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Home My WebLink About820627_INSPECTIONS_20171231NORTH CAROLINA Qepartment of Environmental Quality .I Compliance Iospeetion Reason for Visit: ~utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access Date of Visit: IPz,f'-7%'] Arrival Timed '9; DO Farm Name: G-=or /){c G; II Departure Time:! #o I County:--7-o---Region: Qt:J Owner Email: Owner Name: {fro?_., /ltc {;;Jf Mailing Address: Physical Address: Facility Contact: _ __,G-...z::..:r=:..<•'"'?"r"-"M'-'-'-c-'(-"v'-'·'-'J-.LI __ Title: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: Latitude: Oiseharg~ and St!"'eam Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field a_ Was the conveyance man-made? Phone: 0 Other: 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)? Phone: Integrator: _5;,.rftff74' of Certification Number: I rs-s-3 Certification Number: Longitude: 0 Yes ~DNA DYes 0No DNA DYes 0No DNA DYes rlll.lrr. rlXTA L.....J '~'-' L...J ·~·. d_ Does the discharge bypass the \',Jaste management system? (!fyes, notify D\VR) 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? DYes DYes (!]No DNA [31<10 DNA ONE ONE ONE rll'"' L...J ''L.- ONE ONE Page I of3 214/2015 Continued ,_ • !Facility Number: g-;;L. t.-?-7 Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): /'7 Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on~site which arc not propcily addressed and/or ma.ilaged through a waste management or closure plan? DYes DYes Structure 5 0No DNA DNA Structure 6 ONE ONE DYes~ DNA ONE DYes ~o DNA ONE ~f 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? ~ ~ D NA D NE 8. Do any of the structures lack adequate markers as required by the penn it? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Apolication I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes [3-llfo DNA D NE D Yes C}Ntf DNA D NE DYes [2t1'fo DNA D NE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes (31<10 D NA D NE D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area 12. Crop Type(s): 15 ,-n>w-el ,__ /olh'l"xrd 13.Soi1Type(s): --~~----~~~~Ll+---------------------------------------------------------------~---------------- [31'fo 14. Do the receiving crops difTer from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack oforooerlv oocratine: wao;te annlication enninmPnt? .. ~ . "-' '' ---------.,~-,···-···· Required Records & Documents 19. Did the facility fail to have the Cenificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. DYes DNA ONE DYes [2)1'fo DNA ONE DYes [3"1'/o DNA ONE DYes (3-No DNA ONE 0 Yes rrl-'1\ln llNA llNF L.....l • --L.....l •.•• L.....J. -- DYes [3-No DNA ONE DYes [31'fo DNA ONE Owup Ochecklists 0 DesitP' D Maps D Lease Agreements Oother: ------- 21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes [:}-No DNA D NE n Waste Application D Weekly Freeboard D \Vastc Analysls D Soil Armlysis 0 Waste Transfers D \Vcathcr Code D Rainfall 0Stocking D Crop Yield 0 120 Minute Inspections D Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes B'J'<O D NA D NE 23. If selected, did the facility fai! to instal! and maintain rainbrcakers on irrigation equipment? 0 Yes B-No D NA 0 NE Page 2 of3 21412015 Continued I Facility Number: 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? lfyes, check the appropriate box(es) below. DYes DYes 0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels 0 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 faciiity faii io secure a phosphorus ioss assessments (PLAT) certification? Otber 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? lfyes, 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. 0 Application Field 0 Lagoon/Storage Pond D 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? DYes UYes 0 Yes DYes DYes DYes DYes DYes DYes EfNo DNA -__.. L.::::fNo UNA ~ DNA ~ DNA [<]No DNA ~ DNA ~ DNA j3No DNA ~ DNA Ulmments (refer to question #): Explain any YES &IJliwers aiid/cWany additional r;ecoiDOle~d!ltiooii or !lny other. comments. Usedrawingsoffacilityto·betterexplainsituations(risea'dditionaipai:~..Snecessary). ,. :,., .,, · , , , , , , ., j'b;f'h-c..-<'"-)/ J._?'.__3i:. ~.A. c~-JL:,Zr~.o"" ;vo 1/'/ ;_:, cJ-!'-'fJiJU /'"':z"" 4R*' r-./?7 7, /J10tt/ /..7ce----. P~ Reviewer/Inspector Name: ONE ONE ONE UNE ONE ONE ONE ONE ONE ONE ONE Reviewer/inspector Signature: / ;--) _// /?.-?.. / Date: / vr-;a--vtr Pagel of 3 21411015 for Visit: Date of Visit: I! H-I Z I Arrival Time: 19:/UO Farm Name: f'7Yne,f.c flb-4,; L,J Owner Name: ~0(7--c_ 5I2 tn c-&U/ j/ Mailing Address: Physical Address: Facility Contact: &""'DfT-<!!-;??c. G;f{ Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: !)i~:charges and Stream Impacts 0 Denied Access Departure Time: I I 0; v() I County: -2yzpcz_ Region: ffo Owner Email: Phone: Title: c9<-Urt '<"L Phone: Integrator: ;kn;~/1 Certification Number: Certification Number: Latitude: Longitude: I. Is any discharge observed !Tom any part of the operation? DYes l}?lNo DNA ONE Discharge originated at: 0 Structure 0 Application Field D 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? Page I of3 DYes 0No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE DYes ~No DNA ONE DYes 8No DNA ONE 2/4/2015 Continued I Facility Number: 82--b.rz loate of Inspection: ,//-:;:-12 Waste Collection & Treatment i 4. Is storage capacity (structural plus storm storage plus heavy rainfall) Jess than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): [t Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE DYes 0 No 0 NA D NE Structure 5 Structure 6 DYes BNo DNA ONE DYes ~No DNA ONE 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 ofthe structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures requ{re maintenance or improvement? Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes JXl No DYes ~No DNA ONE DNA ONE D Yes _[2lNo 0 NA 0 NE D Yes 13.._No 0 NA D NE I I. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes [3..No D NA D NE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) D PAN D PAN > I 0% or I 0 Jbs. D Total Phosphorus n Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): 13. Soil Typc(s): 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? i6. Did the faciiity fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18.1s there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility tail to have all components of the CAWMP readily available? If yes, check the appropriate box. DwuP Ochecklists 0 Design D Maps 0 Lease At,'Teements 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes gB-No DNA DYes [29-No DNA U Yes 121 No UNA DYes 121 No DNA 0 Yes r=JI "lrt.T~ fl1rt.TA lLJ L'IU L....J 1'1.n 0 Yes @No DNA DYes L'i!-No DNA 00ther: DYes .01-No DNA ONE ONE UNE ONE rl'h.tl:' L....J I"'L.. ONE ONE ONE 0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Weather Code 0 Rainfall 0Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes I2?J No DNA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes [2'1-No 0 NA 0 NE Page 2 of3 21412015 Continued 'I t ' jFacili!l: Number: ,?:?-(p_;z z: I Date of lns~ection: L/--.P 17 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes EJ No DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? lfyes, check DYes gNo DNA ONE the appropriate box(es) below. 0 Failure to complete annual sludge survey D Failure to develop a POA for sludge levels 0 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? DYes ~No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes ~No DNA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes ~No DNA ONE 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? DYes ~No DNA ONE 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 0 Yes l5a No DNA ONE pennit? (i.e., discharge, freeboard probiems, over-appiication) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes [&No DNA ONE 0 Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~No DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 34. Does the facility require a follow-up visit by the same agency? DYes ~No DNA ONE Coinments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. Use drawings offacility;lo better explain situations (use additional pages as necessary).·, 1,,,, ,, "", ,.:. .. " , · ,, .. ,,1 Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 Date: /J-ff-'-...?o/? 11412015 ompliancc Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: ~tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: I(;Z=z!.J-/ t, I Farm Name: G:ct?r:lr Arrival Time: I /I .' QQ Departure Time: I f?-1, = I County;_£7<"'== Owner Email: (/ OwnerName: .~.r~-=~·~n~f~t~c~~C~L?~~~~c~Gr~-~;~!L/ __________ __ v Phone: Mailing Address: Physkal Addn~ss: Facility Contact: _.:::6__::_z-_.o7?~~'--~"'-!..!c""" . .=6>~'/,L{ __ Title: Phone: Onsite Representative: Integrator: Certified Operator: Certification Number: Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? 0 Yes JiZLNo Discharge originated at: D Structure D Application Field 0 Other: a. Was the conveyance man-made'? n Yes nNo b. Did the discharge reach waters of the State? (If yes. notifY DWR) 0 Yes QNo c. What is the estimated volume that reached waters of the State (gallons)? nvp<;; fiNn L.-..J • --L...J . ·~ d_ Does the discharge bypass the waste management system? (!fyes. notit)' DWR) 2. Is there evidence of a past discharge from any part of the operation? 3. \\.'ere there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? 0 Yes ~No 0 Yes E)__No Region: DNA nNA DNA llNA L...J ---- DNA DNA ONE ONE ONE llNF ~·- ONE ONE Page I of3 21412015 Continued !Facility Number: ftE _ (,2-'7 I Date of Inspection: /2 :f)""'-/ t. 1 Waste Collection & Treatment 4. Is storage capacity (structural plus stom1 sturagt: plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site •.vhich are not properly addressed and/or managed through a waste management or closure plan? D Yt:s r;g r~o DNA D NE 0 Yes 0 No 0 NA 0 NE Structure 5 Structure 6 0 Yes f8,_No 0 NA 0 NE 0 Yes ~No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application I 0. Are there any required buftCrs, setbacks, or compliance alternatives that need maintenance or improvement? 0 Yes 0 Yes 0 Yes DYes ,g(No DNA ONE f9,No DNA ONE ~No DNA ONE ~No DNA ONE I l.ls there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): km,J""-/ OV><>r.,;r-r-/ 13. Soil Type(s): 14. Do the receiving crops differ from those desib'llated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement'! 16. Dict the facility fail to secure and/or operate per the irrigation desibrn or wettable acres determination? 17. Does the facility Jack adequate acreage for land application? 18. Is there a lack of properly operating waste appllcation equipment? Required Records & Documents I 9. Did the facility fail to have the Certificate of Coverage & Permit readily available'? 20. Does the facility fail to have all components of the CAWMP readily available'' If yes. check the appropriate box. Owur 0Checklists 0 Design 0 Maps 0 Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. n Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis 0 Yes~ No DNA ONE 0 Yes )8iNo DNA ONE 0 Yes .IZJ...No DNA ONE 0 Yes Jkt_No DNA ONE 0 Yes RNo DNA ONE DYes ~No DNA ONE 0 Yes §No 0 NA 0 NE Oother: ________ _ 0 Yes (29.,No 0 NA 0 NE 0 Waste Transfers 0 Weather Code 0 Rainfall 0Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23~ If selected. did the facility fail to install and maintain rainbrcakers on irrigation equipment? Page 1 of3 0 Yes i81.No 0 NA 0 NE 0 Yes ~No 0 NA 0 NE 114/2015 Continued -!Facility Number: ft2: -h~7 I nate of Inspection: J2 -12:-I~ 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. QYesEJNo QNA QNE 0 Yes ~o QNA QNE 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 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 faciiity faii to secure a phosphorus ioss assessments (PLAT) certit1cation? Otber 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. 0 Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 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? 0 Yes 0 Yes 0 Yes 0 Yes 0 Yes 0 Yes 0 Yes 0 Yes 0 Yes ~No DNA ONE 5No UNA UNE [3._No DNA ONE [g)_ No DNA ONE ~No DNA ONE ~No DNA ONE 181. No DNA ONE fklNo DNA ONE ~0 DNA ONE Comments (refer to question#): Explain any YES answers and/or any additional recommendations or any otber comments. Use drawings of facility to better explain situations (use additional pages as necessary). Reviewer/Inspector Name: Phone: <)--_.(!-JO ..J-0 I 5 / Reviewer/inspector Signarure: Date: /,2-;so-~/C., Page 3 of3 21412015 ompliance Inspection Operation Review 0 Structure Evaluation Reason for Visit: ~tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: I I c-1-/tl Arrival Time: I // D 0 Farm Name: 0--c ar;-c m C-Cr; I I DepartureTime:l ;;t/DO I County.:_,f::7::t~ Region: fiD Owner Email: Owner Name: ._Qc=<?'l=<:t,')i'-"'-"<:...· __,\D,;.I .::..._____.:./)1:...__c__,(;_:::...:lc..~/'-'I---- Mailing Address: Phone: Physical Address: ------------------------------------------- Facility Contact: Phone: Onsite Representative: Integrator: _,~.m'-<-<'-"p"'----------- Certified Operator: Certification Number: Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? DYes ~No Discharge originated at: 0 Structure 0 Application Field 0 Other: a. Was the conveyance man-made? DYes 0No b. Did the discharge reach waters of the State? (If yes, notifY DWR) DYes 0No 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) 2.1s there evidence of a past discharge from any part of the operation? DYes DYes 0No ~No 3. Were there any obscnrable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? Page I of3 DYes ~No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 21412014 Continued !Facility Number: !Date oflnspection: d-I I '5:' Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure) Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE DYes 0No DNA ONE Structure 5 Structure6 0 Yes [29-..No 0 NA 0 NE 0 Yes !&_No 0 NA 0 NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part oft.l}e waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? ,......, .. =--,_--, "T .. r-"1 'to. TT'" LJ Ies i,Q"'O u !'If\ L_j1"1.C. DYes ~No DNA ONE nves rill Nn nNA nNE '-' ~-·-'--'---'-' 0 Yes ~No 0 NA 0 NE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes [2?1. No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0PAN D Pi~~> 10% or 10 !bs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): /ou,.-r<r-r-J 0 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. owuP Ochecklists 0 Design 0 Maps 0 Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes P?JNo DNA ONE DYes {SNo DNA ONE DYes D1-No DNA ONE DYes l;i?J No DNA ONE DYes (BNo DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE Oother: DYes r:g_No DNA ONE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes !29-No 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? Page2of3 0 Yes IZJ No 0 NA 0 NE 21412014 Continued I . !Facility Number: JDate oflnspection: ,(;z.--/ /r J 24. Did the facility fail to calibrate waste application equipment as required by the permit? > 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. 0 Yes Q1INo DNA ONE DYes ~No DNA ONE 0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes J2l No DNA ONE DYes Jgj No DNA ONE DYes ~No DNA ONE DYes .181No DNA ONE DYes ~No DNA ONE DYes 0.No DNA ONE 0 Application Field D Lagoon/Storage Pond 0 Other: __________ _ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 0 Yes NNo DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes r:;;a No DNA ONE 34. Does the facility require a follow-up visit by the same agency? DYes ~No DNA ONE 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). Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 Phone: _//b-t:'f...J'-J3DV Date: .1,;2-/ -ci0/~ 1/412014 ompliance Inspection Reason for Visit: G'1Gutine 0 Complaint Date of Visit: VIM t'J Arrival Time:! I/, :00 Farm Name: ~tJCf"' , Owner Name: (-:;re 12')-Z:: Mailing Address: meG::!/ D me G;J! Departure Time: I 0 : o£) I County:,}~ Owner Email: Phone: Region: • t:JZO Physical Address: ------------------------------------------- Facility Contact: Phone: Onsite Representative: Integrator: /Jfvpf Certified Operator: Certification Number: I '/"if3 Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? DYes jiQ_No DNA ONE Discharge originated at: D Strucrure D Application Field D Other: a. Was the conveyance man-made? DYes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No DNA ONE 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) DYes 0No DNA ONE 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? Page 1 of3 DYes DYes ~No DNA ONE (2g No DNA ONE 214/2014 Continued I Facility Number: I [)ate of Inspection: 1/-/ fi--Pf Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): > 19 Observed Freeboard (in): 3S: 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? D Yes (lg_No DNA D NE DYes 0No DNA ONE Structure 5 Structure 6 DYes ~No DNA ONE DYes ~No DNA ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify OWR 7. Du any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Docs any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Arc there any required buffers, setbacks, or comp1iance alternatives that need maintenance or improvement? ...., '~--U Jes DYes DYes DYes ~ ... T_ r-1 ..._T A r-1 lro.TJ:' ~l~U L.J 1~/"\. L..J l"I.L ~No DNA ONE JiZt No DNA ONE 181 No DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes 13J..No DNA D NE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area 12. Crop Type(s): $~ /12 v d%r-r/ 13. Soil Type(s): (!ufl/Js.jlJI'D 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? i 8. is there a iack ofpropcriy operating waste appiication equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check the appropriate box. 0WUP 0Checklists 0 Design D Maps D Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA ONE DYes ~No DNA ONE DYes ~No DNA ONE DYes g.No DNA ONE ~" ~ ... T .---., ,_TA r--'1 ,.TT"" U res 051-1,0 U f'H\. L.J 1"C DYes [8.No DNA ONE DYes gNo DNA ONE 00ther: DYes gNo DNA ONE 0 Waste Application D Weekly Freeboard 0 Waste Analysis D Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall D Stocking D Crop Yield 0 120 Minute Inspections D Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Page2of3 DYes ~No DNA ONE UYes ~No UNA UNE 21412014 Continued .,, • I Facility Number: p -t.,,;;. 7 I ' jDate of Inspection: /1-/i= /41 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes !>'!-No DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes ~No DNA ONE the appropriate box(es) below. 0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels 0 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? DYes I2'J No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes [81No DNA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes J2a No DNA ONE and report mortality rates that were higher t.~an norma!? 29. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE 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 DYes jgj No DNA ONE permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes ~No DNA ONE 0 Application Field D Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~No DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 34. Does the facility require a follow-up visit by the same agency? DYes gNo DNA ONE Comments (refer to question#): Explain any YES answers and/or any additional reeommendations or any other comments. Use drawings of facility to better explain situations (use additional pages as neeessary). Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 Phone: 9/o--£.3"_f--,33!:X? Date: //--/&-,?D/~ 2/4/2014 I I/O? )il0/3 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access lillY I\] ~lVV~ I ArrivaiTime:III~®A+f l DepartureTime:IJ,j;Sp l County: 5%125an I Region: FRO Date of Visit: Farm Name:~Ge"'-fYJ~e_=-.!.Hc-=.::fOCJ...{ /,._/ _______ _ OwnerEmail: ---------------------------------- Owner Name: Gecrge HcC,i/1 Phone: Mailing Address: 1,. -, tl ~ r.. f. i AI _ • I • 1 I .I I\ Physical Address: Yfo] Well£ Ulup! Ulvtrh fJib· ttOfl€11£ Facility Contact: 6Erge HcfO/ // Title: Otrnft Onsite Representative: "'G-"P"'-"'t'l'J~e,;,....J.H_,_._c_..004\ +/ t-1----------- Certified Operator: 6eOt!Je Nc G. J 1/ Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field 0 Other: a. \Vas 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)? Phone: Integrator: -'H'--'----'8'--"---------- Certification Number: _,)_,qt3'-"=5'-'3"'-------- Certification Number: Longitude: DYes ~No DNA ONE r-1 V--~"'"'-i'l lo..T A , ""' u 11;;':3 L..J nv L.J l''H""'-L..J l'IL... DYes DNo DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes DNo DNA ONE 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? Pagel of3 DYes DYes ~No DNA ONE f;rNo DNA ONE 21412011 Continued lFiicility Number: l Date oflnspection: }1/ Y ltJ Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure2 Structure3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): _t/_'f+--- Observed Freeboard (in): ---:.~.3!::91--- 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 DYes ~No DNA ONE DYes ~No DNA ONE 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 struciures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Apolication 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? (2SI Yes DYes DYes DYes 0No DNA ONE IS4No DNA ONE D?No DNA ONE E;)}No DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area 12CropType(s): Cath±al l1Prm.,da·.SrnqiiJ«lln f)vtrsf!Po{. r I. I " 7 13. Soil Type(s): {a?/d\ fXI(o A- 14. Do the receiving crops differ from those designated in the CA WMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. is there a iack of properiy operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. owup Ochecklists 0 Design 0 Maps 0 Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes [&No DNA ONE 0 Yes I2Sf No DNA ONE 0 Yes (81 No DNA ONE DYes rgNo DNA ONE U Yes 1):1 No UNA ONE DYes ~No DNA ONE DYes IS;!' No DNA ONE 00ther: 0 Yes 1$J No DNA ONE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes [81 No 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? Page 2 of3 0 Yes 0 No I2SJ NA 0 NE 214120ll Continued II'llcility Number: 0J7 loate of Inspection: 11/y HJ 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. DYes !SI:-No DNA D NE DYes ~No DNA ONE 0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels 0 Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than nonnaJ? 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) DYes §No DNA ONE DYes 0No ~NA ONE DYes ('gNo DNA D NE DYes ~No DNA ONE DYes 5{No DNA D NE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. D Yes c:il No D NA D NE 0 Application Field D Lagoon/Storage Pond D Other: __________ _ 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 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? DYes ~No DNA ONE DYes ~No 0 Yes gNo DNA ONE DNA ONE 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). IL l0""' l~) 7, ?ieaJe.-tnowa-dfO'htrhrcfd~bla&berrfer 0: bachlde. (J(O lryoo-, b01k: lcn-eJ/cle) CM-. se-a:L s-<me.JtaJS. ~L s~; 1_ ieyt-iJ 3m1 lAii I d ~ 1 ~ · ~4.la/ibrai{~ \sgoa-lvrt-il aD/.), Q 5, S/vdje Svrve'/ IS,JoaL ihro'Jh -t"hiJ j{Jtr, PfPPJe do Che... TlfJtf-rear, Reviewerllnspector Name: Reviewer/Inspector Signature: Page 3 of3 Sc bn.pj-Pc Phone 'M-l/33 33q;{of(1l~ Date: NOv '-/) ;::;)0 13 21412011 Facility No. 'io-b"d7 Farm Name ....::6:::.::B~v:J'j>.P---.!...N~c~G<..!r...L.'/I--/-Date 1d ~ 113 Permit COC _J___ OIC_ NPDES (Rainbreaker PLAT Annual Cert Daily Pipe ) IE I I I I I I I I I I I Laaoon Name, S for soillwav Deslan Freeboard I Last Recorded (in) Observed freeboard Sludae Survev Date Sludae Deoth 7ffi LTcluid Trt. ZoneOO Ratio Sludae to Treatment Volume if> 0.45 Date out of coriiOiiance/ POA? 'Ss~~~ovt: Calibration Date 1 71'1111. 2 ., )9; h'l. Rina Size linT {\9; l (\~): DesTcln FlowiODm\ ~ )y,~ Actual Flow \.:l'l, ),;,) Desian Diam. (ft\ Cl'-\\ ?:1:75 Actual Diam. ~I{) -;:).;::) 0 Soil Test Date q\oo\ I} d) I ha_ pH Fields ' 1 2 3 4D ;o.O T 3 4 4 5 5 6 6 7 Transfer Sheets RAIN GAUGE 7 8 Lime Needed (!) Crop Yield / -JI Wettable Acres __ __;"()::: :l 40 !J,~ Y WUP Dead box or incinerator __ _ Lime Applied Cu-I v Zn-1 ./ Needs S (S 1<25) ~ - Needs P 1\\0 "\?.. Weather Codes Weekly Freeboard.../ 1 in Inspections __ _ 120 min lnsp VVaste Date 11n!O~ t;,/ L"' /;'"J, LJ/Jillil b/i1.hc ~~") 1Jnl.'1 -60 Dav roo + 6o Dav N flb/1 ooo GaO \,",'-\ If\. (/l(O I i. I q I,;} (o 10;50 oH -,,-"!: ':1 cl. ., 1, . -) ttl l:-, Pull/Field Soil Crop Acres PAN 1-'-1 tv..J.. ~ P• cY: -"'-JO d-if'c;;;) J 7 ~0\'J M ""'Jo. \)t'J._. Verify PHONE NUMBERS and affiliations,)\0~ w''\\v I A-fA Date last WUP FRO FRO or Farm Rerords Date last WUP at farm !'il-b.-!1 l Lagoon # fl1;0 1> App. Hardware Top Dike :5<> > Stop Pump Start Pump lfitJ Conversion-Cu-I 3000= 1 08 lb/ac; Zn-1 3000= 213 lb/ac Mortality Records Check Lists Storm Water Window Max Rate MaxAmt IL ,_,..S. UA / u I ~Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: <?-Routine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: IJJ\a1 \ \;;)J Arrival Time:lq;o, Atfl Departure Time: liM 4rAt;zl County: Scmpso, Farm Name: GearJe_ H C G; // Owner Email: Region: f@ OwnerName: &ecye Hc.Gf/1 Phone: Mailing Address: Physical Address: %3 hf!l1 Cltff/ Cbvl(h Pd florrei/J , > Facility Contact: GeCY:JP He Gll/ Title: __~Qv41:tlai.I:ff'L-____ _ Phone: Onsite Representative: CO.PO(J e He Gill Integrator: ....L~.C:....,B'-L. _________ _ Certified Operator: Geo9e He Gi /I Certification Number: ..!}....!Cf..::f1:...:Y~3~---- Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts LIs any discharge observed from any part of the operation? DYes IS} No Discharge originated at: 0 Structure 0 Application Field 0 Other: a. Was the conveyance man-made? DYes 0No b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No 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) DYes 0No 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? Page I of3 DYes t;{No DYes J5d'No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 2/4/2011 Continued !Facility NUmber: 'll d-loate of Inspection: I ala !Jt?, Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. lfyes, is waste level into the structural freeboard? Structure l Structure 2 Structure 3 Structure4 Identifier: Spillway?: Designed Freeboard (in): 1'1 Observed Freeboard (in): 5. Are there any iinmediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures un-siie which are noi properiy addressed and/or managed through a waste management or closure plan? DYes ~No DYes DNo DNA ONE DNA ONE Structure 5 Structure 6 DYes }'gNo DNA ONE DYes [2f'No DNA D NE If any of questions 4-6 were answered yes, an~ the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Aoolication 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes IS{ No DNA D NE DYes l&JNo DNA ONE DYes (RNo DNA ONE DYes (SIA<Io DNA D NE ll. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes [SkNo DNA D NE D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs. D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area 12. Crop Type(s): \omta l Betlhvda 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of theCA WMP readily available? If yes, check the appropriate box. DYes ~No DNA ONE DYes ~No DNA ONE DYes (5d-No DNA ONE DYes lSJ No DNA ONE DYes ~No DNA ONE DYes (:8No DNA ONE DYes [2J;No DNA ONE owup Dchecklists D Design D Maps D Lease Agreements Oother:. _________ _ 21. Does record keeping need improvement? If yes, check the appropriate box below. i8'Yes D No D NA D NE 0 \Vaste Application 0 \Veekly Freeboard ~ \Vaste Analysis 0 Soil Analysis 0 Waste Transfers 0 V/eather Code D Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and l" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes ~No D NA D NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes 0 No [8-NA 0 NE Page2of3 214/2011 Continued I Fatility Number: SS'), -led-7 jDate oflns~edion: I~ l.:i!JII~ ' 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes [)JNo DNA ONE the appropriate box(es) below. 0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels 0 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? DYes ~No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes 0No ~NA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes and report mortality rates that were higher than normal? ])a No DNA ONE 29. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE 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 DYes ~No DNA ONE permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes ~No DNA ONE 0 Application Field 0 Lagoon/Storage Pond 0 Other: 32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 34. Does the facility require a follow-up visit by the same agency? DYes ~No DNA ONE Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any otber comments. Use drawings of facility to better explain situations (use additional pages as necessary). Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 Phone Cf!o--'!;33-3200ftffi ce) Date: t)e (.... ci Jj d 0 ld,... 214/lOJI I Facility No. 'D.)-f.>;n Farm Name 6r"crq-€ ft{o((/ / ~ J Permit ._--COC .....,. OIC_ NPDES (Rain breaker PLAT Annual Cert Daily Pipe) FB Drggs · l~lli!lt®¥.>,1!7-l I Lagoon Name S for spillway Is ' .. ~ DesJgn Freeboard I Last Recorded (in) jq l3fa Observed freeboard 3'>'" Sludge Survey Date SludQe Depth (ft) Liquid Tit. Zone (ft) Ratio Sludge to Treatment Volume if> 0.45 Date out of compliance/ POA? 5) M ""t) I 0)0 I<{ Calibration Date 1 ~bo/1:1.. 2 3 4 5 6 7 8 Ring Size (in) '1' hr-,Sh 1)/.:l. DesiQn Flow (Qpm) I '' lJl Actual Flow J: 7 I"'() Design Diam. (It) ;:t?J -~<) Actual Diam. 'J;[) 'd'"\0 Soil Test Date I !Jt\i.J.,_ 4/i'-1/1/ Crop Yield d0!f!PD/! pH Fields Wettable Acres .../ Transfer Sheets Yl/a RAINGAUGE ~ Lime Needed 0 WUP ../ Lime Applied Weekly Freeboard __ Cu-I ~Zn-1 7 .. n. 1 1 in Inspections v Needs S (S-1<25) JJo k-O·itJMtM:1... 120 min lnsp .......-- Needs P it'> Weather Codes ;:::::;' Waste Date l:)lmiiA-1 I;;.,}Jr/ II -60 Day ~ • I + 60 Day N (lb/1 000 Gal) 1.">"1 (),'~b pH /.':\. ,,.. \lt>,"\ 'tJ />, Pi\'--'"' PuiUField Soil Crop Acres PAN i b:>A lrj\r,;,,., ),'-/ ;)-j) '). ';;) l r:;/) Lj : 4·'1 1/ All p,-e {:YOre. ~ ' Verify PHONE NUMBERS and affiliations Date last WUP FRO I~ I rl q) FRO or Farm Records Date last WUP at farm Lagoon # App. Hardware Top Dike :;J.Y Stop Pump4~·7 Start Pump'5Dj~ II Conversiof'l-Cu-! 3000= 108 !b/ac; Zn-! 3000= 213 !b/ac Window It-~, A.A. 5"1J-H11v v I Dead box or incinerator --~ Mortality Records Check Lists ..--- Storm Water Max Rate MaxAmt ru-0.) '· / '-v I. j_ t ~ z g cz '--'--,,..,._, t su :::r. I r-r,-- r _)> Compliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: Routine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: 145 I'!> I M I Arrival Time:lll~WN'j Farm Name: Gfcr3 ~ Me G f II Owner Name: Geczye, MC-01// Mailing Address: Departure Time:p ; 15 prJ I County: ..5rittf£fb Owner Email: Phone: 11 .. ..-. t.t .... ll nl \ /'I , "' I II _ -11 _ Physical Address: '1 (06 IY~ll S Lllare I L/lv1fl f{}.,_ ) twf ff I jJ G ~e {Lf c&H l Title:-----'-----Phone: Facility Contact: Region: Onsite Representative: 0mj e-M c(O I /1 Integrator: ....:...H--.:.._"B:.._ _________ _ Certified Operator: Geoye Mc&i/) Back-up Operator: Location of Farm: Latitude: Discharges and Stream impacts I. Is any discharge observed from any part of the operation" Discharge originated at: 0 Structure 0 Application Field a. Was the conveyance man-made? D Other: 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)? Certification Number: I98D Certification Number: Longitude: DYes ~0 DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE ~ .. ~" ,..--, ..... ,...., ......... U YeS L_j J~O LJ !"'f\ LJ l"'J:.. d. Does tht: 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? Page I of3 DYes DYes t>l No DNA ONE ~0 DNA ONE 214/2011 Continued [Facilitv. Number: !Date oflnspection: q l';r{ (J (o;q ' \\'aste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): _LI'lL_ __ Observed Freeboard (in): ___;)z..:J-l--- 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e .. large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properiy addressed and/or managed through a waste management or closure plan? DYes ~No DYes D No DNA ONE DNA ONE Structure 5 Structure 6 DYes rgNo DNA ONE DYes ~No DNA ONE 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? 8. Do any of the structures lack adequate markers as required by the permit? (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any pan of the waste management system other than the waste structures require maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? tg"'Ycs DYes DYes DYes 0No DNA ONE ~No DNA ONE ~No DNA ONE ~0 DNA ONE II. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes CiJ>No DNA D NE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area I2.CropType(s) ~-fa) 'Btrmvd/J... fJa.Jtwe 'Sillct/lgmJh fUJ~d. 13. Soil Typc(s): 0-1~. L.-... I r 6"/t-_) 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage tor land application? 18. Is there a lack of properly operating ·waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility tail to have all components of the CAWMP readily available? If yes, check the appropriate box. Owup Ochecklists 0 Design D Maps D Lease Agreements 21. Does record keeping need improvement? If yes~ check the appropriate box below. DYes ~No DNA ONE DYes ~No DNA ONE DYes ~0 DNA ONE DYes ~0 DNA ONE ~v .... ,. ~1 .. :~1 ..... n NA n "'" L.J • __ , LA >'V L....J'"~ L....J ··~ DYes ~No DNA ONE DYes ~No DNA ONE 00ther: DYes ~No DNA ONE D \Vaste r'\.pplication 0 'vVeekly FrecboarJ 0 Waste Analysis D Rainfall 0Stocking 0Crop Yield D 120 Minute Inspections 22. Did the facility fail to install and maintain a rain gauge? rl,.._., • '_. ~ .. , r rlnr L r-..l u .:)Uii Anatysts U was1e 1 ranster:s u vveatuer LOue D Monthly and I" Rainfall Inspections D Sludge Survey DYes ~No DNA D NE 23. lf selected. did the facility fail to install and maintain rainbreakers on irrigation equiprnenl? DYes 0No [l!NA ONE Page 2 of3 21412011 Continued [Facility,Number: '"6 a_ I nate oflnspection: <;; / 'i' I! 1 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. n Yes ~No 0 Yes ISJ-'No D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels D 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 Joss 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) 3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. 0 Yes [8-No DYes 0No 0 Yes cs;(No DYes ~No DYes ~No 0 Yes '&]'No 0 Application Field 0 Lagoon/Storage Pond 0 Other: __________ _ 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~No 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 0 Yes §No 34. Does the facility require a follow-up visit by the same agency'' 0 Yes gNo ?le~J~~~iuq Inside l(l 1o01 slOfeJ rvh,e 1 ~~-Jf"'Pti JJfCbrle. Cbal/db/f- nNA nNE DNA ONE DNA ONE ~NA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE ~&~hry([blaclt.ber;. Plb?e__ tvo.rfc. On· lacge_ b1,~-e.Jfrl-nerr o.--i:Jtr!e (]Dr flfJ' at-lq_J co".'J, when ra ~(\ s'iivc:rl{ ~ i'm f"D v't'.J, 16'-Be~ ~m~~ rtt~ir~ oddHfo'l of Svlpilvrc;,d_ p#oj~ fn -fvlu·e_, q,~"l JSif>jOodsit£pe_,Ver1wef; kqrt-records. (;)Y, Red calilYattc1 is d01e e"a! ~ y~1 . fvepi-netr/8:1 {" <JotJ , s 11.(}1e ~him~ cJtri-11 ct o 1 ~. Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 Phone: t/.JJ -JJcoW;g>} Date: Avj <6 @0 J/ · '1412lr ' Fa~ili~ No. ~d.-@J Farm Name Gazy-e KeG r /\ Date _____ _ Permit __ COG----01:~ O• I NPDES (Rainbreakerr :J_O_t_~_LAf-T--A-nf-n-ua_I_C_e-1rt) ~rops ~~~ -EJ'-6/'fl f----+--j ---+----11 I Pop. Design Current Type Lagoon · 1 2 3 4 5 6 7 Spillway Design freeboard Observed freeboard (in) Sludge Survey Date Sludqt:: Depth (it) Liquid Trt. Zone (ft) Ratio Sludge to Treatment Volume ~<;s_ fO'l~'lA Vltlt clDILJ 'II. .• J.J,.,. ,'f, :.;r lhl'.{ ~C~a~lib~r~at~io~n~D~a~te~~~1T-q~~~~./~~T.2~--~3 ___ ~_-r4~---~5~--~6~---~7 ___ ~8 ___ __ Design Flow 1.'5 1'15 :' Actual Flow l!.f J ':> · ,j Design Width " 2> ') '-\ '> 1 'lActual Width ;:n~ ~";) t-~~~ij(ll... kJ5 II I I .. I' ~;{.~011 Test Date ~I 'p-pH Fields ··.~Lime Needed Q Lime Applied Cu-I v Zn-1 ....._/ NeedsP--~ c y· ld c:--rop 1e Waste Analysis Date hiiS'Jil -60 Day .. 4\ISltl +60Day · N Ami (lb/1 000 Gal) r pH 1/':1 Pull/Field Soil Crop \ IGDA :&; & ) I ..., I Wettable Acres ---:- WUP ....--- Weekly Freeboard \./' 1 in Inspections ....--- 120 min Insp. __ _ Weather Codes f s Trans er heels l.ll.:l!IIO 'C/d.f/((} :J I(} lllcl I• t tJ/19 ,,., ---- Acres PAN ~_5',1._ ;) I >CJ S'A-I <;',It\ I Verify PHONE NUMBERS and affiliations Date last WUP FRO Date last WUP at farm FRO or Farm Records Lagoon# 3';), S Top Dike Stop Pump 1.\.~-l j \ ,r. Start Pump 'J<:l I'\ 'r Conversion-Cu-I 3000= 1081b/ac; Zn-1 3000= 213 lb/ac =UGE "-- or incinerator '--" ily Records ~kCxrt <lf;;~'{/(}'/J, -No.sf1CJ'/y Window Max Rate MaxAmt Hur-Od/(,...,...1'1Pt o,,. 0.! " / - tir1 k , J'i'-1-01 h ~ '( App. Hardware I g.,..,...,..,...,. #.,.. .. \IO ... O+ Q"gnutina () rnfTIInl'!llint r"\ IC'nll ...... """ (') D,,ef.o, •. ,~, .• ,1 () _o:,~,,e,ra~,n,c•,• () Q+,,h,e,• ,., .......................... u -• ~--····--.... _.,,,........... -• _ .. .., ...... I" - - - - - ---- - - - D Denied Access Date of Visit: l!a/14/10 I Arrival Time:I9:::?<MtJ I Departure Time: l/0; 55&J I County: S:OtrrfSO'J Region: PM Farm Name: (Q eora-€_ He to(!/ Owner Email:-------------v Owner Name: GeOroR r2 MeG 1// Phone: J Mailing Address: ---------------------------------------- Physical Address:-----:------------------------------------ Facility Contact: WWf N cG J il Title: _.(Q""'r -'-'fv-'-r1'-"£1:'--------Phone No: s<f.0-()<609 Onsite Representative: _,(..,?_,e ... oy'-'f"---1-N--Ucl.-.lG""-. .LJ+/+1--------Integrator: __,_li.l--..:!3::_ __________ _ Certified Operator: Gecrye _,_Hilc__"""{p"-/L{L-1/f------Operator Certification Number: /<fli'.)J Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts 1. ls any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Application Field 0 Other a. \Vas the conveyance rnan-rnade? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page 1 of 3 DYes IS.ii'"No rl ,, __ rllro.T-L-J 1 c~ L.J I"'U DYes 0No DYes 0No DYes ~No DYes ~0 12128104 DNA ONE n .... ,A nlro.rc L..J l'llr\. L-J I"'L DNA ONE DNA ONE DNA ONE DNA ONE Continued I Facility Number:<?)~-ce:n I Date oflnspection I!;} lflj/( D I ~Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes ~No DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:------------------------------------ Spillway?: Designed Freeboard (in): _LI~-1----------------------------------------- Observed Freeboard (in): ~J;z.:.tfJ_ ___ ------------------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes 18No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes l:iJ No DNA ONE 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? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 18"Yes DYes n 'T--LJ It:'!) 0No UNA UNE ~No DNA ONE rn ... ,_ n"'T" n~1r. I,Oll"'U L..J I"'.M. L..J l"'.L 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~No DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes RNo DNA D NE D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 12. croptype(s) CoMfal 12e-mv&a-Pw/vte · s-mll3a1Jb avtrrNd ) . 13. Soil type(s) Goldsboro Is 14. Do the receiving crops differ from those designated in the CAWMP? DYes ~No DNA ONE 15. Does the receiving crop and/or land application site need improvement? n Yes !';)}No 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?D Yes ISfNo 17. Does the facility lack adequate acreage for land application? 18. Is there a iack of properiy operating waste appiication equipment? ~eviewer/lnspector Name Reviewer/Inspector Signature: Page 2 of 3 D Yes 'l!a"No DYes ~No DNA ONE DNA ONE DNA ONE DNA r-"1 ' ....... UNC I Facility Number:~ -{,;lJI Date of Inspection lio lt'/110 J Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other 0 Yes lQ-No 0 NA 0 NE DYes JS}No nNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA ONE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield D 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 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 rainbrcakers 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 DYes DYes DYes DYes DYes DYes ~0 DNA ONE 0No f;id NA ONE lia'No DNA ONE ll(!No DNA ONE IQNo DNA ONE 0No iS,lNA ONE 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? DYes ~No DNA ONE 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 otlice 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? !Additional Comments and/or Drawings: J'l, Oorn/11-e~ -NO\-e__ DYes @-No DYes ~No DYes OO'No DYes !WNo DYes ll!:rNo 7, P1 ec~ iVcvka, bif~s{· ctJ o"_/~oJ, brr,_~ /s-f~cia/1 bo,~ dDJfjifu f'JhcVJfJ Ne.£-cl iofod J I I'm~/ seec Dr S'f'.'J) cJ fJrv((l), ~ IJo ~lft}2.. f.'lOI.Y' ;il,~~t~~ S'~~f~_or~~~~~ £1~ ~ ~~~'J bo d~J A~ ~~I i~:rcL Wt>k Janfle '} DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE t:'\o.V\yeor ru Luv;:r wn ~ray eve.')r-un tctJfP, ' ·~5,, L,~~s/v_dqe... <;lifvey tV{!> dCI!e II\ ~OOC; o~c{ -fn-el c'1re dve. (M11.,,1f!J·, Hot!? o. eJ Cf-.. e.rrur Vf', s (t--dy~ c{ eytn, Plt't.>€.. n:. fvcl/'t n 1.141 b@"_( ({!lc_( mo /I ( Ofll!flJ f:.t.vvr} Ralti 9 ~ fur yo.srl ble_ f.Xf."JrD IY1fer Jot o i or m C<;h~ ltnarr-), Lr7)/.t -i,t£rlnu-.j: Je(P1~~ 7{_4::-greo-lfr-f'rlu, r; -fi-. -:t Iff+ ~p-"'(ho, rt>f._-<JI-f'(Y-1? h-1·1;, C.)(O\"'fr • . rvell mi,,lr\vi~d ~ ttrdJ ChcL r'Jho-3e.J. 1 U~dak._PoJI-~ecio-.: Ga:rye..!-1c&.l/! cal/ftl !a.tJolto, tlecroi!lhe.. ~hhryp.L -ftte!a 9cv., bnti-!lrg Facillty No. ':b<HP;n Farm Name _,6cv;~jpf__,_H=c.(;""-!l.l{f-/--Date \ d./1'-J I ( Q // , .... / Permit V COC ____ OIC_ NPDES (Rainbreaker PLAT Annual Cert ) Pop. Design Current Type J'5'50 FB Drop_s IR':0 tJI/ C '. -·Ci b'!< I (/I) ~I ~f/r ! ..... 'u1 Lagoon 1 2 3 4 5 6 Spillway Design freeboard Observed freeboard (in) ;,:3 fA" l'.r! SludQe Survey Date ~ lie 01 DCf Sludge Depth (It) "-,J, 3, Liquid Trt. Zone (It) -},(, Ratio SludQe to Treatment Volume Calibration Date 1 !?, \~If\ -l-3 4 5 6 7 DesiQn Flow ~IJ'I' ,)~ Actual Flow I '-1) I )"!, Design Width o(>S" ;;JT) Actual Width o J~ ;;>::>") Klr) I I JLld..._ ,'?,:;)._ Soil Test Dat'e '1110 ,( ~ Wettable Acres __ _ pH Fields WUP Lime Needed ~~ :g Weekly Freeboard __ Lime Applied 1 in Inspections __ Cu-I Zn-1 120 min Insp. __ _ Needs P Weather Codes c J y'\IOJ * &:r 5110-0tJ, I'{ rap Yield Transfer Sheets Waste Analysis Date ~I hi () 31101 ,,~ J 1 n11~ ~l<ifO 10 ltl/7 ?ff,/y ~50 Day (o ~:;.-., ~Q + 60 Day lr ~ .. tro ')iJriiJ(\ N Amt (lb/1 000 Gal) r ... , o, (1\5' 1·1 /·· .) pH c . 1'-f 'l. 'r. \I ...., ., f·~ • . - Pull/Field Soil Crop Acres PAN I 6A 6tr&are... S.'f d'i>' ;) 15· ') I 1 SdJ I 4, J I~""" I~ \]/ '60 I I Verify PHONE NUMBERS and affiliations Date last WUP FRO I;J..s4'] Date last WUP at farm 0-1-_(h ' ~") 1 I FRO or Farm Records Lagoon# I q'; . Top Dike · l..L5(.)0; Stop Pump Start Pump Conversion-Cu-I 3000= 108 lb/ac; Zn-1 3000= 213 lb/ac '~· ~~) . L i I..J 7." ·-z i . - Window Max Rate ~-Od-_ App. Hardware ·"' J r I t../ f::";' (),.., I· ' f J . I I 7 8 Max Amt 0.'5'0 /J)~ / Type of Visit <3"Co"mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~ne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date of Visit: VP--.2.7· a9l Arrival Time:! '1: :$0-I Departure Time: !II: t.JO~I County: »--rsc.v Region: r/20 Farm Name: GeCJvqc.... /lie(!;,'// rar-1<-'( Owner Email: v -------------------------- OwnerName: G~'§le_ /J{c,G;// Phone: Mailing Address: --------------------------------------------------------------------------- Physical Address: ----------------------------------------~H-c::c:z;c ;r:F" Facility Contact: G~·g<-/1/c,.G;/( Title: {}.,v,v4/ Phone No: ..!1"10. 0 80 "f On site Representative: G '"'-'"";5 'L Me. 6ii/ Integrator: ;1/o~rtJb · Er-.:r.:J/1/ Certified Operator:--------------------Operator Certification Number: -------- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: D OD'D" Dischaiges & Stream Impacts DYes ~o DNA ONE 1. Is any discharge observed from any part of the operation? Discharge originated at: D Structure 0 Application Field D Other a. Was the conveyance man-made? DYes 0No ErN A ONE b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No ~ ONE 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) DYes 0No ~ONE 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? DYes BNo DYes ~ 11/18104 DNA ONE DNA ONE Continued !Facility Number: BZ-62 71 Dateoflnspection lto·z7-o<fl Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes ~o DNA ONE DYes ~DNA ONE Structure 5 Structure 6 Identifier:--------------------------------------- Spillway?: Designed Freeboard (in):---------------------·--------------------- Observed Freeboard (in): --=3::..3""'---------------·------------------ 5. Arc there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes [B1(o DNA ONE DYes ~DNA ONE 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 l3'1'fo 0 NA 0 NE 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application J 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? 0 Yes (d1<:lO 0 NA 0 NE DYes ~ DNA ONE DYes B'No DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~ 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.) U PAN U PAN> 10% or 10 Jbs LJ Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12. crop typc(s) -~B.::.~:.:rc..:'"'-=• ... :fd~·:::· :.._.L((J.!c:;;~,-~-.,.¥~~)L.._;,--5.i~M::!.!d!!:!!..-'®.:!:!!n>:!!'~·,_,;!.._~{,.!:::o:t.,..:::>-:.:·....::):::__ _________ _ ~ , 13. Soil type(s) Goff 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and! or operate per the irrigation design or wettable acre determination ? I 7. Does the facility Jack adequate acreage for land application? 18. Is there a Jack of properly operating waste application equipment? 5·--rlc... rc..· .. il-> bo.:.d Y"C-C-.:-o"d Reviewer/Inspector Name Reviewer/) nspector Signature: --f ~'-. DYes -~ DNA ONE DYes B1fo' 0NA ONE DYes r:JNo 0 NA 0 NE DYes [31<(o' DNA ONE DYes (31:( DNA ONE Continued I Facility Number:82 -v27j Reguired Records & Documents Date of Inspection j,o ·z.?-"91 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facilir; fail to have all components of theCA \lf:t-.. 1P readily available? If yes, check the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~0 DNA ONE n·u __ r::K,'_ nlo.TA n ... r'C LJ [c;:::, L.:J l"IU L.J 1'11"\. L...J !'U..:.. DYes ~- DNA ONE r-'""1 •••.••• r""'1--···-. -~---.. ----··· .. ,-, ___ --_,_ --·~. LJ waste Appl!catiOn LJ weeKly rreeboard LJ Waste Analysis LJ Mil Analysis LJ Waste lransters LJ Annual cemncanon 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 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 dte 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? . ,~ ' DYes ~0 DNA ONE DYes ~ DNA ONE DYes @No DNA ONE nves ~0 nNA nNE DYes ~ DNA ONE DYes ffNo DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE DYes 0No DNA ONE 12128/04 • Type of Visit WCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit JijfRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access · Date of Visit: l'bOiog-I Arrival Time: jq1.3ctl!J Departure Time: rm tf.rA!J I County: -ScmfsQ, Region: fRO Farm Name: <Pet:tqe_ H C. G j f / Owner Email: ----------- v Owner Name: Ge'fje He.&. j l/ Phone: S3:.=.c..}-:..::4JJo4q~~...._------- MailingAddress: PO t3oJc t,r ...l=Ho~rr:.e.Ll/Uu_ ___________ _ Physical Address:---------------------------------------- Facility Contact: Get(g e H c.<Pl/1 Title: Ot>'IJ !9:-Phone No: ________ _ Integrator: Hu'JAcBtOW1 , Onsite Representative: ------------------- Certified Operator: ....s.Gue'-lf1Jii!CI<PII:...--------'-H..!!cl...!!iGui'-'ll-f------ Back-up Operator: -------------------- Operator Certification Number: )q8S3 t1 IvA- Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: DoD' D" Discharges & Stream Impacts I. Is any discharge observed from any part of the operation'' DYes 8No DNA ONE Discharge originated at: D Structure D Application Field D Other a. Was the conveyance man-made? DYes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE 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) UYes UNo UNA UNE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page I of 3 DYes 81'No DYes 15a"No 12128104 DNA ONE DNA ONE Continued -'I Facility Number:~~ -'l) I Date of Inspection tM>I30JOl I Waste CoUection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes ~No DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:------------------------------------ Spillway?: Designed Freeboard (in): ~ 19 Observed Freeboard (in): .J ~ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/large trees. severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes ~No DNA ONE DYes rijfNo DNA ONE 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? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 1 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? ~Yes 0No DNA ONE DYes ~No DNA ONE DYes !Sii'No DNA D NE DYes !RNo DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes lia"No DNA D NE D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) D PAN U PAN> 10% or 10 lbs D Total Phosphorus 0 Fatlure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area 13. Soil type(s) ..~;G;!.Io;a,ldt:LLr.bi!!OJkLLlo ____ -'------------------------- 14. Do the receiving crops differ from those designated in theCA WMP? DYes 15. Does the receiving crop and/or land application site need improvement? DYes 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deterrnination?D Yes 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Signature: Page 2 of 3 DYes UYes OlNo DNA ONE ~No DNA ONE 8No DNA ONE ~No DNA ONE ~)~:No UNA UNE Continued "' I Facility Number: 'i j\.. -fa) I Date oflnspection '4J30fQ' I .}0-· Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Pennit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA ONE 0 Yes ISCNo 0 NA 0 NE ~es 0No DNA ONE li(['Waste Application n Weekly Freeboard n Waste Analysis n Soil Analysis n Waste Transfers n Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 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 pennit 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? Ple~e.. tvor~""' btt~.r(d'b Ot'll~lXl'l tva 115 ~~Ieee ~ ~n I RR a. :s , No S("~e ~vr~tty -fur 'doo7 II k-e&wltl q..recards o-thern-Jse. • Page 3 of 3 DYes ~No DNA ONE DYes 0No f)jl NA ONE DYes ~0 DNA ONE IK!Yes 0No DNA ONE DYes ~No DNA ONE DYes 0No DjfNA ONE DYes &!'No DNA ONE DYes ~No DNA ONE DYes jgNo DNA ONE DYes llaNo DNA ONE DYes ~No DNA ONE DYes i}lNo DNA ONE 12128104 " . Facility No. C::SC).=h)) Time In____ Time Out ___ _ Date (){:>{Jo( Of Farm Name me"rJe Hc&i II Integrator __________ _ Owner -----------------Site Rep----------- Operator No. _______ _ Back-up No. _______ _ COC -=../__ Circle: ~ or NPDES VVVOII-I VV .... 1 auvvv-rccu Wean-Finish Farrow-Finish Feed -Finish Gilts I Boars Farrow-Wean Others FREEBOARD: Design ---:-:::-:::-r.--r:----. Sludge survey 1;)~,\o~-~I~ r~f Alo.o(l"ftr ;:~~ Crop Yield _,v~-- Observed ~~~~"> Calibration/GPM ld9 .;)['f{l.b t1 /I a/(8 Waste Transfers _1.1tp ___ ~_ !I0-9fr)~ ;~ Rain Gauge -uff.[ D-1-0:4l~Ae_ P~"-'3 :Jf;}} Soil Test 1\i\. lo~ Wettable Acres ~ OOf> j.lf)~ j)OO) Rain Breaker Yt-4- PLAT NIA- Weekly Freeboard J Daily Rainfall t -"" 1-in Inspections_........-___ _ Spray/Freeboard Drop ---------------------- Weather Codes / 120 min Inspections .............. NoS'~ 11/;q-:J/{ }(I S:l-S Waste Analysis: q\lll~ qho\ 0) fD41 113o/09-;))Jt I~ ~ap :n .q t I Date Nitrogen (N) • Date Nitrogen (N) y~ Q,~lq.~ ~I Lill'i lm; .},5' -1 •l \ ~ )Q11tb ~.]-J, 7 s:.s-.!..j.q.L>I91..!<D.ul Ooi...JJ~ .... ~"-1· o,J..._;:;,-.J..lcw.I_ 31;B; !OJ -;).S' -"]. :l -'\~__, . .,..{, '511> ~--.... Pull/Field Soil Crop Pan Window 1>-. ~-0..... L 1..1. I'I.J ~IN> St>if-t1a-t ' .Bill J. / Rv-e... ll n. :1.r I ~ 'r1dl 51 bolo. ~c.vlb <; i/3o/m I -- ~1115 vf<tl'lf; frv I. Qyvnf" eel I f!htre. -Add<"k do-'tlrno.-r+-1>16-iJ a tell# ·I Facility Number I f,~ '711 8 Division of Water Quality s~H 0 Division of Soil and Water Conservation 0 Other Agency :. --: \:-> ,·._, . .-' Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: I f2/1'1 'ltJ11 ArrivaiTimed OfV30bJ Departure Time: I VJ!~county: 5i4mf7soJ Region: F/<1) Farm Name: 7 I ~"~ L tv'tc r;, 1 I Owner Email: J Owner Name: ~e._ D, cv'lcG;,_,_i/;..,/'----------Phone: Mailing Address: ~ox; (;~I t.frurre{/s NC ';).'2,~-''-'-. ---------__ _ t1 Physical Address:---------:-;,----------------------------------- cJee.nr~ f\'l., "'.1.1 Facility Contact: ----u--rr~'"""'---VVl---=..:..:1!_.. ____ Title: -----------Phone No: --------- Onsite Representative: ____ 11_______________ Integrator: _.J./V1..:.J~-4-f)~-IO.a~""i'--------- Certified Operator:------~~----------------Operator Certification Number: _..:./_96:....::;_5._.3 ___ _ Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: DoD' D" "' r- 1-• D .... l~-k""'·. Design Current Design Current es1gn '€urrent Swine Wet Poultry Cattle ,.,,_~ t•'\''" Capacity Population Capacity Population Capacity ~6f!culiltion JD \Vcan to Finish I I ljD La~er I I D Dairy Cow ' I I I i [J Wean to Feeder :0 Non-Layer D Dairy Calf ~Feeder to Finish ~58o ~'-/{bt./ D Dairy Heifer J Farrow to W can Dry Poultry D DrvCow 0 Farrow to Feeder D Non-Dairy D Layers I D Farrow to Finish D Beef Stocker 0Gilts D Non-Lay_ers D Beef Feeder D Boars D Pullets D Beef Brood Cow ' D Turkeys Other 10 Turkey Poults I I I .;,; [I] ·-ID Other I I I Number of Structures: :,; D Other ;; . Dis!:harges & Stream Impacts I. Is any discharge observed from any part of the operation? DYes ~No DNA ONE Discharge originated at: D Structure D Application Field D Other a. Was the conveyance man-made? DYes 0No ~NA ONE b. Did the discharge reach waters of the State? (If yes. notify DWQ) DYes 0No ONE c. What is the estimated volume that reached waters of the State (gallons)? ~NA d. Does discharge bypass the waste management system'' (If yes, notify DWQ) 2. fs 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? DYes 0No DYes ~No DYes ~No 12/28104 lf!NA ONE DNA ONE DNA ONE Continued ~ I Facility Number: I(M.:{a7 I Date of Inspection ~ I \Vaste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? DYes J;»No 0 NA 0 NE DYes 0No ~NA ONE Identifier: __ s-_ .. .Jj~c·_·"_T_c_l _____ s·_"-_"_cr_.,._·c_2 ____ s_t..--u-·c_t_ur_"_-3--___ s·_,r_"_ct_u._-"_4 ___ s_tru_, _""_t_ur_e_J_' ___ s_t.._-u_c_·tu_T_e_6 __ Spillway?: Designed Freeboard (in):-------------------------------------- 3 ~" Observed Freeboard (in): -~-.l..!.~:!......------------------------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? 0 Y;s--!)mo 0 NA 0 NE DYes ~No DNA ONE 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? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Apolication UYes iSlJNo DYes Y~No DYes nih.,~ ip'l'IU UNA UNE DNA ONE n.,.,A. nli.TC L....J j_ """ L..J l"'L.. I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes Jf'iNo DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes $J No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) n P.A_N n PAN> 10% or 10 !bs 0 Total Phosphorus D Failure to Incorporate ~Y1ila"1ure/Siudgc into Bare Soil 0 Outside of Acceptable Crop Window 0 Evidence of Wind Drifi 0 Application Outside of Area 12. Crop type(s) Bvrvu.da ~) 1 ~~ cP~ 1 SM&U-{ Grn.\VJ ~ 13. Soil type(s) -~&o::_.:...1_ _______________________________ _ 14. Do the receiving crops differ from those designated in theCA WMP? DYes ~No DNA ONE 15. Does the receiving crop and/or land application site need improvement? DQ Yes ' 0No DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?O Yes t2PNo DNA ONE 17. Docs the facility lack adequate acreage for land application? DYes ~0 DNA ONE 18. Is there a lack of properly operating waste application equipment? DYes ~0 DNA ONE Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): ~ Re.~l P.ll.t-vnu&_l.l whet, ~ cor.d_N{by,_s a.r<. ~.Jia/.(..., ..., 1- Nof-s:lo{<e fc re.-Spry n;'# VlOW ~. -fo oltr dro~~~- I- ~ Reviewer/Inspector Name '17.1 _I /VIa:ri t Phone: {91D.)'fJ3~33fP Reviewer/Inspector Signature: 7J?.. n..l c.A~h ~11. Date: B/JII/07 11128104 Continued I Facility Number: '3j("bti:11 Date of Inspection I f?/Ji/01 Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Docs the facility fail to have all components of the CAWMP readily available? If yes, check the appropirate box. D WUP D Checklists D Design D Maps D Other DYes ~o DNA ONE DYes l)g>No DNA D NE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~o DNA D NE D Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis D Waste Transfers D Annual Certification D Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections D Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes rj!No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes \iii No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE ,. 26. Did the facility fail to have an actively certified operator in charge? DYes ¥JNo DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~No DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~0 DNA ONE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~No DNA ONE 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? DYes JOINo DNA ONE 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 DYes ~No DNA ONE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ~No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes 'f]No DNA ONE Additional Comments and/or Drawings: ... r-- 12118/04 Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency ~her n Denied Access Date of Visit: ~ ,=:0 7 I Arrival Time: Iii 1/6 ' Departure Time: I ;1 :,3D I County; s;,)"'1'tr-:-Region: CKQ Farm Name: c"7",.; oge-Owner Email: -------------- Owner Name: G:e.of,,.... ll'k G-i II Phone: Mailing Address: ---------------------------------------- Physical Address:----------------------------------------- Facility Contact: ~G.-~..!e:...D~"!<P=~-Lm!l.L.c(b~'l.Lili-... __ Titlc: -----------Phone No: --------- Onsite Representative: -------------------Integrator: /?ta7 Certified Operator:--------------------Operator Certification Number: -------- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: D OD'D" Design Current Design Current Design Current:> Swine Capacity Population Wet Poultry C~pacity Population Cattle Capacity Population · ID Wean to Finish I I I 10 La~er I I I D DairvCow D Wean to Feeder ~D Non-Layct D DairvCalf 1:21"Feeder to Finish I-4S~ D Dairv Heifet D Farrow to Wean Dry Poultry DDrvCow D Farrow to Feeder D Non-Dairv D Farrow to Finish D Lavers D BeefStocket D Gilts D Non-Lavers D Beef Feeder D Boars D Pullets D Beef Brood Co" D Turkevs - Other D Turkev Poults ID Other I I I D Other Number of Structures: Discharges & Stream I moacts I. Is any discharge observed trom any part of the operation? DYes ~0 Discharge originated at: D Structure D Application Field D Other nv..,. ... n-,..r~ L.....J 1 "-3 L.....J I 'IV u. \Vas the conveyance man-made? b. Did the discharge reach waters of the State? (If yes. not it)' DWQ) DYes 0No 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 d1scharge? DYes 0No DYes ~No DYes ~No 12118104 ' ' ' i l ·-. . 0: DNA ONE nl..TA nl\.n; L......l ~ .. ...,. L......l ~ 'IL. DNA ONE UNA UNE DNA ONE DNA ONE Continued J Facility Number: ~-(..d;ii Date of Inspection l;x-{.;-ozl Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure 3 Structure 4 DYes IZJNo DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:---------------------------------------- Spillway?: Designed Freeboard (in): -~/<-9'L-__ ------------------------------- Observed Freeboard (in): _ __,_, 3.L!.V"--------------------------------- 5. Are there any immediate threats to the integrity of any ofthe structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes ~DNA ,l!i:1NE 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes doDNA ~E 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? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Aoplication I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes 0No DNA ®,NE DYes 0No DNA ~NE DYes D No DNA i8l_NE DYes 0No DNA !XNE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes D No DNA J&l NE 0 Excessive Ponding D Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> l 0% or l 0 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil 0 Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area 12. Crop type(s) -------------------------------------- ! 3. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? DYes 0No DNA ~NE 15. Does the receiving crop and/or land application site need improvement? DYes 0No DNA 151lNE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination! 0 Yes 0No DNA ,.liq,NE 17. Does the facility lack adequate acreage for land application? DYes 0No DNA ~NE 18. Is there a lack of properly operating waste application equipment'> DYes 0No DNA lia__NE Comments (refer to qu~tion.#): Explain ~ny YES answers and/or any reconimendatio_fu. c:ir any !)tb;r comments. "--.. :-~ Use drawiligs offacility to bette~ explain situations. (use additionBI pages as '!ecessary); -, ' th6 ,:;:n ~I' ee-~; o "'-vvoo a...-~-r-~ ,~~'0""" iu ~ Tti #~ l""l'l""-c J~ /n ~ d~ /rrp, I! Reviewer/Inspector Name I , il'f-v'b. ,fb-if/f-7 ~ , -I Phone: W.-1~3¢oo I Reviewer/Inspector Signature: _;;:mp /6ci( Date: ,=?...-(.. -Ot:_ I = 12118104 Conttnued ( j Facility Number: %~-@ Date oflnspection b-k -"D71 Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Penn it readily available? DYes 0No DNA 0NE 20. Does the facility fail to have all components of the CA WMP readily available? If yes, check DYes ONe ON.A~ '{4NE the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other 21. Docs record keeping need improvement? If yes, check the appropriate box below. 0 Yes 0 No 0 NA lii:f NE 0 \Vaste Apphcation 0 \Veekly Freeboard D \Vaste Analysis 0 Soil Analysis D \Vaste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes 0No DNA ~NE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes 0No DNA ~NE 24. Did the facility fail to calibrate waste application equipment as required by the penni!? DYes 0No DNA RINE 25. Did the facility fail to conduct a sludge survey as required by the pennit? DYes 0No DNA ~NE 26. Did the facility fail to have an actively certified operator in charge? DYes 0No DNA ~NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No DNA Q!:JNE Other Issues 28. Were any additional problems noted which cause non-compliance of the penni! or CAWMP? DYes 0No DNA J8l,NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes 0No DNA ~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? DYes 0No DNA 181.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 DYes 0No DNA 18JNE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ~Yes 0No DNA ONE 33. Does facility require a follow-up visit by same agency? DYes fillNo DNA ONE Additional Comments and/or Drawings: ~ 1--,... Page3of3 12128/04 • Division of Water Quality O.Division of Soil and Water Conservation 0 Other Agency Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: ilobtiDt. I Arrival Time:! oa:%Qd Departure Time:! I o.;ro QjJ County: .5lraf50II. Farm Name: 1 Gf~f Me {;,"/ L__hu--m Region: F/lO Owner Email: ~~~~~~~~~~~~~~ Owner Name: Phone: (qJD) 53:1.-q:J. 7b G-eo '8-e. M c G; tl Mailing Address: Po Box 05"" l HarreJ./ s 1 rJ c_ ?.£4--'---'-'-t_L/r__ _________ _ Physical Address:~~~~~~---------------~------------------- Facility Contact: __,fu:""-"_.Qt-"'-'j'l-e~--~.M"'-'-'c..,~:::.._· .:...1 ,_I __ Title: ----------Phone No: -------- Onsite Representative:--~~-------~---------Integrator: Mllr=pl 1 Bo .. ,)I/X Certified Operator:---'-'-----------------Operator Certification Number: /9 ~3 Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D ·o·o .. Longitude: 0 "0'0" ... Current , Population Discharges & Stream Imoacts I. Is any discharge observed from any part of the operation? DYes ?'lNo DNA ONE Discharge originated at: D Structure 0 Application Field D Other a. Was the conveyance man-made? DYes 0No !)gNA ONE b. Did the discharge reach waters of the State? (If yes, notify DWQ) DYes 0No cylNA ONE c. What is the estimated volume that reached waters of the State (gallons)? d. Docs discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No ~NA ONE 2. Is there evidence of a past discharge from any part of the operation? DYes ~No DNA ONE 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State DYes fin No DNA ONE other than fro.:U a discharge'! -· , Page I of3 11128104 Continued ........ I FaciHty Number: B ;).._ -b;;l. '1 I Date of Inspection I {b/nja I Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Struct'ure l Structure 2 Stru.cttire 3 St.··ucture 4 DYes 'flNo DNA ONE DYes 0No I$JNA ONE Stmcture 5 Structure 6 Identifier:--..!---------------------------------- Spillway?: Designed Freeboard (in): __ _,_/_jlfL~------------------------_______ ------_,3u Observed Freeboard (in): _ ___,:>~c._ __ ------·------------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? DYes [i!No DNA ONE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed DYes ltJNo DNA ONE 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? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Docs any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 1 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ljZlNo DNA ONE DYes \l9No DNA ONE DYes !SINo DNA ONE DYes ~No DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. D Yes ~No DNA ONE D Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 1 0~/o or ! 0 !bs 0 Total Phosphoms D Failure to Incorporate rvfanure/S!udge into Bare Sci! D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Area 12. Croptype(s) {?QX'fV\.uJo. <Wt1e 1 fl:]e. ~"?!? 1 5wv.tlA (i.ra}" Dv€.r~ 13. Soil type(s) -~Gc~'L·..3.....---------------------------------- I 4. Do the receiving crops differ from those designated in theCA WMP? DYes Jlli No DNA ONE 15. Does the receiving crop and/or land application site need improvement? DYes KlNo DNA ONE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes IS(! No D NA D NE I 7. Does the facility lack adequate acreage for land application? DYes ~No DNA ONE 18. Is there a lack of properly operating waste application equipment? DYes ,KJ No DNA ONE Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): \)€;{-'1 ... 9cd_ ~&-rcl ~,'"3' r- 1-.. , ~~0-:-1::... ]. -IAA~ f ·----~ · Phon~(q(o'. '-1 ~<' 3'~00 Reviewer/Inspector Name fAL .. 117[ Reviewer/Inspector Signature: <iJ J, J-~ Date: tO t1 oG:. Page 2 of3 12128104 Contmued '-"-·· .. I Facility Number: R:;) -011 Required Records & Documents Date of Inspection 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other DYes f)Z!No DNA ONE n yes Ciil No D NA D NE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No D NA D NE D \lfaste .Application D \Veekly Freeboard 0 \Vaste Analysis D Soil Analysis 0 \Vastc Transfers D Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes ~No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? I1SI Yes 0No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? 0!3 Yes 0No DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes iEjNo DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes li]No DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~0 DNA ONE 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? DYes ~No DNA ONE 30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE 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 DYes ~No DNA ONE General Permit? (ic/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes DNA ONE 33. Does facility require a follow-up visit by same agency? DYes DNA ONE Page3of3 12128104 • Division of Water Quality .()J)ivisi•>n of Soil and Water Conservation Q;Olthe'r Agency Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: I (, ·.21·0iJ A.-rival Time: It! DOom I Departure Time: J I County: Sa.¥~ Region: F/fo I L-------~ •'arm Name: -----'&,,e~e l'lc-6;1/ Owner Email: -------------------------- Owner Name: ---------><-G,e=s-r. ~1'1_,..,_c_,6"-';!.J//L-----------Phone: 9to-s3.=2 -Lf.:J. 7lP Mailing Address: P. 0, tl.aa.-r.K'-"~"-'5"'-----------~_ce./b N(.. ___ _ Physical Address:------------------------------------______ _ Facility Contact: __ G::ee:.cor~!J'-''""'----~1'1_:_c"'-.!it,.;-'-/~/---Title: -----------------Phone No: ------------- On site Representative: Gt!'.ac.~ r !lie 6 ·If Integrator: _an,..,Jl_~ ,f (', .. ,b... C. ... ,<,.'& ..... ) Certified Operator: ___ __,&.,.,,.ar:!fe._ ----'/l'l=r."'-"fr"''.l"/.!.1_____ Operator Certification Number: ~/'-'-9_.,"S,_,.r~3._ __ _ Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: 0 °0'0" Longitude: O OD'O" Design Current Design Current Design Current Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity ·Population ID Wean to Finish I I I JD Laver I I I D DairvCow D Wean to Feeder :0 Non-La~er D DairvCalf lid-feeder to Finish l;;tS'Ro .,rob D Dairv Hcife1 ' 0 Farrow to Wean D DrvCow ' n F!'IITOW to Feeder Dry Poultry 0 Non-Dairv D Farrow to Finish D Lavers D Beef Stocker D Gilts D Non-Layers D Beef Feeder ' D Boars D Pullets D Beef Brood Cow D Turkeys Other IU Turkey Poults I I I ID Other I I I Number of Structures: [i] D Other Discharges & Stream Impacts 1. Is any discharge ohserved fTom any part of the operation? DYes [i}r:(o DNA ONE Discharge originated at: D Structure D Application Field D Other a. \Vas the conveyance man-made'! DYes 0No DNA ONE b. Did the discharge reach waters of the State? (If yes. notify DWQ) DYes 0No DNA ONE c. \Vhat is the estimated volume that reached waters of the State (gallons)? d. Docs discharge bypass the waste management system? (If yes, notify D\VQ) 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? DYes 0No DNA ONE DYes ~0 DNA ONE DYes ~DNA ONE 11118104 Continued I Facility Number: 9;:;.-(,;;1 Date of Inspection \\'aste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 D Yes [!J1\io D NA 0 NE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:---'-------------------------------------- Spillway'': /10 ,, Designed Freeboard (in): -~~~t!J"-.· z'f __ ------------------------------ Observed Freeboard (in): ---'3=0_._, __ ------------------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/large trees, severe erosion, seepage, etc.) DYes GJ.1<lO DNA 0 NE 6. Are there structures on-site which are not properly addressed and/or managed DYes [!J1<:1o DNA 0 NE through a waste management or closure plan? If any of questions 4-6 were answered yes, and tbe situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 8. Do any of the stuctures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? Waste Application 1 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes g-No DNA ONE 0 Yes 0"No 0 NA D NE DYes 0"No DNA D NE DYes 81<o DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes B'N'o 0 NA D NE D Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) D PAN D PAN> 10% or 10 lbs 0 Total Phosphorus U Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Area :::J'1) ~0 12. Crop type(s) __i.:U..cm.uc.~~--_J,~.c.----------------------------- 13. Soil type(s) _...Jd.:s;u'L, _________________________________ _ 14. Do the receiving crops differ from those designated in the CAWMP? DYes G3"No DNA ONE 15. Does the receiving crop and/or !and application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination<D Yes 0 No 0 NA Qm 17. Does the facility lack adequate acreage tor land application? 18. Is there a lack of properly operating waste application equipment? DYes D No DNA G3"FJE 0 Yes l:l¥0 DNA D NE . . ' ' ' . ~ . ' .,_, . ' " 1: + ' .. Comm"!lts (refer to question II):, Explain any YES answers and/or imy recommendations or any other crimments. " ) ~ Use drawings of facility to better explain situations. (use additio.nal pages as nec:ess.iry):' · · · .. _ ·. :. ' ' ' ts. 1'/(Ase ,.,a,,{o,. .....f -t-1-.f ~ .Spr"'f /'.e/cls v-c:u /J~C,J~I'"f lo I"/'(' Vt'"" + "'"'..! Ct~~e/.:J,·"" .. Reviewer/Inspector Name [···~~~~ _u n JJ, ~,., 4-~L I Phone: "1/0·'f~·IS'J.l c_,./?ro Reviewer/Inspector Signature: '1,;~./, X ?;;? / Date: {, • ~'1 -0 <;""' 12128104 Continued l Facility Number: !J.?. -1,27 Required Records & Documents Date of Inspection I(, · .)q -oit 19. Did the facility fail to have Certificate of Coverage & Pennit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ·•---. . . ./ ~ Ln~ approp1ra1e oox. 0 ~ 0 C~ists li:d-'6~ D ~ 0 ~ DYes ~o DNA ONE ~s DNo DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. ~s D No DNA 0 NE S·.>>-:> /,"/ .:J-to~?-'1 .--......-:--aste Ap 1· t" n D WPPL-1~, l='r""""~""al=d 0 "'a: t .. al;-sis D S9il ARal,sis D 1}/aste Tfftnsfers D Atmual Cetltllcation ~3 p1C310 41 SCJYft D RsiHfall D s~ssl·iflg [td·Crop Yield 0 128 Mitmce lnspectiottr D MeRtkly diid 1" Rain hupeetiens D V'ez±n c d• 22. Did the facility fail to install and maintain a rain gauge? 23. if seiected, did the faciiity faii to install and maintain rain breakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the pennit? 25. Did the facility fail to conduct a sludge survey as required by the pennit? 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 penn it 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 nonnal? 30. At the time of the inspection did the facility pose an odor or air quality concern? [f 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 Penmit? (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? Additional Comments aJidlor Drawings: · .. C.•r>y ;) Lf, 71,~ u.U,.._I,-.~ 5~u-t .,..,, ,;)~'1 Ji?t?l C ;;...,1"1, Ire/. "Ve;,J I> I 1 IC ""-$~ n~ c.o./, [,.."' £ • ., -..1...1 DYes lid1«o DNA ONE UYes UNo UNA ~ [!}-V'es D No DNA 0 NE I:Y-<es D No DNA D NE DYes ~o DNA ONE DYes DNo DNA ~ DYes ~o DNA ONE DYes G3"No DNA 0 NE D Yes B'No DNA D NE DYes ~o DNA ONE DYes ~~o D N,A, D NE DYes ~o DNA ONE . . , e.'""'' lei~ .FDr-,, , .. ,..); lv ~ ,;~,,,. be fi,,., f-4.._ ~,J or ;Joo > .:.?,5. PI~ ke., ~ "i.. 4>1'7 l-Ie .¥c--lje Sv'~f'T I 'I /'_.,"' r~ct:'rc:/s, :&l'IR-; 12128104 • e Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I Ro.a•:on for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other D Denied Access ' Dat.eofVisit: I) ·/?·CJ'/ITune: I rf:i!:>tl<'ll Facility Number I 11.;?, H ?,27 !0 Not Operational 0 Below Threshold ~nnitted ~ed C Conditionally Certified C Registered Date Last Operated or Above Threshold: -··----·--·· Farm Name: ........ £i:.t'.>?.C,Y.---·--··!}1.._ _ _{r.:JL.......................................................... County: ...... 2.'1(..'¥.-f..IJ.!:J... ______________ .. E./f:.q_ __ , f-lc-L Owner Name: ............. C:.:~P..C!j.e ................... :::.!s.. . .f.::!.L ........... ~---·--·-·--·---·-·· Phone No: ......... '3.lf?. .. :: ... JZ.J.!?: . .::._'t.?..::I..(:r. ................ . Mailing Address: ...... 1:: ... ~"--·-IJ.l?.x... .... J!?. .. ~.---······!::!..~~L~ I I L----~ c; ____ .2:.8. .. ':tH .. ~---···--·-·-·------·---·· ··-·-·-······-·-····· C. .e II Facility Contact: ____________ §.: .. ~~<?!:!J"--···-··{!J·'··f . .JL ........ Title: --------·----·-·-·-······-························ Phone No: :!J_q __ ;§_'!.£: ... J2.?i£Li.-..... . Omite Representative: _______ k.t::..Lc!Ji! ........ LI2.,;_(;:_,:JL...................................... Integrator: ........ ~!::::.,e.ix. ... :._.;lc.&~-'"'14---------·--- Certified Operator: ·-·-·-·------k~.<?!..!j. . .:. ........... J':!..::.f.:."!/. ........... ---····-····-··· Operator Certification Number: ___ }_'1..fl:£.3, ___ , Location of Farm: esvi'ine 0 Poultry O Cattle D Horse Latitode .._ _ _.I• Ll _ _,I' Ll _ __.I" Longitode L--__,1• ._I _ _,I' ._I _ _,I" . ~;._ ., -'·" ~--;; Swine ·< . .. . .. ~ p~:.=:!n P~try · ~2;:~ p~;::::!n :ll:~H'i.,;W:.:~:.::ao:::e.:.:o~to~F Fi~~::::ru:::.:::.~--1--7-,-r: =--+--;;:>.-;>_9_1?-l ··s ~:o~~ayer I I I Farrow to We~Tl · -• :-:- Farrow to Feeder 10 Other I I I ~~~w to Finish ·<~.::C.:~ · To~ D~:~:~ i~~ =====:::ll~ Discharg., & Stream Impacts I. Is any discharge observed from any pan of the operation? Discharge originated at: D Lagoon D Spray Field D Other a. If discharge is observed, was the conveyance man-made? b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) c. If discharge is observed, what is the estimated flow in gal/min? d. Does discharge bypass a lagoon system? (If yes, notify DWQ) 2. Is there evidence of past discharge from any pan of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the Stare other than from a discharge? Waste CoUection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? D Spillway Identifier: Freeboard (inches): 12112103 Structure I .............. /.. .............. .. Structure 2 Structure 3 Structure 4 Structure 5 DYes [f}Ni) DYes [j-N'o DYes [;J..No DYes g.NO DYes [3-Nb DYes G31'fo DYes ~ Structure 6 Continued IFacitity Number: 9 ~ -& ;; '7 I Date of Inspection I 7 -/3-ot f 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? 8. Does any pan of the waste management system other than waste structures require maintenance/improvement? 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? \\'aste Application 10. Are there any buffers that need maintenance/improvement? I I. Is there evidence of over application? If yes, check the appropriate box below. D Excessive Ponding D PAN D Hydraulic Overload D Frozen Ground D Copper and/or Zinc 12. Croptype a?r,.,,Hh; .5mg/( 0-cc,'a Ovcs-~,1 (1t/ 9""'zol) 13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)? 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 !he receiving crop need improvement? 16. Is there a lack of adequate waste application equipment? Odor issues I 7. 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. DYes ~ DYes [3-'No DYes 8No DYes g-Nb DYes r;;J..NO DYes 0-No DYes [3-No DYes (g-No" DYes @-No DYes [3-No DYes B"NO DYes G-No DYes G-NO DYes DNo DYes I]I-HO DYes G-NO' DYes 8-NO ;:~~~r~:?~~~t;t1v~~i~~r~if1 f' /,,_, +o YYIO(.-t.-' --~-~ aJc/ /' '"" '- , r, Reviewer/Inspector Name Reviewerllnspector Signature: 12112103 t::.r~v;"'-~f f-< 51"'~( .... CA t.-re) fc.c.l'J.•,r'J v "'"~' ' +:elc/ C<S ccJI~cJ f"'o .-!.o ;j f_,J-/.. ,..., Date: Continued I FaCility Number: /?? -t;;?l Date oflnspection 17 -n-o'( Required Records & Documents 21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? 22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (iel_l\lill', cbecldiSlS,~etc.) 24. Does record keeping need improvement? If yes, check the appropriate box below. D Waote Applioation, D Preclmartl g.wa:Sle Analysis D Soil SampliHg 3-f'I-7.;J.'l ~-~~-??-"! Jo-G->;;7,0 3·...:><>-? .?·1 Is facility not m compliance With any applicable setback criteria in effect at the time of design? 25. Did the facility fail to have a actively certified operator in charge? 26. Fail to notify regional DWQ of emergency situations as required by General Permit? {iel discharge, freeboard problems, over application) 27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? 28. Does facility require a follow-up visit by same agency? 29. Were any additional problems noted which cause noncompliance of the Certified A WMP? 1\"PDES Permitted Facilities 30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) 31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 32. Did the facility fail to install and maintain a rain gauge? 33. Did the facility fail to conduct an annual sludge survey? 34. Did the facility fail to calibrate waste application equipment? 35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. D Staeking Ftlffil D Crop Yield Form D Rainfall D lnspeeliaH After I" Rain D 120 Mjnute !nspeelioos D A11filliireenlfu:alion.FOHR- DYes DYes !I}'tes DYes DYes DYes DYes DYes DYes (g-Yfs DYes DYes DYes DYes DYes [] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. (];J..N6 G-NO DNo EtNo I9-N1l [iJ-NO [Y.NtJ ~ liJ.l>lo DNo ~ [3-No !B:-NO [3-No [!J.lll&- ~~!~i>ll.~;~~~L~gf,I:>f<ll>j~#;c-• · ( ~~~:, "•f e:;~ft'2.':';•=:· j~~~~t •;f;lk c:bc:'""'.;'" t~: '-"' "':r.zf-!.' yc:Jvr P!eose 11_.1' " (cf'l &f fl, < h:tr,., lv .. ~-~ rt'cvrc/5 yc..-r ' Rev:e..,,J (_l'op Yre/d A'u t1rl.S, 12112103 ff,,, /<,.,, V:ll 11(',J 1-o 1-,ke_ .._/ IJ. /C:..../1< Knd 'X ""·!4 f.J,e l'':OJ fc /'1.,., c' 2c" ''/ fte_ 1 "'""'J S /...cJ'je 5 v r Ll~7 0 ., ~ F:(e q,C. w./( s~nd C< Ct'/'/ /.,7 "n,, .-/. ... f---- .~ ··., ,'.- Site Requires Immediate Attention: NO Facility No. ----- DMSION OF ENVIRONMENTAL MANAGEMENT ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD DATE: 7--z./ , 1995 Time: /o :// Farm Name/Owner:_....,..,,.--~G=::...J;fo~>l!..&~~£--ML..!.!ic...=.~CzZJ·L.!I.L/,-----:----.....,.,-:;-:-;--------- Mailing Address: __ .t:.'F-:Lf.<--'l-!::....._lll?"'"x..J;_-'z;._"S~__i.fl,1l;H~:.r.~~.£.E~ds.___..lzJ:!.!C.::... _ ____.-z..~BrL+.'f~'f:...J'f[._ ______ _ County:. ___ -2~~~-=------------------~~----- Integrator: __ ~L--L-A---L"P\=L-------Phone: __ --'-9.'-'1oe...:-=-~~~~~1..::...-__:1t'Z--'--"Z..""'9'----- 0n Site Representative: __ __(J_J!t:!~---'i:I:::!:L!I------- Physical Address/Location:_....£!U,t~_..:::.__:_____[j~4J:4L---'~~£.--~~&1-ot..I!;;~......S-.~.__.!rr ____ __ . h., Type of Operati : Poultry __ Design Capacity: __ ...£:.:.:z.tl.£_____ Number of Animals on Site: ----~z.'--~~t3-=0::__ ______________ _ OEM Certification Number: OEM Certification Number: ACNEW _______ _ Latitude:_tt_ 0 ~· <>J • Longitude:78 o ~'1~> • Circle Yes or No Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event (approximately I Foot+ 7 inches)(Fr No ~al Freeboard: r Ft. _Linches ~ Was any seepage observed from the a~(s)? Yes o~Was any erosion o~ed? Yes or~ Is adequate land available for spray? es r No Is e cover crop adequate? ~or No Crop(s) beirig utilized:. __ ~C.=· !:!A::.J{U!LL---'I~.n.!o..9.n:.. ______________ .....,_ ___ --,-__ _ Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin~ t!j}.· or No 100 Feet from Wells? ~ o~o ~~ ~~r:::~s:~~ds~~~~~rw:~~~ ~~g~: ~i~!G{s ~=~~~n= ~J~~;~a!e~~~:~e: Yes or~ Is animal waste discharged into water of the state by man-made ditch, flushing system, or other similar man-made devices? Yes o.;Nin If Yes, Please Explain. Doe~n~:. ~~~~:A~~~~~~~~:~:,~:S~~~:=~=~:~~o2~mes of manure, land applied, OJY.IU.J .1.1.1.16U."""" VII OJ~JIJ"' 0."'!1..4.5~ WILli '-"U\'"'1 "'IV}J'J; e/ I~V Additional Comments: · Inspector arne Signature cc: Facility Assessment Unit Use Attachments if Needed. ,. I· .. -r.~ z1 t r ;o: II Alino.L IIUft 'GHlCIP'IIIn'. ~ CU'l'iJ'XOT:tOII J'Oll IIZif Oil. ZDA!mZD I'ICII:DLCI'U •l.-•e oretuza ""-•-l.~ tO= to ta Divi•iOD of EDvir..-tal. K&nag-t at the add:-• -~ &leV-~ ~ thi• foz=. ~;a~;, tah. ,cn;_r_-"£'ntg=-~-.af:=t.=:;{f'o:::"-~'d}ii,~o:""A'"'c-!1.:-f:~~r.. <~c...~C:.-._·L,I:~./-'-------------- Phone ·N"o.: 9/o, $TL ¥7_7{., ;::=-c:---:-":---:-~-:-:-:;---;--::---:;c:--;-':....,= Co~n t:y : · SA,., E'>o /J Farm location: Latitude and Longit:udai~<A' e:J.11 tn°&' 'll}/lraquired). Also, please attach a copy of a county road. map with location iQentified~ Type of operation (swirut: layer: dairy~ ate.) =..-.:~=-;;;-;:S....<J''-'"'"~",J""-.::r==--------- Design capacity (number of animals) =---:---:---'·-=-~'l,':'-'c"----,~,-,;:-:"------- Average size of operation· (12 month population avg.): te¥5s:. Average acreage needed for land application of waste (acres) ' 2 ::Z: · D ··----------------·····---------------------·-········-·······-··············· Technical. Special.i•t c.rtificatiOD As a technical specialist designated by the North Carolina Soil and Water Conservation Commission pursuant to 15A NCAC 6F .0005, I certify that the new or expanded animal wasta ~gement system as installed for the farm named above has an animal waste management plan that meets the design, construccion. operation and maintenance standards and specifications of the Division of Environmental Management and the USDA-Soil Conservation Service G..&""'ld/or the North Carolina Soil and Water Conservation Commission pursuant to l5A NCAC 2H.0217 and 15A NCAC 6F .0001-.0005. The following elements and their corresponding minimum criteria-h~'e heeo_varified by me or other designated technical specialists and are included in the plan as applicable: minimum separations (buffers); liners or equivalent !or lagoons or waste storage ponds; w~sta storage capacity; adequate quantity and amount of land for waste utilization (or use of third party): access or ownership of ·proper wasta application equipment; schedule for timing of applications: application rates; loading, rates; an~ the control of the discharge of pollutants from stormwatar runoff events lass severe than the 25-year, 24-hour storm. ownar/Hana~er Ag%eamant n -...., i..L -G~ Dat:e: --"Kt:::...---~=-"-' _ _,r;...<? I (we) understand the operation and maintenance procedures established in the approved animal waste management plan for the farm named above and will implement these procedures. I (we) know that any additional expansion to the axisting design capacity of the wasta treatme~t and storaqe system or construction of new facilities will require a new certification to be submitted to the Division of Environmental Management before the new animals are stocked. I (we) also understand that there must be no discharge of animal waste from this systam to surface waters of the state either throuqh a man-made conveyance or throuqh runoff from a stor:n event less Severe than the 25-year, 24-l1our storm. The approved plan will be filed at the farm and at the office of the local Soil and Water Conservation District. Signature: Date =------:-:e7:--:--:-- ~: A change in land ownership requires notification or a new certification (if the approved plan is changed) to be submitted to the Division o! Environmental Management within 60 days of a title transfer. OEM USE ONLY:AC~*----------------- I .....,.. (' 0 " ....... 1-f "' .1-