No Project ID_Manure Hauler Miscellaneous_20171231

_o`apF W A TF,gQG
D 'C
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
NC DEPT. OF
AND NATA
Alan W. Klimek, P.E., Director
,,,,_R�yision of Water Quality
June 13, 2005 j�
JUN 1'6 2005
Mr. Billy Houston
Hygro Inc.
441 Cabin Street MOORESVILLE REGIONAL OFFICE
Pink Hill, NC 28572 DVYQ-GROUNDWATER SECTION
Subject: Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & AWG 100000
Dear Mr. Houston:
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the Hygro Inc. record keeping
forms submitted May 24, 2005. Based on our review, the following forms have been approved for use in conjunction with the
requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1. Hygro "Lagoon Rain Fall and Freeboard Levels" (3 lagoons)
2. Hygro "Lagoon Rain Fall and Freeboard Levels" (1 lagoon)
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit`Numbers
NCA200000 and AWG 100000. information required by the referenced permits must be included on forms provided by the
Division or approved by the Division. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are stili the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
Sincerely,
M. Paul Sherman, P.E.
AFO Unit Supervisor
Cc: AAS, Fayetteville Regional Office w/ attachments
APS, Wilmington Regional Office w/ attachments
APS, Washington Regional Office w/ attachments
APS, Raleigh Regional Office w/ attachments
APS; Mooresvilie-Regional-Offce,w/-attachments
AFS, Winston S3Iem Regional Office w/ attachments
APS, Asheville Regional Office wl attachments
Division of Soil & Water Conservation — Central Office
Noy` Carolina
AwAll
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.statc,nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer-- 50% Recycled/10% Post Consumer Paper

Year
January Fet
rain #1 #2 43 rain
days fall lagoon lagoon Lagoon Tall
13
14
15
16
17
20
21
22
23
24
March April
#3 rain #1 #2 #3 rain #1 #2 #3
Lagoon Tall I lagoon lagoon Lagoon fall lagoon lagoon Lagoon
__
mm
mm
mm
mm
__
mm
mm
June
rain #1 92 #3
fall lagoon lagoon Lagoon

July August Septet
rain #1 #2 1 #3 rain #1#2 #3 rain
days fall lagoon lagoon Lagoon fall lagoon lagoon Lagoon fall
1 I
--_m---
-__ m--
__- -__-
-__ --__
_-- m_ -m
-_- ____
_m- _---
_-- -_--
--_m--_
23
28
29
34
31
#3 rain
Lagoon fall
#3
Lagoon
#2
lagoon

January February I March April May June July August I September I October November December
"in
free rain r. rain rain free rain free
f. I
fall board fall board fall be . ard fall board fag board -fall - board fall board fall board fall board fall board f.11 board fall board
free rain free
rain I free
fain [�=I rain I free rain I free ,I,] free rain free rain free

`o�OF W ATF
Michael F. Easley, Governor
William G. Ross Jr., Secretary
[North Carolina Department or Environment and Natural Resources
—f Alan W. Klimek, P.E., Director
NC DEPT, OF E�4 Divisiop,o&Wuter Quality
AND NATURAL RESOURCES
RECEIVED
Mrs. Pat Hart -is
Division of Soil and Water Conservation
943 Washington Square Mall
Washington, NC 27899
Dear Mrs. Harris:
December 10, 2004 DEC I O 2004
MCORESVILLF. REGIONAL OFFICE
DWC�GROLINJll�W ER SECTION
Subject: Animal Permit Record Keeping Forms
General Pemut Nos. NCA200000 & AWG 100000
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the 2005 Pilot record keeping
form submitted November 10, 2004. Based on our review, the following form has been approved for use in conjunction with
the requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1. 2005 Pilot -1 Calendar
Please be aware that perinittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWG 100000. Information required by the referenced permits must be included on forms provided by the
Division or approved by the Division. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
Sincerely,
M. Paul Sherman, P.E.
Environmental Engineer
Cc: APS, Fayetteville Regional Office w/ attachments
APS, Wilmington Regional Office w/ attachments
APS, Washington Regional Office w/ attachments
APS, Raleigh Regional Office w/ attachments
'APS, Mooresville Regionat Office w/ attachments
APS, Winston Salem Regional Office w/ attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation — Central Office w/attachments
—NorthCarolina
�/VQ1MIX14l/
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: httpJ/h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

North Carolina
Department of Environment and Natural Resources
Division of Soil and Water Conservation
Michael F. Easley, Governor
William G. Ross, Jr. Secretary
David S. Vogel, Director
November 9, 2004
Paul Sherman
Aquifer Protection
Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Paul,
A�A
F4CDENR
Enclosed is 2005 PILOT -1 form for your review and approval.
If you have any .questions or recommendations to improve the
calendar, please call me at 252.948.3901.
Thank you for your help,
t
Pat Hooper
Operation Review
Division of Soil & Water Conservation
943 Washington Square Mall, Washington NC 27889
Telephone [phone] FAX [phone]

2005 PILOT -1 Calendar' DRAFT
NORTH CAROLINA PILOT PROGRAM FOR INSPECTIONS
OF ANIMAL WASTE MANAGEMENT SYSTEMS
(Revised November 9, 2004)
Description
The 2005 PILOT -1 Calendar is a compilation of recording forms designed to
reduce the volume of farm records while still meeting basic record keeping
requirements mandated by both NPDES and state non -discharge permits.
The calendar format provides data entry for the more commonly used
records such as freeboard and daily precipitation'records (FRED -1); crop
yield records (CROP -1); irrigation event records (IRR -1); average stocking
and mortality records (STOCK -1); and waste structure inspections records.
The waste operator is responsible for completing all required forms in
accordance with their farm's permit that may not be included within this
calendar.
The Division of Water Quality has approved this document for use both in
and out of the pilot program area.
Instructions
* For the month 'at -a -glance records:
• Space is provided to record waste level readings within the block for
the date the level(s) is read. Readings are to be recorded in inches
and at least weekly.
• Rainfall (precipitation) amounts are to be recorded in inches for
each 24-hour period. Leave space blank if site experiences no
precipitation.
• Initials are to be placed next to "checked by:" signifying that waste
structure(s) was inspected after any precipitation greater than one
inch and at least monthly.
* The IRR -1, CROP -1 and STOCK -1 tables are provided on the back page of
each month. The annual certification form (AFACF 3--14-04) for NPDES
farms, waste transfer form (TRAM -1) and additional IRR -1 tables are
provided at the end of the calendar.
* For more information or a copy of the 2005 calendar, contact the
following. Division of Soil and Water Conservation staff:
For Brunswick & Columbus Counties, contact John College at
910.395.390 (office) or 910.470.0030 (mobile)
• For Jones County, contact Pat Hooper at 252.948.3901 (office)
or 252.974.4051 (mobile)

FARM OWNER
OPERATOR
FACILITY NUMBER - 0
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
'-
Tract Field/Pull Date Crop Field Size Irrigation Time #Sprinklers Operator
Number Number (mmlddlyr) Type (acres) Start Time End Time Total Minutes Operating Initials
*Weather **Inspc#ioAs
Code (initia)s)
5
* Weather Codes: G -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy
' Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes_
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crap Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop . Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Avera a MonthIv Stockinq and Mortali Record Weekly Inventory (E) equals
A B C D E F G H previous Beginning or Weekly
Date Beginning Head In Mortality Culls/Sells Weekly Total Number Monthly Inventory + (B) - (C) - (D).
(mmlddlyr) Inventory N (-) (-) Inventory Inventory of Weeks Average Total Inventory (F) equals the
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages H) divide by 12

JANUARY 2005
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
Rainfall = .
Checked by:
2
3
4
5
6
7
8
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by::
Checked by:
Checked by:;
9
10
11
12
13
14
15
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
16
17
18
19
20
21
22
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall -
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:;
Checked by:,
23
24
25
26
27
28
29
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by: i
30
31
Rainfall =
Rainfall =
Checked by:
Checked by:
PILOT -1 Form

FARM OWNER
OPERATOR
FACILITY NUMBER
Lagoon Liquid irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull:, Date Crop Field Size i Irrigation Time # Sprinklers Operator *Weather "*Inspections
Number Number (mmlddlyr) Type (acres) Start Time End Time Total Minutes Operating. Initials Code (initials)
* Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy
"* Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit,, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date FieldlPull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Averacie Month1v Stockina and Mortal! t Record
Weekly Inventory (E) equals
previous Beginning or Weekly
lnverttory
A
B C D E F G H
Date Beginning
Head In Mortality CUIIsISeIIS Weekly Total Number on
(mmlddlyr) Inventory
{�) (-) (-) Inventory . Inventory of Weeks Average
Total Irnentory (F) equals the
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
i
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages H divide by 12

FEBRUARY 2005
FACILITY NUMBER
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
Rainfall=
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:.
Checked by:,
Checked by:.
6
7
8
9
10
11
12
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:.
Checked by:
13
14.
15
16
17
18
19
Rainfall =
Rainfall =
Rainfall =
Rainfall _
Rainfall =
Rainfall=
Rainfall =.
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:;
Checked by:;
Checked by:;
20
2'l
22
23
24
25
26
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall ='
Checked by:
Checked by:,
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:
27
28
i
Rainfall =
Rainfall =
Checked by:
Checked by:
PILOT -1 Form

FARM OWNER
OPERATOR
FACILITY NUMBER -
'Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator 'Weather *"Inspections
Number Number (mmlddlyr) Type (acres) StartTime End Time Total Minutes Operating Initials Code (Initials)
Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy
" Persons completing the irrigation inspections must initial to signify that inspections were completed at feast every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Avera a Monthlv Stockina and Mortali
Record
F G
Total Number
Weekly Inventory (E) equals
H previous Beginning or Weekly
Monthly tnventory + (B) - (C) - (D).
A
B C D E
Date Beginning
Head In Mortality CullslSells Weekly
(mmlddlyr) Inventory
(+) (-) (-) Inventory
Inventory of Weeks
Average Total Inventory (F) equals the
total of ail Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages(H) divide by 12

MARCH 2005
FACILITY NUMBER
SUNDAY
MONDAYTUESDAY
WEDNESDAYPTHURSDAY
SATURDAY
"1 *
2
EFRIDAY
5
*REMINDER*
Annual Certifications
for NPDES Farms
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
due March 1
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
6
7
8
9
10
11
12
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
=
Checked by:
Checked by:
Checked by:
Checked by:
Checked by.
Checked by:
_Rainfall
Checked by:
13
14
15
16
17
18
19
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall -
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by -,.,Checked
by:,'
20
21
22
23
24
25
26
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfa_ll =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked.by:
Checked by:
Checked by:
Checked by:
27
28
29
30
31
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
PILOT -1 Form

FARM OWNER
OPERATOR
FACILITY NUMBER 1 1 - IIJ
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator "Weather "Inspections
Number Number (mmlddlyr) Type (acres) StartTime End Time Total Minutes Operating Initials Code (initials)
' Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy
*' Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: if conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale.Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmiddlyr) Number Type (bales or bushels) (if applicable)
Avera a Monthiv Stockinq and Mortal!
Record
Weekly Inventory (E) equals
previous Beginning or Weekly
Inventory + (B) - (C) - (D).
A
B C D E F G
H
Date Beginning Head In Mortality Culls/Sells Weekly . Total Number
Monthly
(mmlddlyr) Inventory (+) (-) (-) Inventory
inventory of Weeks
Average
Total Inventory (F) equals the
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages (H) divide by 12

APRIL 2005
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
Rainfall=
Rainfall =
Checked by:
Checked by:
3
4
5.
6
7
8
9
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
-Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:.
10
11
12
13
14
15.
16
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall=`
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
17
#8
19
20
21
22
23
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Rainfall =
Rainfall _
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:
Checked by::
24
25
26
27
28
29
30
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =`
Checked by:
Checked by:
1 Checked by:
Checked by:
Checked by:'.
Checked by:
I Checked -by:
PILOT -1 Form

FARM OWNER
OPERATOR
FACILITY NUMBER -
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator "Weather "Inspections
Number Number (mmlddlyr) Type (acres) StartTime End Time Total Minutes Operating Initials Code (initials)
' Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Mote: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop- Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Ave acie Monthly Stockinq and Mortali Record Weekly Inventory (E) equals
A B C D E F G H previous Beginning or Weekly
Date Beginning Head In Mortality Culls/Sells Weekly To Number Monthly Inventory + (B) - (C) - (D).
(mmlddlyr) Inventory N (-) (-) Inventory Inventory of Weeks Average Total Inventory (F) equals the
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages (H) divide by 12

MAY 2005.
FACILITY NUMBER
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
5
7
Rainfall=
Rainfall =
Rainfall
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by..
8
9
10
11
12
13
1Q
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall'
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:,
15
16
17
18
19
20
21
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:
Checked by,
22
23
24
25
26
27
28
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall -
Rainfall =
Rainfall ==
Checked by:.
Checked by:
Checked by:
Checked by:
Checked by:,
Checked by:
Checked by:,
29
30
31
Rainfall =
Rainfall =
Rainfall =
Checked by.
=Checked by:
Checked by:
PILOT -1 Form

FARM OWNER
OPERATOR
FACILITY NUMBER 0 - 0
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator `Weather *'Inspections
Number Number (mmlddlyr) Type (acres) Start Time End Time Total Minutes Operating Initials Code (initials)
" Weather Codes: C -Clear, PC -Partly Cloudy, Cl-Ctoudy, R -Rain, S-Snow/Sleet, W -Windy
" Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bate Size
(mmlddlyr) Number Type (hales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Averacie Monthlv S#ockin and Mortali
Record
Weekly Inventory (E) equals
previous Beginning or Weekly
Inventory + (B) - (C) - (D).
A B C D E F G
H
Date Beginning Head In Mortality CullslSells Weekly..
Number
Monthly
Total Inventory (F) equals the
(mmlddlyr) Inventory (+) 0 HInventory Inventory.1 of Weeks I
Average
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total MontJ12
Averages H) divide by

JUNE 2005 -
FACILITY NUMBER
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
P.
2
3
4.
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:.
5
6
7
$
9
10
11
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:
12
13
14
15
16
17 1
18
Rainfall =
Rainfall =
Rainfall=
Rainfall =
Rainfall =
Rainfall =
Rainfall -;
Checked by:
Checked by:
Checked by:.
Checked by: Checked
by:
Checked by:.
Checked -by:
19
20
21
22
23
24
25
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:.
Checked by:
Checked by:
Checked by:
Checked
26
27
28
29
30
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
PILOT -1 Form

FARM OWNER
OPERATOR
FACILITY NUMBER - 0
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator 'Weather "*Inspections
Number Number (mm/dd/yr) Type (acres) StartTime End Time Tota! Minutes Operating' Initials Code (initials)
' Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy.
Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (males or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Avera a Monthly Stockin_q and Mortalitv
Record
Weekly Inventory (E) equals
previous Beginning or Weekly
Inventory + (B) - (C) - (D).
A
B C D E F G
I
H
Date Beginning Head In Mortality Culls/Sells Weeklyjjumber
Monthly
Total Inventory (F) equals the
(mmlddlyr) Inventory . (+) (-) (-) Inventory Weeks
Average
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages (H) divide by 12

JULY 2005
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
Rainfall =
Rainfall =
Checked by:
Checked by:
3
4
5
6
7
8
9
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:.
Checked by:
Checked by:
Checked by:;
Checked by:
10
11
12
13
14
1516
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall=
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:;
Checked by:;
17
18
19
20
21
22
23
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:.
Checked by:
Checked by:
Checked by:
Checked by:
_
Checked by:,
24
25
26
27
28
29
30
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:'
Checked by:;
Checked by:
31
'
Rainfall =
Checked by:
PILOT -1 Form

FARM OWNER
OPERATOR
FACILITY NUMBER -
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator *Weather **Inspections
Number Number (mm/dd/yr) Type (acres) Start Time End Time Total Minutes Operating Initials Code (initials)
Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
`* Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Averacie Monthiv Stockifiq and Mortali
Record
F G
Total Number
Weekly Inventory (E) equals
H previous Beginning or Weekly
Monthly Inventory + (B) - (C) - (D).
A
B C D E
Date Beginning
Head In Mortality Culls/Sells Weekly
(mmlddtyr) Inventory
(+) (-) (-) Inventory
inventory of Weeks
Average. Total Inventory (F) equals the
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages H divide by 12

AUGUST 2005
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
6
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:
Checked by:
7
8
9
10.
11
12
13
Rainfall =
Rainfall =
Rainfall=
Rainfall '=
Rainfall =
Rainfall =
Rainfall =:
Checked by:.
Checked by:
Checked by:
Checked by:
Checked by:,
Checked by:
Checked by:
14
15
16
17
18
19 :
2Q
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =.
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:,
21
22
23
24
25
26
.27
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by: •
28
29
30
31
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
PILOT -1 Form

FARM OWNER
OPFRATOR I q
FACILITY NUMBER - 0
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator *Weather "Inspections
Number Number (mmldd/yr) Type . (acres) Start Time End Time Total Minutes Operating Initials Code (initials)
Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
". Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 124 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mm/ddtyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bates or bushels) (if applicable)
Avera a Monthiv Stockinq and Mortali Record Weekly Inventory (E) equals
A B C D E F G H previous Beginning or Weekly
Date Beginning Head In Mortality Culls/Sells Weekly Total Number Monthly Inventory + (Bj - (C) - (D).
(mm/ddtyr) Inventory (+} (-) H Inventory Inventory of Weeks Average Total Inventory (F) equals the
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages H divide by 12

SEPTEMBER 2005
FACILITY NUMBER
SUNDAY'
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by.,
7
8
9
10
Rainfall
Rainfall =
Rainfall =
Rainfall =
Rainfall -
Rainfall =
Rainfall _
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:;
11
12
13
14
15
16
17
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
18
19
20
21
22 j
3
24
Rainfall =
Rainfall
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:,
Checked by:
Checked by-..
Checked by:,
Checked by:.
25
26
27
28
29
30
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:.
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
PILOT -1 Form

FARM OWNER
nPFRATnR
FACILITY NUMBER - 0
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator *Weather **Inspections
Number Number (mmlddlyr) Type (acres) Start Time End Time Total Minutes Operating Initials Code (initials)
' Weather Codes: C -Clear, PC -Partly Cloudy, CI-Cioudy, R -Rain, SSnow/Sleet, W -Windy
"Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes. .
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales ar bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales'or bushels) (if applicable)
Avera a Monthiv Stockinq and Mortalit Record Weekly Inventory (E) equals
A B C D E ' F G H previous Beginning or Weekly
Date Beginning Head I
to
n Mortality Culls/Sens Weekly Total Number Monthly Inventory + (B) - (C) - (D).
(mmlddlyr) Inventory (+) (-) (-) Inventory Inventory of Weeks Average Total Inventory (F) equals the
tal of all Weekly Inventories
for the month.
Monthly Average '(H) .equals
Total Inventory (F) dirrided by
Number of Weeks (G)
End of year, total Monthly
Averages H) divide by 12

OCTOBER 2005
FACILITY NUMBER
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
q
Rainfall =
Checked by:
2
3
4
5
6
7
8
Rainfall =
Rainfall =
Rainfall -
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:.
Checked by:
Checked by:
Checked by:
Checked by:,
Checked by:.
Checked by:
9
10
11
12
13
14 '
15
Rainfall =
Rainfall .='
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:,
Checked by:;
Checked by:
16
17
18
19
20
21
22 '
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =;
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:,
Checked by:
23
24
25
26 j
27
28
29
Rainfall =
Rainfall =
Rainfall =
Rainfall .=
Rainfall =
Rainfall =
Rainfall =;
Checked by:
Checked by:
Checked by:
Checked by:'
Checked by:
Checked by:.
Checked by:.
30
31
Rainfall =
Rainfall ='
Checked by:
Checked by:,
PILOT -1 Form

FARM OWNER
OPFRATOR I q
FACILITY. NUMBER
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator *.Weather "Inspections
Number Number (mrrtlddlyr) Type (acres) StartTime End Time Total Minutes Operating Initials Code (initials)
" Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
** Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes. .
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mm/dd/yr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mm/ddlyr) Number Type (bales or bushels) (if applicable)
Avera a Monthly Stockin and Mortali Record Weekly Inventory (E) equals
A B C D E F G H previous Beginning or Weekly
Date Beginning Head In Mortality Cu11slSells WeeklyTotal Number Monthly Inventory + (B) - (C)'- {l7}.
(mmldd/yr) Inventory (+) (-) (-) Inventory Inventory of Weeks' Average Total Inventory (F) equals the
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F) divided by
Number of Weeks (G)
End of year, total Monthly
Averages (H) divide by 12
D

NOVEMBER 2005
FACILITY NUMBER
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY -
1
2
3
4
5
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
6
7
8
9
10
11
12
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall -
Rainfall -
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by::
Checked by:
13
14
1516
17
18
19
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:,
20
21
22
23 J24
25
26
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:
Checked by:.
27
28
29
30
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
PILOT -1 Form

FARM OWNER
OPERATOR
FACILITY NUMBER I
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator 'Weather `Inspections
Number Number -(mmlddlyr) Type (acres) Start Time End Time Total Minutes Operating Initials Code (initials)
` Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
** Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Fieid/Pull Crop Yield Bale Size
(mm/ddlyr) Number Type (bales or bushels) (if applicable)
Averacie Monthiv Stockina and Mortali
Record Weekly Inventory (E) equals.
F G H previous Beginning or Weekly
Total Number Monthly Inventory + (B) - (C) - (D).
A B C D E
Date Beginning
Head In Mortality Culls/Sells Weekly
(mmlddlyr) Inventory
(+) (-) H Inventory
Inventory of Weeks Average Total Inventory (F) equals the
total of all Weekly Inventories
for the month.
Monthly Average (H) equals
Total Inventory (F).divided by
!
Number of Weeks (G)
End of year, total Monthly
Averages (H) divide by 12

DECEMBER 2005
FACILITY NUMBER
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
Rainfall
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
.4-
5
6
7
8
9
10
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall �.
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:,
11
12
13
14
15
16
17
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall .=
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
18
19
20
21
22
23
24
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =°
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:,
25
26
27
28
29
30
31
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:,
Checked by:.
PILOT -1 Form

ANIMAL FACILITY ANNUAL CERTIFICATION FORM
Certificate of Coverage or Permit Number
Facility Name (as shown on Certificate of Coverage or Permit)
Operator in Charge for this Facility
County
Certification #
Year 200_
Land application of animal waste as allowed by the above permit occurred during the past calendar year —
YES NO. If NO, skip Part I and Part II and proceed to the certification. Also, if animal waste was
generated but not land applied, please attach an explanation on how the animal waste was handled.
Part I : Facility Information:
1. Total number of application Fields ❑ or Pulls ❑ (please check the appropriate box) in the Certified Animal
Waste Management Plan (CAWMP):
Total Useable Acres approved in the CAWMP
2. Total number of Fields ❑ or Pulls ❑ (please check the appropriate box) on which land application occurred
during the year:
Total Acres -on which waste was applied
3. Total pounds of PIant Available Nitrogen (PAN) applied during the year for all application sites:
4. Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied annually by the CAWMP and
the permit:
S.. Estimated amount of total manure, litter and process wastewater sold or given to other persons and taken
off site during the year .tons ❑ or gallons ❑ (please check the appropriate box)
6. Annual average number of animals by type at this facility during the previous year:
7. Largest and smallest number of animals by type at this facility at any one time during the previous year:
Largest
Smallest
(These numbers are for informational purposes only since the only permit limit on the number of animals at
the facility is the annual average numbers)
8. Facility's Integrator if applicable:
Part I][: Facilitv Status:
IF THE ANSWER TO ANY STATEMENT BELOW IS "NO", PLEASE PROVIDE A WRITTEN
DESCRIPTION AS TO WHY THE FACILITY WAS NOT COMPLIANT, THE DATES OF ANY NON
COMPLIANCE, AND EXPLAIN CORRECTIVE ACTION TAKEN OR PROPOSED TO BE TAKEN TO
BRING THIS FACILITY BACK INTO COMPLIANCE.
Only animal waste generated at this facility was applied to the permitted sites during ❑ Yes []No
the past calendar year.
AFACF 3-14-03 1

2. The facility was operated in such a way that there was no direct runoff of waste from ❑ Yes ❑ No .
the facility (including the houses, lagoons/storage ponds and the application sites) during
the past calendar year.
3. There was no discharge of waste to surface water from this facility during the past []Yes ❑ No
calendar year.
4. There was no freeboard violation in any lagoons or storage ponds at this facility during ' ❑ Yes ❑ No
the past calendar year.
S. There was no PAN application to any fields or crops at this facility greater than the ❑ Yes ❑ No
levels specified in this facility's CAWMP during the past calendar year.
6. All land application equipment was calibrated at least once during the past calendar year. ❑ Yes ❑ No
7. Sludge accumulation in all lagoons did not exceed the volume for which the lagoon ❑ Yes .❑ No
was designed or reduce the lagoon's minimum treatment volume to less than the volume
for which the lagoon was designed.
8. A copy of the Annual Sludge Survey Form for this facility is attached to this ❑ Yes ❑ No
Certification.
9. Annual soils analysis were perfonned on each field receiving animal waste during the ❑ Yes ❑ No
past calendar year.
10. Soil pH was maintained as specified in the permit during the past calendar Year? ❑ Yes ❑, No
11. All required monitoring and reporting was performed in accordance with the facility's ❑ Yes ❑ No
permit during the past calendar year.
12. All operations and maintenance requirements in the permit were complied with during ❑ Yes ❑ No
the past calendar year or, in the case of a deviation, prior authorization was received
from the Division of.Water Quality.
13. Crops as specified in the CAWMP were maintained during the past calendar year on all ❑ Yes , ❑ No
sites receiving animal waste and the crops grown were removed in accordance with
the facility's penmit.
14. All buffer requirements as specified on the permit and the CAWMP for this facility were ❑ Yes ❑ No
maintained during each application of animal waste during the past calendar year.
"I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, trice, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Permittee Name and Title (type or print)
Signature of Permittee Date
Signature of Operator in Charge Date
(if different from Permittee)
AFACF 3-14-03 2

FORM IRRA Lagoon Liquid Irrigation Fields Record
For Recording Irrigation Events on Different Fields
Farm Owner Facility Number� -
Operator L I
Tract &
Field #
Date
(mmlddlyr)
Crop
Type
Field Size
(acres)
Irrigation Time
# Sprinklers
Operating
Operator
Initials
"Weather
Code
**Inspections
(initials)
Start Time
End Time
Total Minutes
* Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy 3/14/2003
*' Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions beyond the permittee's control have caused noncompliance with the CAWMP or permit, explain on reverse.

FORM IRR -1 Lagoon Liquid Irrigation Fields Record
For Recording Irrigation Events on Different Fields
Farm Owner Facility Number -
Operator
Tract &
Field #
Date
(mmlddlyr)
Crop
Type
Field Size
(acres)
Irrigation Time
# Sprinklers
Operating
Operator
Initials
`Weather
Code
'Inspections
(initials)
Start Time
End Time
Total Minutes
' Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy 3/14/2003
Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions beyond the permittee's control have caused noncompliance with the CAWMP or permit, explain on reverse.

FORM TRAM -9
Farm Owner
Address
Owner's Phone #
Animal Waste Transfer Record
Record Each Transfer of Waste Between Lagoons or Third Party
Facility Number -1 i
Irrigation Operator
Irrigation Operator's
Address
Operator's Phone #
Date
Time 1
Nutient
Analysis
Transfer From
(lagoon ID)
Transfer To
(lagoon ID or third party)
'Volume
Transferred
**Third Party Information
Permit #
Name
Phone #
*Volume Transferred must be recorded in gallons, tons, or cubic yards..
*"Third Parry must be provided with nutrient analysis.
Waste Transfers over 4 cubic yards must be accepted by a permitted facility or a field in the permittee's WUP.
3114!2003

Ms. Betsy Gerwig
Division of Soil and Water Conservation
3800 Barrett Drive
Raleigh, NC 27609
Dear Ms. Gerwig:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Caroli^^ rim arlment of Environment and Natural Resources
October 18, 2005 Ll
WQ
LFN—C DENR
rifer a
1 z.
Subject: Animal Permit Record Keeping Forms.
General Permit Nos. NCA200000 & AWG 100000
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the record keeping forms
submitted June 29, 2005. Based on our review, the following forms have been approved for use in conjunction with the
requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1. Form Frbd-1B
2. Form Frbd-1 C
3. Form Stock -IB
4. Form: Combined IRR -1 & IRR -2
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWG100000. Information required by the referenced permits must be included on forms provided by the
Division or approved by the Division. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
Sincerely,.
A-
M. Paul Sherman, P.E.
Animal Feeding Operations Unit Supervisor
Cc: APS, Fayetteville Regional Office wl attachments
APS, Wilmington Regional Office w/ attachments
APS, Washington Regional Office w/ attachments
APS, Raleigh Regional Office w/ attachments
APS, Mooresville Regional Office w/ attachments'
APS, Winston Salem Regional Office w/ attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation — Central Office w/attachments
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone].623-6748
Fax [phone]
An Equal OpportunitylAffirmative Action Employer— 50% Recycled110% Post Consumer Paper
VCNow
arolina
tura!!r�

4
[Fwd: forms...]
Subject: [Fwd: forms...]
From: Keith Larick <[e-mail]>
Date: Wed, 14 Sep 2005 09:59:38 -0400
To: Paul Sherman <[e-mail]>
Paul,
Betsy sent me these modified forms to see if they could get approved.
Keith
------- Original Message--------
Subject:forms...
Date:Wed, 29 Jun 2005 13:38:19 -0400
From:Betsy Gerwig <be_ tsY•gerwig,@ncmaiLn_et>
To:Keith Larick <Keit_h.Larick cr ncmaiLnet>
Hey Keith! I made a few changes to some of the forms used by farmers.
Moat of the changes are things I am seeing them do to make things a
little simpler. I will try to summarize the changes below. Could you
review them and let me know what you think? If you like them,- can I get
them approved for use. Also, would it be possible to post these on the
website also. Let me know if you have any questions. Thanks.
1. Modified IRR -2 form --- I changed the name to reflect what it truly
is; a combination of the IRR -2 & IRR -1 forms. It has confused some to
where to IRR -1 form goes when you use this form. I don't make any other
changes.
2. Stocking: I dropped the last 2 columns, because a lot of my farmers
try to calculate this number every month. I think with only one line it
will be more clear that it is an annual (once per year) calculation.
3.Freeboard & rainfall form: I have 2 different iterations of this
one. On the FRBD-1B form, I have added a column for the date of the
rainfall events, since they don't always occur when the lagoon level is
checked. Hopefully this will reinforce the daily rainfall recording.
One can hope. second, on the FRBD-1C form, I kept the new date for
rainfall and added a column for animal population. I've seen this used
on several finishing farms. They records the freeboard and the animal
population at the same time. Probably a little easier to keep up this
way. I didn't find anything to say they had to record mortality
directly. Correct me if I'm wrong.
Let me know what you think. Thanks.
Betsy.
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1 of 1 10/12/2005 10:42 AM

Y
FORM FRBD-1 B
Waste Structure Weekly Freeboard and Daily Precipitation Record
Farm Owner Facility Number -
Operator
1. Lagoon freeboard is the difference between the lowest point of a lagoon embankment and the level of liquid.
For lagoons with spillways, the difference between the level of liquid and the bottom of the spillway should be recorded.
2. Freeboard plus available storage capacity must be recorded at least weekly.
3. Rainfall must be recorded for every rain event. 6/292005

V
FORM FRBD-1 C
Weekly Freeboard, Weekly Animal Population, and Daily Precipitation Record
Farm Owner L Facility Number -�
Operator
1. Lagoon freeboard is the difference between the lowest point of a lagoon embankment and the level of liquid.
For lagoons with spillways, the difference between the level of liquid and the bottom of the spillway should be recorded.
2. Freeboard plus available storage capacity must be recorded at least weekly.
3. Rainfall must be recorded for every rain event.
4. Animal population (stocking) should be records, at a minimum, once per month. 6/292005

FORM STOCK -11 B
Monthly Average Stocking and Mortality Record
Farm Owner I Facility Number
Operator
'Date
m
{71
Previous Stocked
#
(2)
Placement Stocked
#
{3)
Stock Shipped
#
(4)
Mortality
#
(5)
**Total Stock
#
***Annual Average Stock (6)
'Annual Average Mortality (7)
At a minimum, records must be kept monthly.
Total Stocked (5): equals (1) + (2) - (3) - (4)
Average Stocked (6): Add previous 12 months of Total Stocked (5) and divide by # of entries.
*"' Average Mortality (7): Add previous 12 months Mortality (4) and divide by # of entries.
6129!2005

FORM: COMBINED IRR -1 & IRR -2
Tract #
Field Size (wetted arses) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
Field #
Irrigation Operator
Irrigation Operators
Address
Operators Phone #
Facility Number '
From Waste Utilization Plan
Crop Type Recommended PAN
Loading (lb/acre) = (B)
111 (2) 131 141 151 (a) 171 181 (91 1101 nil
Lagoon
ID
Date
(mmlddlyr)
Irri ation
Waste Analysis
PAN*
(1611000 gal)
PAN Applied
(lblacre)
(8) x (91
1000
Nitrogen
Balance
([Macre)
(B) - (10)
Weather
Code
Inspections
(Initials) "
Start
Time
End
Time
Total
Minutes
(3)-(2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
B=
Crop Cycle Totals I
Owners Signature
Certified Operator
Total PAN I
Operators Signature
Operator Certification #
' Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy
"" Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.

1f
f
OF wAT f Michael F. Easley, Governor
William G. Ross Jr., Secretary
y North Carolina Department of Environment and Natural Resources
� r
- I Alan W. Klimek, P.E., Director
O `C Division of Water Quality
Mrs. Pat Harris
Division of Soil and Water Conservation
943 Washington Square Mall
Washington, NC 27899
Dear Mrs. Harris:
October 18, 2005
Subject: Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & AWG 100000
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the 2006 Pilot record keeping
form submitted September 14, 2005. Based on our review, the following form has been approved for use in conjunction with
the requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1. 2005 Pilot -2 Calendar
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWGI00000. Information required by the referenced permits must be included ori forms provided by the
Division or approved by the Division. Please—pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
Sincerely,
M. Paul Sherman, P.E.
Animal Feeding Operations Unit Supervisor
Cc: APS, Fayetteville Regional Office w/ attachments
APS, Wilmington Regional Office w/ attachments
APS, Washington Regional Office w/ attachments
APS, Raleigh Regional Office w/ attachments
APS, Mooresville Regional Office w/ attachments
APS, Winston Salem Regional Office w/ attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation — Central Office w/attachments
D C C C 0 W E
OCT 1 :9:2.005
NC DEN,, MRO
DVV -A uifer Protection
Noy` Carolina
Xtrrrr l&
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.ne.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

North Carolina
Department of Environment and Natural Resources
Division of Soil and Water. Conservation
Michael F. Easley, Governor
William G. Ross, Jr. Secretary
David B. Williams, Acting Director
September 16, 2005
Paul Sherman
Aquifer Protection
Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Paul,
eZ11W I
NCDENR
AQU'FER PROTECTION REZVED/DENRS SECTION
SEP 2 3 2005
Enclosed is 2006 PILOT -1 form for your review and approval.
If you have any questions or recommendations to improve the
calendar, please call me at 252.948.3901.
Thank you for your help,
11-/� wa44x�-
Pat Harris
Operation Review
Division of Soil & Water Conservation
943 Washington Square Mall, Washington NC 27889
Telephone [phone] FAX [phone]

2006 ANIMAL WASTE RECORD KEEPING (PILOT -2) CALENDAR
The North Carolina Pilot Program for Inspections of Animal Waste Systems
Revised September 14, 2005
Description
The 2006 ANIMAL WASTE RECORD KEEPING (PILOT -2) Calendar is a
compilation of recording forms designed to reduce the volume of farm
records while still meeting basic record keeping requirements mandated by
both NPDES and state non -discharge permits. The calendar format provides
data entry for the more commonly used records such as freeboard and daily
precipitation records (FRBD-1); crop yield records (CROP -1); irrigation event
records (IRR -1); average stocking and mortality records (STOCK -1); and
waste structure inspections records. The waste operator is reseonsible for
completing all required forms in accordance with their farm's permit that
may _not _be included within this calendar.
The Division of Water Quality has approved this document for use both in
and out of the pilot program area.
r
Instructions
* For the month at -a -glance records:
• Space is provided to record waste level readings within the block for
the date the level(s) is read. Readings are to be recorded in inches
and at least weekly.
• Rainfall (precipitation) amounts are to be recorded in inches for
each 24-hour period. Leave_ space blank if site experiences no
precipitation.
• Initials are to be placed next to "checked by." on the date the
waste structure(s) and system was inspected. This inspection is
required after any precipitation event that was greater than one
inch, and at least once during the month when all daily precipitation
amounts are one inch or less.
* The IRR -1, CROP -1 and STOCK -1 tables are provided on the back page of
each month. The annual certification form (AFACF 3-14-04) for NPDES
farms only, waste transfer form (TRAN-1) and additional IRR -1 tables are
provided at the end of the calendar. In addition, a Modified IRR-2.that can
be substituted for the IRR -1 and IRR -2 forms is also included.
* For a copy of the 2006 PILOT -2 Calendar or for more information about
the NC Pilot Program of Inspections' of Animal Waste Management Systems,
contact one of the following Division of Soil and Water Conservation -staff:
• Pat Harris at 252.948.3901 (office) or 252.974.4051 (mobile)
John College at 910.395.390 (office) or 910.470.0030 (mobile)

FARM OWNER
OPERATOR
FACILITY NUMBER I I -
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator Weather "Inspections
Number Number (mmlddtyr) Type (acres) Start Time End Time I Total Minutes Operating Initials Code (initials)
' Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
" Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.,
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Average Monthly Stockinci f
f
•
• - f- •
Number
Monthly
® ® ���
iI'lliiAll/70�iiiii=00,V'iiiiai00//VZiN"ONN,00i00M,

JANUARY 2006
FACILITY NUMBER
SUNDAY I
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
6
7
Rainfall =
Rainfall=
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:1
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
8
9
10
11
12
13
14
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
15
16
17
NN
18
19
20
21
Rainfall =
Rainfall =
Rainfall =
Rainfall
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
22
23
24
25
26
27
28
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
29
30
31
Rainfall =
Rainfall
Rainfall
Checked by.
Checked by:
Checked by:
30
31
Structure #1
Structure #1
Structure #2
Structure #2
Structure #3
Structure #3
Rainfall =
Rainfall =
Checked by:
Checked b
PILOT --2 Farm

FARM OWNER
OPERATOR
FACILITY NUMBER - L.
Lagoon Liquid Irrigation Fields
Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irri ation Time # Sprinklers Operator "Weather **Inspections
Number Number (mmldd/yr) Type (acres) Start Time End Time Total Minutes Operating .1nifials Code (initials)
Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R-Rain,.S-Snow/Sleet, W Windy
'• Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note- if conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
f(mnIddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Averageiwont—hlystack-inci and Mortality Record
Date Culls/Sells Number Monthly inventory + (B) - (C) - (D).
%////////////..%IIIA//111///%//1///AAAI/AAAI.. ////////////%/////////%%///////////,WOOP/////////i%/////////////%i ,
Mlt

FEBRUARY 2006
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
.1
2
3
4
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
5
fi
7
8
9
10
11
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
12
13
14
75
76
17
18
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked b :
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by.
19
20
27
22
23
24
25
ti
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checker! by:
Checked by: I
Checked by:
Checked by:
Checked by:
Checked by:
26
27
28
Rainfall =
'Rainfall =
Rainfall =
Checked b :
Checked by:.
Checked by:
PILOT -2 Form

FARM -OWNER
OPERATOR
FACILITY NUMBER 1 1 -
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator *Weather **Inspections
Number Number (mmlddlyr) Type (acres) Start Time End Time Totai Minutes Operating -initials Code (initials)
Weather Codes: C -Clear, PC -Partly Cloudy, Cl-Gioudy, R -Rain, S-SnowlSleet, W -Windy
" Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
!Vote: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Rale Size
(mmlddlyr) !Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmldd!yr) Number Type (bales or bushels) (if applicable)
_q and Mortality
Record
FeginmHg.
0©�pleviols
�. - i-. r .• f Number.
���

MARCH 2006 FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
*REMINDER*
*�*
2T
3
4
Annual Certifications
Farms
for NPDES
March 1
Rainfall =
Rainfall =
Rainfall
Rainfall =
due
Checked by:
Checked by:
Checked by:
Checked by:
5
6
7
8
9
10
11
Rainfall =
Rainfall .=
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
12
13
L14 j
15
16
17
-18
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
19
20
21
22
23
24
25
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =1
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:.
Checked by:
Checked by:
26
27
28
29
30
31
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by: I
Checked by:
Checked by:,
PILOT -2 Form

FARM OWNER
OPERATOR
FACILITYNUMBER -
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator 'Weather "Inspections
Number Number (mm/ddlyr) Type (acres) Start Time End Time Total Minutes Operating .initials Code (initials)
r
r Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy
s completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
onditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr)Number Type (bales or bushels) (if applicable)
Averacte Monthly Stockincl and Mortality
R cord
Weekly Inventory (E) equal%
(mrrVddlyr)
of Weeks
Average
SWI? 1/14%//////////%////////////%i%/////////////%i
for the month.
��VN�ONiii,iiii���ii00M,0/00/�/i/00,.
19 T.. - . .. .

APRIL 2006 FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
i
1
Rainfall =
Checked by:
2,
3
4
5
s
7
8
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
9
10
11
12
13
14
15
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
16
17
18
19
20
21
22
Rainfall =
Rainfall =
Rainfall =
Rainfall
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
23
24
25
26
27
28
29
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall
Rainfall
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
30
Rainfall
41 1
Checked by:
-
PILO Form

FARM OWNER
OPERATOR
FACILITY NUM13ER -
Lagoon Liquid Irrigation Fields
Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator 'Weather '*Inspections
Number Number (mmlddlyr) Type (acres) StartTime End Time Total Minutes Operating -Initials Code (initials)
Weekly Inventory (E) equals
.-�Krtm__TITM-
-
• Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
" Persons coMpleting the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
Date Field/Pull. Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Hale Size
(mmlddlyr) Number Type (bales or. bushels) (if applicable)
Average Monthly Stocking and Mortality
Record_-.
i
Weekly Inventory (E) equals
.-�Krtm__TITM-
-

MAY 2006
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
6
Rainfall
Rainfall =
Rainfall =
Rainfall
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
7
8
9
10
11.
12
13
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
14
15
16
17
18
19
20
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
21
22
23
24
25
26
27
Rainfall =
Rainfall =
Rainfall =
- Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:Checked
bp
Checked by:
Checked by:
Checked by:
28
29
30
31
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked bp e
PILOT --2 Form

FARM OWNER
OPERATOR
FACILITY NUMBER -
Lagoon Liquid Irrigation Fields
Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time * Sprinklers Operator *Weather **Inspections
Number Number (mmlddlyr) Type (acres) Start Time End Time Total Minutes Operating -Initials Code (initials)
Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSeet, W -Windy
Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or ermit, need to provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bates or bushels) (if applicable)
Averane Monthly Stocking andMortalitv-Record
Date Head In Number Monthly
////0%/////////////.�/////////////1////////////.. �/////////i%//////////�i.////////////�i,�/////////////%r.....
for the month.
,//./rM—onth—ly Ave—rage (H) equals
■��iNOM/ �■�■� ���� �iiiiiiii iiiiiiii,//ii, iriiia/ail/i,

JUNE 2005
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2—F
3
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
44
5
fi 1
7 1
8 1 1
9 1
10
Rainfall
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
_
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
11
12
131
14 1
15 1
16 1
17
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by: I
Checked by:
Checked by:
18
19
20
21
22
23
24
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
_
Checked by-..
Checked by -
y25
25
26
27
28
29
30
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Rainfall =
Checked by:
Checked by:
Checked by:
Checked by:
Checked by:
Checked b :
PILOT -2 Form

FARM OWNER
inPFRATOR
FACILITY NUMBER 1
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time - # Sprinklers Operator *Weather **Inspections
Number Number (mmlddlyr) Type (acres) Start Time End Time Total Minutes Operating Initials Code (initials)
" Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: It conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
FD,ate Field/Pull Crop Yield Bale Size
ddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels (if applicable)
Averacie Month ITStocki
nci and Mortality
Record
Date
Monthly
(mrnldd/yr)
Millillne A=X=,
Average
//�/J/OR/j, 00111 /0/1MR,
j�/////�/✓///R, f - rn •
V11114 0100// V11=110011=1.'
I-Okko. VISM
'//����00M/''//��/��/Z///////.=1M/��//��/���,Number
of Weeks (G)
/WMI ,
V/////////%���/1%0�00/0V//00001/0///�%
.. - . • . •

JULY 2006
FACILITY NUMBER -
PILOT --2 Form
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
F5S�UN-D-IAY
-
1
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2
3
4
5
6 1
7
8
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9
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15
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30
31
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Checked b :
PILOT --2 Form

FARM OWNER
OPERATOR
FACILITY NUMBER I I -
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator *Weather **Inspections
Number Number (mm/ddlyr) Type (acres) Start Time End Time Total Minutes Operating Initials Code (initials)
" E
. 4
" Weather Codes: C -Clear, PC -Partly Cloudy, Cl -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
"* Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: if conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
Date Field/Full Crop Yield Hale Size
(mmldd/yr) 1 Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Averacie Monthly Stocking and Mortality
Record-.
Number
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AUGUST 2006 FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
S
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6
7
8
9
10
11
12
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13
14 1
16
17
18 1
19
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20
21
22
23
24
25
26
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27
28j
29 1
30
31
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PILOT -2 Form

FARM OWNER
nPFRATnR
FACILITY NUMBER
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time I# Sprinklers Operator *Weather *"Inspections
Number Number (mmlddlyr) Type (acres) StartTime End Time Total Minutes Operating Initials Code (initials)
"Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy
" Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Averaae Monthlys s and MsrtalitV Record s s
71040111 . . .
Me
Number Monthly
of eeks Average
�� f///////�,�■�
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111IN11111%/////=4 %%///////%%////////////%%//////////////
�%/////////�%//////////%'%

SEPTEMBER 2006 FACILITY NUMBER I I - 1 :1
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
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3
4
5
6
7
8
9
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10
11
12
13
14
15
16
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17
18
19
20
21
22
23
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24
25
26
27
28
29
30
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Checked by:
PILOT -2 Form

FARM OWNER
'OPERATOR
FACILITY NUMBER 1 1 - L��J
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract >=ieldlPull Date Crop Field Size Irrigation Time # Sprinklers Operator ;Weather "Inspections
Number Number (mmlddlyr) Type (acres) StartTime End Time Total Minutes Operating Initials Code (initials)
" Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-SnowlSleet, W -Windy
Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 920 minutes.
Note: If conditions occur beyond the ermittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
FDate Field/Pull Crop Yield Bale Size
ddlyr) Number Type (bale's or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Averacie Monthly• . and Mortality
Record
inventory+ (B) -(Ci- (D) -M
Date Head In Number
Monthly I�
(mrn/dd/yr)
k of Weeks
Average
000/1XV000/1. V, ON, WON/1 NO/% NOXIM/1 WN 0 00 Nz =011 0000%
=� 0/001// 0/000MM/1
M/00/11 NO/ 97",
NO 11 1. 1 NMI '6 1 101 1 IN NO-,
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OCTOBER 2006
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
6
7
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8
.9
10
11
12
13
14
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15
16
17
18
19
20
21
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22
23
24
25
26
27
28
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Checked
29
30
31
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'30
31
Rainfall =
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Checked b
PILOT -2 Form

FARM OWNER
OPERATOR
FACILITY NUMBER 1 1 -
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields
Tract Field/Pull Date Crop Field Size Irrigation Time # Sprinklers Operator *Weather "*Inspections
Number Number (mmlddlyr) Type (acres) Start Time End Time Total Minutes Operating Initials Code (initials)
` Weather Codes: C -Clear, PC -Partly Cloudy, Cl -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions occur beyond the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
StockingAveraae Monthly and MortWeekly Inventory (E) equals
ality Record
Monthly I
Inventory + (B)
(mm/dd/yr). of Weeks Average
/////11/%/1%//////////////1
equals
�''/////////%ice ��� - _ . - • - •

NOVEMBER 2006
FACILITY NUMBER -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
Rainfall =
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Rainfall
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5
6
7
8
9
10
11
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12
13
14
15
16
17
18
7
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19
20 .
21
22
23
24
25
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26
27
28
29
30
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Checked U-.
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Checked b
PILOT --2 Form

FARM OWNER
OPERATOR
FACILITY NUMBER -
Lagoon Liquid Irrigation Fields Record for Irrigation Events on Different Fields.
Tract Field/Pull Date i Crop Field Size Irrigation Time # Sprinklers Operator Weather *'"Inspections.
Number Number (mmlddlyr) Type (acres) StartTime End Time Total Minutes Operating -Initials Code (initials)
* Weather Codes: C -Clear, PC -Partly Cloudy, Cl -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
" Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: if conditions occur be and the permittee's control that cause noncompliance with the CAWMP or permit, need to provide written explanation.
Crop Yield Record
Date Field/Pull Crop Yield Bale Size
(mmtddlyr) Number Type (bales or bushels) (if applicable)
Crop Yield Record
Date FieldlPull Crop Yield Bale Size
(mmlddlyr) Number Type (bales or bushels) (if applicable)
Average Monthly Stocking and Mortality
Record
Date Number
monthly
(mm/dd/yr)
of Weeks
0100110/01 V,5VV1114/ON/1OW��/,"M//� X111/e/lZIP �/OWNSM/10%�0/0/�//.%ON//M�N..�'///000���0/1
.... . .

DECEMBER 2006
FACILITY NUMBER' -
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
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Checked by -
3
a
5
.6
7
8
9
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10
11
12
13
14
15
16
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17
18
19
20
21
22
23
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24
25
26
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28
29
30
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31
ainfall =
RL_ -1
1
Checked by:
PILOT --2 Form

ANIMAL FACILITY ANNUAL CERTIFICATION FORM
Certificate of Coverage or Permit Number
I
Facility Name (as shown on Certificate of Coverage or Permit)
Operator in Charge for this Facility
County
Certification #
Year 200
Land application of animal waste as allowed by the above permit occurred during the past calendar year
YES NO. If NO, skip Part I and Part H and proceed to the certification. Also, if animal waste
was generated but not land applied, please attach an explanation on how the animal waste was handled.
Part I : Facility Information:
1. Total number of application Fields ❑ or Pulls ❑ (please check the appropriate box) in the Certified Animal
Waste Management Plan (CAWMP): Total Useable Acres approved in the CAWMP
2. Total number of Fields ❑ or Pulls ❑ (please check the appropriate box) on which land application
occurred during the year:
Total Acres on which waste was applied
3. Total pounds of Plant Available Nitrogen (PAN) applied during the year for all application sites:
4. Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied annually by the CAWMP and
the permit:
1 5. Estimated amount of total manure, litter and process wastewater sold or given to other persons and taken
off site during the year
tons ❑ or gallons ❑ (please check the appropriate box)
6. Annual average number of animals by type at this facility during the previous year:
7. Largest and smallest number of animals by type at this facility at any one time during the previous year:
Largest
Smallest
(These numbers are for informational purposes only since the only permit limit on the number of animals
at the facility is the annual average numbers)
8. Facility's Integrator if applicable:
Part II: Facility Status:
IF THE ANSWER TO ANY STATEMENT BELOW IS "NO", PLEASE PROVIDE A WRITTEN
DESCRIPTION AS TO WHY THE FACILITY WAS NOT COMPLIANT, THE DATES OF ANY NON
COMPLIANCE, AND EXPLAIN CORRECTIVE ACTION TAKEN OR PROPOSED TO BE TAKEN. TO
BRING THIS FACILITY BACK INTO COMPLIANCE.
1 1. Only animal waste generated at this facility was applied to the permitted sites during ❑ Yes ❑ No
the past calendar year.
AFACF 3-14-03 1

2. The facility was operated in such a way that there was no direct runoff of waste from
❑ Yes ❑ No
the facility (including the houses, lagoons/storage ponds and the application sites) during
the past calendar year.
3. There was no discharge of waste to surface water from this facility during the past
❑ Yes ❑ No
calendar year.
4. There was no freeboard violation in any lagoons*orstorage ponds at this facility during
❑ Yes ❑ No
the past calendar year.
5. There was no PAN application to any fields or crops at this facility greater than the
❑ Yes ❑ No
levels specified in this facility's CAWMP during the past calendar year.
6. All land application equipment was calibrated at least once during the past calendar year. ❑ Yes ❑ No
7. Sludge accumulation in all lagoons did not exceed the volume for which the lagoon ❑ Yes ❑ No
was designed or reduce the lagoon's minimum treatment volume to less than the volume
for which the lagoon was designed.
8. A copy of the Annual Sludge Survey Form for this facility is attached to this Certification. ❑ Yes ❑ No
9. Annual soils analysis were performed on each field receiving animal waste during the ❑ Yes ❑ No
past calendar year.
10. Soil pH was maintained as specified in the permit during the past calendar Year? ❑ Yes ❑ No
11. All required monitoring and reporting was performed in accordance with the facility's ❑ Yes ❑ No
permit during the past calendar year.
12. All operations and maintenance requirements in the permit were complied with during ❑ Yes ❑ No
the past calendar year or, in the case of a deviation, prior authorization was received
from the Division of Water Quality.
13. Crops as specified in the CAWMP were maintained during the past calendar year on all ❑ Yes O'No
sites receiving animal waste and the crops grown were removed in accordance with
the facility's permit.
14. All buffer requirements as specified on the permit and the CAWMP for this facility were ❑ Yes ❑ No
maintained during each application of animal waste during the past calendar year.
"I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of
my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Permittee Name and Title (type or print) .
Signature of Permittee
Signature of Operator in Charge
(if different from Permittee)
AFACF 3-94-03 2
Date
Date

FORM IRR -1 Lagoon Liquid irrigation Fields Record "
For Recording Irrigation Events on Different Fields
t
Farm Owner Facility Number -
Operator
Tract 8
Field #
Date
(mmldd/yr)
Crop
Type
Field Size
(acres)
Irrigation Time
# Sprinklers
Operating
Operator
Initials
'Weather
Code
"Inspections
(initials)
Start Time
End Time
Total Minutes
-------------
* Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy 3/14/2003
** Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: If conditions beyond the permittee's control have caused noncompliance with the CAWMP or permit, explain on reverse.

FORM IRRA Lagoon Liquid irrigation Fields Record
For Recording Irrigation Events on Different Fields
Farm Owner Facility Number -
Operator
Tract &
Field #
Date
(mmlddfyr)
Crop
Type
Field Size
(acres)
Irrigation Time
# Sprinklers
Operating
Operator
.Initials
*Weather
Code
"Inspections
(initials)
Start Time
End Time
Total Minutes
t
" Weather Codes: C -Clear, PC -Partly Cloudy, CI -Cloudy, R -Rain, S-Snow/Sleet, W -Windy 3/14/2003
Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
Note: if conditions beyond the permittee's control have caused noncompliance with the CAWMP or permit, explain on reverse.

FORM TRAN-1
Faun Owner
Owners Address
Owner's Phone #
Animal Waste Transfer Record
Record Each Transfer of Waste Between Lagoons or Third Party
Facility Number -
Irrigation Operator
Irrigation Operators
Address
Operator's Phone #
Date
Time
Nutient
Analysis
Transfer From
(lagoon ID)
Transfer To
(lagoon ID or third party)
*Volume
Transferred
"Third Party Information
Permit #
Name
Phone #
*Volume Transferred must be recorded in gallons, tons, or cubic yards_
"Third Party must be provided with nutrient analysis.
Waste Transfers over 4 cubic yards must be accepted by a permitted facility or a field in the permittee's WUP.
3/14/2003

Modified FORL,_ A-2
Lagoon Liquid Inigatk ,Ids Record
One Form for Each Fiela'per Crop Cycle
Tract # Field # Facility Number -
Feld Size (wetted acres) = (A)
Farm Owner Irrigation Operator
Owner's Address Irrigation Operator's
Address
Owner's Phone # I Operator's Phone #
From Waste Utilization Plan
Crop Type Recommended PAN
Loading (Iblacre) = (8)
(91 (41 (5) (B1 (71 (Al (9) (10) (111
Lagoon
ID
Date
(mmlddlyr)
I m anon
Waste Anatysls
PAN'
(Ib11000 gal)
PAN Applied
(lblacre)
(8) x (9)
1000
Nitrogen
Balance
Iblacre)
(B) - (10)
Weather
Code'
Inspections
(Initials) "
start
Time
End
Time
Total
Minutes
(3)-(2)
# of
Sprinklers
Operating
Flow
Rate
(gailmin)
Total Volume
(gallons){gaVacre)
(6) x (5) x (4)
Volume
per Acre
{7)1(A)
= 0
Crop Cycle Totals O Total PAN O.OG
Ownefs Signature Operator's Signature
Certified Operator (print) Operator Certification #
` Weather Codes: C -Clear, PC -Partly Cloudy, Cl -Cloudy, R -Rain, S-SnowlSleet, W Windy
"' Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P. E., Director
Division of Water Quality
April 27, 2005
Mr. Doug Niemond
TDM Farms
PO Box 300
Newton Grove, NC 28366-0300
Subject: Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & AWG 100000
Dear Mr, Niemond:
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the TDM Farms record keeping
forms submitted April 18, 2005. Based on our review, the following forms have been approved for use in conjunction with
the requirements set forth in General Permit Numbers NCA200000 and AWG100000.
1. TDM Weekly Inventory Log
2. TDM Weekly Freeboard Log
3. TDM Rainfall Log
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWG 100000. Information required by the referenced permits must be included on forms provided by the
Division or approved by the Division. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
Cc: APS, Fayetteville Regional Office wl attachments
APS, Wilmington Regional Office wl attachments
APS, Washington Regional Office wl attachments
APS, Raleigh Regional Office w/ attachments
E'A'P-S WMo6Fesvillee—Regional Office w/'attaching
APS, Winston Salem Regional Office w/ attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation -- Central Office
Sincerely,
M. Paul Sherman, P.E.
AFO Unit Supervisor
NC DEPT. OF ENVIRONIAENT
AND NARECEIRESOURCES
APR 2s2005
MOORESVILLE REGIONAL OFFICE
nkkt J-fzPnl IN1n1NATER SECTION
ow
Nof Carolina
Adwra!!y
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: hup:l/h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal OppartunitylAfrmaBve Action Employer— 50% Recycled/t0% Post Consumer Paper

Facility Name:
WEEK OF
01/02/05
01/09/05
01116/05
01123/05
01130105
02/06/05
02/13/05
02/20105
02127105
03106/05
03/13105
03120/05
03127/05
04103/05
04110/05
04117/05
04124/05
05/01/05
05/08/05
05/15105
05122105
05/29105
06/05105
06/12105
06/19/05
06/26/05
WEEKLY INVENTORY LOG
I INVENTORY I MORTALITY I
SIGNATURE OF OWNER OR OIC:
Facility #:
WEEK OF
07/03/05
07/10/05
07117105
07/24105
07/31/05
08107/05
08/14/05
08121/05
08/28/05
09/04/05
09/11/05
09118/05
09125/05
10/02/05
10109105
10/16/05
10123/05
10130/05
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12/18/05
12/25/05
I INVENTORY I MORTALITY I

Facility Name:
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01/02/05
01/09/05
01/16/05
01/23/05
01/30/05
02/06/05
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02/27/05
03/06105
03/13105
03120105
03/27105
04103105
04110105
04/17105
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05/01/05
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05/29/05
06/05/05
X61121
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WEEKLY FREEBOARD LOG
I FREEBOARD READING I
Facility #:
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07/03/05
07/10/05
07117105
07/24/05
07/31/05
08107/05
08/14/05
08/21/05
08128105
09104105
09/11/05
09/18/05
09/25/05
10102/05
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10/16105
10/23/05
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11/06/05
11/13/05
11120105
11127105
12/04105
12/11105
12/18105
12/25/05
I FREEBOARD READING I
I CERTIFY THAT THE WASTE HANDLING SYSTEM HAS BEEN INSPECTED EACH WEEK
SIGNATURE OF OWNER OR OIC:

Fc. ct ili�f #
Year:
V a \Ae.5 Lt` on
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1 r\5 f O-cAi O \
Jan
i eh
Mar
April
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July jAuq
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Nov
Dec
1
2
3
4
5
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7
8
9
10
11
12
13
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16
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18
19
20
21
22
23
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4
w A rFgQG
A �
March 21, 2005
Mr. Tony Moore
N.G. Purvis Farms, Inc.
2504 Spies Road
Robbins, NC 27325-7213
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.H., Director
Division of Water Quality
Subject: Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & A WG 100000
Dear Mr. Moore:
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the N.G. Purvis, Inc. record
keeping form submitted March 15, 2005. Based on our review, the following form has been approved for use in conjunction
with the requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1. N.G. Purvis Stocking Form
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWG 100000. information required by the referenced permits must be included on forms provided by the
Division or approved by the Divisiori. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
Cc: ✓APS, Fayetteville Regional Office w/ attachments
APS, Wilmington Regional Office wl attachments
APS, Washington Regional Office w/ attachments
APS, Raleigh Regional Office w/ attachments
APS, Winston Salem Regional Office w/ attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation — Central Office
Sincerely, NC D&j 1. Or EliViKOIVIvICN I
AND ,R CERESOURCES 1
MAR 2 3
M. Paul erman, P.B.
2005
AFO Unit Supervisor
MOORESVILLE REGIONAL OFFICE
DWO-GROUNDWATER SECTION
NC DEPT OF
AND Nfitiae
R 212
DW&GRO1JNnW,&-n11NA OFFICE
Nope Caro ina
�tu,11171`Y
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://lt2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycledt10% Post Consumer Paper

j MAR -15-05 TUE 17:04 N G PURVIS FARMS FAX NO. 910 948 3213 P,02
Average Stockijlg anti Mortality, Record
Farm Owper: , N.U. r Puj nTLs.,,,.Lijc.
-y _S_I-q— -L
F�LiLin Na nw,
Invemory
30
RAla-A
.00J 2 1 1 ----
0
FaciNy Number:
G i Its
Added
CLUIIIS
Mortality
Total
Sows
Average
Sows
Average
Mortality

OF W A 7f Michael F. Easley, Govemor
William G. Ross Jr., Secretary
y North Carolina Department of Environment and Natural Resources
=� Alan W. Klimek, Y.E., Director
`C Division of Water Quality
March 21, 2005
Mr. Ronnie G. Kennedy, Jr.
Agriment Services Inc.
PO Box 1096
Beulaville, NC 28518
Subject. Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & AWG 100000
Dear Mr. Kennedy:
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the Agriment Services Inc.
record keeping forms submitted March 17, 2005. Based on our review, the following forms have been approved for use in
conjunction with the requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1. Agriment Services Irr-1
2. Agriment Services Daily Rainfall/Weekly Freeboard
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWG 100000. Information required by the referenced permits must be included on forms provided by the
Division or approved by the Division. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
NC DEPI, OF Eiv vie -.%j w ,641
Sincerely, AND NATURAL RESOURCES
RECEIVED
IVIA -2-3 2005
Cc: APS, Fayetteville Regional Office w/ attachments
APS, Wilmington Regional Office w/ attachments
APS, Washington Regional Office w/ attachments
AFS, Raleigh Regional Office w/ attachments
APS, Winston Salem Regional Office w attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation — Central Office
M. Paul Sherman, P.E.
AFO Unit Supervisor MOORESVILLE REGIONALOFFICE
M -GROUNDWATER SECTION
Noy` Carolina
Natumlly
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.st2te.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

CORM IRR -1
Lagoon Liquid Irrigation Fields Record
For Recording Irrigation Events on Different Fields
Farre Owner -
Operator
LAGOON PULL x DATE CROP TYPE IRRIGATION TIMES Operator 'Weather "Inspections
CODE
mrrVdd! StartTime End Time Total Minutes Initials Code initials
Weather Codes: C -Clear, PC -Partly Cloudy, CL -Cloudy, R -Rain, S-Snow/Sleet, W -Windy
Persons compladrig the krlgatlon Inspections must initial to signify that Inspections were completed at least every 120 minutes.
Note: If conditions beyond the permittee's control have caused noncompliance with the CAWMP or permit, explain on reverse.

0
FARM:
AGRIMENT SERVICES INC.
DAILY RAINF'ALUWEEKLY LAGOON LEVEL RECORD
2005
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Mr. George Pettus
Goldsboro I -log Farms
PO Box 10009
Goldsboro, NC 27532
Dear Mr. Pettus:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department orEsivironrnent and Natural Resources
Alan W. Klimek, P.G., Director
Division or Water Quality
NC DEPT, OF ENVIRONMENT
Min NATI IRAI RF. -SCA
RECEIVED
January 11, 2005
JAN 14 2005
MOORESVILLE REGIONAL OFFICE
DW( -GROUNDWATER SECTION
Subject: Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & AWG 100000
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the Goldsboro glob f=arms record
keeping form submitted January 10, 2005. Based on our review, the following form has been approved for use in conjunction
with the requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1 -Inch Rain Record./Monthly Inspection Record
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWGIQ0000. Information required by the referenced permits must be included on forms provided by the
Division or approved by the Division. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
Sincerely,
M. Paul Sherman, P.E.
Environmental Engineer
Cc: APS, Fayetteville Regional Office w/ attachments
APS, Wilmington Regional Office w/ attachments
APS, Washington Regional Office wl attachments
APS, Raleigh Regional Office wl attachments
APS, Mooresville Regional Office wl attachments
APS, Winston Salem Regional Office w/ attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation — Central Office
N,og�`thCarolina
,/VlItllPli�%1�
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.s1ate.ac.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

ALBERTSON 1 -INCH RAIN RECORD 1 MONTHLY INSPECTION RECORD
2005
JANUARY
SUN
MON
TUE
WED
THUR FRI
SAT
1 FM
FM
1 FM
2 FM
FM
FM
1
FM
2 FM
3 FM
4 FM
5 FM
6 Fill
7 FM
8
FM
9 FM
10 FM
11 FM
12 FN
13 FM
14 FM
15
FM
16 FM
17 FM
18 FM
19 FM
20 FM
21 FM
22
FM
23 FM
24 FIN
25 FM
26 FM
27 FM
28 FM
29
FM
30 FM
31
El
APRIL
SUN
MON
TUE
WED
THUR FRI
SAT
1 FM
FM
1 FM
2 FM
FM
1 FM
2
FM
3 FM
4 FIN
5 IN
6 FM
7 FM
8 FM
9
FM
10 FM
11 FM
12 FM
13 FM
14 FM
15 FM
16
FM
17 FM
18 FM
19 FM
20 fM
21 JFM
22 FM
23
FM
24 FM
25 FM
26 FM
27 FM
28 FFA
29 FM
30
FM
31
31
El
JULY
SUN
MON
TUE
WED
THUR FRI
SAT
1 FM
FM
1 FM
2 FM
FM
1 FM
2
fM
3 FM
4 FRF
5 FM
6 FM
7 FM
8 FM
9
FM
10 FM
11 FM
12 IFM
13 FM
14 FM
15 FM
16
FM
17 JFM
18 FM
19 FM
20 1 FIA
21 FM
22 IFM
23
FM
24 FM
25 FM
26 FM
27 FM
28 FM
29 FM
30
FM
31
31
El
OCTOBER
SUN
MON
TUE
WED
THUR IFRI
SAT
1 FM
FM
1 FM
2 FM
3 FM
FM
1
FM
2 FM
3 FM
4 FM
5FM
6 FM
7 FM
8
FM
9 FIN
10 FM
11 FM
12 FM
13 FM
14 FM
15
FM
16 FIN
17 FM
18 FN
19 FM
20 FM
21 FM
22
FM
23 FM
24 FIN
25 FM
26 FM
27 FM
28 FM
29
FRI
30 FM
31
El
FEBRUARY
SUN
MON
TUE
WED
THUR FRI
SAT
1 FM
FM
1 FM
2 FM
3 FM
4 FM
5
FM
6 FM
7 FM
8 FM
9 FM
10 FN
11 FM
12
FIN
13 FM
14 FM
15 FM
16 FM
17 FM
18 FM
19
FM
20 FN
21 FM
22 FM
23 FM
24 FM
25 FM
26
FM
27 FM
28
31
31
31
30
31
El
MAY
SUN
MON
TUE
WED
THUR FRI
SAT
1 FM
2 FM
3 FM
4 FM
5 FM
6 FM
7
FM
8 FN
9 FM
10 FM
11 IN
12 FM
13 FM
14
FM
15 FM
16 FM
17 FM
18 FM
19 FM
20 FM
21
FM
22 FM
23 FM
24 FM
25 FM
26 FM
27 FM
28
FM
29 FM
30 FM
31
31
31
30
31
El
AUGUST
SUN
MON
TUE
WED
THUR FRI
SAT
FM
1 FM
2 FM
3 FM
4 FM
5 FM
6
FM
7 FM
8 FIN
9 FM
10 FM
11 FM
12 FM
13
IN
14 FM
15 FM
16 FM
17 FM
18 FM
19 FM
20
FM
21 FM
22 1 FM
23 FM
24 FM
25 JFM
26 FM
27
FM
28 FM
29 FM
30 FM
31
31
30
31
El
NOVEMBER
SUN
MON
TUE
WED
THUR FRI
SAT
FM
1 FM
2 FM
3 FM
4 FM
5
FM
6 FM
7 FM
8 FM
9 FM
10 FM
11 FM
12
FM
13 FM
14 FFVI
15 FM
16 FM
17 FM
18 FM
19
FM
20 FM
21 FM
22 FM
23 FM
24 1 FN
25 FM
26
FM
27 FM
28 FM
29 FM
30
31
30
31
El
1 k'RA1 N
SN = S0W MANAGER NNI - NURSERY MANAGER FIN =FINISHING NIA GFA AFM = AI NWIA&ER
MARCH
SUN
MON
TUE
WED
THUR FRI
SAT
FM
1 FM
2 FM
3 FM
4 FRI
5
FM
6 FM
7 FM
8 FM
9 FM
10 FM
11 FM
12
FM
13 FM
14 FM
15 FM
16 FM
17 FM
18 FM
19
FM
20 FM
21 JFM
22 FM
23 RN
24 FM
25 FM
26
FM
27 FM
28 JFM
29 FM
30 FM
31
30
31
El
JUNE
SUN
MON
TUE
WED
THUR FRI
SAT
FM
1 FM
2 FN
3 FM
4
FM
5 FM
6 FM
7 FM
8 FM
9 FM
10 FM
11
FM
12 FM
13 FM
14 FM
15 FM
16 FM
17 FM
18
FM
19 FM
20 FM
21 FM
22 FM
23 FM
24 FM
25
FM
26 fM
27 FM
28 FN
29 FM
30
30
31
El
SEPTEMBER
SUN
MON
TUE
WED
THUR FRI
SAT
FM
1 FM
2 FM
3
FM
4 FM
5 FM
6 FM
7 FN
8 FM
9 FM
10
FN
11 FM
12 FM
13 FM
14 FM
15 IFM
16 FM
17
FM
18 FM
19 FM
24 FM
21 FIN
22 FM
23 FM
24
FM
25 FM
26 FM
27 FM
28 RN
29 RA
30
31
El
DECEMBER
SUN
MON
TUE
WED
THUR FRI
SAT
FM
1 FM
2 FM
3
FIN
4 FM
5 FM
6 FM
7 FM
8 FM
9 FM
10
FM
11 FM
12 FM
13 FM
14 FM
15 FM
16 FM
17
RVI
18 FM
19 FM
20 FM
21 FRE
22 fM
23 FIR
24
FN
25 FM
26 FM
27 FFA
28 FM
29 FM
30 FM
31

N
Michael F, Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
{ Alan W. Klimek, P,E., Director
0 NC DEPT. OF ENV 1R(Divisiori of Water Quality
AND NATUR;.L RESOURCES
R1nL !VED
December 10, 2004 DEC 1 5 2004
Mr. Kraig Westerbeek
Murphy -Brown, LLC MOORGWRILE REGDIONAL OFFICE
PO Drawer 856 !3WO-GROUND0ATER SECTION
Warsaw, NC 28398
Subject: Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & AWG 100000
Dear Mr. ,Westerbeek:
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the Murphy -Brown, LLC record
keeping form submitted November 10, 2004. Based on our review, the following form has been approved for use in
conjunction with the requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1. MUrphy-Brown Crop Yield Report
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWGi00000. Information required by the referenced permits must be included on forms provided by the
Division or approved by the Division. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation,
Sincerely,
M. Paul Sherman, P.E.
Environmental Engineer
Cc: APS, Fayetteville Regional Office w/ attachments
APS, Wilmington Regional Office w/ attachments
APS, Washington Regional Office w/ attachments
APS, Raleigh Regional Office w/ attachments
APS, Mooresville Regional Office w/ attachments
APS. Winston Salem Regional Office w/ attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation — Central Office
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.ne.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycied110% Post Consumer Paper
N�rhCarolina

Murphy -Brown LLC PO Drawer 856
2822 Hwy. 24 West
Warsaw, NC 28398
Tel: [phone]
Fax: [phone]
May 10, 2004
NC DENR
Division of Water Quality
Attn. Paul Sherman
1617 Mail Service Center
Raleigh, NC 26799-1617
Mr. Sherman,
In an effort to provide the Division and its inspectors with all applicable environmental
information specific to both the North Carolina General and NPDES permits, while streamlining the record
keeping process for Murphy -Brown LLC, I ask that you consider the following request.
Currently, our permits require that crops not become `unusable'. Given this requirement, the
division has requested that crop yield/removal information be maintained. It has come to my attentionthat
many inspectors have been requested crop yield information as a routine part of the inspection process.
While I agree that it is important to document these activities to insure compliance with the farms
CAWMP, keeping up to date yield information on the farm at all times is burdensome on our system given
our management structure. Individual OIC's in our system are not responsible for crop removal. This task
is assigned to Murphy -Brown LLC's centralized Farming, Cattle, and Hay Departments. This organization
structure serves us well as more focus is brought to bear on these areas, while our OIC's can concentrate on
other essential elements of compliance. This approach, however, does not lend itself to immediate transfer
of information. Crop removal and yield data is collected and analyzed within the specific department
assigned the task (ie. Corn yields to farming department), and is later made available to the farm OIC's.
I have attached for your review our internal EMS policy specific to crop removal, and an example
of a yearly yield report. You can see that the EMS policy requires crop yield information to be transferred
to the divisional level, and, therefore, the farm environmental files, on a yearly basis. In addition, you can
see that the divisional report contains all required documentation with respect to yield. My request is that
the Division accept this method of yield recording for our company owned and managed farms. If, at any
time, there is a question with regards to this yield information, it can be made available to an inspector for
the current year with only a request. Absent of this, the yield information contained in the farm file will be
for the previous year.
As you can see, Murphy -Brown LLC is not trying to circumvent the intent of the permit in making
this request. Rather, we are trying to streamline the record keeping process to insure that all parties have
access to the most accurate information possible. Please let me know at your earliest convenience if the
process outlined is acceptable.
If there are any further questions of concerns regarding this request, please call me at (910) 293
5330, or e-mail at [e-mail].

Murphy Brown ,u
EMS Policies/Procedures
(DRAFT)
Original Date: xx/xx/xx
Revision Date:
Doc.# MB xxx
Page 1 of I
1.0 PURPOSE AND SCOPE
Purpose: To provide farm specific yield data to document the proper removal of crops from
spray fields.
Scope: Murphy -Brown LLC Eastern Operations located in North Carolina
2.0 REQUIREMENTS
All crop yield information will be compiled by Murphy -Brown LLC Environmental
Compliance Department in a set of databases intended for such purpose. By January 1 of each
year, yield information for the previous year will be forwarded to each Division's LNM
Department to be included as part of each farm's environmental file. At a minimum, yield
information will detail the following:
'Row crops: Farm name, acres, crop yield in bushels
*Forage crops: Farm name, date of removal, number of bales
(note: documentation of grazing removal not required)
For farms whose crops are not managed by the Murphy -Brown LLC Farming and/or Hay
Departments, harvest and yield information must be communicated to the Environmental
Compliance Department to be included in the master yield spreadsheet.
3.0 REFERENCES
North Carolina NPDES Permit, Part II, item 25
North Carolina Certified Animal Waste Management Plan
4.0 FORMS
Row Crop Yield Record
Forage Crop Yield Record
5.0 DEFINITIONS
Row crops — Corn, Wheat, Soybeans, or other small grain harvested for grain.
Forage crops — Bermuda, Fescue, Small grain, millet, matua or other plant harvested as
vegetation in the form of hay and/or silage.
6.0 REVISION HISTORY

Murphy -Brown LLC
Forage Crop Yield Report
KENANSVILLE FARMS
# of Wrapped
# of Dry
Farm #-Michael Ammons
Cutter
Date
Hay Bails
Hay Bails
# of Bails -Used
Total #
Franklin Lindsey
2187
Home: [phone]
0
0
0
0
3096
Cell: [phone]
0
0
0
0
David Tew Home:
716104-8/6/04-
3727
[phone]
9129104
0
449
0
449
8/6/2004-
2149(Edge)
Cell: [phone]
9129104
288
121
0
409
9 2 12004-
Foxfire
10/27/04
177
384
0
561
Jimmy Starling
711104-7120104
2096
Work(910)525-5586
9127104
0
482
0
482
# of Wrapped
# of Dry
Farm #-Kaye Barbee
Cutter
Date
Hay Bails
Hay Bails
# of Bails -Used
Total #
Michael Jackson
Cell: 910 271-0325
2120104-
3106 & 3505
"
7119104
521
157
0
678
7/19/04-
9 04-
3507
3507 & 3508
'!
1011104
546
0
0
546
Tabasco
0
0
0
0
Lenoir
n
0
0
0
0
onerwood jaCKSon
4129104-
3509
910-271-0325
7119104
80
0
0
80
Retention: 5 years Page 1 of 5 Original: 211104

Murphy -Brown LLC
Forage Crop Yield Report
KENANSVILLE FARMS
Farm #-Johnny Cain
Cutter
Date
of Wrappedo
Hay Bails
ry
Hay Bails
# of Bails -Used
Total #
3092
Charles and Chris Shell
10/20/04
0
181
0
181
3515
Home: [phone]
09/13/2004
0
341
0
341
3316
If
10/20/2004
0
106
0
106
76901(21&26)
rr
10/20/2004
0
247
0
247
74421 (24)
rr
1o12o/a4
0
254
0
254
Tarheel Truck Wash
rr
10/20/04
0
239
0
239
Squire
Jay Russell, Sr.
0
0
0
0
0
Evergreen
Home: [phone]
0
0
0
0
White Oak TW
n
1 0
0
0
0
0
Retention: 5 years Page 2 of 5 Original: 2/1104
# of Wrapped
# of Dry
Farm #-Paull Eisner
Cutter
Date
Hay Bails
Hay Bails
# of Bails -Used
Total #
2142
M.F. McCullen
08/11/2004
0
311
0
311
518104-6121104
2526
Home: [phone]
914104
58
188
0
246
C&M II
n
9/11104
0
205
0
205
2148
rr
0
0
0
0
2546
rr
09/24/2004 i
0
249
0
249
,
7117104-
2539
9112104
1 0
212
1 0
212
Retention: 5 years Page 2 of 5 Original: 2/1104

Murphy -Brown LLC
Forage Crop Yield Report
KENANSVILLE FARMS
David Tew
# of Wrapped
# of Dry
2702
Cell: (910)99 -5510
1 09/29/2004 0
172
0
172
KENANSVILLE FARMS
# of Wrapped
# of Dry
Farm #-Bradley Herring
Cutter
Date
Hay Bails
Hay Bails
# of Bails -Used
Total #
2104
Jamie Pierc
10/02/2004
0
30
0
30
2106
Home: [phone]
10/02/2004
0
86
0
86
10/2104-
2149
Cell: [phone]
1012104
0
164
0
164
2118
"
517104-1012104
25
33
0
58
2704
"
09/29/2004
241
0
0
241
2706
-
1012104
141
131
0
272
2102
If
10/02/2004
0
110
0
110
2105
0
0
0
0
2701
If
10/02/2004
0
108
0
108
Ronnie Williams Cell:
3090
[phone]
0
0
0
0
b/18104-
7/20/04-
3112
Hugh Mac Hunter
10/15/04
0
352
0
352
Brown
Home: [phone]
0
76
0
76
5/1812004 -
Rainbow TW
Pager: [phone]
10115/04
0
157
0
157
Freddie Rouse
4123104-717104
Sanitation
Pa er: 252 52fi-2159
1014/04
69
178
0
247
Retention: 5 years Page 3 of 5 Original: 2/1104

Murphy -Brown LLC
Forage Crop Yield Report
KENANSVILLE FARMS
Farm #-Sammie Hill
Cutter
Date
# of Wrapped
Hay Bails
# of Dry
Hay Bails
# of Bails -Used
Total #
2147
Donnell Kornegay
0
0
0
0
Cottle
Home: [phone]
0
0
0
0
Batchelor
0
0
0
0
Volunteer
Freddie Rouse
06/10/2004
0
39
0
39
Nahunga
Home: [phone]
7121104101510
4
63
122
0
185
Benson
of7/22104-9/2
6/10/04 -
209
91
0
300
2529
Pager: [phone]
6111/2004-
7125104
0
307
0
307
Farm #-Blake Moore
Cutter
Date
of Wrappedof
Hay Bails
Dry
Hay Bails
# of Bails -Used
Total #
C&M I
Freddie Rouse
09/29/2004
0
77
0
77
2141
Home: [phone]
07/16/2004
0
74
0
74
Page : 252 526-2159
0
0
0
0
2537 & 2538
if
7/14/04-
9/25/04
0
831
0
831
2123
Jamie Piercy
10/02/2004
0
32
0
32
2528
Home: [phone]
Cell: [phone]
1
1 0
0
1 0
1 0
Retention: 5 years Page 4 of 5 Original: 2/1/04

Murphy -Brown LLC
Forage Crop Yield Report
KENANSVILLE FARMS
# of Wrapped
# of Dry
Farm #-Wayne Sanderson
Cutter
Date
Hay Bails
Hay Bails
# of Bails -Used
Total #
David Tew Home:
9129104-
2508
[phone]
10/27/04
0
653
0
653
2703
Cell: [phone]
0
0
0
0
3102/3501
10/27/04
120
439
0
559
,1
0
0
0
0
3514
0
0
0
0
Smith/Alderman
"
10/27/04
0
191
0
191
Quiwhiffle
1'
10/27/04
40
320
0
360
Ezzell
11
10/27/04
53
188
0
241
GRAND TOTAL 11718
Retention: 5 years Page 5 of 5 Original: 211104

Murphy -Brown LLC
Forage Crop Yield Report
ROSE HILL FARMS
# of Wrapped
# of Dry
Farm #-Walt Burney
Cutter
Date
Hay Bails
Hay Bails
# of Bails -Used
Total #
Lisbon
Richard Alien
05/24/2004
112
0
0
112
Oafs Springs
n
0
0
0
0
Frenches Creek
10/20/04
0
681
0
681
Pine View
0
0
0
0
3417
04/27/2004
135
0
0
135
3730
"
05/26/2004
115
0
0
115
3091
05/17/2004
271
0
0
271
Pinnacle
0
0
0
0
David Tew
Cain
Cell: [phone]
09/29/2004
0
389
0
389
# of Wrapped
# of Dry
Farm #-Richard Murphy
Cutter
Date
Hay Bails
Hay Bails
# of Bails -Used
Total #
Michael Jackson
Hwy 43
Cell: 910 271-0325
08/06/2004
45
0
0
45
Maul Swamp
08/06/2004
67
0
0
67
5/27104 -
Oakwood
"
8161041019104
774
0
0
774
Summitt
06/09/2004
0
70
0
70
Palmetto
08/06/2004
67
0
0
67
Retention: 5 years Page 1 of 4 Original: 211104

Murphy --Brown LLC
Forage Crop Yield Report
ROSE HILL F
Farm #-Michael Norris
Cutter
Date
# of Wrapped
Hay Bails
# of Dry
Hay Bails
# of Bails -Used
Total #
Sands
Dwight Johnson
Home: [phone]
0
0
0
0
Bland
Hugh Mac Hunter
0
0
0
0
Corbett
Horne: [phone]
Pager: [phone]
9/1412004 -
1015104
0
177
0
177
Bostic
Greg Brown
0
0
0
0
Vestel
Cell: [phone]
0
0
0
0
Peg Leg
David Tew
b/b/2UU4-
10/27/04
0
293
0
293
Wa cross
Cell: [phone]
10127/04
34
121
0
155
TaylorsBrode
0
0
0
0
Kilpatrick
Ronnie Williams
Cell: [phone]
1
1 0
1 0
1 0
0
ROSE HILL FARM
Retention: 5 years Page 2 of 4 Original: 211104

Murphy -Brown LLC
Forage Crop Yield Report
ROSE HILL FARMS I
Retention: 5 years Page 3 of 4 Original: 211104
# of Wrapped
# of Dry
Farm #-Richard Smith
Cutter
Date
Hay Baits
Hay Bails
# of Bails -Used
Total #
David Tew Home:
716104-816104
2602
[phone]
10/27/04
665
194
0
859
Harrells
Cell: [phone]
0
0
0
0
Riverfront
0
0
0
0
CCITomahowk
0
0
0
0
Southern Pines
0
0
0
0
Simmons
0
0
0
0
Garland/Petty
n
0
0
0
0
Ingold
0
0
0
0
Sampson BS
0
0
0
0
2084
0
0
0
0
Sholar
Earl Simmons
0
0
0
0
Charles and Chris Shelly
Kerr
Home: [phone]
1
1 a
1 a
1 0
1 0
ROSE HILL FARMS I
Retention: 5 years Page 3 of 4 Original: 211104

Murphy -Brown LLC
Forage Crop Yield Report
GRAND TOTAL 5442
Retention: 5 years Page 4 of 4 Original: 211104
# of Wrapped
# of Dry
Farm #-Robert Young
Cutter
Date
Hay Bails
Hay Bails
# of Bails -Used
Total #
David Tew Home:
Peter's Creek
[phone]
08/06/2004
0
110
0
110
9/29104-
H 242
Cell: 910 990-5510
10/27/04
240
312
0
552
716104-8/6/04
2601-2;
++
10/27/04
52
399
0
451
Blueberry
0
0
0
0
Ammon
0
0
0
0
Cypress Creek
f+
0
0
0
0
Maguire
Paul Maguire
07/06/2004
33
0
0
33
Mr. Holmes
1 08/06/2004
0
86
0
86
GRAND TOTAL 5442
Retention: 5 years Page 4 of 4 Original: 211104

Michael F. Easley, Governor
William G. Ross Jr., Secretary
[North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
July 28, 2005
Mr. Mike Snyder
CAFO Software Solutions
17033 3`d Ave. SE
Bothell, WA 98012
Subject: Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & AWG 100000
Dear Mr. Snyder:
The Animal Feeding Operations Permitting and Compliance Unit has conducted a review of the CAFO Software Solutions
record keeping forms submitted July 12, 2005 and July 21, 2005. Based on our review, the following forms have been
approved for use in conjunction with the requirements set forth in General Permit Numbers NCA200000 and AWG 100000.
1. CAFO SS "Form CAFOSS-IRR-2"
2. CAFO SS "Daily Rainfall Calendar"
3. CAFO SS "Weekly Lagoon Freeboard Levels"
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit Numbers
NCA200000 and AWG 100000. Information required by the referenced permits must be included on farms provided by the
Division or approved by the Division. Please pay particular attention that all forms must include the facility name and
number. Any modifications to the approved forms must be submitted to the Division for review. Any oversights that
occurred in the review of the subject forms are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone]. Thank you for your
cooperation.
Cc: AFS, Fayetteville Regional Office w/ attachments
APS, Wilmington Regional Office w/ attachments
APS, Washington Regional Office wl attachments
APS, Raleigh Regional Office w/ attachments
APS, Mooresville Regional Office wl attachments
APS, Winston Salem Regional Office wl attachments
APS, Asheville Regional Office w/ attachments
Division of Soil & Water Conservation — Central Office
Sincerely,
Paul Sherman, P.E.Y ..
AFO Unit Supervisor
NorthCarolina
Al abo-a!!y
Aquifer Protcction Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Intemet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycledl10% Post Consumer Paper

loo l

Form CAFOSS-IRR-2 Lagoon Liquid Irrigation. Field Record Page 1 of 1
(One Form for Each Field Per Crop Cycle)
Tract #: 72030 Field #: F1 Hydrant #: P2 Facility Number: 31-26
Reid Size (ac.): 5.32
Facility Agri -Grow
Information Dennis Graham - Owner
359 Blackmore Rd.
Street2
Warsaw, NC 29398
Operator Dennis Graham
Information 359 Blackmore Rd.
Street2
Warsaw, NC 29398
From Animal Waste Management Plan
Crop Number: 1
Crop Type: Hybrid BermudaGrass - Hay
Recommended PAN Loading = 325.00
Owner Signature:
Certified Operator Name: Dennis Graham
Crop Cycle Totals: 599,040
154.47 170.53
Operator Signature:
Operator Certification Number: 1231
NOTES:
See your animal waste management plan for sampling frequency. At a minimum, waste analysis is required within 60 days of land application events.
Persons completing the irrigation inspections initials signify that inspections were completed at least every 120 min.
Volume
Lagoon Name
Event Date
Start
Time
End
Time
Total
Minutes
Sprinkler
Count
Flow
Rate
Total
Per
Acre
Waste
Analysis*
Pan
Applied
Nitrogen
Balance
Weather
Code
Operator
Initial
1
03/13/2005
05:00
14:00
540
1
156
84,240
15,834
1.10
17.42
307.58
C
DG
1
03/15/2005
05:00
1100
480
1
156
74,880
14,075
1.10
15.48
292.10
C
DG
2
04/05/2005
06:00
15:00
540
1
156
84,240
15,834
1.40
22.17
269.93
C
DG
1
04/06/2005
04:00
13:00
540
1
156
84,240
15,834
1.10
17.42
252.52
C
DG
1
05/04/2005
05:00
13:00
480
1
156
74,880
14,075
1.90
26.74
225.77
C
DG
1
05/05/2005
05:00
09:00
240
1
156
37,440
7,037
1.90
13.37
212.40
C
DG
2
06/18/2005
05:00
14:00
540
1
156
84,240
15,834
1.40
22.17
190.23
C
DG
2
06/22/2005
04:00
12:00
480
1
156
74,880
14,075
1.40
19.71
170.53
C
DG
Owner Signature:
Certified Operator Name: Dennis Graham
Crop Cycle Totals: 599,040
154.47 170.53
Operator Signature:
Operator Certification Number: 1231
NOTES:
See your animal waste management plan for sampling frequency. At a minimum, waste analysis is required within 60 days of land application events.
Persons completing the irrigation inspections initials signify that inspections were completed at least every 120 min.

Daily Rainfall Calendar
Agri -Grow
Owner: Dennis Graham Operator: Dennis Graham
359 Blackmore Rd. 359 Blackmore Rd.
Street2 Street2
Warsaw, NC 29398 Warsaw, NC 29398
Permit #: 31-26 Certification #: 1231
2004
January
Sun Mon Tue Wed Thu Fri Sat
February
Sun
Mon Tue Wed Thu Fri Sat
1
2
3
4
1
2
3
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
4
5 7
6
7
8
9
10
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
11
12
13
14
15
16
17
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
18
19
20
21
22
23
24
0 in.
0 in.
1.00 in.
0 in.
0 in.
0 in.
0 in.
25
26
27
28
29
30
31
0 in.
0.50 in.
0 in.
0 in.
0 in.
0 in.
0 in.
February
Sun
Mon Tue Wed Thu Fri Sat
1
2
3
4
5
6
7
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
8
9
10
11
12
13
14
0 in.
1 0 in.
0 in.
0 in.
0 in.
0 in.
0.30 in.
15
16
17
18
19
20
21
0 in.
0 in.
0 in.
0.60 in.
0 in.
0 in.
0 in.
22
23
24
25
26
27
28
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
29
29
30
31
29
30
29
0 in.
0 in.
0 in.
p.60 in.
0 in.
0 in.
0 in.
March
Sun Mon
Tue Wed Thu Fri Sat
April
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4
5
6
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
7
8
9
10
11
12
13
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
14
15
16
17
18
19
20
0 in.
0.20 in.
0 in.
0 in.
0 in.
0 in.
0 in.
21
22
23
24
25
26
27
0 in.
0 in.
0 in.
0 in..
0 in.
0 in.
0 in.
28
29
30
31
29
30
29
0 in.
0 in.
0 in.
p.60 in.
0 in.
0 in.
0 in.
April
Sun Mon Tue Wed Thu Fri Sat
May
Sun Mon
Tue Wed Thu Fri Sat
1
2
1
23
1
0 in.
0 in.
0 in.
0 in.
0 in.
4
5
6
7
8
9
10
0 in.
0 in.
0 in.
0 in.
1 0 in.
0 in.
0 in.
11
12
13
14
15
16
17
1.00 in.
2.50 in.
0.30 in.
1.50 in.
0 in.
0 in.
0 in.
18
19
20
21
22
23
24
0 in.
0 in.
0 in.
0 in.
1 0 in.
0 in.
0 in.
25
26
27
28
29
30
29
0 in.
11.20 in.1
0 in.
0 in.
0 in.
0 in.
0 in.
May
Sun Mon
Tue Wed Thu Fri Sat
,lune
Sun Mon Tue Wed Thu
Fri Sat
1
2
34
1
0 in.
0 in.
0 in.
0 in.
0.80 in.
2
3
4
5
6
7
8
0 in.
1.00 in.
0.80 in.
0 in.
0 in.
0 in.
0 in.
9
10
11
12
1314
18
15
0 in.
0 in.
0 in.
11,10 in.
0 in.
0 in.
0 in.
16
17
18
19
20
21
22
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
23
24
25
26
27
28
29
1.50 in.
0 in.
0 in.
0 in.
1 0 in.
0 in.
0 in.
30
31
0 in.
1.60 in.
,lune
Sun Mon Tue Wed Thu
Fri Sat
1
2
34
5
0 in.
0 in.
0 in.
0 in.
0 in.
6
7
8
9
10
11
12
0 in.
0 in.
0 in.
0.20 in.
0 in.
1.20 in.
0 in.
13
14
15
16
17
18
19
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
20
21
22
23
24
25
26
0 in.
0 in.
0 in.
1.20 in.
0 in.
0 in.
0 in.
27
28
29
30
0 in.
10.80 in.
1.10 in.
0.70 in.

July
Sun Mon Tue Wed Thu Fri Sat
August
Sun Man
Tue Wed Thu Fri Sat
1
2
3
4
1
2
3
0.30 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
4
5
6
7
8
9
10
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
11
12
13
14
1516
20
17
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
18
19
20
21
22
23
24
0 in.
0 in.
0 in.
0 in.
0 in.
0.20 in.
0 in.
25
26
27
28
29
30
31
0 in.
1 0 in.
0 in.
0 in.
1 0 in.
10.20 in.
0.80 in.
August
Sun Man
Tue Wed Thu Fri Sat
1
2
3
4
5
6
7
0.30 in.
0 in.
0 in.
0 in.
0 in.
0.70 in.
0 in.
8
9
10
11
12
13
14
0 in.
1 0 in.
0 in.
1 0 in.
0 in.
11.40 in.
2.50 in.
15
16
17
18
19
20
21
1.00 in.
0 in.
0 in.
0 in.
0 in.
0 in.
2.00 in.
22
23
24
25
26
27
28
0 in.
0 in.
0 in.
0 in.
0 in.
1.20 in.
0 in.
29
30
31
29
30
29
30
2.00 in.
0 in.
1.10 in.
0 in.
0 in.
0 in.
0 in.
September
Sun Mon
Tue Wed Thu Fri Sat
October
Sun Mon . Tue Wed Thu Fri Sat
1
2
1
2
3
4
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
5
6
7
8
9
10
11
0 in.
0.80 in,
0 in.
0.30 in.
0 in.
0 in.
0 in.
12
13
14
15
16
17
18
0 in.
0 in.
0 in.
0.50 in.
0 in.
0.80 in.
0 in.
19
20
21
22
'23
24
25
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
26
27
28
29
30
29
30
0 in.
0.30 in.
0 in.
0 in.
0 in.
0 in.
0 in.
October
Sun Mon . Tue Wed Thu Fri Sat
November
Sun Mon Tue Wed Thu
Fri Sat
1
2
34
2
1
2
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
3
.4
5
6
7
8
9
0 in.
0 in.
0 in.
11.00 in.
0 in.
0 in.
0 in.
10
11
12
13
14
15
16
0 in.
0 in.
0 in,
0 in.
0 in,
0 in.
0 in.
17
18
19
20
21
22
23
0 in.
0 in.
0.50 in.
0 in.
0 in.
0 in.
0 in.
24
25
26
27
28
29
30
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
31
0 in.
November
Sun Mon Tue Wed Thu
Fri Sat
December
Sun Mon
Tue Wed Thu Fri Sat
1
2
34
2
5
6
0 in.
0 in.
0 in.
0 in.
0.50 in.
0 in.
7
8
9
10
11
12
13
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
1.00 in.
14
15
16
17
18
19
20
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
0 in.
21
22
23
24
25
26
27
0 in.
0 in.
1.40 in.
0.50 in.
0 in.
0 in.
1.50 in.
28
29
30
29
30
31
0 in.
0 in.
0 in.
0 in.
0 in,
0 in.
December
Sun Mon
Tue Wed Thu Fri Sat
1
2
3
4
1.00 in.
0 in.
0 in.
0 in.
5
6
7
8
9
10
11
1.20 in.1
0 in.
0.50 in.
0 in.
0 in.
0 in.
1.10 in.
12
13
14
15
16
17
18
0.60 in.
0 in.
0 in.
0 in.
0 in.
0.30 in.
0 in.
19
20
21
22
23
24
25
0 in.
0 in.
0 in.
0 in.
0 in.
0.40 in.
0 in,
26
27
28
29
30
31
0 in.
0 in.
0 in.
0 in.
0 in,
0 in.

Weekl a oo_ n�Freeboard l --eve ifir_
Agri -Grow Permit# 31-26
primary Operator: Certification# 1231
Dennis Graham - Owner
Dennis Graham
359 Blackmore Rd.
359 Blackmore Rd.
Street2
Street2
Warsaw, NC 29398
Warsaw, NC 29398
Week Ending
1./2/2004
1/9/2004
1/16/2004
1/23/2004
1/30/2004
2/6/2004
2/13/2004
2/20/2004
2/27/2004
3/5/2004
3/12/2004
3/19/2004
3/26/2004
4/2/2004
4/9/2004
4/16/2004
4/23/2004
4/30/2004
5/7/2004
5/14/2004
5/21/2004
5/28/2004
6/4/2004
6/11/2004
6/18/2004
6/25/2004
7/2/2004
7/9/2004
7/16/2004
7/23/2004
7/30/2004
6/6/2004
8/13/2004
8/20/2004
8/27/2004
9/3/2004
9/10/2004
9/17/2004
9/24/2004
10/1/2004
10/8/2004
10/15/2004
10/22/2004
10/29/2004
11/5/2004
11/12/2004
11/19/2004
11/26/2004
12/3/2004
12/10/2004
12/17/2004
12/24/2004
12/31/2004
1 2
30.00
33.00
30.00
33.00
29.00
34.00
25.00
35.00
24.00
34.00
24.00
34.00
23.00
26.00
22.00
26.00
21.00
25.00
22.00
28.00
24.00
28.00
25.00
28.00
26.00
28.00
26.00
28.00
27.00
28.00
28.00
28.00
25.00
31.00
25.00
31.00
24.00
30.00
28.00
30.00
32.00
30.00
34.00
28.00
33.00
23.00
35.00
23.00
38.00
23.00
37.00
22.00
39.00
21.00
43.00
22.00
42.00
24.00
42.00
27.00
43.00
29.00
43.00
37.00
42.00
36.00
40.00
39.00
35.00
34.00
33.00
34.00
29.00
32.00
28.00
31.00
27.00
30.00
26.00
30.00
28.00
35.00
30.00
36.00
29.00
35.00
30.00
34.00
32.00
34.00
32.00
34.00
34.00
34.00
34.00
33.00
32.00
31.00
31.00
30.00
30.00
29.00
29.00
28.00
28.00
27.00

W A r�RQG
0 �
February 28, 2006
Carolina & Howard Farms
PO Box 10
Deep Run, NC 28525
Michael F. Gas ley, Goventor
William G. Ross Jr., Secretary
North Carolina Department of Fnvironmcn and Natural Resources
t
MAR - 2 2006
Subject: Animal Permit Record Keeping Forms
General Permit Nos. NCA200000 & AWG100000
Dear Carolina & Howard Farms:
, P.E. Director
Water Quality
The Animal Feeding Operations Unit has conducted a review of the Carolina & Howard Farms record
keeping form submitted February 17, 2006. Based on our review, the following form has been approved
for use in conjunction with the requirements set forth in General Permit Numbers NCA200000 and
AWG 100000.
1. Carolina & Howard Farms Stocking Form
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit
Numbers NCA200000 and AWG100000. Information required by the referenced permits must be
included on forms provided by the Division or approved by the Division. Please pay particular attention
that all forms must include the facility name and number. Any modifications to the approved forms must
be submitted to the Division for review. Any oversights that occurred in the review of the subject forms
are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact me at [phone].
Thank you for your cooperation.
Sincerely,
4,.. oPaulerman, P. E.
Animal Feeding Operations Unit Supervisor
Cc: APS -Fayetteville Regional Office w/ attachments
APS -Wilmington Regional Office w/ attachments
APS -Washington Regional Office w/ attachments
APS -Raleigh Regional Office w/ attachments
APS -Mooresville Regional Office w/ attachments
APS -Winston Salem Regional Office w/ attachments
APS -Asheville Regional Office w/ attachments
Vernon Cox -Division of Soil & Water Conservation w/ attachments
No ihCarolina
Natrrra!!j
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: [phone]
Internet: www.ncwaterqualily.org Location: 2728 Capital Boulevard Raleigh„NC 27604 Fax 1: [phone]
Fax 2: [phone]
An Equal OpportunitylAffirmative Action Employer— 50% Recycled/10% Post Consumer Paper Custamcr 5crvice: [phone]

(Farns Name) (Facility No.)
(Beginning Inventory) (Year)
A u r n
CURRENT
WEEK HEAD IN (+) MORTALITY(-) CULLSISELLS (-) INVENTORY COMMENTS
1
2
3
4
5
8
7
8
9
L-10
I 11
12
_ 13
14
_ 15
16 p
17 _ T
18
19
_20 T --
21
22
23 -
- 24 - --
26
Total inventory (E) Average Inventory (F)
GOrmol Inventory (D) equals your previous current = (A) - (B) - C
Tota! Inventory (E) equals the total of all correnl inventory enlrieS
Average ending inventory (F) equals "Total Invanlory" (E) divided by # entries
TrarWer Total Inventory (E) to Annuai Averape Stocking recurd for each month

Facilities that have not submitted sludge survev form for 2005 (deadline 03/01/06
Permit Owner Name - Facility Name Owner Type Permit Type County
"4NCA284415 Melvin K Huneycutt - Melvin K. Huneycutt Farm individual Swine NPDES COC Stanly
-•NC Farms Individual Wet Poultry NPDES Stanly
.-1 24U91 pson s ggs - i son's Egg, inc. Non -Government Wet Poultry NPDES Union

Issued Date
Effect Date Region
04/09/03
04/09/03 Mooresville
04/09/03
04/09/03 Mooresville
07/23/03
07/23/03 Mooresville

#� '
Facilities that have not.submitted annual certification for 2005/2006 (deadline 03.101.106)
Number Owner Name - Facility Name Owner Type Permit Type County Issued Date
NCA284015 Melvin K Huneycutt -Melvin K. Huneycutt Farm Individual Swine NPDES COC Stanly 04/09/03f-
Arlin Buttke - Arlin Buttke Dairy
-` NC 484001 L Fau - s
NCA49000 Simpson's Eggs - 5im son's E Inc.
•NCA490004 Sam Lee - Lee -Howell Farm
p
Individual
Individual
Non -Government
Individual
Cattle NPDES COC Iredell 04/14/03
Wet Poultry NPDES COC Stanly 04/09/03 — 1,p0��e
Wet Poultry NPDES COC Union 07/23/03_.{• o an11,14y � �` tj L1/7
Wet Poultry NPDES COC Union 04/09/03 L �o kr"pn
ria a��P.
-7
(- KMACXJZ Y

MEMORANDUM
DIVISION OF WATER QUALI
July 24, 2008
p [EC [E0W
JUL 2 5 2008
NC DENR MRO
DWQ - Aquifer Protection
To: Keith Larick, Supervisor
Animal Feeding Operations Permitting and Compliance Unit
From: Ted L. Bush, Jr.
Chief, Aquifer Protection Sectio
Subject: Delegation of Authority
In keeping with the Division's organization and in order to simplify and speed up the
processing of permits, certifications, and other approval documents, I am hereby delegating
the following authorities to you. This Delegation of Authority supersedes all previous
delegations relating to these animal feeding operations responsibilities. In order to ensure
continuity of program implementation, some delegations are made to more than one position
or individual. However, all staff members are to follow established agency processes in
carrying out daily job duties. The following authorities are delegated effective today:
1. To sign all permits, Certificates of Coverage (COC), Certificates of Approval (COA), and
other associated documents for animal waste management systems and pump and haul
activities.
2. To provide acknowledgement and/or approval for all activities associated with permit
applications, amendments, rescissions, modifications of permits, and other miscellaneous
permit processing documents, to include public notices.
3. To sign Public notices for Special Orders by Consent (SOC's);
4. To sign Notices of Violation and Notices of Intent to Enforce;
To sign documents relating to the scheduling of persons to appear before the
Enviromnental Management Commission's Committee on Civil Penalty Remissions;
6. To issue Tax Certifications;
7. To approve or disapprove Alternative Design Criteria as authorized in 15A NCAC 2H
.0200, with my concurrence.
I of 2

Please notice that I am not delegating any authority to deny, suspend, revoke or to
unilaterally rescind anypezmit or any other authority specifically excluded from delegation in
the EMC rules. I am also retaining authority to rescind this delegation as it relates to any
specific permit or civil penalty assessment that for any reason, I feel I should sign. Likewise,
any permit or civil penalty assessment that you feel uncomfortable with signing shall be referred
back tome for final action. These delegations are to remain in effect until rescinded by me or
my,successor. Also, in the event of your absence, the above-specified delegations may be
assumed by the person designated to serve temporarily in your position.
cc: Coleen Sullins
Chuck Wakild
APS Regional Supervisors
2 of 2

Beverly Eaves Perdue
Governor
MEMORANDUM
C_71�lcLw P,c�2vZ - 7_�,Wd
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Coleen H. Sullins
Director
July 31, 2009
TO: Aquifer Protection Section Central Office
Aquifer Protection Section Regional Offices
Interested Parties
FROM: Ted L. Bush, Jr.
Chief, Aquifer Protection Se ion 'N
SUBJECT: Guidelines for Expired Permits
AUG - 4 2O9
Protection
Dee Freeman
Secretary
There have been many questions as to how to deal with expired non -discharge permits. In talking with legal counsel from
the Attorney General's Office (AGO), we have developed guidelines for some of these questions (see questions (Q) and
the corresponding answers (A) below). Also included are recommendations based on the guidelines and discussions with
the AGO as NOTES. All recommendations should only be considered after due notification of the expiration has been
given to the permittee.
Q.1. Does the Division have the authority to revoke a permit if the permit has expired and the permittee has not
requested it be renewed?
Al. If the permit has expired, statutory authority exists to revoke the permit. To do so, the state must notify the
permittee of their rights and give the permittee the option to appeal to the Office of Administrative Hearings (OAH).
NOTE: This is probably notthe best option if the permittee is uncooperative in that the appeal process could.
potentially take up to 4 years. It might be better to see other options (below) before pursuing.
Q.2. What is the state's course of action for expired permits under the following conditions:
Q.2.1. The wastewater system has not been constructed?
A.2.1. If the permit has expired and the wastewater system has not been constructed, the permit is no
longer valid. The permittee must reapply for a permit if they want to operate a wastewater system in the
future: NOTE: Action should be taken after due notification of the expiration has been given to the
permittee. Once the expiration date has past, the permit should be made inactive in BIMS, and a letter
should be sent to the permittee notifying them they no longer have a permit [G.S. 143-215.1(d)(I )].,
AQUIFER PROTECTION SECTION'
1635 Mail Service Center; Raleigh, North Carolina 27699-1636
Location: 2728 Capital Bouievard, Raleigh, North Carolina 27604
Phone: [phone] S FAX 1; 919-7 FAX 2:949-715-60481 Customer Service: 1-877.623-6748
Intemet www.nrwaterauality.org
An Equal Unponunity 1 Affirmative; Action Employer
One
Nor thCarolina
Natmi"JI14,11

Q.2.2. The wastewater system has been constructed and the permittee is continuing to operate the system?
A.2.2. If the permit has expired, the wastewater system has been constructed, and they are continuing to operate
the system, the permittee is operating a system without a permit and they are in violation of G.S. 143-215.1.
Normal enforcement activities should follow.
Q.2.3. The wastewater system has been constructed, the permittee has discontinued the activities that require the
permit, but the permittee has not closed out the facilities in accordance with the terms and conditions of the
permit? t
A.2.3. If the permitteehas discontinued the activities that require the permit, has not closed out the facilities in
accordance with the terms and conditions of the permit, and has not renewed his permit, the permit conditions
continue; that is, the permittee is still required to close out the systems before the permit can become inactive
[ 15A NCAC 2T .01056)). NOTE: Unfortunately there are no timelines on how soon a permittee must close their
facilities out, but until the facilities are properly closed out, the state can continue to charge fees [15A NCAC 2T
.0105(e)], and can assess civil penalties if the fees are not paid. Fees must be paid for operating facilities, and
until the facility has been closed out, the facility is considered an operating facility.
Q.3. If the state tries to notify the owner for any of the actions above and cannot locate the owner, what is the
notification process?
A.3. If the state tries to notify the owner and cannot locate the owner, notification can be published in the area of their
last known address for three weeks and this is considered notification. This notice has to be published in the
newspaper once a week for three successive weeks [specific requirements for the notice are listed in G. S. lA-10 1)).
However, the enforcement agency needs to try to serve this notification by sheriff before serving by public
notification.
Q.4. What legal authority does the state have over a facility once a permit is rescinded?
AA If a permit is rescinded, there is no continuing authority under the rescinded permit over that facility. If potential
contamination is suspected due to past permitting activities, this must be pursued under 15A NCAC 2L, or other
applicable regulations or.statues.
Q.S. If the owner of the facility changes, but the permit remains under the name of the previous owner and there is a
violation of the permit, who is responsible?
A.S. If the owner of the facility changes but the permit remains under the name of the previous owner, any discharge
or other types of violation can be made accountable to the new owner (operating without a permit) as well as the
current permittee, who is still responsible for the operation and maintenance of the non -discharge system.
Q.6. Can a new owner request a rescission for a permit if the current permit holder can no longer be reached or is
uncooperative?
A.6. If the new owner can provide documentation that he owns the facility, and requests the permit be changed to his
name, the facility can be transferred to the new owner without the previous owners permission. If the new owner then
requests a rescission of the permit, and the Regional office verifies that the system has never been built or that the
facilities have been properly closed, the permit can be rescinded without the previous owners permission.
SAGroundwater Protection\PermittinglGuidelines for Expired Permits.doc 7

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. Ronnie G. Kennedy, Jr.
Agriment Services Inc.
PO Box 1096
Beulaville, NC 28518
Dear Mr. Kennedy,
Division of Water Quality.
Charles Wakild, P.E.
Director
May 4, 2012
Dee Freeman
Secretary
Subject: Animal Permit Record Keeping Forms
General Permits NCA200000 & AWG100000
The Animal Feeding Operations Unit has conducted a review of the Agriment Services Inc. record
keeping form submitted.May 3, 2012. Based on our review, the attached form has been approved for use
in conjunction with the following requirements set forth in General Permit' Numbers NCA200000 and
AWG100000 (the condition numbers are the same for both permits).
Permit Condition II1.1: Inspections at least monthly or after 1 inch of rainfall
Permit Condition 111.2: Freeboard levels
Permit Condition 111.3: Recording precipitation events
Please be aware that permittees are responsible for meeting all requirements set forth in General Permit
Numbers NCA200000 and AWG100000. Information required by the referenced permits must be - '
included on forms provided by the Division or approved by the Division. Please pay, particular attention
that all forms must include the facility name and number. Any modifications to the approved forms must
be submitted to the Division for review. -Any oversights that occurred in the review.of the subject forms
are still the responsibility of the permittee.
If you have any questions regarding this request, please do not hesitate to contact meat [phone].
Thank you for your cooperation.
Sincerely,
Keith Larick, Supervisor
Animal Feeding Operations Unit
Cc: APS Fayetteville Regional Office wl attachments
APS Wilmington Regional Office wl attachments
'APS Washington Regional Office wl attachments
APSRaleigh Regional Office wl attachments
APS Mooresville Regional Office wl attachments
APS Winston Salem Regional Office wI attachments
APS Asheville Regional Office wl attachments
Division of Soil & Water Conservation — Central Office
1636 Mall Service Center, Raleigh, North Carolina 27699-1636
Cbcatlon: 512 N. Salisbury St., Raleigh, North Carolina 27604 '
Phone: [phone] t FAX: [phone] Customer Service: 1-877-623-6748
Internet: www,n0waterqual4 org
An Fnual Onnnrlgni'v 1 AHvmativq A. ?[nn Frta!nver.
,.: MAY* - 7 2012
One
North Carol Ina
;Vatural&

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APPENDIX I AA
Animal Waste'Application Windows'
For Common Crops Which Receive Animal Waste
These applicatlon windows include 30 days prior to planting and greenup bf Bermudagrass.
End 30 days before harvest.
Bermudagrass
Small Grain Overseeded
. in Bermudagrass
Begin March ist
Begin October 1st
Com Begin February 15th
Cotton Begin March 15th
End September 30th
End March 3r
End June 30th
End August tat
Cucumbers - Direct consumption Begin March list (100 % at planting)
- For Processing Begin April 1st End May 31st
(2 seasons) Begin July 131 End August 31 at
Rye
Barley, Oats, Triticale
Wheat
Peanuts
Sorghum/
Sudan Grass Hay
Soybeans
Begin September tat End March 31st
Begin September list End April 15th
,Begin September 1st: End April 30th .
Begin April tat End September 30th
Begin March 15th End August 31`t
Begin April list End September 15th
Tobacco - Flue Cured Begin March 15th End June 301h
- Burley Begin May 15th End August 15th
Fescue Begin August 1st End July 31st
Dates Shawn repres m stawmWe amffs.- Planting and ham -wing dates nary acrom the stale and from year to year. Aeaeatvaw. .
shalt:erect site spw lc rsmdlllons and In rm case allow application Moto than a'lhaf 30 days prior to plan2n9brealri0 dormancy .
or less than 33 days before harvest. Soo General Permit for food crops
= Mountains — &mit N application during June and July f no nitrogen In Deoamber and Jwwary '
Pledmont d Coaslat Platin - D dt N appUratbh durfnp June and July r as nitrogen in Dec and Jan dudny savers winters.
September 19, 2006
NCDENR Regional Office Map
Asheville Regional office
2090 US Hwy 70
Swannanoa, NC 28778
Office: 828-296.4500
Fax: [phone]
Fayetteville Regional Office
Systel Building,
225 Green St., Suite 714
Fayetteville, NC 28301.5094
Office: 910-486.0707
Fax: [phone] -
Mooresville Regional Office
610 East Center Ave.
Mooresville, NC 28115
Office; 704-663.1699
Fax; 704.663.5040
Raleigh Regional office
Wilmington Regional Office
Mall to:
127 Cardinal Dr, Extension
1628 Mail Service Center
. Wilmington, NC 28405
Raleigh, NC 27699-1628
Office: 910.796-7215
Location:
Fax: [phone]
3800 Barrett Drive
Raleigh, NC 27609,
Winston-Salem Regional office
Office: 919-7914200
5851Woughto" Street
Fax: [phone]
Winston-Salem, NC 27107
Office: 336.771.4631
Washington Reglonat Office
Main Fat: 336 771-4631
943 Washington Square Mall
WQFax:336.771-4530
Washington, Mr -27889
Office: 252-946-6481
Fax: 25Z -97S-3716
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