820436_INSPECTIONS_20171231

NORTH CAROLINA J
Department of Environmental Qual

_ ivisiiin of Water Resourres
Facility Number ®� - q3 O Division of Soil and Water Eooservation
Q (}ther Agency
Fype of Visit: Compliance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: 016titine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ; Departure Time: / County: �njs-- Region: f�
Farm Name: �` (� �G► 5 Owner Email:
Owner Name: [�(_� ; �1 Phone:
Mailing Address:
Physical Address:
Facility Contact: '/ �r�P_ ��-� Title: Phone:
Ousite Representative: Integrator: �jJi1 l
Certified Operator: Certification Number: `-g`b q3 V
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design Current,
Cn nt
Des' ►
ig
Swine Ca aci Pu
` P ty P•
We# L?oult . Ca achy Po
r'y � p P•
Cattle `Y
`'
Ca aci Po
P �Y P
Wean to Finish
La er
Dai Cow
'
Wean to Feeder
Non -La er
Dai Caif
ceder to Finish
/
—�
t; ';,
a D�ign CurrenI
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D . Pout#r �,, ,Ga e' I;o
Non -Dairy
_
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
_
Boars
Pullets
Beef Rrood Cow
y
Turke s
" p
Other`'.
Turkey Poults"'
Other
Other
,.....�a ,.
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
INo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance than -made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
❑ Yes
❑ No
❑ NA
[] NE
2. Is there evidence of a past discharge from any part of the operation?
[:]Yes
O_No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
VLNo
❑ NA
❑ NE
`Xfthe State other than from a discharge?
Page 1 of 3
21412015 Continued

!F
Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 25-No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 1
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes kg No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [ o ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes A No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [Z No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [allo ❑ NA ❑ NE
maintenance or improvement?
_Waste Applicati2n
10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes allo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ZLNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload D Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 11 'pr rL
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Z_No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes allo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 2� No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? -
❑ Yes
—_1 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19_ Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[]�No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
17-7No
❑ NA
❑ NE
the appropriate box.
❑WUP [—]Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stacking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E&No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes RNo ❑ NA ❑ NE
k\ Page 2 of 3 21412015 Continued

` Facility Number: - Date of Inspection: /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes [allo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes allo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes " No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewerlinspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signatut
Page 3 of 3
0 Yes JE� No ❑ NA ❑ NE
❑ Yes 2 No ❑ NA 0 NE
❑Yes MNo ❑NA ❑NE
❑ Yes JA No ❑ NA ❑ NE
❑ Yes , C No
❑ Yes ELNo
❑ Yes 0 No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: 5_; � /,f l
Date:
T
21412015

r`
"ype of Visit: It:, - Compliance Inspection V Operation Review U Structure Evaluation () Technical Assistance
Reason for Visit: outine O Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 ' - / Arrival Time: L'Departure Time: Q County: , �jcsyl'i�- — Region: J
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: _/j �'1/ r` Z/ ; 6 Title: �}'y�7r�� Phone:
Onsite Representative: Jam— Integrator: o r /
� lA
Certified Operator: J`�'`� Certification Number: 99'e. %d
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
g I; x Design Cur> ent'
Swine Capae ty CPopt_ , Wet Ppultry j Capacity CPo�r nt Cattl b
-
.;- . , Ca
w.� .
x e
Wean to Finish La er Dairy Cow
Wean to Feeder Non -La er Dairy Calf
Feeder to Finish txlo fi T = Dairy Heifer
Farrow to Weans Design Current - D Cow
Farrow to Feeder D P©uEf AYE* Ca act -Po Non -Dairy
Farrow to Finish La ers Beef Stocker
Gilts - Non -Layers Beef Feeder
Boars Pullets Beef Brood Cow
-_ �' Turkeys
Qthe�r _ Turkey Pouets :
Other 10ther °� r
4V 3
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify D W R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (I f yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes PjL4o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
[:]No
❑NA
❑NE
❑ Yes ❑ No
[] Yes 2 No
[:]Yes �o
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page l of 3 21412015 Continued

Facili Number: - L, Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
allo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
0 Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5_ Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
allo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
� No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
T Do any of the structures need maintenance or improvement?
/,Yes
❑ No
❑ NA
❑ NE
8_ Do any of the structures lack adequate markers as required by the permit?
❑ Yes
,&No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[R,,No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
XNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ELNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window
% ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 5
13. Soil Types): f
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 2�No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes E-No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes KNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
CB -No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
C3,No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
I&No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes. check
❑ Yes
[!-No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design 0 Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? I f yes, check the appropriate box below. C3- Yes ❑ No
-Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes L3.No
23. I f selected, did the tacility fail to install and maintain rainbreakers on irrigation equipment'? [:]Yes M-No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection: -
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �allo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [&Yes ❑ No
the appropriate box(es) below.
OFailure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes � No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes CH -No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e_, discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below_
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes 2 No ❑ NA ❑ NE
[]Yes [3.No ❑ NA ❑ NE
❑ Yes J�g No ❑ NA ❑ NE
[:]Yes [RNo ❑ NA ❑ NE
❑ Yes allo
❑ Yes �No
❑ Yes allo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessarv).
g� dam- -fm s /7s�✓�w r -
F�
1 J f / p r 14W&�I�/ IFZ /10
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
UF_ J_ `-' Foe e r,o l +,
Phone: I 3u- tj /,s/
Date: L!-� / ��4
21412015

i
A
Type of Visit: (9'Compliance Inspection Q Operation Review () Structure Evaluation O Technical Assistance I
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access J
Date of Visit: Arrival Time: ,' p c� Departure Time: County:e-�. Region:
Farm Name: ���`� Owner Email:
Owner Name: ��� _ _� ! d-� Phone:
Mailing Address:
Physical Address:
Facility Contact: f/«rl(� Title:
Onsite Representative:
Certified Operator: ��.--�—
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: 0/
e
enn
Certification Number: �"r/'a
Certification Number:
Longitude:
Design Current Desiga Current
Design Current
Swine. Ca aci Po Wet Pohl Ca aci Fo
P ty P• try p ty P•
Cattle CTaci Pa
p ty F-
Wean to Finish
Layer I
Dairy Cow
Wean to Feeder
I
jNon-Layer I
Dairy Calf
Feeder to Finish
%
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D . P,oul Ca acit P,o
Layers
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Pouits
Other
Other
Discharges and Stream Im arts
I . is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes JERNo ❑ NA ❑ NE
❑Yes No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) U Yes U No U NA U NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes Lt�No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes C�-No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili Number: - 10 (- jDate of Inspection: %—
Waste Collection & Treatment
y 4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JN.-No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Frecboard (in):
Observed Freeboard (in):]
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes J�jNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes �o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes R;rNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes EgNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes JgNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes jallo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes J No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑/Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s) �rn Z 1,0,L. — % 1
---
13. Soil Type(s): yJ0k
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 2. No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes fZfNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 1No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes ELNo C] NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes 0 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes [!� No
❑ NA
ONE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes Q-No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes [�LNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes [!-No
❑ NA
❑ NE
Page 2 of 3 2141201 S Continued

Facili Number: jDate of Inspection: -
-�
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
allo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
[:]Yes
fgNo
❑ NA [] NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
Z�3_No
0 NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
EgYo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
allo
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
&No
[DNA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
54-No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
jgjNo
0 NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP? ❑ Yes [+-No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes EjNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 2[-No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Phone:��}-L3.3cT�
Date: f i /(71�j
21412015
Page 3 of 3

P/ CAP
'0/ra�--
Type of Visit: (!3'Compliance Inspection U Operation Review U Structure Evaluation O Technical Assistance I
Reason for Visit: outine O Complaint O Follow-up O Referral O Emerizency O Other O Denied Access
Date of Visit: Arrival Time: '3 a Departure Time: 9 D[-? County Region- Region:
Farm Name: �Q��I a/" I'i'lr� Owner Email:
Owner Name: �p , ft y ix~f Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: j$_- Phone:
Onsite Representative: ,5 crr s.�_ - Integrator: V
Certified Operator: �G � Certification Number: 994i q3r z)
Sack -up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
..'Design
Current
�L�sign
Current
Designpacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
La er
Non -La er
Dairy Cow
Dairy Calf
Feeder to Finish
/ %
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Ary,P,vuliry
Ca paei
P,o P.
Non -Dairy
Farrow to Finish
l a ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Uther
Turke Poults
Other
Other
Discharges and Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑Yes [ZNo ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes ❑ No
[-]Yes No
❑ Yes J. No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3
21412014 Continued

lFacility Number: jDate of Inspection:
s
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes R No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): j q
Observed Freeboard (in)_ 193
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes KNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [a No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [] Yes [a No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Jj No
❑ NA
❑ NE
maintenance or improvement?
11 _ Is there evidence of incorrect land application? if yes, check the appropriate box below. [:]Yes N No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc_)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): ('e'►4, �L[�/�,- 1 y4'
13, Soil Type(s): jJ O A _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes jZ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 0 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [—]Yes ® No ❑ NA ❑ NE
acres determination?
17, Does the facility lack adequate acreage for land application?
❑ Yes
allo
❑ NA
❑ NE
18, Is there a lack of properly operating waste application equipment?
❑ Yes
®. No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
jg] No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
5,No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Eg_No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes fS No
23, If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0,No
❑ NA ❑ NE
[] Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

[F—acWty Number: -Ll !�, Date of Ins ection: (o
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [a No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes I& No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3I . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
���R r �n rry1S
G "Vr r,CJOris i g�7--� 1.�,{•17D•�- dv�.+<C `� .
li
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑Yes [SNo ❑NA ❑NE
❑ Yes ;K No ❑ NA ❑ NE
❑ Yes C5 No ❑ NA ❑ NE
[gYes ❑ No ❑ NA ❑ NE
❑ Yes IN No
[:]Yes No
❑ Yes No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
ei�'•f19c�lt'—
Phone: �V *X! `EOa
Date:
21412O14

. , �W TyS loba-b
Divi"lion of Water @� %C�'
Facility Number g � - � O Division of Soil and Water Conservation
Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: igRoutine O Complaint Q Follow-up 0 Referral C) Emergency O Other Q Denied Access
Date of Visit: �Q Arrival Time: Departure Time:County: Region: 46
Farm Name: a F&A-7 Owner Email:
Owner Name: h Y/i ) Phone:
Mailing Address: Physical Address: "�R
3 qo Awe
Facility Contact: s*ve Title: �I1�criL r r�YtQ Phone:
Onsite Representative: s40Vf, 1'Y 11-11 dm � Integrator:
Certified Operator:✓� i [ 4S L" 1bs) Certification Number: fp30 —
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
'�RDesi nCurt;entr ` _ Design Current
g
SwineCaty: _ Pop.Wet Poultry Cap city . =Pop: Cattle
Design Current
C►apacity Pop.
Wean to Finish
La er I
airy Cow
Wean to Feeder
I
jNon-Laer I
airy Calf
Feeder to Finish
Farrow to Wean
13LaL#
ai Heifer
Design Current Dry Cow
- D . Pooult . Ca achy "_1'0 Non -Dairy
Farrow to Feeder
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
M1 113eef Brood Cow
_ _
Other
OtherJEJ
Turkeys
Turkey Poults
10ther
Dischar es and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at_ ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[] Yes [ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No [DNA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
Ej No
❑ NA
❑ NE
Page I of 3 21412011 Continued

lFacility'Number: lga - L43& Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes S No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes CK No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? R Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes (2 No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E�fNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need []Yes [ZNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes r'No ❑ NA [] NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window L ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): C0111
13. Soil Type(s): NQ rfo 1
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ® No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes Q9 No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes � No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA 0 NE
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. (3 Yes ❑ No
�] Waste Application ❑ Weekly Freeboard [] Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes N No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [—]No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
® NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 4ga - Date of Inspection: 3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [,;I No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes (R No ❑ NA ❑ NE
the appropriate box(es) below_
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of fast survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes W No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:)Yes ❑ No [RNA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
N No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
r' No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
allo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
® Yes
❑ No
❑ NA
❑ NE
CK Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
R No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Co No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary). .
P4 e, bath borac sma l f tlefj 4 biu3 h a I i le ai wet std,e e. ) RAO,
�&m yvee. M&+� -Rik 1l' * 9na.f a&6 f goi) arld ae 3tplvtn . a� �v kv
I f UA
Gt�t I� 5��r � .hflLooL so+l6-�js 4- �F'� ii )� soglMfCrnSe
Mt h^ ��, �e ��( �I I I �� yaps
1. Gory con;(J excg1' 1 RR a s ee nod` rite ,eoL �b� ap�a a►d_ ao J ,1 R is ark �
qw�-shoft 4�1 30 44ysl
,Sig � SolVw 1Si�-�YOyh 0-1013-Yv0117'ed—`i0 WOE fn a01 y.
31, held dro ih i 1e_ d rams fo Povte�t lo kalok e P.&,
1L.41C�rM -61led or�dil!P
e /I s��io,, CCni c.�a��..I�'�i�da� `i�a u3 1o�3'ao�3],
10Jdi i ml M e06P neon fled Vr rceel 7
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: a Q
21412011

P
Facility No. %D,`3� Farm Name r) _ Date Q i 3
Permit COC ✓ OIC_ NPDES (Rainbreaker PLAT Annual Cert Daily Pipe )
Lagoon Name, S forspillway
1
2
3
4
5
6
7
Design Freeboard i Last Recorded in
Observed freeboard
Sludge Survey Date
Slud a De th ft
Liquid Trt. Zone ft
Ratio Sludge to Treatment Volume ifs 0.45
D ut of co OA?
lS1 *. U/rfeI-AAr(4 ) LIIT-aA11
r -
M��-��
Ring
r -
W--
Design Fiam. (ft)
Actual Fiam.
-----
Soil Tst Date 9 %
Crop Yield
Transfer Sheets
pH Fields
Wettable Acres
RAIN GAUGE
Lime Neededv- 0* �
WUP
Dead box or incinerator
Lime Applied
Weekly Freeboard
Mortality Records
Cu-I ,1Z Zn-I ✓
1 in Inspections
Check Lists
Needs S (5-1<25)
120 min Insp.
Storm Water
Needs P
Weather Codes
='tMAN
. , t
��
air
�I
�
Pull/Field
Soil
Crop
Acres
PAN
Window
Max Rate
Max Amt
I/
I-�--
a
SQ
3
a
4
Verify PHONE NUMBS $and affiliations
Date last WUP FRO Of OL FRO or Farm Records
Date last WUP at farm llalf� Lagoon #
App. Hardware Top Dike t}7
Stop Pump
z Start Pump 1�}
Conversion- Cu-I 3000= 108 Iblac; Zn-1 3000= 213 Iblac

I M S Jvj` g14(1-,�_
Type of Visit: ff Compliance Inspection O Operation Review 0 Structu`re Evaluation O Technical Assistance
Reason for Visit: (2F Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:,Region:
Farm Name: 4 Falm Owner Email:
Owner Name: J 0f,P hh t j III rhJ Phone. -
Mailing Address:
I
Physical Address: C 1 I
Facility Contact: ,S tlR— �v { 1) I'al" Paii %1a�ar' ._ Phone: gg0_aa-jg
Onsite Representative:iIntegrator:—�
4 ficaIV Certified Operator: �QSQ bn �l ! � ] Uml Certification Number:
Back-up Operator: pp �/f p Certification Number:(q�,
Location of Farm: Latitude: Longitude:
D gnu Current ,
Destgn Current _
- Design Current
Swine
Caviiii ` Pap
Wet Poultry
Capactty Pop
Cattle Capacity Pop.
Wean to sh
Layer
Dairy Cow
Wean to Feeder
I
jNon-Layer
I
Dairy Calf
Feeder to Finish
" �` -'-
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
Dr Paul
Ca a P.o .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
OtherI
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: CjKrStructure ❑ Application Field ❑ Other:
Yes JE No ❑ NA [] NE
a. Was the conveyance man-made? ❑ YesQP No ❑ NA ❑ NE
b- Did the discharge reach waters of the State? (If yes, notify DWQ) []Yes Off No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes &rNo ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? 0 Yes [:]No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes � No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3
21412011 Continued

Facility Sumber: VA - Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):,
Observed Freeboard (in): --�-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
DU No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/br managed through a
❑ Yes
�'No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
IR Yes
[] No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
10 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if ves, check the appropriate box below. ❑ Yes 12 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs_ ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindow❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): C m . Tvri4_. eqr bean(
13. Soil Type(s): JV Q _.
14. Do the receiving crops ditFer from those designated in the CAWMP? ❑ Yes RNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'? ❑ Yes R No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes CRNo ❑ NA ❑ NE
acres determination'?
17. Does the facility lack adequate acreage for land application?
[:]Yes
RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[RNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[R No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
ER No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
2 1. Does record keeping need improvement'? If yes, check the appropriate box below. ❑ Yes fR No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis [] Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No fj7g[ NA 0 NE
`r Page 2 of 3 21412011 Continued
,, t

[Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ®'No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes RNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes N'No ❑SNA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [::]Yes ❑ No C-NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
Cj�No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
f5jeNo
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[WNo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
fp Yes
❑ No
❑ NA ❑ NE
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
to No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
allo
0 NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments..
Use drawings of facility to better explain situations (use additional pages as necessary).
a�sw_ rn)'*460(n q- M61We sly" YV#P_dAf&17LOOC*Ot
B�� in a On �]jne I'le����
-AMMi var 5M411 ohd d d7 n ` fo Svrfa(e wa`Kor,. ��p� res�q�s f61e war ('
1 i eL b sfeve l Is evw0fe�
-7� �s� s rye of IQy , valide b2nir 6fe}aa�e rn�j�r lxrer o Ord aye �' t? �n��angr
ppaaeb gm ill 04'�CVd
*4 Im rr�sCo� P` n i, d
/' f 9 �-� Jns�de �
e Qy�S J hae o 00yCOven
IS, PoiSe Ctk4CE 0) eXISO; j of -Q_ li) r ,r iP•Aa7
o5, swve? e0ler (,0,7 a DI y.
Mvch rlh��d►� �Q��'Wc}'�C,r
file m��io,r�r
*� � baaE t) � r
w
�sle'e iII orfl
p
Reviewer/inspector Name: Zj(]/�^ �CIIII>°1r[l• _ Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 i, f 21412011
\�

. Facility No. 'ga'g3le Farm Name �4 i� �!� �,�Date �f �
Permit ✓ COC ✓ OIC A"'f '9e �,o 14PDES (Rainbreaker PLAT Annual Cert Daily Pipe }
Lagoon Name, S forspillway
1 1
2
3
4
5
6
7
Design Freeboard 1 Last Recorded in
Observed freeboard
Sludge Survey Date
Sludge Depth ft
Liquid Trt. Zone ft
Ratio Sludge to Treatment Volume if> 0.45
Date out of compliance/ POA?
1 CNfr1.-,da �t��►trs ►.r�rPrF
Ron-
NOT40,11..
F��---��--
Design f .'�--�-�-
WITA _ -
Soil Test Date
pH Fields
Lime Needed
Lime Applied
Cu-I t/Zn
Needs S (S-1<25)
NPPrfc P
Crop Yield
Wettable Acres
WUP
Weekly Freeboard
1 in Inspections
120 min Insp.
Wpathpr r:rvfpq
Transfer Sheets
RAIN GAUGE
Dead box or Incinerator
Mortality Records
Check Lists
Storm Water
_ - s - -
IIIj MHUMQI!.11MIii'
�rt:74'►I�
---�
NUMFUMN-011111111111111P-.
• .
. .
Vi�;�a'
IIIMP
c1�
gogm
mr
�lLnp�fil
.0
Verify PHONE NUMBERS and affili tions
`3 Date last WUP FRO FRO or Farm Records
Date last WUP at farm ���Lagoon #
App_ Hardware Top Dike
Stop Pump
Start Pump
Conversion- Cu-1 3000= 108 Ib/ac; Zn-I 3000= 213 Iblac

1 ype OF V ISM k9 4.ompnance Inspecnon t! vperaraon Keview V atruciure evaluation v I ecnnlcat Assistance
Reason for Visit: outine Q Complaint 05 Follow-up O Referral p Emergency O Other O Denied Access
Date of Visit: Fqlal-J Arrival Time:1%00 Departure Time: County: �Q�yjp$� Region:}
Farm Name,__Iq J Owner Email:
r
Owner Name: TQAi I !I1 Phone:
Mailing Address: `" �
Physical Address: a3yQ RQQr10kyPR-
e . C�fttlUl
Facility Contact: S`tt'V�i f i p4" - _ Title: Phone:
Onsite Representative: G,te..r,P __ Integrator:
—
Certified Operator: TnSW w0 l Ali f Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
besign Curraent Design @urrent Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pnp.
Wean to Finish Layer - Dairy Cow
Wean to Feeder
Non-Laer
I
Dairy Calf
Feeder to Finish
Design Current
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D . P,oultr CaIcity Po ,
Non -Dairy
Farrow to Finish
Beef Stocker
Layers
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
1 ...m
--..
Turkeys
All 1116'
©thee
Turkey Poults
Other
Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge'?
0 Yes �allo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
[] No
❑ NA
❑ NE
[—]Yes
C" No
❑ NA
❑ NE
[:]Yes
C�'No
[] NA
❑ NE
Page I of 3 21412011 Continued

Fvcility,Number: -436 Date of Ins ecdon:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[] No
❑ NA
to NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
C'NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):_
Observed Freeboard (in): o
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
❑ NA
[5jNE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑ No
❑ NA
�NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
C'NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
CErNE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ No
❑ NA
Eq�NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks. or compliance alternatives that need
❑ Yes
❑ No
❑ NA
[RNE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes. check the appropriate box below.
❑ Yes
❑ No
❑ NA
®-NE
❑ Excessive Ponding ❑ Hydraulic Overload [D Frozen Ground ❑ Heavy Metals
(Cu. zn, etc.)
❑ PAN ❑ PAN > 10% or 10 ]bs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Windom- [] Evidence of Wind Drifi ❑ Application
Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
CRNE
15_ Does the receiving crop and/or land application site need improvement'?
❑ Yes
❑ No
❑ NA
aNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
R[ NE
acres determination'?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
®"NE
18. Is there a lack of properly operating waste application equipment?
[] Yes
❑ No
❑ NA
CaNE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[] No
❑ NA
taNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
0 No
❑ NA
CR`NE
the appropriate box.
❑ WUP [—]Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [] Yes ❑ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑ NA gNE
❑ Weather Code
[:]Sludge Survey
❑ NA EfNE
❑ NA r" NE
Page 2 of 3 21412011 Continued

Facility.Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA 1.;�JNE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ❑ No ❑ NA , D N£
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, Freeboard problems, over -application)
31. Do subsurface the drains exist at the facility'? I f yes, check the appropriate box below.
❑ Application Field
❑ Lagoon/Storage Pond
❑ Other:
❑ Yes ❑ No ❑ NA ERNE
❑ Yes ❑ No E] NA ❑ NE
❑ Yes ❑ No ❑ NA � NE
❑ Yes J�j No ❑ NA ❑ NE
❑ Yes CD No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA tR NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? Yes ❑ No ❑ NA P NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? es [a No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes t@ No ❑ NA ❑ NE
Comments (refer to question #}: Explain any YES answers And/or -any additional recomtnendahonsaf any otm ocr mmNW11-i
Use drawings of facility to better explain situations (use.addttional nEes as necessary). « .
rotlow, ► M- it; chi slPd�e_ c lieaiov'- re adsi
Add 67al riecaA_r- e mi 10, 10 Q sly► b ladowir-
CP whee SIB wa-rapfIfetL
Paso sv r►e �r�i- --�l1s 04 haw- fier rerE� - ai -61st-i 017
l y
�� ,e I� 3 / 13�'S
d� 13�3 Q ) ' s'V ds am l ses��i -et
T s� � 1d- a coel Of- � t Q��l �1 �7 7 d y
S� a Coe cry/ice- O f f b a-7 so, � re FMS -& -���ds
� Yyaj -evide�l r&-0 W f,) Pal ' h.
7
Reviewer/Inspector Name:
W910L JI .
Phone: $ jj qJ3-3333(0ffi
ReviewerAnspector Signature:
Page 3 of 3
r•
Date: rU -
2/4/2011

a(Ms uV_j 1611� j
•` � � Divi'siau of Water Quality
Faciiin Nurtlber ®- Division of Sail and Water Conservation
© Uther Ag�y
Type of Visit: '�& Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: () Routine 0 Complaint 0 Follow-u 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1A 1CI 110 Arrival Time: Departure Time: jnlr County: r ,�
Farm Name: & ��-- -�-�� Owner Email:
�7
Owner Name: —0-Qf erh (,art { Phone:
Mailing Address:
Physical Address: aZ3q o �L Dfe P& Chl lion
Facility Contact: 9e!e, 1 Y RI ioyr µTiller
Onsiitc Representative:JQ_�tt� l7 3P1f llitC Integrator:
r t
Region: fm
Phone: a
N -B
Certified Operator: joyep VV f 1 IS Certification Number: jllwST
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude. -
Design Current
Design
Current
Current
Im
Swine
Capacity Pop.
Wet Poul ry
Capacity
Pop:
Cattle Capacity Pop.
Wean to Finish
I Layer
DairvCow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr. Roultrv,
Ca aei.
P,_o .
Non -Dairy
Farrow to Finish
Lavers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
..:
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream ImDaCtS
1. Is any discharge observed from any part of the operation?
[] Yes
[a No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
�qNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
5dNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

- Facile , Number: - j Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
1---rNo
[] NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[] No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1-
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
® Yes
❑ No
[] NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
1K No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P No
❑ NA
❑ NE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ allo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application'? If yes, check the appropriate box below.
❑ Yes
[$No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s): Cotp.-2D,bPag Wheat
13. Soil Type(s): )AL
14. Do the receiving. crops differ from those designated in the CAWMP?
❑Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
( No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination'?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
YW No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[a No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design [] Maps []Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [�j Yes ❑ No
Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA NE
NrNA ❑ NE
Page 2 of 3 21412011 Continued

Facilt , Number: a - 43 fa I I Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [&No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �R No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal'?
29. At the time of the inspection did the facility pose an odor or air quality concern?
1 f yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
® Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
rXj NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes Dg No ❑ NA ❑ NE
❑ Yes F'No ❑ NA ❑ NE
Nr Yes ❑ No ❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes W-No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
-Qpn boks aer2 a b of T(iow siL, 9 C �aa o i `F'ql I, p
q �p soil IIY?� S s ra rnvj�j sv�Jef+1 +0 `�'avLYabC� iY�P�
r� � / j ,�
Ctnd, ofcr ,
u i e bti � rYDr 4w� buck but ntWs Saxe- rnq'� YY�'%r
aye o id
e-
P��� a� 1 RRDS -for Gut/� cro� per
z4o
D D Ne, VY W � NO/) � �. � � uns �0 elm o+ d- tkl Pop nok e �
a n � vim- - e IOC
�e n
M V�h j m ro.IeL r ecord S' I oa q 1 S hooted,
5, S �
U n�a> "i1d0 'In Meb6-
�
Reviewerllnspector Name
ZM Sohn f] Phone: q 33 00
Reviewerllnspector Signature:
Page 3 of 3
Date:Au.o cr.ao
/412011

Type of Visit '(*Compliance Inspection 0 Operation Review 0. Structure Evaluation 0 Technical Assistance
Reason for Visit 'fir Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: E&m Owner Email:
Owner Naxne: Tnxev h _ _ W1 II fans Phone:
Mailing Address:
Physical Address: Facility Contact: 70.tpfh �v I 1 I 1 "S —Title- Phone No:
Onsite Representative: a-meph 4S 4elle— �/I 1 h` & i Integrator: _N— B
11
Certified Operator: lAfph IW Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = 0 0 ' = « Longitude: a ° = 6 =
Design s Current _ _ ; Design Currents p Design Current
Swine ;t;F Capty Population 6W,etAPoutr}Capacity Poplation Cable Capacity Population
❑ Wean to Finish ❑ Layer ❑ Da Cow
❑ Wean to Feeder ❑ Non -La er ❑ DairyCalf
Feeder to Finish ❑ Dairy Heifer
❑ Farrow to Wean ' ' ❑ D Cow
Dry Poaltg-
❑ Farrow to Feeder ❑ Non -Dairy
❑ Farrow to Finish ❑ Layers ❑ Beef Stocker
PE0
Gilts ❑ Non -Layers ❑ Beef Feeder
Boars ❑ Pullets ❑ Beef Brood Co
❑ Turkeys
Other
+" ❑ Turke Poults''
❑ Other ❑ Other Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
'RNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
(3No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
ff No
❑ NA
❑ NE
other than from a discharge?
Page 1 o f 3
12128104
Continued

Facility Number: a — Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes C@No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): + q
Observed Freeboard (in): Lip
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
'RNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
P No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? 12Yes
❑ No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
NrNo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
J�rNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
29 No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
t9 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
M No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
ERNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
IgNo
❑ NA
IM Nl��
IT Does the facility lack adequate acreage for land application?
❑ Yes
U No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
§d No
❑ NA
❑ NE
.S
Reviewer/Inspector Name ��' f @1—_ , J t � Phone: N IQ) 933-3W
Reviewer/] n specto r Signature: Date: tie C. ;).q D 10
parnp 2 of 3 12128104 Continued

Facility Number: 00a y3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? m'es ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check RYes [:]No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 'Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard N Waste Analysis Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield JK 120 Minute Inspections ® Monthly and I" Rain Inspections aWeather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27, Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28_ Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal'?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
EP No
❑ NA
❑ NE
❑ Yes
❑ No
ERNA
❑ NE
❑ Yes
IgNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
UNE
❑ Yes
CR No
❑ NA
❑ NE
❑ Yes
❑ No
ERN
❑ NE
❑ Yes, Kio ❑ NA ❑ NE
❑ Yes RINo ❑ NA ❑ NE
❑ Yes allo
❑ Yes C'No
❑ Yes ERNo
aYes ❑ No
El NA El NE
El NA ❑NE
El NA ❑NE
El NA ❑NE
-7,pleae r-Ut� 4 0'�S0 or mmY✓ b�c� :mj sma// jrnyj Qi barltsile a H �m�fi reads to �baekdo -f r� `i
Qfi0'�°er, v h'e cmdU
aa� I�i a- M, vj 0o da .sj sores
aha iys� 9 y C{ urn y
15 Pie -e poit,5oH
PI aico � e rase ecov&o c�rr�-�- �i�� i S'f- Vvae fiu-+ +%1
�+ books � r � � h11
v� 1 hp s 4-1f r col"n *r- Yyea#cod , a
� � rci�a
a I . 03+ ra ih tl ns eb Off
S�ray���►� mod. -Per aoi oaf it. �� 1 nod.. @oil -�0*-
I ro caf�sjud e, Bey a � �
p � 9 bW mo be elf r ble. � e emfkf ' a u -
cY(not+ s dg e sirv� a o 9 Q 1aye Ileal OL+
SJ vd e- ►ya-r cl,eu14 o� ►� 4c-bb� , p
re (H r sa,5 t cad- k-e - hfn vv'► 0-j-�-Pr re(6-dJ
col u -�o check Un re cast , seka� �aofirsrtia)
At-
�Pvme e �l�s h raIs cow- on I goo-lbcl ks, or, vp K"') 7 a�o�iR v��
9U
Page 3 of 3
Tier et and ri l c LYE f 1e1�-�- a-� /}, C% L/4(J i sh &o e— a 12/28/OQ

Facility No. a-y Farm Name } Date 1 a
Permit COC 01C N F NPDES (Rainbreaker PLAT Annual Cert )
FB
Drops
i TO
Lagoon
1
2
3
4
5
6
7
Spillway
Design freeboard
_
Observed freeboard in
Sludge Survey Date
Sludge Depth ft
Liquid Trt. Zone ft
Ratio Sludge to Treatment Volume
I A, 't- 4,4?
►�,�; r�r: Nor. air,
Soil Test Date
Wettable Ac es
pH Fields
WUP A�f�,,
Lime Needed
Weekly Freeboar
Lime Applied
1 in Inspections
Cu-I Zn-I
120 min Insp.
Needs P
Weather Codes
Crop Yield cafib
Transfer Sheets In C
Waste Analysis Date
- 60 Da
} 60 Da
N Amt f Ib11000 Gall
nfn
RAIN GAUGE
Dead box or incinerator
Mortality Records
Pull/Field
Soil
crop
Acres
PAN
Window
Max Rate
Max Amt
n/)V
1�%40
Verify PHONE NUMBERS and affiliations
Date last WUP FRO f J Ij)�103 Date last WUP at farm App_ Hardware
FRO or Farm Records floS �f,W ��`�'`� f
Lagoon # �f- P ho i T- fY10e Url f� D�
Top Dike See f t
Stop Pump
Start Pump
Conversion- Cu-1 3000= 108 Iblac- Zn-I 3000= 213 Iblac

Division P.— ater Quality
iFacility Number��� Division Sail and Water Conservation�
0 Other Agency 0 �� P�9� .J L
Type of Visit Qeompliance
Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
@46utine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: o- D Arrival Time: ; 3 Departure Time: County: v—,, Region: �y
AV
Farm Name:�'�-- __ Owner Email:
Owner Name: 11 DSr—dk Phone:
Mailing Address:
Physical Address:
Facility Contact: Phone No:
Onsite Representative: 5.��-4_ Integrator: .617&r%2IL
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =O =I =" Longitude: a° =! =
Design GWlurrent D�ewsign Current �- Design Current
Swine Capaty FopulBtion Wet}PoultrWGapaki y I?opuiation Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑ Da' Calf
Feeder to Finish
Dry Poultry '
❑ La ers
Da' Heifer
= ay_k-:
` ❑ b Caw
Non -Dairy
❑ Beef Stocker
❑Beef Feeder
❑Beef Brood Co
Number of Structures:
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑Non -La ers
❑ Gilts
❑pullets
❑ Boars
f
v
❑ Turke s
_. -
Other ��",xi.
El Turkey Poults
❑ Other
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
®No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
71
d_ Does discharge bypass the waste management system? (lfyes, notify DWQ}
❑ Yes
❑ No
❑ NA
❑ NE
Z. Is there evidence of a past discharge from any part of the operation?
❑ Yes
R No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
R.No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued
;k

4 Facility Number: -- Date of inspection -D
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [2jNo ❑ NA ❑ N1
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes R No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ®No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Ryes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes MNo [INA ElNE
(Not applicable to roofed pits, dry stacks and/or wet stacks) WK
9. Does any part of the waste management system other than the waste structures require ❑ Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc_)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
[]Yes
W No
❑ NA
❑ Nf
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
RNo
❑ NA
❑ NL
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
[a No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
E4 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
Comments {refer to question #): Explain any YES answers and/or any recommene tions or any outer comments.
Use drawings of facility to better explain situations. (use raddkional pages as necessary):
0 40V
ND L-4nolysi`S
�j o cc�c y; 4f
Reviewerllnspector Name
yl�t1p's-�� EPhone:
Reviewer/lnspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19- Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,4 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ,® No ❑ NA Q NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design g ❑ Maps Q Other
21. Does record keeping need improvement? If yes, check the appropriate box below. [ 'Yes ❑ No ❑ NA ❑ NE
IRWaste Application ❑ Weekly Freeboard ❑ Waste Analysis IgSoil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ® Crop Yield 12 120 Minute inspections ❑ Monthly and 1" Rain Inspections ® Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/]nspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
IANo
❑ NA
❑ NE
❑ Yes
53 No
❑ NA
❑ NE
RYes
❑ No
❑ NA
❑ NE
[9 Yes
❑ No
❑ NA
❑ NE
❑ Yes
TR No
❑ NA
❑ NE
❑ Yes
fRNo
❑ NA
❑ NE
❑ Yes
(2 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
(9 No
❑ NA
❑ NE
❑ Yes
($No
❑ NA
❑ NE
❑ Yes
tgNo
❑ NA
❑ NE
MYes
❑ No
❑ NA
❑ NE
A`diltttonalwCamniepts antl/or�Dr�a, Wings: � ,�?�� � �� - � -
o�
� ag � b`� Cq�teG��['� cR ,j,? ucrt�.jic ►` v�y � ��`1��� ���o)
5
� O� / `-' D
b
--" ;1 � ► �� tci t� � �Sr�s-v�5� �"' ��- C �'` �etna � � � r Ci u ,i J
yw
��Z�,� fir- �� [<�{�,•� t"ecars
Page 3 of 3 12128104

�s
ytnvision of Water Quality
Facility Number 0 Division of Soil and Water Conservation /p— / 7
0 Other Agency
Type of Visit., mmppliance Inspection Q Operation Review Q Structure Evaluation 0 Technical Assistance
W Reason for Visit outine 0 Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: QaL 0 Arrival Time: Q' D Departure Time: �` 'D County:,// Region:'
Farm Name:
�.V (% �arm6 Owner Email: gC�7
Owner Name: (/DS.�r7� � �r`f�i�rr5 Phone: 710— / ' 0-6_J 6 `r/
'fel'l
Mailing Address:
Physical Address:
Facility Contact: Uv✓` ,¢ .Ullllt n4 Title:
Onsite Representative: 7<""
Certified Operator: 1� �—
Back-up Operator:
Phone No:
Integrator:/1J/Zy e
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = = Longitude: = U = I = u
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design
Cattle Capacity I
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: 17� I
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)"?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes KNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
Jf No
❑ NA
❑ NE
❑ Yes
®No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes KNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier.
Spillway?:
Designed Freeboard (in): �9
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 8 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ® No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [] Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ® Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 9 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [:]Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 4!:�-blrt¢
13.
Soil type(s) ^L' Djoff
14.
Do the receiving crops differ from those designated in the CAWMP'?
❑ Yes
,® No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
0 Yes
9K No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[-] Yes
ERNo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
91 No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
0 No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Kyt . tie"ras 0-rz- � n j A�
�i x Fl­us k, -If ►, 7�p u
Reviewer/lnspector Name phone:
Reviewer/Inspector Signature: Date:
IViai/u4 c.onrinuea

Facility Number: g - Date of Inspection /y—I �r,7
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropirate box.
❑ WUP El Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes 91No ❑ NA ❑ NE
❑ Yes ,9No ❑ NA ❑ NE
® Yes ❑ No ❑ NA ❑ N E
Waste Application ❑ Weekly Freeboard ❑ Waste Analysis JRSoii Analysis ❑ Waste Transfers ❑ Annual Certification
Rainfall ❑ Stocking Z Crop Yield Rr120 Minute Inspections 9 Monthly and I" Rain Inspections 'gWeather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
® Yes
❑ No
❑ NA
❑ NE
❑ Yes
(g No
❑ NA
❑ NE
❑ Yes 1ANo ❑ NA [:]NJ-',
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
&I No
❑ NA
❑ NE
❑ Yes
29 No
❑ NA
❑ NE
19Yes ❑ No ❑ NA ❑ NE
lAdditional Comments and/or Drawings: i
le"W"'�'ON.i L h e �l��i dy t Cv�'� 1 ` ���-ors f c� l 0_i N`ofi
7;*, C"'Oje 10 0 /77 i -I—
�/i7/<< �; �:�'3 /lGr,� /Lt��f �CO/'��p( �''�f' �;���� a•!/�r'+�'S. OC �'D���j'
1'^� Su �►�s eft d rn r W 4 6 an.�
' orf C -C 8 i - � �"%, �%J212810 V' `Ji.

(Current Date) ,5`-1 /-0200
CERTIFIED MAIL
4 AURN RECEIPT REQUESTED
Mr S. To 4 r n:ti_ ids i I l i a s
(Mail Address- ) D oo,,rL Q ke-
r✓. ; +ntD—, North Carolina Vgt32,pl
Subject: & OTICE OF VIOLATION/ Cl NOTICE OF INTENT
JM'Tministrative Code 15A NCAC 21-1.0217
(Or)
U(NCGS 143-215 et SM & Section 402 of the Clean Water Act)
(Name of Facility) �4t ✓ rw
FacilityNo.
County
Perms mit No, �}C I,I,t_5 B� 7 Q d.< I-
DearOvls. LU'; 1) '' 0 KS
FJYnu are hereby notified that, having been permitted to have a non -discharge permit for the subject animal waste disposal system
pursuant to 15A NCAC 2H .0217, you have been found to be in violation of your 2H .0217 Permit.
(Or)
OYou are hereby notified that, having been permitted to have a National Pollutant Discharge Elimination System (NPDES) permit for
the subject animal waste disposal system pursuant to N. C. General Statutes 143-215 et seq. and Section 402 of the Clean Water Act,
you have been found to be in violation of your NPDES Permit.
❑Violation 1: Failure to maintain waste levels in your waste structure(s) in accordance with the facilities Certified
Animal Waste Management Plan. (Permit No. Section -
/Note: Reference Section V 2. will be the applicable cite for ND perutits/
jNote: Reference Section V 3. for NPDES permits)
On (date) _ a waste structure liquid level was documented at inches of freeboard at (describe
which lagoon). A level of inches is the maximum level allowed by your permit.
Required Corrective Action for Violation 1:
O (If POA submitted) Continue to follow the proposed actions outlined in your Plan of Action (POA) dated
_ and received in the Fayetteville Regional Office on -_— _---------- Take all necessary additional
steps to ensure lagoon levels remain in compliance with Section (DV 3. or DV2.) of your permit.
O (If no POA in Storm ,Storage) Submit a Plan of Action (POA) within 48 hours of receipt of this letter that
will indicate how you propose to lower the lagoon level to greater than 19 inches of freeboard over the next 30
days. Take all necessary additional steps to insure lagoon levels remain in compliance with Section V
Condition 3 of your permit.
O (If no POA in Structural Storage) Submit a Plan of Action (POA) within 24 hours of receipt of this letter
that will indicate how you propose to lower the waste level to greater than 12 inches of freeboard over the next
5 days, and over the next 30 days to greater than 19 inches. Take all necessary additional steps to insure lagoon
levels remain in compliance with Section V Condition 3 of your permit.
OViolation 2: Failure to notify Division of Water Quality of Inadequate freeboard in your waste structure(s) within 24
hours 0 and failure to submit a written report within 5 days. (Permit No. Section
(Note: Reference Section 11113 c.. will be the applicable cite for ND permitsf
/Note: Reference Section III He. for NPDES permits]
Your permit specifically requires notification by telephone within 24 hours and a written report within 5
calendar days following first knowledge of the occurrence of a reportable permit condition. The Division of
Water Quality has no record of receiving the 24-hour notification 13(and/or the required 5 day written report).
Required Corrective Action for Violation 2:
In the future, please notify the Division of Water Quality of the occurrence of any reportable events in
accordance with your permit.
OViolation 3:. Failure to apply animal waste at rates in accordance with your permit and Certified Animal Waste
Management Plan: (Permit No. Section)
[Note: Reference Section 114. will be the applicable cite far ND permits/
[Note: Reference Section Il 4. for NPDES permitsf
On (date) (describe the violation observed/documenred ... PAN, ponding, run-off,
etc...) _.-______________.____..W___._____.__________________________---
Required Corrective action for Violation 3:
If you have not already done so, immediately cease application methods of animal waste that cause or
contribute to (described violations above)_ and
take all necessary steps to insure this violation does not reoccur. The steps could include but are not limited to
modification of your Certified Animal Waste Management Plan and/or adjustment and calibration of the spray
irrigation equipment.

-T:>"f VL Pp
.�/��u'�d n! o �u ►yr�� •za
rrc arol,� � a �
b ��-ri �C �r f�.
`� Y y�� ��/r--d r _
j�p u i a u t JV bf �r L ►�rad�i o� D r $ 0 f I r!'l �7 r� c. 1, 57
j'p v ✓ ..zw Z -J• a
z� Yt�cC tJe- 0a-46,�1�'-,-v CU �`� ��1 $ ►7t�/` L �f` +�5c YCrwccr � v� yaUdr
5 �.� r-r' `�DcA fa', L
�Y�G�rr.t �1 <<+�of Y�G/rC /V �}C ��7Srt!/(r o•� ad*( ;�(

❑Violation 4: Discharge of animal waste to surface waters andlor wetlands as prohibited by your facility's permit.
(Permit No. Section _ }
{ fNote: Reference Section 11. will be the applicable cite for ND permits]
Note: Reference Section 11. for NPDES permits]
On (date) (describe the violation observedldocumented...)
Required Corrective action for Violation 4:
If you have not already done so, immediately cease discharging and begin efforts to recover the discharged
animal waste. This waste must be handled as prescribed by your CAWMP and applicable state law.
Additionally, take all necessary steps to ensure this violation does not reoccur.
The Division of Water Quality re uests that, in addition to the specified corrective action above, please submit the following
items on or before (date)T i' �� s another time frame is indicated below:
(Use item 1. below if there is a liquid level violation, excess application violation, discharge violation)
f11. Copies of all the pumping records, lagoon levels, rainfall records and waste analyses for this farm from January 1, 2004 to the present
along with a copy of your CAWMP.
(Use item 2. below if 2 or more NODS far freeboard identified wfiu 3 years)
1:12. Within 60 days of receipt of this notice please obtain and submit a comprehensive review report of your CAWMP by a Technical
Specialist. The purpose of this review is to identify the cause(s) of the facility not being able to maintain adequate freeboard in it's
structures and must contain any corrective action taken or proposed to improve the facility's compliance.
(Use item 3. below jar freeboard problems, within 1st storm storage)
03. Submit weekly update reports by 11:00 AM each Monday indicating, (1) the structure liquid level(s) and (2) total volume of waste
irrigated or removed from the system for the seven days prior to the report date. These weekly update reports should continue until all
structures are greater than 19 inches.
(Use item 4. below far acute freeboard problems, within structural storage)
114. Submit daily update reports by 11:00 AM each day indicating, (1) the structure liquid level(s) and (2) total volume of waste irrigated
or removed from the system for the day prior to the report date. These daily update reports should continue until all structures arc
below 12 inches, After reaching 12 inches, reporting should be conducted on a weekly basis. Submit weekly update reports by 11:00
AM each Monday indicating, (1) the structure liquid level(s) and (2) total volume of waste irrigated or removed from the system for
the seven days prior to the report date. These weekly update reports should continue until all structures are below 19 incites.
-1 . Please have the OIC for this farm include an explanation as to how this violation occurred.
OK Please have the OIC include a list of the steps that will be taken to prevent this violation from occurring in the future.
Please be advised that this notice does not prevent the Division of Water Quality from taking enforcement actions for this violation or
any past or future violation. Furthermore, the Division of Water Quality has the authority to levy a civil penalty of not more than
$25,000,00 per day per violation.
(Use paragraph below far enforcement Intent)
0 If you have an explanation for these violations that you wish to present to this office, please forward a detailed explanation, in writing,
of the event noted and why you feel that this office should not proceed with recommendation for enforcement. This office should
receive information in the time frame requested within this letter. Information provided to this office will be reviewed and, if
enforcement is still deemed appropriate, your explanation will be forwarded to the Director with the enforcement package for his
consideration.
If you have any questions concerning this matter, please do not hesitate to contact either Mr. (Inspector, Position)
or myself at [phone].
Sincerely,
Stephen A. Barnhardt
Regional Aquifer Protection Supervisor
S131rf
cc: Keith karick - Compliance Group
Trent Allen. SWC, FRO
Central Files - Raleigh

Division of Water Qulie
ality
�Faci�ity Nitlnbef 3 �, Division of Soil and Water Conservation
Qther Agency
Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
Q Technical Assistance
Reason for Visit
0 Routine Q Complaint
Q Follow up O Referral Q Emergency
O Other ❑ Denied Access
Date of Visit: Q Arrival Time: Q Departure Time: /�' ,� County:S.S�T� Region:
Farm Name: _ _ 2_e7T ��_ Owner Email: 10,
Owner Name: moo - �� �, at vYt:S - - Phone:
Mailing Address: -RL7 G�i�a�D �•
Physical Address:
Facility Contact: 1 UJI PAL4-6 Title:
Onsite Representative: f •
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 c = & = « Longitude: 0 ° 0 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑-Non_La et
Dry Poultry
Lars
Non-L;
Pullets
Poults
Discharges & Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at. ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Daia Heifer
❑
Da Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
ail"
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?,
❑ Yes allo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
❑No
❑NA
ONE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
,®,No
❑ NA
❑ NE
❑ Yes
D2LNo
❑ NA
❑ NE
12128104 Continaed

Facility Number. Date of Inspection
Waste Collection & Treatment
!
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes SqNo ❑NA ONE
a_ If yes, is waste level into the structural freeboard? ❑ Yes [3No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): %
Observed Freeboard (in): f
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 4 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [ZNo ❑ NA ❑ NE
through a waste management or closure plan'?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? 9 Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes RNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ yes [9No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ANo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu. Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) �1(f D. 3_
_
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
99No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site [teed improvement?
❑ Yes
[NNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[]
Yes
ONo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Cg�IVo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
allo
❑ NA
❑ NE
Reviewer/Inspector Name t ;; ;hi�T, _ d"�a..�c Phone:
Reviewer/Inspector Signature: Date; O(a
!l1,Z8/U4 C onnnued

0-
Ficility Number: — Date of Inspection
Re_q_uired Records & Documents
r
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes allo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 0-.Yes ❑ No ❑ NA ❑ N£
9 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis oil Analysis ❑ Waste Transfers ❑ Annual Certification
.Rainfall ❑ Stocking CgLCrop Yield C9,120 Minute Inspections CRIMonthly and I" Rain Inspections Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
KYes
❑ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
(RNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
E3 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
MNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
R No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
P_NA
❑ NE
Otber Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Lallo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
allo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
R1 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
NNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
K Yes
❑ No
❑ NA
❑ NE
Additioaal Comments and/or Drawings: w
� ✓'1� � "� i - / r(,t: wf % ei'-rr V : r� �� �afl n4 ; PL rd;a"'�
T� ,I w;t-4 At (,1 j' //goo 4k ;s of,4 .ri l( To-jk w,41, rw,— '
.yv�rr��'4r dtt��5.
"A -t-o
� r
b-c rr�ra�-t-d•
I
12128104

Type of Visit S Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit i Routine O Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facilitv Number Date of visit: "l- oil 'rime: 'Ura
Not O erational 0 Below Threshold
UA?Crmitted Q Certified © Conditionally Certified Q Registered Date Last Operated or Above Threshold -
Farm Name: G1XI? FRrrn/ County: .saqdg*el7 /C;VO
Owner Name: _ J rrrr.re Phone No: 9/V S4 %-
Mailing Address: /te g&j C-r' n vn IV � 3.P JS
Facilitv Contact: W < Title: Phone No-
OnsiteRepresentative: t Integrator: 6r_"s
Certified Operator: TO.faa� 1,✓r S Operator Certification Number:
Location of Farm:
`[Swine ❑ Poultry ❑ Cattle ❑Horse Latitude ' 0 0" Longitude 0' �• 0••
Design 7Current
awlne L;z achy t o ulatton
❑ Wean to Feeder
z '_ :Design Current D.. 'Ciirr
E v_ -� Canneity Ponutstirie Cattle � _ :Canacity SPonuls
elder to Finish >>
1 9 7 -l1 Non -Layer = ` ❑ Non -Dairy
❑ Farrow to Wean
Farrow to Feeder ❑ Other
Farrow to Finish = Total DelignCa ae p n}'
Csilts
❑Boars -- Teta1 SSLW-~
;tiuiuber of Lagoon§ _ Subsurface Drains Present ❑ La oop Area ❑ S ray Field Area
.Hi►Iditig Ponds / Solid Traps ❑ No Liquid Waste Management System
Discha= 8 Stream Impacts -,,�
I . Is any discharge observed from any part of the operation? El Yes
Yes L
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the conveyance man-made? ❑ Yes ,2rvo
b. If discharge is observed, did it reach Water of the State? (If ves. notify DWQ) ❑ Yes
c. If discharge is observed. what is the estimated flow- in gal/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ) ❑ Yes El -No
2_ Is there evidence of past discharge from any parr of the operation? El Yes 9<0
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Q-110
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ET-.'q'o
Structure 1 Structure 2 Structure 3 Structure 4 Structure S Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

FacilityNumber —
Date of Inspection 1 ' / /
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
Closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public stealth or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprvvement?
8. Does any part of the waste management system other than waste structures require maintenancefimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10, Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑PAN j❑ Hydraulic Overload [I Frozen Ground ❑Copper and/ Zinc
12. Crop type
11 Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor ]ssaes
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18, Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes
❑ Yes ❑<
❑ Yes ❑'Ko­
❑ Yes ❑M
❑ Yes E941-o
❑ Yes ❑-No
❑ Yes 0-No
❑ Yes G�M
❑ Yes M Alo
❑ Yes 3-NNo
❑ Yes G3-M
❑ Yes D-K'o
❑ Yes 3-W
❑ Yes ❑ No
❑ Yes ❑'K0_
❑ Yes [}i0
❑ Yes [}i+d"o
❑ Final Notes
Please rrrO"t
y
P G /U9 L,74 %a p�pvr.,� Pros-t+
Reviewer/litspectot• Name - - cl/' t` - _`._ '. • � . , .... - - _ _.�; G- �, '� .. . �... .,`-.. .° . , .. ' �_ ..
Reviewer/Inspector Signature: Date: d�
1Z✓1Z1UJ wnanuea

Facility Number: 82 —q3 Date of Inspection
Reauired Records & Document.
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes BZlo -.
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ieJh dam, ,etc.) ❑Yes SINT-
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
71 7 -2, Li K -/G —� 3, 0 7. I I —/ta �� 2
Yes
24. Is facility not m compliance with any applicable set ack criteria n effect at the time of design?
❑
Goo
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑-96—
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
O-No-
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑Ko
28. Does facility require a follow-up visit by same agency?
❑ Yes
94o
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONO
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
B-N-o-
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
12112103

State of North Carolina
Department of Environment
and Natural Resources
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Kerr T. Stevens, Director
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Joanne Williams
J &J Farm
2340 Roanoke Rd.
Clinton NC 28328
Dear Joanne Williams:
4&6T1T,4 ?W, A
%WWWW %woolm so 2
8 a M;lk
N CDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
February 5, 2001
L3I�k `' J
Fl-3 13 2001
Subject: Notification for Wettable Acre Determination
Animal Waste Management System
J&J Farm
Facility Number 82436
Sampson County
A letter dated January 15, 1999 was sent to advise you about concerns associated with Certified Animal
Waste Management Plans and the method by which the irrigated acres within the plans were calculated. Only
the acres that are wetted can be credited in the waste management plan as receiving waste application. Any
acreage within the plan that can not be reached by waste application equipment can not be used as part of your
plan.
An evaluation by Trent Allen on 5/6/99 was made to review the actual number of acres at your facility
that receive animal waste during land application. The evaluation of your facility has yielded one of the
following two results as indicated by the box marked with an "X".
Category 1:
Y,The evaluation of your facility could not be completed due to a lack of information. Please
contact your Technical Specialist to assist in providing Trent Allen the necessary
information to potentially exempt your facility from undergoing a complete wettable acre
determination. Please submit this information to Trent Allen, at 225 Green Street, Suite
714, Fayetteville, NC 28301, within in 90 days of the receipt of this letter. If you have any
questions please contact Trent Allen at [phone]. If within 90 days you are unable
to provide Trent Allen with the information you are automatically required to complete
a Wettable Acre Determination as described by Category 2 below, within 180 days
of receipt of this letter.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

Notification for Wettable Acre Determination
Animal Waste Management System
Page 2
Category 2:
❑ Your facility has been identified by the Department of Environment and Natural Resources
as a facility that may have overestimated the number of acres actually receiving animal
waste. Therefore, some or all of your fields may be exceeding the allowable loading rates
set in your Certified Animal Waste Management Plan.
In order to resolve this issue, please contact a designated Technical Specialist to have him
or her conduct a Wettable Acre Determination for your facility. The Technical Specialist must
be one that has been approved by the Soil and Water Conservation Commission to conduct
Wettable Acre Determinations. Many Technical Specialist with the N.C. Cooperative Extension
Service, the Soil and Water Conservation Districts, the Natural Resources Conservation
Service, and the Division of Soil and Water Conservation have received this special
designation. You may also contact a private Technical Specialist who has received this
designation, or a Professional Engineer.
All needed modifications to your Animal Waste Management System must be made and
the Wettable Acres Determination Certification must be returned to DWO within the next
180 days, if the needed modifications are not made and if the form is not returned within the
required time, DWQ will be forced to take appropriate enforcement actions to bring this facility
into compliance. These actions may include civil penalty assessments, permit revocation,
and/or injunctive relief.
Once a Wettable Acre Determination has been completed, a copy of the attached Wettable
Acre Determination Certification must be submitted to the address listed on the form. Please
note that both the owner and the Technical Specialist must sign the certification. A copy of all
the Wettable Acre Determination documentation that applies to your Waste Utilization Plan
must be kept at your facility. DWQ and the Division of Soil & Water Conservation Staff will
review all documentation during their annual visit of your facility. An additional copy must by
kept on file at the local Soil & Water Conservation District Office. Please note that if you install
or modify your irrigation system, a designated Irrigation Specialist or a Professional Engineer
must also sign the Wettable Acre Determination Certification.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Sonya Avant of our
Central. Office staff at [phone] ext. 571.
Sincerely,
X
tiOIL--
Kerr T. Stevens
cc: Fayetteville Regional Office
Sampson County Soil and Water Conservation District
Facility File
Murphy Family Farms

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
-James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
January 10, 2000
J&J FARM
2470 ROANOKE RD.
CLINTON NC 28328
Attn: Joanne Williams
A
IT
• •
.--NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT ANo NATURAL RESOURCES
Subject: Application No. AWS820436
Additional Information Request
J&J Farm
Animal Waste Operation
Sampson County
Dear Joanne Williams:
The Non -Discharge Permitting Unit has completed a preliminary engineering review of the subject application. Additional
information is required before we can continue our review, Please address the following by February 9, 2000:
Best Management Practices (BMPS) that are to be implemented at this facility should be identified (check
the appropriate BMPs) on the Insect Control Checklist, the Odor Control Checklist and the Mortality
Management Checklist_
2. Please provide the Operation and Maintenance Plan for this facility.
3. Please provide the Emergency Action Plan for this facility.
Please note that all WUP revisions trust be signed and dated by both the owner and the technical specialist. Please
reference the :::abject permit application number when providing the requested irf:.-mation. All information should be signed,
sealed, and submitted in duplicate to my attention at the address below. The information requested by this letter must be
submitted on or before February 9, 2000 or the Division will return your application as incomplete in accordance with 15A
N.C.A.C. 2H .0200 and your facility will be considered to be operating without a permit.
Please be advised that operation of the subject animal waste management system without a valid permit is a violation of North
Carolina General Statute 143-215.1 and will subject you to the enforcement authority of the Environmental Management
Commission.
If you have any questions regarding this request, please call me at [phone], extension 364.
Sincerely,
Dianne Thomas
Soil Scientist
Non -Discharge Permitting Unit
cc: Fa ettevil ee Regional Office, Water uali
ermtt t
1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina
Department of Environment
and Natural Resources RECE --
Division of Water Quality: VED
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Joanne Williams
J&J Farm
2470 Roanoke Rd.
Clinton NC 28328
Faun Number: 82 - 436
Dear Joanne Williams:
•- C P 2 1 1999
FAYETTEVILLE
NEG. OFF:CE
September 15, 1999
A IT4
NCDENR
NORTH CAROUNA DEPARTMENT OF
ENVIRONMENT ANo NATURAL RESOURCES
You are hereby notified that J&J Farm, in accordance with G.S. 143-215.1OC, must apply for coverage under an
Animal Waste Operation General Permit. Upon receipt of this letter, your farm has six 60 da s to submit the attached
application and all supporting documentation. In accordance with Chapter 626 of 1995 Session Laws (Regular Session
1996), Section 19(c)(2), any owner or operator who fails to submit an application by the date specified by the
Department SHALL NOT OPERATE the animal waste system after the specified date. Your application must be
returned within sixty (60) days of receipt of this letter. Failure to submit the application as required may also subject your
facility to a civil penalty and other enforcement actions for each day the facility is operated following the due date of the
application.
The attached application has been partially completed using information listed in your Animal Waste Management
Plan Certification Form. If any of the general or operation information listed is incorrect please make corrections as noted on
the application before returning the application package. The signed original application, one copy of the signed application,
two copies of a general location map, and two copies of the Certified Animal Waste Management Plan must be returned to
complete the application package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Non -Discharge Permitting Unit
1617Mail Service Center
Raleigh, NC 27699-1617
If you have any questions concerning this letter, please call Susan Cauley at [phone] extension 546 or Jeffery
Brown with the Fayetteville Regional Office at [phone].
Sincerely,
c
for Kerr T. Stevens
cc: Permit File (w/o encl.)
Fayetteville Regional Office (w/o encl.)
1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone [phone] FAX [phone]
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M
Date of inspection L �
Facility Number $Z 3�
Time of Inspection : o"D 24 hr. (hh:mrrr)
© Registered ® Certified © Applied for Permit © Permitted 113 Not Operational Date Last Operated :..................
Farm Name. J .•� Countv:.........?,0!20oSv'`�..........................................
........................... 'J-....................................I.................... /.�
Owner Name. til!?.,lQ.. �`/�.R�.t ...................................... Phone No:....L.../6... �r`7:..ar�..............................
Facility Contact: ................. ... Title: .. Phone No:
Mailing Address:� �
.5'7a.....,�.........................................,. . �{/..* ....�:�:3z............. f............. ,�..
Onsite Representative .................. . Integrator ..,--.�� ' ..........................
�............. ....... .............I.... '�
Certified Operator, ............:,% Operator Certification Number;..--...............-
P. _ .............................................................................
Location of Farm:
..............................a.. ..................................................................................................................................................................................................................... ......... ..
................�tJ..e4N... ...C..�:�.._ .. .............................................................................----.............----..........................................................................
Latitude Longitude
ter:
t
Design ` `Current Design urrent :: * ' 'sign fi .t<rrent
vrure .. Capacity<Popnlation PoulEry Capactty,;PopulaEion Collie Ca acr Po ulateon:r
P t... Is
❑ Wean to Feeder
Feeder to Finish
/LZ
/ZZ
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other "
Total Design Capacity
y Total sk -'
4Number of Lagtiorrs /Hold ng Ponds -❑uburface Drains Preset ❑Lagoon Area Spray
Field Arean
E wrE1 No Liquid Waste Management System
General
1. Are there any buffers that need maintenancelimprovement? ❑ Yes VLNo
2. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes. notify DWQ) ❑ Yes 1No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes XNo
3. Is there evidence of past discharge from any part of the operation? ❑ Yes CgNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes FNo
5. Does any part of the waste management system (other than lagoonstholding ponds) require ❑ Yes No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
T Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
7125/97
Continued on back

r
Facility Number:EZ —
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes No
Structures (I,agoons.Holding Ponds. Flush Pits,etc )
9. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (ft): ........a7....0 h _� .......... r. ... __ _.... _.. ....
� ..... ...
10. Is seepage observed from any of the structures? ❑ Yes ;5 No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenancelimprovement?
(1f any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop typeQ! Sa-----.... ................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0: No.violations_vr deficiencies.were: noted during thisMsit._ You:vtiifl ieceive no further : -
- : � cnrresporidence alioutthis:visit:- : : .. � .. • • . � .: - : ::: � : � ::: � : ::: � : � : • . :..... , .: .
❑ Yes
No
❑ Yes
No
Q Yes
No
❑ Yes
ANo
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes IN No
❑ Yes Wo
❑ Yes A No
XYes ❑ No
❑ Yes ZNo
❑ Yes ((No
❑ Yes ❑ No
7/25/97