem, travel Hwy. 67 West/Busisness 67 into East Bend; turn right onto Fairground Road (labeled
'AIRGR") ; then right on Shady Grove Road. Farm is on Shady Grove Rd.
❑ Swine ❑ Poultry ® Cattle [I Horse Latitude 36 • 13 59 Longitude 80 • 31 33
SM
w DesSijA),;j'
[t{k
.£vUA
Current
." 51e.. e&r 5'`M Y 'S 4
' Design Current y , D g"ne /Cur"r'ent '
Cattle ''
S-,w.me Ca acit
E+
P,o ulation'"
Poultry @a acit P,o >_ulation . @ti acd ,. Po ulatibn'
❑ Wean to Feeder .
❑Layer ®Dairy 400
r ';
❑ Feeder to Finish
❑Non -Layer
�. ❑Non -Dairy
❑ Farrow to Wean
•; ❑Other+.
t fir. atl"'r*
❑ Farrow to Feeder
"
❑Farrow to Finish
`°� Total Destgt Capacity.
;
400
❑Gilts
❑ Boars
:
Tal SSLW
560,000 .
' Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Number of Lagoons Su g p
1-folidling
_❑_
Prinds / Solid Traps ®NJEI No Liquid Waste Management System
Discharges.& Stream Impacts
I. 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
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[]Yes . ❑ No
❑ Yes []No
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: .................................... .... Righi.fr=stall .... ................................... .................................... .................................... ....................................
Freeboard (inches): 48
5100 — Continued on back

Facility -Number: 99-12 1 Date of Inspection 12/21/2000 Printed on: 1/4/2001
5.
Are there any immediate threats to the Obrity of any of the structures observed? (ie/ tre evere erosion,
❑ Yes
❑ No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
[]Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11.
Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reuuired Records & Documen
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
No violhtious;or. deficiencies were noted ¢uriug this; visit,: ;You:wilt receive no•further
ctirresuotideitce. abouf this .visit. .... . ....... .
1. At silage storage area, berm has been extended through the two lateral drainageways which flow perpendicular to the creek,
effectively cutting off silage runoff from entering them. 15" corrugated plastic culvert has been extended. Need to make sure that joint
between the two sections of pipe remains intact, so no leakage can occur, prior to release point. Snow cover on the date of inspection
made observation of the silage runoff release area difficult, but it did not appear that any was currently reaching creek. Cutting off
runoff from the two drainageways mentioned above should benefit efforts to release the silage runoff in a diffuse manner, not
immediately adjacent to creek, but it will be necessary to maintain the berm periodically.
4. Right freestall pond has been pumped since previous inspection, and currently has adequate freeboard.
Reviewer/Inspector Name Abner raddy�
Reviewer/Inspector Signature: Date: 5100

Type of Visit *Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit OO Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 99 12 Date ul' Visit: 10/10/2000 Time: 1315 Printed on: 10/11/2000
0 Not Operational C Below Threshold
0 Permitted ■ Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Shady.Gu.Rxe.i?,airy........................................................I............................. County: VAdkin............................................... WS.i3Q........
Owner Name: Tito ........................................... Smithcrmi.............................................. Phone No: 03.b1.699.:1f136..mr... 3.7.9.9.....................................
Facility Contact: TIMS.rtAitltermm..........................................Title:................................................................ Phone No:...................................................
Mailing Address: 1Q40.Ho.Q1.Qtvl.11ollmet..................................................................... East fie lid...N..C...................................................... 2.7.018 .............
Onsite Representative: T1m.Smithermaa....................................................................... Integrator:......................................................................................
Certified Operator:Mauricc................................ alp:ltherm7a................................... Operator Certification Number: 219SS.............................
Location of Farm:
From Winston-Salem, travel Hwy. 67 West/Busisness 67 into East Bend; turn right onto Fairground Road (labeled
`AIRGR") ; then right on Shady Grove Road. Farm is on Shady Grove Rd.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • =1 F-5-9-111 Longitude 80 • =1 =1
Designs'Curr�ent * h 4 e Design° Ctiirent' F Design;. Current'.
•Ca tacU ' P,o ulation,y PoultrX ..', ..Ca tacit . Po ulahon(' 'aide Ca tacit 'Po mlation'
❑ Wean to Feeder ❑ Layer "� aD iry 400 I80
❑ Feeder to Finish ❑Non -Layer ❑Non -Dairy
❑ Farrow to Wean 'e°'"�a"^+,s;.a+rwtttcxi3a.: Kr. �4 Ter �-`•'"- r ..-"w
❑ ❑ Other Farrow to Feeder ❑ Farrow to Finish A 1
M �x x,� `� �'' Total DesignCapactty 400
❑ Gilts i,)`iy'$�.�� 3
❑ BONS &qs a4 a w t: K i", T ttaaa SSLW 560,000
�r Number of MOREO ❑ Subsurface Drains Present Lagoon Area ❑Spray Field Area
Ring Win ss / Solid Traps ® ❑ No Liquid Waste Management System
Discharges 8& Stream Impacts
I. Is any discharge observed from any part of the operation? ® Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the. State'? (If yes, notify DWQ) ❑ Yes []No
c. If discharge is observed, what is the estimated flow in gal/min? Not estimatable
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: ....... Milk9arn........ ... Right Freestall.......Left Freestall.......... Small. Pond..............................................................................
Freeboard (inches): 24 18 48 48 fj
Continued on back

Facility Number: 99-12 Date of Inspection 10/10/2000Printed on: 10/11/2000 `
5.
Are there any immediate threats to the int ty of any of the structures observed? (ie/ tree ere erosion,
❑ Yes
® No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
® Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
® Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
® Yes
❑ No
Waste
Application
10.
Are there any buffers that need maintenance/improvlement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12.
Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley, Soybeans
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Reuuired Records & Document
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) 1
❑ 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
�' No Yiolatiotis:or deficiencies were;noted:duripg this; visit. 'You:will "receiveno ftirt6r.:
corres�otidence. about this. ............. .
1. and #2. Silage runoff to creek is still occurring. Owner has made changes suggested by SWCD.
15. Suggest extending 15 inch surface water pipe and building up bens of silage ditch/culvert near creek. Surface runoff from pipe
appears to be causing the silage juice to get into the creek.
24. Above to be completed within one month. Check on this next month.
. Need to have dry stack added to WUP prior to stockpiling.
7. Continue efforts to control vegetation on right freestall pond (cut seedlings).
. Need to install gauged markers per permit prior to becoming permitted.
19. T4580 has 13.5 usable acres per WUP. IRR I forth uses 18 acres. Need to change calculations.
Reviewer/Inspector Name (Melissa Rosebrock
Reviewer/Inspector Signatur Q12A4 AJL__-Date 144 1 Ion5/00
rk, V'Tl

t'
1 Facility Number: 99-12 Da: to of Inspection 10/10/2000 Printed on: 10/11/2000
Odor Issues 0
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor 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
Right freestall pond needs to be pumped immediately. Evidence that waste level had been past maximum level. No
ration from owner was received until I called to schedule inspection.
5/00

Division of Water Quality
Division of Soil and Water Conservation
Other Agency
Type of Visit `CJompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit �Q Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Dale. or visit:
0 Permitted Certified ❑ Conditionally Certified I] Registered
Farm Name: ...... s.. h .....�.row.f7(,e ......�...1(...V..............................
Owner Name:.......T.....J.m...............�m 1�7�t�'..& . mr.}................................
Facility Contact:
Mailing Address:
Onsite
Certified Operator:
Location of Farm:
Time: DM= Printed on: 7/21/2000
Date Last Operated or Above Threshold: .........................
County:......�(Q..1./k..i.!....9..�..........ccJ�.......2.....................
Phone No:......11.......T�.....1.././...'...L�i.%.�Li%...1.2...'.7........
...........
Phone N ' 1QtG.t../..... �../... 9
L26 ...... er�d..t............................a....7..0...1...
c.(.%r.oLI.1.��..........
<.. y.).���.,{,��iQll Integrator: ......................................................................................
tG... (J,� •... m..1 r tv14C)....., Operator Certification Number: ..........................................
-From6-'6kDi SoiJeS on w el�uslness
a La. e II A
[:]Swine ❑ Poultry YCattle ❑ Horse Latitude La-U• ®'
Design Current
Swine Canacitv Ponulation
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
urn r)ghf-I_
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer Dairy
❑ Non -Layer Non -Dairy
❑ Other
Total Design Capacity dQ
Total SSLW
I Number of Lagoons I❑ Subsurface Drains Present JILJ Lag,-�m Area JLJ Spray Field Area
Holding Ponds / Solid Traps E7V ❑ No Liquid Waste Management Systcm
Discharges & Stream Imuac4s
1. Is any discharge observed from any part of the operation'? Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field x 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 dischar�,e is observed. what is the estimated flow in gadhnin?
d. Does discharge bypass a lagoon system'? (Il'yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? XYes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes XNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway ❑ Yes *0
Slructt%re Struy���V/.��,yyre 2 Structure 3 Structure 4 Structure 5 Structure 6
Idemifier: ....l...L.lLbAfn...........1.j..... .1........ U•... 1......sIYIA.►1.,Q.�.
Freeboard (inches): a y' � I l O I 4V
5100
tJ '"11 QQ
Continued on back

Facility Number: — Date of Inspection O D& Printed on: 7/21/2000
5. Are there any immediate threats to tholgrity of any of the structures observed? (ie/ lre s, severe erosion, ❑ Yes tyrvo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes *0
(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?
ECJ 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
(*0
11_
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
Nlo
12.
Crop type (Inrh Stlnoo or. Ll o ,
brut l ti �- s64 beans
13. Do the receiving crops differ with those designatecvin the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes o
14. a) Does the facility lack adequate acreage for land application? ❑ YestNo
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
❑ Yes No
❑ Yes No
❑ Yes gt No
❑ Yes No
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? NIA E3 Yes
B-NO
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
fie/ WUP, checklists, design, maps, etc.)
❑ Yes
[Io
19.
Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
A Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
�dNo
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)
X,Yes
] No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
y,
t� No
24.
Does facility require a follow-up visit by same agency'?
y❑JYes
I]l,Yes
/❑] No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP'?
[] Yes
D(I No
/// ���
�lYd
yMhti6iis:ot deTciencies were noted d6ring this'visit: - Yo(k Will i•eceiye lid rui•tb& • ; • ; •
.-.-corresp6Tideh�e'.ab6�fthL�S.'Yisit-'
:::::::::::::::::::::::::::::::::: :
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):
-9Iru r)-of'V io creel-11,5 6- r 1► occurri n ®(9,t0jj - MaS �e
�� Gh
° sur pipe- y +Sbwuci �1 v,65h��u9ep5fb�e,t�-+reh.►�ot� 45lIc_S�'erA
4ka.5:, 61uI ver+ noo-r pond o be 0,e) k-ie_d (l)lqhtvi on2VvAr
Chec-v_ vn4h15 ne + Mc +h _
Reviewer/Inspector Name
Reviewer/Inspector Signature: \:dlflLLl&0 11LJ"j 1), .b' 1p /

acility Number: — to of Inspection b Q d printed on: 7/21/2000
Odor Issues 49 1
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ^�-"---^� o
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours'? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ 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? ^ �000 .p Xes�1N/` o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover. V ( No
Trae,+ 433) ge-14
/Ne, d 46 ►n64)1 9av�ed Inn-rlLeA75P-C*-e� ml*
Wll S
T i �creS�Vl�•ivu� to Up dftVAJ-,J 'a
Str�c,�-
147. Oor,4inu2 aot4mt
PDV)a.Lc+ SeeAr,►�5).
�U lar0 h,5 firm u
4 LOUP p rio r -b
ve e4a+hm on /L-+•
4 ad , Pond needs `gym
E►VdAcL 4 - wWe 1w d Ind
40a WZ1 a No no+ Cc c0+c'1
m tb A c4 sc9►PA,) (2 1 nc;d)4 Czag
be � I M a4e-d a
r 60L
Rom oumi r- ur+ 1
eD
5100

Facility Number 99 1� Date of Visit: 7/11/2000 Time: 9:30 Printed on: 10/2/2000
Not Operational O Below Threshold
0 Permitted ® Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
Farrar Name: Sbady...Gr.axe.l?aia'.X..................................................................................... County: ]'ad.kin............................................... W..SRQ........
Owner Name: lim.......................................... SmithermlA............................................. Phone No:(dG).b44.:b.1].k..eK...a.7.49.....................................
FacilityContact: ..............................................................................Title:................................................................ Phone No:...................................................
Mailing Address: 1Q9.O..klna).Qxt1.HfAllaxv..................................................................... E2,51 slid..N..C...................................................... 2.7.018 ..............
Onsite Representative: AtIauXlee..S[nitheXmap............................................................. Integrator:......................................................................................
Certified Operator: M; uXjl;p............................. 5ttlufllexmal0................................... Operator Certification Number:119.5.&.............................
Location of Farm:
From Winston-Salem, travel Hwy. 67 WestBusisness 67 into East Bend; turn right onto Fairground Road (labeled
`AIRGR") ; then right on Shady Grove Road. I—V
[]Swine []Poultry ® Cattle ❑ Horse Latitude F 36 • 13 11 F_59 [t Longitude 1 80 101 31 11 1 33 11,
Design Current
Swine Canacitv Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
,Number, of Lagoons C
Holding Ponds,/ Solid Traps;. C
Design Current Design Current
Poultry Capacity Population Cattle Ca sell - Po mI tion
❑ Layer ® Dairy 400 400
❑ Non -Layer I 1 10 Non -Dairy
❑ Other
Total Design Capacity 400
❑ No
Total SSLW
Drains Present II❑ Lagoon Area
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify D WQ)
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: ........IkJU.bam.............. Rt-freestall...... ...... LL.freestall...... ....... amall.pond....... .............................
Freeboard (inches): 36 36 25 72
5100
❑ Yes ® No
❑ Yes []No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
® No
❑ Yes
® No
❑ Yes
®No
Structure 6
.............................
Continued
on back

Facility Number: 99-12 .19 'llate of Inspection 7/11/2000 a Printed on: 10/2/2000
5. Are there any immediate threats to the i ty of any of the structures observed? (ie/ tree .vere erosion, ❑ Yes ® No
seepage, etes)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes ❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
®No
9.
Do any stuctures lack adequate_, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
®No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
®No
11.
Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
❑ Yes
®No
12.
Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley, Fescue (Graze) Fescue (Hay)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
®No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
®No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
®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?
❑ Yes
® No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
No•violad 6ns;or defciencies•were',noted;diiHit g•this: visit. ;Ytiu;will receive no•ftirthcr
corresvondence 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):..
Veed to have Tract 4331 field # 2 & 3 added to the WUP.
V 7. Need to build berm up to divert milk parlor water, on the large wsp side, into WSP #1. This was mentioned last year as a site of
last discharge.
s 9. Operator stated that he had a stake that marked the max. liquid level on the waste storage ponds. However, the only one that was
dsihle, due to vegetation, was on the Lt freestall pond. I instructed the operator to have his technical specialist to assist him with
nstalling a graduated marker with the top of dam and max. liquid level indicated and in the meantime locate and mow around the
xisting stakes.
9perator had vegetative diversion installed to filter silage and commodity shed runoff.
Reviewer/Inspector Name Rocky Durham
r
Reviewer/Inspector Signature: Date: 5100

Facility Number: 99-12 D of Inspection 7/11/2000 Printed on: 10/2/2000
oil
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
WUP needed to be amended to reflect irrigation design acreage. WUP is counting more acres than design shows.
5100

Facility Number 99 12 Date of Inspection 12/22/99
Time of Inspection 10:30 24 hr. (hh:mm)
Permitted ® Certified 0 Conditionally Certified 13 Registered Not O erational Date Last Operated: ..........................
Farm Name: Sbady...GiA'.axe.l?.airy..................................................................................... County: Xm. .............................................. W5RQ........
Owner Name: Tim .......................................... SmitlAetAnatA............................................. Phone No:Q3.6).6994.13.6.ar...3.7.99.....................................
Facility Contact:
Title.
Phone No:
Mailing Address: 1040.Huut.0wl.Hullaw.................................................................... Eas.t.b.aid-NC ................
Representative: P............................p..�..,,2.7.Q�tS..............Q j
Onsite Re
A1aaAAce.kX..StAt111Aerttlatl..................................................... Integrator:........ .......................
Certified Operator:Ma.UldCC..W.......................... SjWjhcxmm ................................... Operator Certification Number: 1Q$5.............................
Location of Farm:
Latitude 36 • 13 S9 Longitude 80 • 31 F33
Design Current
Design
Poultry 'Ca
Current Design Curnot `
` V? '' .r ear . °onq
Ca aeit +
Po rotation
taco
P,o mlahon aCattlet'�
@a taco P,o ulation9
,�❑ Wean to Feeder
❑Layer
❑Non -Layer
®Dairy
-Dairy
400 310
K
❑ Feeder to Finish
❑ Farrow to Wean
❑Other
, -' a'
4t
❑ Farrow to Feeder
r r
r
❑ Farrow to Finish
,'
Total Design Capac it400
s*
Total SSLW
560.000
❑ Gilts
❑ Boars
Number of Lagoons
I __JM10 Subsurface Drains
Present ❑ Lagoon Area
ID Spray Field Area
Holding Ponds /Solid Traps ® ❑ No Liquid Waste Management System
Discharges $t 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
e. 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: Milk Barn Old Freestall Newer Freestall Small Lot
Freeboard(inches): ............... 24 ............... ............... 9.6 ............... .............. Lao ............. ............... " ............... .................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
3/23/99 Continued on back
Printed on 1/6/2000

Facility Number: 99-12 of Inspection
6. Are there structures on -site which arelaroperly addressed and/or managed through a0ste 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?
12/22/99
® Yes
❑ No
® Yes
❑ No
® Yes
❑ No
® Yes
❑ No
❑ Yes
® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes ❑ No
12. Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley, Fescue (Hay)
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?
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?
Reiluired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
No•viol;atiol;s:or ileekienetes were:noted ;dining this; visif.::You:wiII receive rto ftirthei
corresboridence aibouf this.visit... .
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes ❑ No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
3.) Cattle not confined to fenced areas. Evidence of cattle waste on bank of stream. No broken fences/wire noted.
Suggest adding watering boxes - possible cost share?
5.) The small waste storage pond is not accounted for in the Waste Management Plan. It needs to be added.
7.) Need to cut trees/maintain bank of storage pond (milk barn) dam.
3.) Area around calving barn greatly eroded and denuded. Suggest working with NRCS to develop alternative loafing area.
From feed stall area of silage/feed/drainage was also noted.
1. No max. liquid markers noted for any of the waste holding ponds.
19. Waste analysis records (for Spring) were not on site.
Reviewer/Inspector Name IM,
Reviewer/Inspector Signature:
Date:
on

0 Division of and Water Conservation Operation R
ll Q Division of an"d, Water CQR9ervadoll Complianee tlon ' y t t i^ ' I j ' t dit
,.. , ..I f t E ill
ivision of Water Quaiity •,co, pliance Insoction 4 E Er '-1 r , ,, ut E s, 1 `iq i'',6 E i I ''+
,t Ot}Ier A enC - O eretlon Revtew a I6'� , t Ii; 1,� t tl 4 , �)
,.' g y ;..P
outine O Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
Facility Number Date of Inspection IZ 2
Time of Inspection D : 24 hr. (hh:mm)
0 Permitted Certified Q Conditionally Certified 0 Registered Not O erational Date Last Operated:
Farm Name: 6r6vo,.+.ill.r.y.......................................................... County: ...ytd.k:.I.n....... ...... ....................... ..{F... ..... F...^.'..
mt6.r..rna.rlPhone
Owner Name: ,.��;; ,1,I m .... .................................................................. No: ... ..............................
FacilityContact:..........I.............j......................................................... Title:................................................................ Phone No:...................................................
Mailing Address:. l'..Q._'IQ.... E....�.'...... f7¢110.10............. I....... a % . �. ........
a5.f.... �rl ..�...N.....�.................
OnsiteRepresentative: BW_V/....li .�i...W......�. `!7x ..dh.VrL'h
Eas+ a7O�S
Certified Operator:,,, ,�,J,1,./(C: ..(,(,J. y (', jQT,/„},'1(„�. ................... Operator certification Number:,..............,
Location of Farm:
From ...Wins -To..... n. ert1.,..Tf2tw.7.... w.y. ...... .u'.I, ......l.a..-6 .. .... ........urn riykit...anb...
FaLkq rot,rd.............C1,abe.IP_ l....._A.I G.K.....�..;.1ien...r i yht. on...sm. . 'r.. at'e.... d.............................................
Latitude ®•®' [�•' Longitude ®• ©' ®"
Design
Current,'' !.' -Design 'Current '';''
Design Current.. "
Swine Ca acity
Po ulation Poultry Ga achy Po ulation . Cattle
Ca racit Po lulation -
❑ Layer Dairy
3
4t
❑ Non Layer ❑ Non -Dairy
• 2 9 q�r , , , ,". I�ii'
❑ Other
Total Design Capacity
6 d
TotaISSLW
' Number: of Lagoons
'-' ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
13oldingpPonds / Solid' Traps
'_ • ❑ No Liquid Waste Management System
❑
Wean to Feeder
❑
Feeder [o Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
Discharpes & 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 Slate'? (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 KNo
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 O(No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Milit %aril 01dFro-61a.il NQ�FreeS� d Strati L.o+
�l �t / a a 0.........
Freeboard(inches): ................T............................. .10...........................1 A.............................. ....
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes I No
seepage, etc.)
3/23/99 Continued on back

Facility Number: — •te of Inspection
6. Are there structures on -site which are0properly addressed and/or managed through a waste management or •—t'-'Y--`*•
closure plan? .. X 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? Xj Yes ❑ No
8. Does any part. of the waste management system other than waste structures require maintenance/improvement? j Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. croptype , .Nat Vgae, 5inall arain (Aar IPLrj -19,5 C U&
Yes
❑ Yes
❑ Yes
haV
❑ No
)<No
❑ No
13.
Do the receiving crops differ with those designate m the•Certified Animal Waste Management Plan (CAWMP)?
❑ es
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
IX No
b) Does the facility need a wettable acre determination?
❑ Yes
XNo
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
No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
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
KNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
A No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
KlNoµ'r-
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
No M
24.
Does facility require a follow-up visit by same agency?
t❑/YesXk�
pp Yes
J❑�
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
Yes
KNo
iVo•yiol'atigris;ord$fjckncie�•werepqtetl-84t-ringthjs;visit:-Yo witl-r'eceiyetjo;fujth$r;•:
cliriesporidenke: abu' U' f this :visit.' :::::::::::::::::::::::::::::::::: :
f
ThG ShMaI1 WA5+e5tord9e.porXj 15 no+cfccounted For, in bats+efKami. PIon, Needs %
be added
Need it eu+ frzes/mat n+v°fn loan V- of 5+-ora3e pond Lm'i I K- barn AaM
Area. arovnd C�alvin barn � rea,+l tl eroded +den uded- Su*&r Ki n
wi4h NC5+6Je.vel6, I+ernai,Wjojiv% area, K'un-00 trom Feed 51I$.1
Oxen- 0� 5 tao,t�,�/�4xeA rai s at5o �o}ed
'1�itlVytcu-Itu s 6�efl -tor avx4 4V 4,fe, was+e_ holds tq pony
Reviewer/Inspector Name
Reviewer/Inspector Signai
3/23/99

.FaeiiityrNumber: — ' . of Inspection t PydAl •
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.) I
❑ 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
3• Cagle, oaf &onPined -Ho-Avneedatr-eg5, Evidenee of o4gle wa*
ovi bgnI/ of 5�►-e m. No bnok.� -(�oee5/coire no4ip-d .
Ju99est Odd" � uxtter- boces- eosf"5hare
�I
3/23/99

Facility Number 99 12 Date of Inspection 7/8/99
Time of Inspection 9:40 24 hr. (hh:mm)
F
[3 Permitted ®Certified 0 Conditionally Certified 0 Registered Not O erational Dale Last Operated; ,,,,,,,,,,,,,,,,,,,,,,,,,,
FarmName: S.hady....Gr.Qn.l?,airy..................................................................................... County: YAdkifx.............................................. W5RQ........
Owner Name: Tim .......................................... Smit6t:cttuaa............................................. Phone No:(33G)..b'19..-B1aG..ar... 3.7.94.....................................
Facility Contact: ..............................................................................Title:
Phone No:
MailingAddress: 1Q4Q.HnaR.O.W.Hollatt:....................................................................EA$.tX.c;xd..NC ...................................................... UQ18 .............
Onsite Representative: Maurjcv..%.SmIt1ARr10.7An..................................................... Integrator:
Certified Operator: Maudr.C..A.......................... SWIherman ................................... Operator Certification Number: 2,1Q50.............................
Location of Farm:
Latitude 36 • E 13 59 .. Longitude 80 • 317, F 33 ..
tea' Desi`�'
3 , Disi"un
Swine �' Ca
Current
P,o
Desi n Current "�Dest
ei 1, B s pia,.
Poultry'-' Ca P,o CattleCa
nW YCurren''t i
t9M g,rty x , efi'
Po
tacit
wlation
reed ulatton
actt ulation
❑ Layer ® Dairy
400 400
❑Non -Layer ❑Non -Dairy
�
n ??
❑ Other
Total Design, Capacity
400
Total SSIW
560,000
❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Arca0
1EMPonds
❑ No Liquid Waste Management!
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges $c rem Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
u a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the Slate'? (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?
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: Milk Barn Old Freestall Newer Freestall Small Lot
Freeboard(inches): ................3b................................3b...............................24..............................42............................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
® Yes ❑ No
[]Yes ®No
❑ Yes ®No
Structure 6
❑ Yes ®No
Continued on back
Printed on 12/23/99
3/23/99

Facility Number: 99-12 I • of Inspection
6. Are there structures on -site which are nc 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
12. Crop type Corn (Silage) Small Grain (Silage) Fescue (Hay)
7/8/99
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 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? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Reuuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit 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' No yiolatiotis:or ;deTciencies were noted ;dur. ittgdhig.. visif::You'*ill receive no further ;
corresootidence. tibouf this visit:::. .
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
19. Need to have waste analysis within 60 days of applications. Have annual soil samples on all fields waste is applied on.
2. Evidence of past discharge at milk barn. Parlor pipe empties into ditch which flows into open end PVC pipe to WSP# I and can
tpass WSP# I. Also evidence of past discharge from broken curbing at free stall barn at WSP# 2.
6. The small WSP is not accounted for in WUP. This is a small holding pond that receives a .small amount of runojffrom the
ilk barn lot. /t is located to the left of the milk barn and just above the stock trail leading to the large free stall barn.
9. No visible max. liquid markers in any WSP. Need to have technical specialist install graduated marker with max. liquid level
id reference to low point on dam for general permit requirements. Cont. Pg: 3
IReviewer/Inspector Name Rocky Durham I
Reviewer/Inspector Signature: Date:
on

facility Nurn 99-12 �oflnspection 7/8/99
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ® No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
IN No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
®No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
® No
ona •ommen an o aw ngs:
Need to have technical specialist look at milk parlor pipe and curbing discharge areas. Also, need to have WSP# 4 accounted for in
UP. Should be done within 7 to 14 days.
Printed on 12/23/99

Facility Number 99 12
® Registered © Certified [3 Applied for Permit 0 Permitted
Date of Inspection 11/25/98
Time of Inspection � 24 hr. (hh:mm)
10 Not Operational Date Last Operated:
Farm Name: S.I ft,GxmxAj)zky..................................................................................... County: Yadkin .........................�yoeee w..s.R.Q........
Owner Name: Tim .......................................... Smlthccmaa............................................. Phone No: 9.1A-b29-3794..ac.81(x...fTr.. ....../.
FacilityContact:Same................................................................... Title:................................................................ Phone No: Same............................... 7 /
Mailing Address: 1Q4Q.Hoot.Q.w.IHW1Qw...................................................................... EAO.Aciad..N.0 ...................................................... 17.0.111............. Onsite Representative: Tjm.SmjAhcrman...................................................................... Integrator:......................................................... .. �7(p /C
Certified Operator: Tim .......................................... smidumman ................................... Operator Certification Number: 212.14.............................
Location of Farm:
Latitude 36 • 13 59 Longitude Ei0 •F 31 33
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 Surface Water'? (If yes, notify D WQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
4. Were there any adverse impacts to the waters of the State other than from a discharge'? ❑ Yes ®No
5. Does any part of the waste management system (other than lagoomAiolding ponds) require ❑ Yes 10 No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 19 No
7. Did the facility fail to have a certified operator in responsible charge'? ❑ Yes ® No
7/25/97

Facility Number, 99-12 Die Inspection 11/25/98
8. Are there ragoons or storage ponds on site which need to be properly closed'? • ❑ Yes ® No
Structures (Laeoons,Holdinc Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................................................................................................................................................
Freeboard(ft):............................................................................................................................................. ......................................................................
10. Is seepage observed from any of the structures? ❑ Yes ® No
11. Is erosion, or any other threats to the integrity of any of die structures observed? ❑ Yes H No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
® No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimmn or maximum liquid level markers?
❑ Yes
❑ No
Waste Application
14.
is there physical evidence of over application?
❑ Yes
® No
(If in excess of WMP, or nnoffentering waters of the State, notify DWQ)
15.
Crop type ....................... P.r.SGug....................... ...................................................................................................................... ...................................................
16.
Do the receiving crops differ with those designated in die Animal Waste Management Plan (AWMP)'?
❑ Yes
❑ No
17.
Does the facility have a lack of adequate acreage for limd application?
❑ Yes
® No
18.
Does the receiving crop need improvement?
❑ Yes
IN No
19.
Is [here 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/hrspector fail to discuss review/inspection with on -site representative?
❑ Yes
® 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
❑ No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
..... _ - - -.-. -.-.
No•vioIa ions ur'deficieucies• Wore''gate'd'during t4is•visit.: •You •M11'ruelve'up faether
. .ci&resDondeilcti iliouf this:visit :: :::::::::::::::::::::::: :
Animal waste plan being prepared by NRM stock trail and some fencing done.
2 large lagoons below.free stall barns recently pumped; in addition to those 2, there is a separate lagoon for milk parlor, as well as
New barn Under construction '
Farm appeared well operated and maintained.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:

0 Division of MV and Water Conservation ❑ Oth ency N
v
alfivision of Water Quality ` Xz p�
0 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number
j Date of Inspection
'
Time of inspection 24 he (hh:mm)
0 Registered 0 Certifled�P Applied for Permit E3 Permitted JE3 Not Operational Date Last Operated:.....,,__ ...............
Farm Name: ...1.. _............©.....fl.... County:..../Gl...lC/..............................................
Jf� �...................
Owner Name: .......... lIt... ......................... I �/. ......... Phone No f �� .. /. (,�
Facility Contact: .... ?l.1?/'mil..............�W................................. Title:
/............n................................�...L..... Phone
No: ......
./70_. e......7.............
/
Mailing Address:..../..5 ./..0.....,( ...t j..�.�1
OtlsiteRepresentativM?�...................................................................... Integrator:......................................................................................
Certified Operator;..... 11,17................................... �/!1/.�%.��%�/j Operator Certification Number:.........................................
Location of Farm:
Latitude Longitude®* =, ®"
to 1
to
I to
to
to
I ° Poultry Capacity-„
mfi
a� x x a
Present
Catty .
Area
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
;�No
2. Is any discharge observed from any part of the operation?
❑ Yes
PNo
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 Surface Water? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated Flow in gallmin?
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
KNo
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
KNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
maintenance/improvement?
ITNo
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
9No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
Pd No
7/25/97

f,
Facility Number: — • •
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons.11olding Ponds. Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? .
Structure l Structure 2
Identifier:
Freeboard (ft):
10. Is seepage observed from any of the structures?
❑ Yes tR No
❑ Yes )UNo
Structure 3 Structure 4 . Structure 5 Structure 6
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WvM`P, or runoff entering waters of the State, notify DWQ)
I5. Crop type I.5..7.(We ..,..... KWeI�,J.................................................................................................................
16. Do the receiving crops differ with [[those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0-No.violations6rdeficiencies.werenoted duringthis.visit. You'v llrecdve•noftirtliei
0rr0p0tideitce about this:visit:: ;
❑ Yes P(No
❑ Yes *0
❑ Yes � No
❑ Yes ❑ No
❑ Yes NrNo
❑ Yes ❑ No
❑ Yes ,® No
❑ Yes /'No
❑ Yes FNo
❑ Yes �FNo
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
o� /�i e' 1-lfOO�S �x�w /� J �// /��llirs �/crr/ �i1��i���t
Aree to
�Glf/Olrl <l6 sue///ITS 11 A// hD�/•�j ��/// G✓G✓/;,
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature:

Uate of Inspection 10/2S/97
Facility Number
Time of Inspection 0 24 hr. (hh:mm)
Registered a Certified a Applied for Permit a Permitted in NotOperational Date Last Operated:
Farm Name: Shady,Garave..Rairy...................................................................................... County: Yadkin WSRO
Owner Namc: Tim .......................................... Smitherman............................................. Phone No: 9.113-.699-3.7.99-ox.8.13.6 .........................................
Facility Contact: Tim.Smitherman..........................................Title: Owner .................................................. Phone No: 9.10.69%379.9 ........................
Mailing Address:.I.040..Huo.L0.wLH.ollow..................................................................... East.Bend..NG....................................................... 27DIR ..............
Onsite Representative: Tim..Smitherman...................................................................... Integrator:.............................................
Certified Operator: Maartee.Smitherman.................................................................. Operator Certification Number:
Location of Farm:
Latitude ®• ©' ®" Longitude ®' ©' ©"
' ,._„a ,, ''Design : urren .;,1.
Poultry
esign urren
Cattle.
Design
Current ,
Swme Capacity Population'-'
Capacity Population
Capacity
Population _
E3 Layer
�� ® airy
�. E3 on- ayer
p Non -Dairy
p ter
Total•Design Capacity,200
Total SSLW"
Holdmg Ponds
13 u
sur ace rams resen p Lagoon Area
p pray FieldAre "+
rlp�lI!lumbe;i' 'oons/, tl; , �,,� (,,
� i n r I i �
t
p o
tqm Waste Managementys em
�;
�fi Ldtp 11f(lil. n v .IPA ' ( f:ilc
p can o Peeder
p ee er to mts
p arrow to can
p arrow to ee er
p Farrow to Finish
p Gilts
p Boars
General
1. Are there any buffers that need maintenance/improvement?
p Yes
® No
2. Is any discharge observed from any part of the operation?
p Yes
®No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made?
p Yes
p No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
p Yes
p No
c. If discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system? (It'yes, notify DWQ)
p Yes
p No
3. Is there evidence of past discharge from any part of the operation?
p Yes
®No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
p Yes
®No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
p Yes
®No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
®No
7. Did the facility fail to have a certified operator in responsible charge?
p Yes
®No
7/25/97

act t y Number: 99_12 0 is
8.
Are there lagoons or storage ponds on site which need to be properly closed?
Yes
® No
Structures (Laeoons,Holdina Ponds, Flush Pits, etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
p Yes
® No
Structure I Structure 2 Structure 3 Structure 4 StrnClnre 5
Structure 6
Identifier: West No.2 Milk Barn
Freeboard(11):................ fa ................ ................ k................ ................2................. ................................... ...................................
...............................
10.
Is seepage observed from any of the structures?
p Yes
N No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
p Yes
® No
12.
Do any of the structures need maintenance/improvement?
Yes
® No
(if any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
p Yes
p No
Waste Application
14.
Is there physical evidence of over application?
p Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type.......Corn.(Silage.&.Gxain.)....... Small_Grain.(Wheal,.Barley,........................ F.escue....................... ...............................................
,
16.
MiI Rats)
Do the receiving crops differ with those designated tote ntmal 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
®No
20.
Does facility require a follow-up visit by same agency?
p Yes
®No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
®No
22.
Does record keeping need improvement?
p Yes
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
p No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
p Yes
p No
25.
Were any additional problems noted which cause noncompliance of the Permit?
p Yes
p No
R . •N_o:vtolationes.or tletteretnctes•were.notet.aunngthis visit. Yon. will no tnrtner . • .
.. h::u
::............... s.............................

State of North China
Department of Environment,
Health and Natural Resources
Mooresville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Tim Smitherman
1040 Hoot Owl Road
East Bend, North Carolina 27018
SUBJECT:
Dear Mr. Smitherman:
,•r
IDEHNFR
DIVISION OF SOIL AND WATER CONSERVATION
May 2�EI�IVEO,Aft
N c OeP� O' r
2 S 199?
TA ,a1eM
Reg 011al Ojiice
Operation Review Corrective Action Recommendation
Shady Grove Dairy
Facility No. 99-12
Yadkin County
On May 13, an Operation Review was conducted of Shady Grove Dairy, facility no. 99-12. This Review,
undertaken in accordance with G.S. 143-215.1 OD, is one of two visits scheduled for all registered livestock
operations during the 1997 calendar year. The Division of Water Quality will conduct a second site inspection.
During the Review, it was determined that waste was = being discharged to the waters of the State,
and the animal waste collection, treatment, storage and disposal systems were properly maintained and
operated under the responsible charge of a designated operator. However, the following management
deficiency was discovered and noted for corrective action: failure to install start pumping markers within the
pond. This management deficiency needs to be addressed and corrected. You are encouraged to contact your
certified technical specialist if additional assistance is needed. During ensuing reviews, this same deficiency will
be re-examined to determine if corrective actions were implemented.
In order for your facility to remain in compliance with environmental regulations, animal waste cannot be
discharged into the waters of the State, and the animal waste collection, treatment, storage and disposal
systems must be prooeriy maintained and operated under the responsible charge of a certified operator.
Please remember that you are required to obtain and implement an approved animal waste
management plan by the end of this year and have a certified operator. The plan must be certified by either a
designated technical specialist or a professional engineer. For additional assistance with the plan or the
certification course, please contact your local Soil and Water Conservation District Office or local Cooperative
Extension Service Office.
919 North Main Street, FAX [phone]
Mooresville, North Carolina 28115 N,owl
� C
An Equal Opportunity/Affirmative Action Employer
Voice704-663-1699 50% recycled/ 10% post -consumer paper

0
CJ
I Mr. Ti m Smitherrnan
May 23, 1997
Page Two
The Division of Soil and Water Conservation appreciates your cooperation with this Operation Review.
Please do not hesitate to call me at 704/663-1699 ext. 277 if you have any questions, concerns or need
additional information.
Sincerely,
L
os h ennan
Environm I Engineer I
cc: Yadkin Soil and Water Conservation District
(0M-Bassinger,,-DWQ-lnspector forYadkin Cow
DSWC Regional Files

10 Routine Q Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Date of Inspection 5/13/97
Facility Number 99 1 Time o[ Inspection 17:16 24 hr. (hh:mm)
Farm Status: Registered......................................................................... (ex:1.25 for 1 hr 15 min)) Spent on Review 2.25
or Inspection (includes travel and processing)
Farm Name: Sbgdy.Grave.D.airx..................................................................................... County: YAdkjn .............................................. WSRQ........
Owner Name: Tim .......................................... Smithermatl............................................. Phone No: 9.10.499.r.3.799-9r.,813.6 .........................................
Mailing Address: JQ.4Q..Hapt.Q»:I.ii.Q1AQ..W..................................................................... East.Beud...N.C...................................................... V0.1A ..............
Onsite Representative: Tim.%Wthermall...................................................................... Integrator:
Certified Operator:
Location of Farm:
Operator Certification Number: ..........................................
Latitude 36 • 13 59 Longitude =0113 31 33
Not Operational Date Last Operated: ...............................................................................
ppe of Operation and Design Capacity
Swine Number
❑ Wean to Feeder
Feeder to Finish
Lj Farrow to Wean
Lj Farrow to Feeder
Lj Farrow to mts —
---
Poultry _Number Cattle Number
❑ Layer I Dairy 200
ILI Non -Layer INon-Dairy
❑ Other
I Number of Lagoons / Holding Ponds 0 ❑ Subsurface Drains Present I
❑ Lagoon Area ❑ Spray Field Area
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in 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/bolding ponds) require
maintenance/improvement?
❑ Yes ® No
❑ Yes ® No
❑ Yes H No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes H No
❑ Yes ® No
Continued on bock

6. Is facility not in compliance with any a cable setback criteria?
7. Did the facility fail to have a certified o'3 ator in responsible charge (if inspection after*7)?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons and/or Holdine Pondsl
9. Is structural freeboard less than adequate?
Freeboard (it): Lagoon 1 Lagoon 2 Lagoon 3
................ 1+................. .................5.t.................. ................5.t..........
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ............... Gom.LS.ilaBeA-Cicain).............. .........................................................................
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For Certified Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes
® No
❑ Yes
® No
❑ Yes
®No
❑ Yes
®No
Lagoon 4
...........................
❑ Yes
® No
❑ Yes
® No
❑ Yes
®No
IN Yes
❑ No
❑ Yes
® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. 99-12
Use drawings of facility to'better explain situations.,(use additional pages as necessary):.
Question 13: All 3 ponds need start pumping markers as part of certification process.
Comments: Operation is in good shape. Pond 1 needs to be pumped soon since it is approaching the maximum level allowable.
There is also a heavy use/denuded area at the top of the draw at the head of a small branch that may present some errosion/run-off
problems. Operation may want to look at fencing out branch or adding a buffer.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: �-'6
V,
cc: Division of Water Quality, Water QualEty Secti6r(, Facility Assessment Unit 11/14/96

° • OPERATIONS BRANCH - b'' Fax, :91'=I-'15.-f 04S Ju l 19,'' 95 14 :49 F. 015
�� saerequirasimmeciate�na�l�i •�`•,
aaamy number
SITE VISITATION RECOR10
Date: �„Tu Lu 1—�1995
Cwner. l . ,• S., : f'hc ti Farm Name: L dr G,OY4
county: Yy;�
Agent Visiting Site: j/, S4,C4^ R 3'too Fhare: ic- s
Operalor. Fhane: Cl to - (p94 -�21?q
On -Site Rapresentatiye; Phcne:
Physical P,ddress:
Nlailing Adcrass:
Type of Ocera:on: J Swine Poultry i" Catte
Design Czpa: Cj; 1510 Number ofkirrals on Site:
La:;iur'e: 3� ° 13 Longitude:
Ty,e c' Ins 2c:'ar,; _ ✓�rcunG Aer:'I
Circle Yes cr No
Dees the=Lirloi Waste La -,cc,-, have s'u 7clent freebcaarzl or 1 Fcot - 25 yE:'a' 2-' IOUr slc-1 cr'9nt
,2_Gf•�X,Ta!ey ! Fccf t 7 inches) Yes or `Jc
c al Fraenzrd: 2 =bet �_ Itches
taC';ihes m h more than one la•.ecn, please address :.e zdner iagcons' f veccac underthe
cac-mants sectvcn.
:2sa;�ti
Was There erosion of the dam, Yes q
Is a e::at> land available for!acc aoplica 7wn: tMs or No
is ;.`? Over cro,2 ade-uate? a3 C- No
Fox is f91"oi T'S•355?