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Home My WebLink About820692_INSPECTIONS_20171231NORTH CAROLINA Qepartment of Environmental Quality •. • Division of Watar Resources D D Division of Soil and Water Conservation Other Agency Facility Number: 820692 FacUlty Status: -------- lnpsection Type: Compliance Inspection Reason for Vaslt · Routine Active Permit AWS820692 Inactive Or Closed Date: Sampson Region: ----------------------------County: ------- Date of Visit 09120/2017 Entry nme: 01:00pm Exit Time: 1:45pm Incident# Farm Name: Taylor's Bridge Sow Farm Owner Email: Chmer: QuarterM Ranch Inc Phone: Mailing Address: PO Box 1139 Wallace NC 284661139 Physical Address: 1573 Trinity Church Rd Magnolia NC 28453 Facility Status: • Compliant D Not Compliant Integrator: Murphy-Brown LLC 0 Denied Access Fayetteville 910-285-1005 Location of Farm: Utltude: 34 • 51' 25" Longitude: 75• 13' 14" from Clinton, take 421 South app. 11 mi. tum left on SR 1960, go 2.2 mi to Taylors Bridge. Tum left onto SR 1945, go 1.6 mi to entrance on left. Farm# 2809-2811. Question Areas: • Dischrge & Stream Impacts • Waste Col, Stor, & Treat • Waste Application • Records and Doruments • Other Issues Certified Operator: Douglas Stephan Atkins Operator Certification Number: Secondary OIC(s): On-Site Representatlve(sl: Name Title Phone 24 hour contact name Doug Atkins Phone: On-site representative Doug Atkins Phone: Primary Inspector: Bill Dunlap Phone: Inspector Signature: Date: Secondary lnspector(sl: Inspection Summary: Calibration 5-15-2017 S ludge Survey in primary N-4.0, 0-4.2 45% 985738 p age: Permit: AWS820692 Inspection Date: 09/20/17 Regulated Opei'IIUonl Swine • Swine -Boar/Stud • Swine -Farrow to Wean • Swine -Feeder to Finish • Swine -Wean to Feeder Owner-Facility : Quarter M Ranch Inc lnpsection Type: Compliance Inspection Design Capacity 130 4,462 1,224 500 Facility Number: 820692 Reason for Visit: Routine Current promotions 130 4,462 1,224 500 Total Design Capacity: 6 .316 2,164,2 86 Wgte Sttucturts Type Identifier Closed Oat. Lagoon PRIMARY r Lagoon SECONDARY I Start Date TotaiSSLW: Olslgnated Freeboard 19.00 19.00 Observed Freeboard 19.50 78.00 page: 2 Permit: AWSB20692 Inspection Date: 09/20/17 Discharges & Stream Impacts Owner-Facility: Quarter M Ranch Inc lnpsection Type: Compliance Inspection 1. Is any discharge observed from any part of the operation? Discharge originated at: Structure Application Field Other a. Was conveyance man-made? b. Did discharge reach waters of the State? (if yes, notify DVVQ) 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? Facility Number. Reason for Visit: 3. Were there any observable adverse impacts or potential adverse impacts to Waters of the State other than from a discharge? Waslll Collection. Storage & Treatment 4. Is storage capacity less than adequate? If yes, is waste level into structural freeboard? 5. Are there any immediate threats to the integrity of any of the structures observed (I.e .I large trees, severe erosion, seepage, etc.)? 6. Are there structures on-site that are not properly addressed and/or managed through a waste management or closure plan? 7. Do any of the structures need maintenance or improvement? 8. Do any of the structures lack adequate mar1<ers as required by the permit? (Not app licab le to roofed pits, dry stacks and/or wet stacks} 9. Does any part of the waste management system other than the waste structures req uire maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. Excessive Pending? Hydraulic Overload? Frozen Ground? Heavy metals (Cu. Zn, etc}? PAN? Is PAN> 10%/10 lbs.? Total Phosphorus? Failure to incorporate manure/sludge into bare soil? Outside of acceptable crop window? Evidence of wind drift? Application outside of application area? 820692 Routine Yn NoNa Ne Yes NoNa Ne o•oo D o •o o- Yes NoNa Ne D D D D D D D D D D D p age : 3 Owner-Facility : Quarter M Ranch Inc Facility Number: Permit: AWS820692 Inspection Date: 09120/17 lnpsection Type: Compliance Inspection Reason for Visit: Waste Application Crop Type 1 Crop Type 2 Crop Type 3 Crop Type 4 Crop Type 5 Crop Type 6 Soil Type 1 Soil Type 2 Soil Type 3 Soil Type4 Soil Type 5 Soil Type 6 14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of property operating waste application equipment? Records and Documents 19. Did the facility fail to have Certificate of Coverage and Permit readily available? 20. Does the facility fail to have all components of the CAVVMP readily available? If yes , check the appropriate box below. VVUP? Checklists? Design? Maps? Lease Agreements? Other? If Other, please specify 21 . Does record keeping need improvement? If yes, check the appropriate box below. waste Application? Weekly Freeboard? Waste Analysis? Soil analysis? Waste Transfers? VVeather code? Rainfall? 820692 Routine Yn NoNa Nt Coastal Bermuda Grass (Hay) Coastal Bermuda Grass w/ Rye Overseed wagram Yn NoNa Nt D D 0 D D 0 D D D D D D D page: 4 Owner-Facility: Quarter M Ranch Inc Facility Number: Permit AWS820692 Inspection Date: 09120/17 lnpsection Type: Compliance Inspection Reason for Visit: Records and Documents Stocking? Crop yields? 120 Minute inspections? Monthly and 1" Rainfall Inspections Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below: Failure to complete annual sludge survey Failure to develop a POA for sludge levels NorH:Ompliant sludge levels in any lagoon list structure(s) and date of first survey indicating norH:Ompliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? Other Issues 26. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report mortality rates that exceed normal rates? 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 regional DWQ of emergency situations as required by Permit? (i.e., discharge, freeboard problems, over-application} 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. Application Field Lagoon I Storage Pond Other If Other, please specify 32. VVere any additional problems noted which cause non-compliance of the Permit or CAVVMP? 33. Did the Reviewer/Inspector fail to discuss review/inspection with on-site representative? 34. Does the facility require a follow-up visit by same agency? 820692 Routine Yn NoNa Nt D D D Yn No Nil Nt D D D page: 5 Operation Review 0 Structure Evaluation Reason for Visit: 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: 13() Nl&/bl Arrival Time: I }!1llJJ I Departure Time: ldlf5 I County: _s· 1/-)'1' . Region:Ff!:e> Farm Name: Ta..y ~/s £5 h$ Sovu fiz_.r.-. Owner Email: Owner Name: 0 ~ /t{ ~ Phone: Mailing Address: Physical Address: Fadlily Contad: Dou ~ A-.(.k·~ Onsite Representative: l ( Title: ------------------------------------------- Certified Operator: Ct Back-up Operator: Latitude: '(' I Discharges and Stream Impacts I. Is any discharge observed from any part of the operation? Discharge originated at: 0 Structure 0 Appl ication Field a. Was the conveyance man-made? 0 Other: b. Did the di scharge reach wa ters of the State? (If yes, notify DWR) c. What is the estimated vol ume that reached waters of the State (gallons)? Phone: Integrator: J)/..!i -5 Certification Number: <foSZ 3K Certification Number: Longitude: 0 Y es ~ D NA ONE D Yes 0 No ErN A O N E DYes 0 No BI'JA ON E d . Does the discharge bypass the waste management system ? (If yes, notify DWR ) DYes 0 No ~A O NE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adve rse impacts to the waters of the State other than from a discharge? Page I of3 0 Yes L}-'No 0 Y es ~No D NA O NE D NA O NE 1141201 5 Continued (Facility Nootber: A: -61 b I nate of Inspection: 3 () lfW JO 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 Structure4 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 ~NA ONE 0 Yes 0 No ..{d-NA 0 NE StructureS Structure 6 DYes~ 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 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 Appllcation I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes ~o DYes ~o DNA ONE DNA ONE 0 Yes c:(N"o DNA 0 NE DYes ~o 0NA ONE 1 I. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes 0'No DNA 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 D Evidence of Wind Drift 0 Application Outside of Approved Area 12 . Crop Type(s): B·v~". s' '() 13. Soil Type(s): 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 facil ity 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. D WUP 0Checklists 0 Design 0 Maps 0 Lease Agreements 21. Does record keeping need improvement? lfyes, check the appropriate box below. 0 Yes ONE 0 Yes ONE 0 Yes ONE 0 Yes ~ DNA ONE DYes [3iio DNA ONE DYes QN: D NA ONE 0 Yes ~0 D NA ONE OOtber : DYes L]'No DNA ONE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis D Soil Analysis D 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? 23. If sel ected , did the facility fail to install and maintain rainbreakers on irrigation equipment? Page 1 of3 DYes ~ DNA ONE 0 Yes ~ No D NA 0 NE 11411015 Continued I Facility N'@ber: I nate of Inspection: So /Vorz /6 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. D Yes~ DNA ONE DYes~ 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 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? 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 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? Reviewer/Inspector Name: {2?1'~ l _Qt~ls Reviewer/Inspector S ignature: £1 li' wJ.rn t1 v Page 3 o/3 tf I D DYes ~DNA ONE 0 Yes ~ DNA ONE DYes ~ DNA ONE DYes ~ DNA ONE DYes ~ DNA ONE D Yes ~ DNA ONE DYes ~DNA ONE DYes ~DNA ONE DYes ~DNA ONE Phone:<{ 33-33 3 ( Date: 0 0 {f)O V /b 2/411015 0 Other 0 Denied Access • Date of Visit: If 6: )too J:f Arrival Time: I /{ c ~~ FannName: TCL~( tJ.,..1 ~ ~~~.-~.e Departure Time:ljtfJv I County: .s-.t1:ft< Region: Fib Owner Email: Owner Name: Q\J (,~ f\A ~ Phone: Mailing Address: Physical Address: ---------------------------------------------------------------------------------------=D'-o~u a'fl"'--t-/t+...l..-"-ki....1,_~~---Title: _____ _ Onsite Representative: \ ( Integrator: ___ ..a.M..:;.._..:;{] ____________________ _ Facility Contact: Phone: Certified Operator: ------\(~------- Certification Number: T t5 7 ] r Back-up Operator: Certification Number: Location ofFann: Latitude: Longitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? DYes~ DNA ONE Discharge originated at: 0 Structure D Application Field 0 Other: a. Was the conveyance man-made? DYes 0No E:]'NA ONE b. Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No (;I--NA 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 C}NA 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 CJNo DNA ONE 214/2014 Continued If acility ·Number: -?fb-~'i21 !Date of Inspection: hf V r.v( J Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a . If yes, is waste level into the structural freeboard? Structure I Structure 2 Structure3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): {q 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 ~ DNA ONE DYes ~ DNA ONE StructureS Structure 6 DYes ~ DNA ONE 0Yes ~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 of the structures need maintenance or improvement? 0 Yes ~ 0 NA 0 NE 8. D o any of the structure s 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 buffers, setbacks, or compliance alternatives that need maintenance or improvement? II. Is th ere evidence of incorrect land application? lfyes, check the appropriate box below. 0 Yes g-tqO D NA 0 NE 0 Yes (31'lO DNA 0 NE DYes lf:]No DNA ONE DYes ~o DNA ONE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN > 10% or 10 lbs. D 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 --g~v-"1~ s~ o lf7 12 . Crop Type(s): 13 . Soil Type(s ): 14 . Do the receivi ng crops differ from those designated in theCA WMP? 15. Doe s the receiving crop and/or land application site need improvement? 16. Did the facility fa il to secure and/or operate per the irrigation design or wettable acres detennination? 17. Docs the fac ility 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 & Permi t readily available? 20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check the appropriate box. 0WUP Ochecklists D Design 0 Maps 0 Lease Agreements 22. Did the facility fai l to install and maintain a rain gauge? 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? Page2of3 DYes DYes DYes DYes DYes DYes DYes 00ther: DYes Q.Hb DNA ONE I [JX<( DNA ONE [d-No B1'fo (2t1\fo ~0 ~0 ifNo DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE 21412014 Continued I Fp.cility Number: I Date of Inspection: ltfl) 10 /J 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. D Yes (2]..Ne-0 NA 0 NE DYes ~~ONE 0 Failure to complete annual sludge survey 0Failure to dev elop 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 a nd report mortality rates that were higher than normal? 29. At the time of the inspection did the fac ility pose an odor or air quali ty conc ern? I f yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency si tuations as required by the permit? (i.e., discharge, freeboard problems, over-application) 31. Do subsurface tile drains exist at the facility? Ifyes, check the appropriate box below. DYes DYes DYes 0Yes DYes DYes ~ ' DNA ONE ~ DNA ONE ~DNA ONE ~ DNA ONE ~DNA ONE ~DNA ONE D 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/In spector fail to discuss review/in spection with an on-site representative? 34. Does the facility require a follow-up visit by the same agency? DYes DNA ONE g: DYes DNA ONE DYes DNA ONE 0 or any otber ... ,., /0 --to --I) fo1. jV -L(~ 0 {t(4r ·~~ Kn f '--oo(c;"'J ~' ... l.( 5 '/~ o IJ sl'q'J '( Reviewer/Inspec tor Name : J:!ll(l D 11 ~ Phone : R ev iewer/Inspector Signature: o ate: f'r fVIJtJ { J ~~----~-------- Page 3 ofJ 214/2014 Reason for Visit: Date of Visit: lfu@ \5I Arrival Time: I ~,}~0 4 I Departure Time:l•i>! "§.) 4 I County: Sl}tv Farm Name: ~ry/, ~ J'.S\1 ~Y Owner Email: Owner Name: ~ 1fl ·~ Phone: Region: t:f,.f) Mailing Address: Physical Address :------------~-------------------------------------------------------------------- _()-.:6b-~JJ-......::..t4f: ........... kJ~l ~._ ..... ___ Title:--------Facility Contact: Phone: Onsite Representative: Integrator: __ M___:~=------------------- Certified Operator: Certification Number: CffS 73 f' Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? DYes ~DNA ONE Discharge originated at: D Structure D Application Field D Other: a . Was the conveyance man-made? DYes DNo [31'f"A ONE b. Did the di scharge reach waters of the State? (If yes, notify DWR) DYes DNo (91{.\ 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 ~ ONE 2. Is there evidence of a past di sc harge 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 disc harge ? Page 1 o/3 DYes ~0 DYes L(No DNA ONE DNA ONE 214/1014 Continued !Facility Number: I nate oflnspection: ')'.~ /J I Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure4 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~ DNA ONE DYes 0No ~ONE \ Structure 5 Structure 6 DYes~ DNA ONE D Yes [2tr'io D NA D NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threa4 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 DYes DYes DYes DYes ~ DNA ONE ~0 DNA ONE [2l'No DNA ONE ~0 DNA ONE I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~o 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. D 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 12 . Crop Type(s): )3r::~ S G (.;7 13. SoH Type(•)o ~""-"'-£& .,JI'? 14. Do the receiving crops differ om those destgnated m the CAWMP? 15. Docs the receiving crop and/or land application site need improve ment? 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 faci lity 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 ~0 DNA DYes ~ DNA DYes ~ DNA ' DYes ~ DNA DYes [)..XO 0 NA DYes ~ DNA DYes ~0 DNA ONE ONE ONE ONE ONE ONE ONE OWUP 0Chec klists D Design 0 Maps D Lease Agreements 00ther: _________ _ 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~o DNA D NE D Was te Application 0 Weekl y Freeboard D Was te Analysis D Soil Analysis 0 W~te Transfers D Weather Code D Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and l" Rainfall Inspections ~Sludg e Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes ~o DNA D NE 23 . If selected, did the facility fai l to install and maintain rainbreakers on irrigation equipment? 0 Yes cJ No DNA D NE Page 2 of3 21412014 Continued -!Facility Number: Oj!-bj~ I nate of lns(!ection: 9-.6'~ Js 24. Did the facility fail to calibrate waste application equipment as required by the permit ? DYes ~ DNA ONE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check DYes ~ 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 offrrst survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? DYes ~ DNA O NE 27. Did the facility fail to secure a phosphorus Joss assessments (PLAT) certification? DYes 01fu DNA ONE Other Issues 28 . Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes [d1fo 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 ~0 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 ~0 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 (3'1ijo DNA ONE 0 Application Field D Lagoon/Storage Pond D Other: 32. Were any additional problems noted which cause non-compliance of the pennit orCA WMP? DYes {2fNo 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 ~0 DNA ONE \ ,._,_ hit c.( Reviewer/Inspector Name: Phone: l{3..3 -J 3 3t{ Reviewer/Inspector Signature: Date: f! ~ /:5 Page3of3 2/412014 Compliance Inspection Operation Review 8 Routine 0 Referral 0 l'.nu•raPru•v 0 Denied Access Date of Visit: ~ Arrival Time:bfi'/5c MnDeparture Time:FfOOQn, I County:~ =tA'\, (Qt?1 & $-a~ JS$= $>w Owner Email: Region: Farm Name: Owner Name: ~t~ 0\ ft;ocb 'Tee Phone: Mailing Address: Physical Address: ------------------------------------------- Facility Contact: _<U"""""""' ....... <lhL..U...c!~:r--~.oaL...:!...&.....:..¥§~ .. ,.u."s=---Title: ______ _ Phone: Oosite Representative: -~--.... ·....=..,...,==---+~-""""" .... 'h....,...).___ ________ _ Certified Operator: ~ f\ttns Back-up Operator: Location of Farm: Latitude: Discharges and Stream Impacts I. Is any discharge observed from any part ofthe operation? Discharge originated at: 0 Structure 0 Application Field a. Was the conveyance man-made? D Other: b. Did the discharge reach waters ofthe State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? Integrator: A4t< qly 3tsvn Certification Number: ')55 ?t3!J Certification Number: Longitude: DYes DNA ONE 0 Yes 0No DNA ONE 0 Yes DNo DNA ONE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes f0NA 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 0 Yes DYes DNA ONE No DNA ONE 214/2011 Continued • IFacil!ty Number: I nate of Inspection: Jo!zl/tl T/ ~DNA Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? I a. If yes, is waste level into the structural freeboard? Struchrrel Structure2 Structure 3 Structure4 Identifier: """"fC> prt.,ryy TO $«:._ Spillway?: Designed Freeboard (in): Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any ofthe 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 0 Yes Structure 5 rz(No DNA Structure 6 / 0 Y" [2(? 0 NA 0 Yes )Ll No 0 NA ONE ONE ONE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or eovironmen~reat, notify DWQ 7. Do any of the structures need maintenance or improvement? D Yes lZ(~N/0 NA 0 NE 8. Do any of the structures lack adequate markers as required by the permit? . D Yes No NA 0 NE (not applicable to roofed pits, dry stacks, and/or wet stacks) mamtenance or 1mprovement? 10. Are there any required buffers, setbacks, or compliance alternatives that need 0 Yes 0 NA D NE Waste Application z maintenance or improvement? II. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes DNA 0 NE 0 Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) D 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): 13. Soil Type(s): 14. Do the receiving crops differ from those designated in theCA WMP? 15. Does the receiving crop and/or land application site need improvement? I 6. Did the faci lity 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 fac ility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. O WUP O checklists DYes DNA 0 Yes D NA DYes DNA DYes DNA DYes DNA DYes D NA 0 Yes DNA ONE ONE O NE ONE ONE ONE ONE QDesign 0 Maps 0 L ease Agreements 00ther: / 21 . Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes iiJ No D NA 0 NE D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Trans fers D Weather Code D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections D Monthly and 1" Rainfall Inspection~,,/ 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? 0 Yes 0 'l';Jo 0 NA 0 NE 23. If sele cted , did the facility fai l to install and maintain rainbrcakers on irrigation equipme nt? 0 Yes ~o DNA 0 NE Page 2 of3 21412011 Continued •IFaciUtyNumber::;k -~tl:>:-:1 loateoflnspection: Jo/4/}3 I / 24. Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes [2{N/ DNA 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes r;YNo 0 NA the appropriate box(es) below. 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 oftirst survey indicating non-<:ompliance : 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) DYes DYes DYes DYes DYes D Yes 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 or CAWMP? DYes 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes 34. Does the facility require a follow-up visit by the same agency? DYes DNA DNA DNA ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE ONE C~ptmen~ (r~f~r to question #): Explain any YES answers and/or any additional recommendations or any other comment • use-draWings ofracility to better explain situations (use additional pa es as necessary). ; . ,,. .. . ' •. ' • ~·.,-·~yq_:~: .. Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of3 ~/fc/rs ~ /•'-1 /13 5'/2-'f /13 IBS6wP 1--<B~ f.So ~.=r~ tf /?.Gjr~ d-~.:l.... 51 ,e/t3 ~·~3 ;;.jJsjf3 1·13 I /2?:./1 3 .<8( SowS ~ceq '4b . 51 , too f. l ~ , -=f) , 18 \rr.~on rc...l,k4brl 'Loll ~~ ~~·~, Z-o) 3 ~)/-'}f- ~rr;~'¥"1 ~s ~SfPt j ~ ~Jt Lj -o I ~cox.--J.~ Phone: <)?'?~Lj(/-'3~ 4'L Date: 4/I(L/3 21411011 • Division of Water Quality O Division of Soil and Water Conservation D Other Agency Facility Number : ,.82,..0..,6,..9 .. 2.._ ____ Facility Status: ~A~ct.!!,;iv'-'lie.__ ___ _ Permit: AW$820692 0 Denied Access Inspection Type: Compliance lnsoection Inactive or Closed Date: Reason for Visit: .wR.,.o.,.yt~in~e...._ _____________ _ Coun~: ~S.,.aum~p~s~on~---Region: Fayetteyi!!e Date of Visit: 10(11/2013 Entry Time: 08:30 AM Exit Time: 09-QQ AM Incident#: -------- Farm Name: Taylor's Bridge Sow Faun Owner Email: -------- Owner: Quarter M Ranch Inc Phone: 91 0-285=1 005 Mailing Address: ._r...,o .... B..,o,..x,_1.._1 ... 3"'9'-----------------Wallace NC 284661139 Physical Address: 1573 Trinity Church Rd Magnolia NC 28453 Facility Status: • Compliant 0 Not Compliant Integrator: Murnhy-Brown LLC Location of Farm: Latitude: 34 •51 '25" Longitude: 78.13'14" from Clinton, take 421 South app. 11 mi. turn !eft on SR 1960, go 2.2 mi to Taylors Bridge. Tum left onto SR 1945, go 1.6 mi to entrance on left. Farm # 2809-2811. Question Areas: ~ Dischrge & Stream Impacts II Waste Col, Stor, & Treat II Waste Application ~ Records and Documents II Other Issues Certified Operator: Douglas Stephan Atkin s Operator Certification Number: 985736 Secondary OIC(s): On-Site Representative(s): Name 24 hour co ntact name On-site representative Doug Atkins Doug Atkins Primary Inspector: Ronnie T Smith Inspector Signature: Secondary lnspector(s): Title Phone Phone: Phone: Phone: Date: Page: 1 Permit: AWSB20692 Inspection Date: 1 0/1112013 Inspection Summary: CoC in records WuP 1/8/04 Crop yeild reviewed Sludge Survey 1 0/9/20 13 ••due again 2014** thickness = 3.2 LTZ = 4.5 pump intake = 5.6 39% Soil Test 11/27112 ***due again 2015** L = 1.1T Cu & Zn levels w/in range Waste Analysis N TBSowP TBSowS 8/6/13 = 1.86 .64 6/14/13 = 1.50 .46 5/24/13 = 2.73 .59 4/25/13 = 2.52 .60 3/18/13= 2.53 1.14 2/15/13 = 1.73 .75 1/22/13= .89 .18 irrigation calibration 2011 ••*due again 2013** Owner· Facility: Quarter M Ranch Inc Inspection Type: Compliance Inspection irrigaiton records to rainfall and lagoon records. Facility Number: 820692 Reason for VIsit: Routine Page: 2 Permit: AWS820692 Inspection Date: 10/11/2013 Regulated Operations Swine ii Swine -Boar/Stud li Swine-Farrow to Wean ii Swine -Feeder to Finish ii Swine-Wean to Feeder Waste Structures Type a goon a goon Owner • Facility: Quarter M Ranch inc Facility Number : 820692 Inspection Type: Compliance Inspection Reason for Visit: Routine Design Capacity Current Population 130 130 4,462 4 ,462 1,224 1,224 500 500 Total Design Capacity: 6,316 2 .164,286 Identifier Closed Date Start Date PRIMARY SECONDARY Total SSLW: Designed Freeboard 19.00 19 .00 Observed Freeboard 21 .00 84.00 Page: 3 Permit: AWS820692 Owner -Facility: Quarter M Ranch Inc Facility Number : 820692 Inspection Date: 10/1112013 Inspection Type: Compliance inspection Reason for VIsit: Routine Discharges & Stream Impacts 1. Is any discharge.observed from any part of the operation? Discharge originated at: Structure Application Field Other a. Was conveyance man-made? b. Did discharge reach Waters of the State? (if yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? Yes No NA NE D•DD 0 0 0 O•OD O•DO d. Does discharge bypass the waste management system? (if yes, notify DWQ) 0 • 0 0 2 . Is there evidence of a past discharge from any part of the operation? 0 • 0 0 3. Were there any observable adverse impacts or potential adverse impacts to Waters of the State other than 0 • 0 0 from a discharge? Waste Collection, Storage & Treatment Yes No NA NE 4 . Is storage capacity less than adequate? 0 • 0 0 If yes, is waste level into structural freeboard? 0 5. Are there any immediate threats to the integrity of any of the structures observed (I.e ./large t rees, severe 0 • 0 0 erosion, seepage, etc.)? 6 . Are there structures on-site that are not properly addressed and/or managed through a waste management 0 • 0 0 or closure plan? 7 . Do any of the structures need maintenance or improvement? 8 . Do any of the structures lack adequate markers as required by the permit? (Not a pp li cab le to roofed pits, dry stacks and/or wet stacks) 9 . Does any part of the waste management system other than the waste structures require mai ntenance or improvement? Waste Application 10. Are there any required buffers, setbacks. or compliance alternatives that need maintena nce or improvement? 11 . Is there evidence of incorrect applicat ion? If yes, check the appro priate box below. Excessive Ponding ? Hydraulic Overload? Frozen Ground? Heavy metals (Cu . Zn . etc)? O•DD D•DD D•DO Yes No NA NE 0 0 0 0 Page: 4 Permit: AWS620692 Inspection Date: 10/11/2013 Waste Application PAN? Is PAN> 10%/10 lbs.? Total Phosphorus? Owner -Facility: Quarter M Ranch Inc Inspection Type: Compliance Inspection Failure to incorporate manure/sludge into bare soil? Outside of acceptable crop window? Evidence of wind drift? Application outside of application area? Crop Type 1 Crop Type 2 Crop Type 3 Crop Type 4 Crop Type 5 Crop Type 6 Soil Type 1 Soil Type 2 Soil Type 3 Soil Type 4 Soil Type 5 Soil Type 6 14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)? 15. Does the receiving crop and/or land application site need improvement? Facility Number: 820692 Reason for Visit: Routine Yes No NA NE 0 0 0 0 D 0 D Coastal Bermuda Grass (Pasture) Wagram Blanton sand, 0 to 6% slopes D • DO D • DO 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? O•DD 17. Does the facility lack adequate acreage for land application? 0 • DO 18. Is there a lack of property operating waste application equipment? 0 • DO Records and Documents · Yes No NA NE 19. Did the facility fail to have Certificate of Coverage and Permit readily available? 0 • DO 20. Does the facility fail to have all components of the CAWMP readily available? 0 • DO If yes, check the appropriate box below. Page: 5 Permit: AWS820692 Owner· Facility: Quarter M Ranch Inc Facility Number : 820 69 2 Inspection Date: 10/11/2013 Inspection Type: Compliance Inspection Reason for Visit: Rou tine Records and Documents WUP? Checklists? Design? Maps? Lease Agreements? Other? If Other, please specify 21. Does record keeping need improvement? If yes, check the appropriate box below. Waste Application? Weekly Freeboard? Waste Analysis? Soil analysis? Waste Transfers ? Weather co de? Rainfall? Stocking? Crop yie lds? 120 Minute ins pections? Monthly and 1" R ainfall Ins pections Sludge Survey 22. Did the facility fail t o in stall and maintain a rain gaug e? 23. If select ed, d id the facility fail to install and maintain a rain bre a ker on irrigation equipment (NPOES only)? 24 . Did the f acility f a il to calibrate waste applicatio n equipme nt as requi re d by the pe rm it? 25. Is the faci lity o ut of co m p li a n ce with permit conditi o n s re la t ed t o sludge? If yes, check th e ap pro pri at e box(es) belo w : Failure to com plete annual sludge survey Failure t o develop a POA f or s ludg e levels Non-co mpliant sludge lev e ls in a ny lagoon Li st structure(s) and d ate of fi rst survey indicating non ·co mpliance : Yes No NA NE 0 0 0 0 0 0 O•DO 0 0 0 0 0 0 0 0 0 0 0 0 0 • DO 0 • DO 0 • DO 0 • DO 0 0 0 Pa ge : 6 Pennit: AWS820592 Owner· Facility: Quarter M Ranch Inc Facility Number : 620592 Inspection Date: 10/11/2013 Inspection Type: Compliance Inspection Reason for Visit: Routine Records and Documents Yes No NA NE 26 . Did the facility fail to provide documentation of an actively certified operator in charge? 0 • 0 0 27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification? 0 • 0 0 Other Issues Yes No NA NE 28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report 0 • 0 0 mortality rates that exceed normal rates? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional 0 • 0 0 Air Quality representative immediately. 30 . Did the facility fail to notify regional DWQ of emergency situations as required by Permit? (i.e .• discharge, 0 • 0 0 freeboard problems, over-application) 31 . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. Application Field Lagoon I Storage Pond Other If Other, please specify 32. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? 33. Did the Rev iewer/Inspector fail to discuss review/inspection with on-site representative? 34 . Does the facility require a follow-up visit by same agency? O•OO 0 0 0 o.oo o.oo D•DD Page: 7 Technical Assistance Reason for Visit: 0 FoUow-up 0 Other 0 Denied Access Maifing Address: Pbysic~Addr~s: ________________________________________________________________________________ ___ Title: Phone: Facility Coofact' 'i2R:!J A/f.h _5 -------------------- Onsite Representative: -------"'------------------------------- Certified Operator: f/ Integrator: Adt+t(P~ Certification Number: CJ 8" 57.3 8'" Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Discha!Ees and Stream Impacts I. Is any discharge observed from any part of the operation? DYes ~No DNA ONE Discharge originated at: D Structure 0 Application Field 0 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 ~NA 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 DWQ) DYes 0No j;]NA ONE 2. Is there evidence of a past discharge from any part ofthe operation? 3. Were there any observable adven;e impacts or potential adverse impacts to the waters of the State other than from a discharge? Page I of3 DYes DYes £»No DNA ONE f:»No DNA ONE 21412011 Continued I Facility Number: I nate of Inspection: tipJ/! ~ 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? p;tructure 1 Identifier: (•~'{ _.S_tru~tur~~ Structure 3 ~C~'f Structure 4 ----- Spillway?: Designed Freeboard (in): Observed Freeboard (in): .2.7" 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? 0 Yes I)SI No 0 NA 0 NE 0 Yes D No ~ NA 0 NE StructureS Structure 6 0 Yes ~ No DNA 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 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 th~n the waste structures require maintenance or improvement? Waste Application 1 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement? DYes DYes DYes DYes ogJ No DNA ONE ~No DNA ONE ~No DNA ONE ~No DNA ONE 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes ~No DNA 0 NE D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 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 0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area 12. Crop Typc(s): Cbas.Ja {J»-fY\;udq Grzr~ (J/~);,)n]l ~L ~ 13. Soil Type(s): 'BlanJoh-&8 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 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. owuP Ochecklists D Design D Maps 0 Lease Agreements 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes DYes DYes DYes DYes DYes DYes Oother: DYes ~No DNA ONE ~No DNA ONE Efl No DNA ONE ~No DNA ONE ~No DNA ONE ~No DNA ONE [59 No DNA ONE ~No DNA ONE D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Weather Code 0 Rainfall D Stocking 0 Crop Yield D 120 Minute Inspections D Monthly and 1" Rainfall Inspections 0 Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes ~No 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes fJ No DNA 0 NE Page 2 of3 214120]] Continued . ' jFacility Number: I Date of Inspection: tl 11/1 ~ 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. DYes ~No DNA ONE 0 Yes riJ No D NA 0 NE 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? DYes ~No DNA ONE DYes No DNA ONE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes (a 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 tEJ 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 permit? (i.e., discharge, freeboard problems, over-application) DYes ~No DNA ONE 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. DYes G}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? 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? Reviewer/Inspector Name: Reviewer/Inspector Signature: Page3 of3 DYes ~No DNA ONE 0 Yes No DNA ONE DYes !]] No DNA ONE Phone: "'0!33-3300 Date: _l+l,.L>o[ ~.........,.'"};~--- 214/1011 0 Technical Assistance Reason for Visit: e Routine 0 Complaint 0 FoUow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Phone: Mailing Address: Physical Address: ------------------------------------------- Title: Phone: Facility Contact: ~ AJ-tt~ .S ----------------- Int•g"tor: ~ -bv .. Certification Number: ~ S '7"f3 Onsite Representative: "{ ------------------------- Certified Operator: 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? 0 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: Longitude: DYes ~No DYes 0No DYes 0No 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 1 of3 DYes lQ] No DYes ~No DNA ONE ~NA ONE ~NA ONE ~NA ONE DNA ONE DNA ONE 214/2011 Continued !Facility ;umber: 1 I I Date of Inspection: / o/?Qfl i Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate ? a. If yes, is waste level into the structural freeboard? Identifier: Structure I Pn~ Structure 2 Structure 3 ~ Structure 4 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 0 Yes 0No DNA ONE fJJ NA ONE Structure 5 Strucrure 6 0 Yes ~ No 0 NA 0 NE 0 Yes 1jZl 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 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 Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement'! 0 Yes 0 Yes DYes DYes ~No DNA ONE ~No DNA ONE ~No D NA ONE ~No DNA ONE II. Is there evidence of incorrect land application? lfyes, check the appropriate box below. DYes rsa No 0 NA D NE 0 Excessive Pending 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D PAN> 10% or 10 lbs. D Total Phosphorus 12. Crop Typc(s): 13. Soil Type(s): 14. Do the receiving crops differ from those designated in theCA 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 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 0 Yes~ No DYes ~No DYes ~No DYes ~No DYes Qg No DYes 6Q No DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE Owup Ochecklists D Design 0 Maps 0 Lease Agreements 00ther: _________ _ 21. Does record keeping need improvement? lfyes, check the appropriate box below. D Yes lpl No 0 NA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysi s D Waste Transfers 0 Weather Code 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall Inspections D Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? D Yes ~No 0 NA 0 NE 23. If selected, did the facility fail to install and maintain rainbrcakers on irrigation equipment? D Y es f1J No DNA 0 NE Poge2of3 21412011 Continued IF;cility Number: I Date of Inspection: 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. I I 0 Yes Ita No O Yes [¥J No DNA ONE 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 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. 0 Application Field D Lagoon/Storage Pond 0 Other: 0 Yes (}a No DNA ONE QYes ~No DNA ONE 0 Yes ISQJ No DNA ONE DYes [)11 No DNA ONE DYes (ENo DNA ONE 0 Yes ~No DNA ONE --------------------- 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? Reviewer/[nspector Name: Reviewer/Inspector Signature: Page3of3 0 Yes DNA ONE 0 Yes DNA ONE DYes DNA ONE Phone: Date: ----J/L-. V.::::r:=~~f--.11..1....1 __ 214/2011 t ompliance Inspection 0 Operation Review 0 Structure Evaluation Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access Date of Visit: lt,J.-=IS"-10 I Arrival Time: I cr.' 0 b Departure Time: I 3 ~.:JO I County: ~ ~ Region: PF..J:J Farm Nam~ ua .. rh-r M R a-eeL r,.. c, Owner Email: --------------OwnerNaJt:~/ors J3c!Jfc:::: 6Qt:.V &cyt...._ Phone: Mailing Address: ----------------------------------------- Physical Address:----------------------------------------- Facility Contact: tlr17,.. ~ Title: E, t/. M?'. Phone No:--------- Onsite Representative:~ ,..~..t..L.."'~"=?Jo::::....---e'tf;..Jo...jk,L..:...~l-"l...a.,.:J,.,________ Integrator: .hf4.!.£p"'ft _ Certified Operator: ~ _,,A±:;......:. _,_.....L..;k.._'.L.I, f::\..~8:::1------Operator Certification Number: %"::? 75Y' Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? DYes IBNo DNA ONE Discharge originated at: D Structure D Application Field D Other a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (lfyes, 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? DYes 0No DNA ONE DYes 0No DNA ONE I DYes 0No DNA ONE DYes ~0 DNA ONE DYes ~No DNA ONE Page 1 of 3 12118104 Continued i jFacility Number:~ -fpty2'j Date of Inspection [/I-to -/Dl Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 0 Yes 1:3-No DNA D NE DYes ~No DNA ONE Structure 5 Structure 6 Identifier: :U; 1'1 ry £-~ Spillway?: -------------------------- Designed Freeboard (in): ~-_,J......_'-1:,__ ____ 1'-9_,_ __ ------------------------ Observed Freeboard (in): __ ..~.~.iJ..::...::....JIL....-____ 7'-lo..S"----:--------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? (icl 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 ~o 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 ofthe 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/improvement? DYes ~No DNA ONE DYes ~No DNA ONE DYes gJ,No 0 NA 0 NE DYes ~No DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below . DYes ~o DNA D NE D Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heav y Metals (Cu, Zn, etc.) 0 PAN 0 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 Area 12. Crop type(s) &,.Ja_ / ~q--...-J 13. Soil type(s) ..::Zb:!::....::::..)Eitt!...._ _____________________________ _ 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? DYes ~No DNA ONE 16 . Did the facility fail to se cure and/or operate per the irrigation design or wettable acre determination ? DYes 00 NoD NA 0 NE 17. Does the facility lack adequate acreage for land application? I 8. Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Signature: Page 2 of3 ====== DYes ~No DNA ONE DYes 12JNo DNA ONE Phone: Date: 12128104 Continued .. I Facility Number:~-k92l-Date of Inspection I I f=/5:'/0 I I 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 theCA WMP readily available? If yes, check the appropriate box. 0 WUP 0 Checklists D Design 0 Maps 0 Other DYes ~No DNA ONE 0 Yes [iii.No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes liaNo DNA D NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections 0 Weather Code 22. Did the facility fail to install and maintain a rain gauge? DYes lRNo DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes l»_No DNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes l:&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 ~No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes l'&_No DNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes aNo 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 ~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 ~0 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 ~0 DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~0 DNA ONE Page3 of 3 12128104 ' Type of Visit 8 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit B' Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access J DateofVisit: lqffoiCfl I ArrivaiTirne:l~'!tJA-H I DepartureTime: I5:"'30PJ1 I County: ~{"? Farm Name: To..y l fi' J BriJje .Sow fiv"l Owner Email: ----------- Region: fJe(j Owner Name: {!lv.dfr H Raxh lac. Phone: Mailing Address: ----------------------------------------- Physical Address:----------------------------------------- Facility Contact: ..... Au...;V:IIC.........!l-~tll..LiO)...:....~~~~-------Title: -----------Phone No: --------- Onsite Representatiw: ---------------Integrator: JtvtpAy=~rKn( HVflz fttnfj) Certified Operator: _\).:::....lo'()1'-'~q.------_At.....;..o.....:..K.:...Jihf._=--------Operator Certification Number: 9$5738' Back-up Operator: kfnnfth Av.ff'V Back-up Certification Number: ;;)hO~ I Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? DYes ~No DNA D NE 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 ofthe State? (If yes, notify DWQ) DYes 0 N o 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) DYes 0No DNA 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 ~No DYes fSfN o 12128104 DNA ONE DNA ONE Continued I Facility Number: <"6()..-b<O Date of Inspection IClltolOt( I Waste Collection & Treatment 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 1 Structure 2 Structure 3 Structure 4 DYes rs;I'No DNA D NE D Yes D No D NA D NE Structure 5 Structure 6 Identifier: _f'-f,"""I~-"'{J'"-"ll/f---......:::~::...f~(I'JI:.l.lodu..'7'-+------------------------f Spillway?: Designed Freeboard (in): _._lq+------........,~!...._=,+----------------------------- Observed Freeboard (in): ...:~:::....::.5" ____ --~.J..JoO~Qo£...... _____________________ ------ 5. Are there any immediate threats to the inte~:,rrity 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 ~No DNA ONE If any of questions 4-6 were answered yes, and the situati~n poses an immediate public health or environmental threat, notify DWQ 7. Do any ofthe structures need maintenance or improvement? 8. Do any of the stucturcs 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 buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~No DNA ONE DYes !RNo DNA ONE DYes r;gNo DNA 0 NE DYes RNo DNA ONE II. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes ~o 0 NA D NE D Excessive Ponding 0 Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn , etc.) 0 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. Crop type(s) BflmvJa.. ~ 4 PPrfvre__ j S G OS 13. Soil type(s) 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 faci lity fail to secure and/or operate per the irrigation design or wettable acre determination? 17 . Does the facility lack adequate acreage for land application? 18 . Is there a lack of properly operating waste application equipment? Reviewer/Inspector Name Reviewer/Inspector Sig nature: DYes ~No DNA ONE 1§3 Yes 0No DNA ONE DYes s-No DNA D NE DYes ~0 DNA ONE DYes ~0 DNA ONE -. I Facility Number:~;;).. =@b. I Date of Inspection lqf(dC1( Required Records & Documents 19. Did the facility fail to have Certificate ofCoverage & 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 GlNo DNA ONE DYes r:;}No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~No D NA 0 NE 0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections D 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 0No ~NA ONE 24. Did the facility fail to calibrate waste application equipment as required b y the permit? DYes QNo DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes 5dNo DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes 18No DNA ONE 27 . Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No (g-NA ONE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No 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 th e 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? (ie/ discharge, freeboard problems, over application) ~No 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 gNo DNA ONE 12118104 Facility No. '5(}-~J-_ Farm Name Permit __ COC ___ _ Pop. Type Design Current Lagoon Spillway Design freeboard Observed freeboard (in) Sludge Survey Date Sludge Depth (ft) & % Liquid Trt. Zone (ft) Calibration Date 1 2 Design Flow Actual Flow Design Width Actual Width OAAff(A( C}l5fo9 foH=-4, 7 lJ-DH ll.t41 ~l4e_ Soil Test Date CH Fields t;: ir+~Q Need~ Lime Applied Date q/ tol(f( NPDES (Rainbreaker PLAT Annual Cert) H.+c' \Jli/V OltL '( ~ ..5EP ~~~~I& I l~l 1 2 3 4 5 6 7 ~j;;? lo~ laltflot_ ~I -~1( 3 4 5 6 7 8 Wettable Acres -----,..---- WUP 7 Weather Codes ..--- Transfer Sheets --- Weekly Freeboard ...l.L..-RAIN GAUGE Rainfall >1" ........-Dead bo x or incinerator __ _ Cu ....../ Zn ./ IOo-fJo{/yltt_ 1 in Inspections ~·· Mortal ity Re cords NeedsP~ ~~ 120 min Inspections i-Crop Yield 1 oork( ( ~ · d. ../"' ~ ~ ~ ~..--""""" t:;" ·' t., I Waste Analysis Date -60 Day + 60 Day N Amt (lb/1 000 Gal) ~~ i1f ~0 ()..Js-IJrJ ,70 pH ./ / "/ , Pull/Field Soil Crop RYE PAN Window Max Rate Max Amt J 1u Bob D-rr~(l -56 1qo .Yo ~drS~.~ o ,(p 0 ,3-l 0 B~ 'WO~ 3b t1i fl.tf' l~r;·' 10o <~A !:"'T r 1 ~Ub;.)j'-l 7 111,1 -\pA ~.oi-AK _, I v / fJ v ---·- .. FRO or Farm R~c<z,rd s () Lagoon# 1_1_-~ Top Dik e '*'·~ 'flf·Cf' Stop Pump ~c., ~ Start Pump 1 ,$ \r £, Approx. Conversion -C u-I 3000= 108 lb/ac; Zn-1 3000= 21 3 lb/ac Verify PHON E NUM B ~RS and affiliatio ns Date la st WUP FRO 1~ID'-f Date last WUP at farm . App . Hardware , "\$I o 0 b r + h i_j h-~e1f"-'3 /:J-J f). II 10J "7 A-v-bn "f c VQD 6-e-q i-t q '' . • ompliance Inspection Reason for Visit 0 Routine 0 Complaint 0 Operation Review 0 Structure Evaluation 0 Technical Assistance 0 Follow up 0 Referral 0 Emergency ~er 0 Denied Access DateofVIsit: lthlJfofl Arriva1Time:l//:o£C I Departure Time: I// • 1¢ I County:Lrz.t~ Region: ~'f) FarmName: ~ J:c<Jp~-y....___ OwnerEmail: OwnerName: ~.,.....-fJ1 rgt::fttt.J _.:J:;;;;/.1.?-· Phone : --------------- Mailing Address: ----------------------------------------- Physical Address :----------------------------------------- Facility Contact: i/: T L ~ -'2. -j-pn_ Title: -----------Phone No: ________ _ Onsite Representative: ------------------Integrator:---------------- Certified Operator:--------------------Operator Certification Number: -------- Back-up Operator: --------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: Discharges & Stream Impacts I. Is any discharge observed from any part of the operation? DYes ~No Discharge originated at: D Structure 0 Application Field D Other a. Was the conveyance man-made'! D Yes 0No b. Did the discharge reach waters of the State? (If yes , notify DWQ) D Yes 0 No c. What is the estim ated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) D Yes 0 No 2. Is there evid ence 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? D Yes 0No DYes 0No 11118104 DNA ONE DNA ONE DNA ONE DNA ONE DNA (8NE DNA !SiN E Continued I Facility Number: ({d-?9g-- Reguired Records & Documents Date of Inspection I ¥jl ij--o'jf- 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 D Maps D Other DYes DNo DNA ~NE 0 Yes D No 0 NA I:2JNE 21. Does record keeping need improvement? If yes, check the appropriate box below. D Yes D No DNA l2i NE D Waste Application D Weekly Freeboard D Waste Analysis 0 Soil Analysis D Waste Transfers D Annual Certification D Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rain Inspections D 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 rainbreakers on irrigation equipment? DYes DNo DNA gNE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes 0No DNA 18NE 25. Did the facility fail to conduct a sludge survey as required by the permit? 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 ~NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes DNo DNA ~~E 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes DNo DNA (DNE 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 12J.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 0-NE . 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 ~o DNA ONE 12128104 .· I Facility Number: ¥?-: kLi} Date of Inspection [Jt-df"1J?t Waste Collection & Treatment 4. Is storage capacity (structural plus stonn 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 DYes DNo DNA ~ DYes DNo DNA ONE Structure 5 Structure 6 Identifier:----------------------------------------- Spillway?: DesignedFreeboard(in): ______________________________________ _ ObservedFreeboard(in): ______________________________________ _ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed through a waste management or closure plan? DYes DNo DNA _1g)NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? 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 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes 0No DNA ~E DYes D No DNA 13-NE DYes DNo DNA ~NE DYes DNo DNA ~E II. Is there evidence of incorrect application? If yes, check the appropriate box below. ~Yes D No DNA D NE .' ~xcessive Ponding D Hydraulic Overload 0 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 D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Area 12. Crop type(s) _!...)IJ=-.:£::::.. ______________________________ _ 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? DYes 0No DNA El-NE 15. Does the receiving crop and/or land application site need improvement? DYes 0No DNA ~NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination '? 5-Ycs D NoD NA D NE 17. Does the facility lack adequate acreage for land application? DYes DNo DNA I'JlNE 18. Is there a lack of properly operating waste application equipment? DYes 0No DNA [&NE Reviewer/Inspector Signature: Phone: 9;/zr-1/33 -3:ScC) Reviewer/Inspector Name Date: ..S:: /)-~ 12118104 Continued Type of Visit 0Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: IS§~ljki I Arrhra) Time:l~)a?lfl I Departure Time: lr~:~Jo r 11 I County: S()wtfJOl Region: fJeQ Farm Name: la~tt.r 1C 'f>tidje SIJJI"' Por~ Owner Email:----------- Owner Name: l2wr.fo--H J<tncJ, Joe_ Phone: Mailing Address: ---------------------------------------- Physical Address:---------------------------------------- Facility Contact: ....~..:A:;L.O.o\f'---~L......:..d-JL..:cfP:>=-...t _______ Title: ----------Phone No: ________ _ Onsite Representative: _A--.:...~;;;.....---~.Lhtrno<L...:.....u~~----------- Certified Operator: .Jit),..a.L"J:.....If-------..... Att....J.:L-"k:..t..~:.ih,.,.rt..-_____ _ Integrator:---------------- Operator Certification Number: ArrA q857.J8"" Back-up Operator: ~tf,_,f...;.l\wnu.fTh.-L..;.J....._ ___ _._Av"""-'.e"'-~)-+------Back-up Certification Number: AlvA Q~O~~ Location of Farm: Latitude: D OD'D" Longitude: D OD'D" Discharges & ~Impacts 1. Is any discharge observed from any part of the operation? DYes ~o DNA ONE Discharge originated at: 0 Structure D Application Field 0 Other a. Was the conveyance man-made? DYes 0No DNA ONE b. Did the di sc harge reach waters of the State? (If yes, notify DWQ) DYes 0No DNA ONE c. Wh at 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 DNA ONE 2. Is there evidence of a past discharge from any part ofthe operation? 3. Were there any adve rs e im pacts or potential adverse impacts to the Wat ers of the State other than from a di sc harge? Page I of 3 DYes "fS"No D Yes ~0 12/28104 DNA ONE DNA ONE Continued . I Facility Number: i6a... -<;q), I Date of Inspection llffl(} il(lJ 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 1 Structure 2 Structure 3 Structure 4 DYes ~o DNA ONE DYes 0No DNA ONE Structure 5 Structure 6 Identifier:---------------------------------------- Spillway?: ----------------------------------------DesignedFreeboard(in):_...~,.lq_,_ _____ ---J)~,..9~---------------------------- Observed Freeboard (in): _.!...I..J.CJ ______ 0~3:::;..... ______________ ------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes ~0 DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes 8-'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 1 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes ~o DNA ONE DYes ~No DNA ONE DYes 3'No DNA ONE DYes m:No DNA ONE 11. Is there evidence of incorrect application? If yes, check th e appropriate box below . DYes ~No 0 NA 0 NE 0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN D 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 Area 12 . Croptype(s)~±a l }kr,,wJtt..(J±q..~) ~ SG OJ / 13 . Soil type(s) ..!<B~larlrn:::!!..!.J'-Q-. -=5::...._ ____________________________ _ 14 . Do the receiving crops differ from those designated in theCA WMP? DYes IStNo 15. Does the receivin g crop and/or land application site need improvement? DYes IS!tN"o I 6 . Did the facility fail to secure and/o r operate per the irrigation design or wettable acre determination?O Yes ~No 17 . Does the facility lack adequate acreage for land application? 0 Yes ~o 18 . Is there a lack o f properly o perating waste application e quipm ent? Reviewer/Inspector Name R evie wer/Inspector Signature : Page 2 of 3 DYes ~o 12128104 DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE Continued I Facility Number: p -&?JJ Date oflnspection lliib4Jbt 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 theCA WMP readily available? If yes, check the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps D Other 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes [i.No 0 NA 0 NE 0 Yes l:aNo 0 NA 0 NE DYes [B-No DNA ONE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste 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 !R-No DNA ONE 23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment? DYes 0No (RNA ONE 24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes 1St No DNA ONE 25. Did the facility fail to conduct a sludge survey as required by the permit? DYes IB-No DNA ONE 26. Did the facility fail to have an actively certified operator in charge? DYes £a No DNA ONE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes 0No 12tNA ONE Other Issues 28. Were any additional problems noted which cause non-compliance ofthe 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 ~0 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 ~0 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 1:2fNo 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 18-N'o DNA ONE 33. Does facility require a follow-up visit by same agency? DYes ~No DNA ONE ~ ~ P ledte... f~i-OOf y f -eid s-far ;;J Ol:JK. ;;>~ t; ~vi f"'D\i c.a l1 bro--Ntl_ ~ / r~ I 01 , . :It I :ff>;> dOSOB~ ~~'",.,_e-t\6-?li~ J') ~fl). 'vv(,l bl recoll'wo-lel -n,,•r ftll+o (»'fa\t-(Y()h/fh, 7. A--f'e ~v bere. s fol:s iY' llija:n ::> . }ve fl rnanio~ re rwj-01 c£Pr..~'fer:, Pag e 3 of 3 12128104 • Fa'cility No. ~~'h. Farm Name latfO""S IYI~e_. I 9 ..:>-) Permit COG___ OIC_ NPDES (Rainbreaker PLAT Annual Cert ) Pop. Type Design Current I FB Drops I I I Lagoon 1 2 3 Spillway Design freeboard bnb::d Observed freeboard in) Sluqge Survey Date Perm Liquid (ft) s,q •lttllm Sludge Depth (ft) _;).Q ([I 'V¥'' 116--% 'f.IIDI 11<1.'1" '?" no'rJI~lt,~~r..-. ~ Calibration Date 1 tPfcl ID1 Design Flow ~ Actual Flow ::>!if) Design Width ~ Actual Width IQ}S) 1\.'JI ~ Soil Test Date ~ pH Fields Lime Needed )JO Lime Applied ~ Cu ~ Zn 7 Needs P k!Q 2 rol~lcn 3 fo h;,_fv'> 4~h~lb) 5 ;rr;- 'J&,o 3i£. ;nO) ~ ·~,. 1~'1 1;)0 ~Nr J'fr ~D ~) f\. Crop Yield llP.RI iol'lrtJ~ll' Wettable Acres-~----:::-- WUP ...., RAIN GAUGE --- Weekly Freeboard 7 Rainfall >1" ./ Date of last Waste Plan in FRO 11fl1 _ Date of last Waste Plan at farm ff J 10'1 Pull/Field Soil Crop RYE 4 5 6 7 6 7 8 1 in Inspections /. __ _ 120 min Inspections v Weather Codes --- Transfer Sheets App . Hardware PAN Window 50 u v ~\Mtl.fp Slat='t),r 5~,.::-Cf),) y- LOV£ ~L!f~U ~~'t/- 0J) L-~) ~ hi ~~ hiJL-'lJI~I5 ~~ ~t; -o ~rd rs~~4 7 (Facility Number f6~ _ H L{1idl J> DiYi s io n of W ater Quality 0 Division of Soil and Water C onservation 0 Other Agency Type of Visit ~ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~ Routine 0 Complai nt 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Vi sit: !1£.h\O\ti)l Arrival Time: I~(\'~~ I Departure Time: I \ q;c;: l C ounty: Region: t::~ \ '...\~ ':') ,~ Farm Name: ~~<::.. DT I Owner Email : Owner Name: (\) \)~~ ro Lv'\_;...;:~=----------Phone : -------------- Mailing Addr ess: -----------------------------------____ _ Physical Address:---------------------------------------- Facility Contact: A -:s l \nkn Title: _Z-.:....::..:..V\.....;__V~~ _m_-p.&.-z("---Phone No : -------- Ons ite Representative: o~u ~ M\c: ~~ Integrator: m -~ -~ ~-~ Certified Operator: u~ t-± \d ns. Operator Certification Number: Jtb I'?> _a \~ C\ l '-()~ Back-up Operator: __ \..::..~~=------1'1 ~ Ba<k-up C <ntifi<ation Numbe" 0( "' Locatio nofFarm: Latitude: o o D ' D" Longitude: o oo · D " Design Current Design C urrent Design Current Swine Capacity Population W et Poultry C apacity Population Cattle C apa city Population ID Wean to Fini s h I I :;gwean to Feeder S'DO ~o:> 0 Dai!}'Cow I 0 Dairy Ca lf 10 Layer 0 Non-Layer ~Fee d er to Fin ish t?_ -z..lf ) <.t..'f ~arrow to Wean '-#-'f(n 1... lWLL 0 Farrow to Feeder 0 Farrow to Fin is h 0 Gilt s Klsoars 150 I]D . --. -·--·-·~ D Dairy He ifer i 0 Dry Cow I D No n-Dairy 0 Beef Stocker D Beef Feeder 0 Beef Brood Cow ! --~ ~--~-~ Dry Poultry D Layers 0 Non-Layers 0 Pull ets 0 T urk eys Other 0 T urkey P oults 0 Othe r -· ID Other I Number of Structures: 0 Discharges & Stream Impa cts I . Is any di sc harge observed fTo m any part o f the operati on? DYes Je No DNA O NE Di sc harge o r ig inated at: 0 Structure 0 A ppl ica tion Fie ld 0 Other a. Was the c onveyance man-ma de ? D Yes 0 No ~N A ONE b. Did the discharge reac h waters of the St ate? (l f yes, notify DWQ) D Yes 0 No ..eiNA ONE c. What is the estim at ed vo lume that reached waters of th e Stat e (ga ll ons)? - d. Does discharge bypass th e waste man agement system? (I f yes, not ify DWQ) 2. Is the re evidence of a p ast discharge fro m any pan of the operatio n? 3 . Were there any adverse im pac ts or potential adverse impacts to the Waters of the State other th an from a di sc harge? D Yes D No /fSJNA O NE D Yes a No D N A ONE D Yes 0 No )g NA O NE 12/28/04 Con tinued I Facili,!y Number:~(_ ~1'2-I Date of Inspection CJ!f$ •' Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) Je ss than adequate? a. If yes, is waste level into the structura l freeboard? DYes ~No DNA ONE DYes 0No Qi:NA ONE _r$tructurc I Identifier: +-'f \ fY'.. Spillway?: ~tructure 2 ~mA Structure 3 Structure 4 Structure 5 Structure 6 Designed Freeboard (in): --·-~_::1--___ --~-Y--=---------------------------- Observed Freeboard (in): __ "t..:....;;..~:)"-----___ 9.a.;~=--+....:....._ ------------------------ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) DYes ~No DNA ONE 6. Are there structures on-site which are not properly addressed and/or managed DYes ~No DNA ONE through a waste manageme nt or closure plan? If any of question s 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 mainte nance or improvement? ~Yes 0 No 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 o r improvement? 0 Yes )'rNo DNA D NE DYes jlJNo DNA ONE Waste Application I 0. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes 11. Is there evidence of incorrect application? If yes , check the appropriate box below. 0 Yes D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metal s (Cu, Zn, etc.) ~No Omo DNA ONE DNA ONE 0 PAN D PAN > 10% or 10 lb s 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area 12. Crop type(s) -~f6u==::.:...:..:.m..:..=~~P.........:b~J G...~u~;-~~~.!.....L~G-u_( ~0.!4:{~C.:...__ _________ _ Q)o6 13. Soil typc(s) 14. Do the receiving crops differ from those des ignated in theCA WMP? 15 . Does the receiving crop and/or land application s ite need improvement? DYes DYes 16 . Did th e facility fail to secure and/or operate per the irrigation design or wenable acre determination?D Yes 17 . Does the facility lack adequate acreage for land application? 18 . Is there a lack of properly operating waste application equipment? DYes DYes PlNo ~No ~No ~No .MNo 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): DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE -~ ~~ OJ!~ C1Y\. t..t'"h.~~t.t\--1 l SilY'NL evo~IC)Y\ No :~fOfC.V'r\t.~ S~rt...~ • ·r_t'\".~~ ~rtf~ ·b ..... :~. e.'"' ~ t\ n-. ~ x c... • : ~ i G) ·1 o laa.ru. ~ +of i e(cd: n~. 'Ke~rrc::. rnu~-\ ~~~€ ·~"' eo..~ W:ll ll6wup· Reviewer/Inspector Name Reviewer/Inspector Signature: I Facility Number: ~-\6i"ld Date of Inspection ~ Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Pennit readily available? 20. Docs the facility fail to have all components of the CA WMP readily available? If yes, check the appropirate box . 0 WUP 0 Checklists 0 De sign 0 Maps 0 Other DYes ~No DNA ONE DYes ~No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes JitNo DNA 0 NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections D Monthly and 1" 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 penn it? 25. Did the facility fail to conduct a sludge survey as required by the pcnnit? 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 orCA WMP? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality represe ntati ve 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/ins pection with an on-site representative? 33. Does facility require a follow-up visit by same agency? Additional Comments and/or Drawings: DYes 18JNo DNA ONE DYes 0No tiCJ NA ONE DYes ~No DNA ONE DYes jsaNo DNA ONE DYes ~o DNA ONE DYes 0No ~NA ONE DYes li!No DNA ONE DYes ~No DNA ONE 0 Yes 'm(No DNA ONE DYes ~No DNA ONE 0 Yes f82No DNA ONE DYes DQNo DNA D NE ... 1-- 1--... 12/28104 Facility No. <b L-~q L Time In ___ _ , Fann Name~S ~~ Owner ~4k ffl ~~{J Operator DDu ~ M:\t.~vi> Back-up \~ ~ Ari."' ' Time Out ____ I'Y\ D. Date Integrator--='-1 '"-!...::)-=--------- Site Rep-----.~-------- No. 9.1QI"S~ No. ~y()~~ coc ___ _ Circle: General or NPDES Current Current Sludge Survey _____ _ Crop Yield ___ _ Waste Transfers ____ _ Rain Gauge ___ _ Rain Breaker __ _ Soil Test ......---Wettable Acres ,..-- \..-~..-· J Weekly Freeboard___ Daily Rainfall ___ _ PLAT ___ _ 1-in Inspections __ / __ · __ Spray/Freeboard Drop ------------------------ Weather Codes ---120 min Inspections ___ _ Waste Analysis: Date Nitrogen (N) Date l o}1.1. Pull/Field Soil Crop Pan Window 1\ fl l')o \~ ~.~VIr\. ~ \~() ~~-~J " f)() ~ <.loc- u ~ ~ Division ofW ~ter Quality 0 .Division of Soil and Water Conservation _ O_;.(?.tberAgenc~tF:.i~~~~'::;;D -~ Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Dat< o<Vi>it' ~ AnMI Ti~" IJ: ~~ I Doportun y;..,, 13 ?Q p I Coun • Rogion;\=R..I::::l Farm Nam" ~()1 '~ fu:d~~ b:>.tm Owner EmaU: ----------- Owner Name:~ ~~M_ Phone: MailingAddress: '?a~ I D~~ ~~ ~·, l\ NC, ~%45~ Physical Address:------...,------------------------------____ _ Facility Contact: e -:s ~nlun Title: tr'">\J' m tf Ooslk Roprosentatlv" ~-: U "'~ Certified Operator: +<~-n._ ----;;~ Baok·up Operato" D.&1 ~ A~ Operator Certification N umber: -.....31~~...::;:=~ Back-up Certification Number: q~ 5131 Location of Farm : Discharges & Stream Impacts Latitude: Design--;~':·current Wet Poultry CapacifY'4:topulation Dry Poultry .. D Layers D Non-Lay_ers D Pullets D Turkeys D Turkey Poults D Other _, ·,-·-: -.. -.---.. .· ·· ..... ' .. -~,...,..,._"~" :• :"~-~-.. I . Is any discharge observed from any part of the operation? 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 DWQ) ; ' c. What is the estimated vo lume that re ached waters of the State (gallons)? Longitude: D Yes ~No DNA ONE DYes 0No ~NA ONE DYes 0No ~NA ONE I d. Does discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No f§lNA ONE 2. Is there evidence of a past discharge from any part of the operation? 3. Were there a ny adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Page I of3 DYes ~No DYes ~No 12/18104 DNA ONE DNA ONE Continued j I Facility Number:)\:X 3d} 1_ I Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? 0 Yes )l1 No DNA ONE 0 Yes 0No t'S!NA ONE O ~tructure I ~ructure 2 Identifier:\ Y' 0"0..~~ ~~~ Spillway?: Structure3 Structure 4 Structure 5 Structure 6 :''l'' 2 J ,, Designed Freeboard (in): ----~~...::::.:;0/..-~---__ ..... ~=u(..~---------------------------- '">>11 '"'?1' Observed Freeboard (in): C)(..o(.. o(. Q 5. Are there any immediate threats to the integrity of any of the structures observed? DYes jKlNo DNA ONE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on-site which are not properly addressed and/or managed DYes through a waste management or closure plan? ~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? ~Yes 0 No 0 NA 0 NE 8. Do any ofthe stuctures lack adequate markers as required by the permit? DYes "67( No DNA D NE (Not applicable to roofed pits, dry stacks and/or wet stacks) /'") 9. Does any part of the waste management system other than the waste structures require maintenance or improvement? DYes JKlNo DNA ONE Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes DNA ONE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. DYes ~0 ~0 DNA ONE D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 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 0 Application Outside of Area 12 . Croptype(s)?-st.rmud.P.. ~ Sn Gr~ o(s ~6 13. Soil type(s) 14 . Do the receiving crops differ from those designated in theCA WMP? DYes ~0 DNA 15 . Does the rece iving crop and/or land application site need improvement? DYes ~No DNA ONE ONE \ DYes ~NoD NA 0 NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? 17. Does the facility lack adequate acreage for land application? DYes DNA ONE 18. Is there a lack of properly operating waste application eq uipment? DYes DNA ONE ~~~me~ts (;.efer to "#): Explain any YES answers and/or ~~:~fn(~·!;m1atiolltS or any other o;uo1uu~"' ;pse draWings of facilityto'.l)~tter explain situations. (use additional pag;~ii "'sG.!J.e~c_e!iSaJry): . '·· --• --, . ·. . ~.,. •. ,.,.>·." ' ~rj ~, ~ ~r6 lnc..cons i ~ i:P-.fe._ tie ~ _ W : HV -G-c 116\J.:) ~ \ "' Page 2 of3 .-. I Facility Number: 3\:} -lJ1'2J Date of Inspection I \ l pg(aJ 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 theCA WMP readily available? If yes, check the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other DYes ~o DNA ONE DYes ~No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA D NE 0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers 0 Annual Certification 0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections D 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 rain breakers on irrigation equipment? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 29 . Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30 . At the time of the inspection did the facility pose an odor or air quality concern ? If yes , contact a regional Air Quality repre sentative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by- General Pe rmit? (ie/ discharge, fre e board problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? 33. Does facil ity require a follow-up visit by same agenc y? Additional Comments i~lulfor Drawings: Page 3 of3 DYes .l!JNo DYes ]&~o DYes ~o DYes ~o DYes ~o DYes DNo DYes }81No DYes ·~o 0Yes~o DYes )ONo DYes ~No DYe s }KJNo ~ . .-.~;~_ •;M4 ,.. . ,' . _ ...... ,. }2/28/04 DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA :ii.NE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE DNA ONE ~-;·~~~~~~!~:~~.;~ ... f- I'. t · ........ Facility No. hll2~ L Time In____ Time Out Date ll/~ Fann Name--:C""~O:! ''::> 1\v : ~ Integrator ~ Owner S?Sfu Site Rep A:S Qh'Pc& ~:::~~:r---A:~=""""'"'~ ...... %f®~:t~~bS-----: ~ ~?5~fl"~ COC -----::~=--Circle : General or ~DE;} Current Oesi n Current .....:..:__-...:.........;=---..::....-~ Observed _____ _ Sludge Survey _.J_-=---Calibration/GPM __ __,__/ ___ _ Crop Yield v::· Waste Transfers ____ _ Rain Gauge--r----Rain Breaker __ _ SoiiTest 0) 11 PLAT _____ _ Wettable Acres __ v' __ _ Weekly Freeboard ---=V';....__. Daily Rainfall ~ 1-in Inspections ~ Spray/Freeboard Drop ----------------------- Weather Codes __ _ 120 min Inspections ___ _ Waste Analysi s: Date Nitrogen (N) Date Nitr og en (N) Q.~~ l.{p l.l of/aS 3/' 0 .~ 1.5 o.U Pull/Field Soil Crop Pan Window ....... A c:J ~ -~ ·e:nh f-o.-~ Mv.J (>.. -~ r M1 19.0 _rrh.r-~~ o· ' -..3rv'l ~r e~AQif ~t &:../l ~ -.iJaL '0 --. ~ Type of Visit e Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ~ Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: I ':l-/~"?/()51 Arri\'al Time: I /D ~ 3{) I Departure Time: ._l ___ _.l County: _St.~~ Region: Ff2.o FarmName: T4yltJr's gri~ ~..y Fa.r~ Owner Email: ------------- Owner Name: P.$ M A ~::.0 ~A--k.s..r;_,,,__.L_L,~C--=------Phone: 1\tailing Address: Po gC¥ [O 81 Physical Address:---------------------------------------- Facility Contact: _ _J!A:...:...:.·..=j::....:....· --~~:~:::!.·..!::""-!::....-mn-1=..:=----Title: ---------PhoneNo: ___________ __ Onsite Representative: __ ....:.A--L":......:::~::..:-~--..:::L:..!;..!:~.::...!-hn,.._-=-=--:::._,/'-.,t:_::l(..:!\J!!.:.,:....:w..:.:..._P,!...~ Integrator: __ _.M~.J.vcpt..y~4~....:.-....-.!g!!!:!.!nr...lol..l<'!""""""ot...,;li~-- Certified Operator: __ t>t~o~v'4\3~lA-=..:;S:..___S_. __ _JAL.!..,.;~:.....=;;;..:... _""--_~.;:::______ Operator Certification Number: __ i-=8:..:>=--1:.....;;;!'-fJ,.,._ Back-up Operator: --------------------------Back-up Certification Number: Location of Farm: Latitude: D OD'D" Longitude: D OD'D" Design Current Design Current Design Current D Layers ; D Non-Layers ' D Pullets 0Turkeys t D Turkey Poults ! I Oother I --·--· - - -. _::!J Number of Structures: Swine Capacity Population Wet Poultry Capacity Population ··r.:ID=-w-e'-a....:.n_to---'-F-in-is-h~]-....:.._........;...,],.......:;;.__ __ ]: I§ ~~~~~axer I ~· ~~ Cattle Capacity Population ~ Wean to Feeder Sbo I ~Feeder to Finish 12..-2.-4{ I ! 129 Farrow to Wean 'f&{ftl L l 0 Farrow to Feeder · 0 Farrow to Finish j . 0Gilts I ' IKl Boars 13.0 I ---r·-·---.......... Dry Poultry D Dairy Cow t D Dairy Calf I 0 Dairy Heife1 i D Dry Cow I I 0Non-Dairy I I D Beef Stockel ! D Beef Feeder D BeefBrood Cow I -----·--dJ .Other , .·· .. Discharges & Stream Impacts L Is any discharge observed from any part of the operation? DYes 18-No 0 NA D NE Discharge originated at: D Structure D Application Field D Other a. Was the conveyance man-made? DYes 0No (}iNA ONE b. Did the discharge reach waters of the State? (lfyes, notify DWQ) DYes 0No ~NA ONE c. What is the estimated volume that reached waters of the State (gallons)? I 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? DYes 0No DYes ~No DYes 181-No 12128104 f:a.NA ONE DNA ONE DNA ONE Continued LFacilitY Number: 8L-l99A.j Date of Inspection 17 /z. ~/o;o9- Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 DYes ~No DNA ONE 0 Yes D No !)aNA D NE Structure 5 Structure 6 't> '7 "-~ Identifier: r rl ~· _ _:~::::...::::~::!·~.!!:!!. ~-~::...._ ____________ -------------- V'\o /'f-0 Spillway?: Designed Freeboard (in): __ ..,:/_.'f._/=·--__ ·_·-...JfL...q_.___· ~ ..... ______ ------------------ Observed Freeboard (in): _ __.__.Z~Z..=-· _..J_· ___ ·_. -~~:...~?J...,·'-_J-·. -------------------------- 5. Are there any immediate threats to the integrity of any of the structures observed? DYes ~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 ~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? ~ es D No D NA D 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 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? DYes (g'No DNA ONE DYes lit No DNA D NE DYes ~No DNA ONE 11. Is there evidence of incorrect application? Ifyes, check the appropriate box below. 0 Yes (gNo DNA 0 NE D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.) 0 PAN 0 PAN> 10% or 10 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. Croptype(s) &er~yJe. -t}r&.?:£., 13. Soil type(s) So g loJA S 14. Do the receiving crops differ from those designated in the CA WMP? DYes '!8No DNA 15. Does the receiving crop and/or land application site need improvement? DYes ~No DNA 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'! 0 Yes [)!No DNA 17. Does the facility lack adequate acreage for land application? DYes ~No DNA 18. Is there a lack of properly operating waste application equipment? DYes ~No DNA w., .... ~ ~ c~~'-~ n.. v ..... .:t e \c. t1.r:L-~ O""l"'- e-.-pec:,c..~ ~~ ~ l~~s. ONE ONE ONE ONE ONE Reviewer/Inspector Name Reviewer/Inspector Signature: Date: "!fz~/tJs - 12128104 Continued ./ I .Facility Number: f)~ -1/tz.l Date of Inspection [ -:f/'l/f/o5t Reg uired 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 Check1istw" D Desigo" D Mal"( 0 Other DYes !RNo DNA 0 NE DYes ~No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below . ~Ye s D No D NA 0 NE 0 Waste Application D Weekly Freeboard D Waste Analysis D Soil Analy sis 0 Waste Transfers D Annual Certification 0 Rainfall KJ. Stocking 0 Crop Yield 0 120 Minute Inspections D Monthl y and I" Rain Inspections D 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 equipm ent? 24. Did the facility fail to calibrate waste application equipment as required by the permit? 25. Did the facility fail to conduct a sludge survey as required by the permit? 26. Did the facility fail to have an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? Other Issues 28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately 31. Did the facility 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 represen tative? 33. Does facility require a follow-up visit by same agency? DYes jgNo DNA ONE DYes ~No DNA ONE DYes 81No DNA ONE DYes ~No DNA ONE DYes rRNo DNA ONE DYes I.Kl No DNA ONE DYes gJNo DNA ONE DYes ~No DNA ONE DYes gjNo DNA ONE DYes ~No DNA ONE DYes BJNo DNA ONE DYes ~No DNA ONE "Z-(. lk. pe-r~•~ ~v;Nt.-c:,. ~~"-t-e-~c.e o-f s.fo~ ~ ru...~s ~ \o~ ~ ~ ~ ~c..tu d; ~ ""f'k;"-c:. ~ ..J:c ~ 0\o"-I VIA-~ { o-~'( . 11118104 Type of Visit • Compliance Inspection 0 Operation Review 0 Lagoon Evaluation Reason for Visit • Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access I DateofVisit: I fO/Z.1/o'/lrune: I 1 ~oo Facility Number I e z.. H {p~ 2.. I . - --· . '----------------------1 lo Not Operational 0 Below Threshold &Permitted IZS.Certified C Conditionally Certified C Registered Farm Name: _ __:r:;_'f lor·~ B r"'~e... ~~--Fa.rMA. Owner Name: _ _£~ 4~st2c:<l ~-~----U....C.---'-"-'' -.:..· ----- Date Last Operated or Above Threshold: --- County: Se,"""fl s. a VL 'Phone No: Mailing Address: _ _¥-=o. \3o" to BJ= NC- Facility Contact: __ A . .l. k:-1 ~'---Title: ___ ·----·--Phone No: -------- ' Onsite Representative: ~j · certified opel-ator: Integrator: My-rply-&cnw!""-- Operator Certification Number: I ! Csz z.s- Location of Farm: ~&,swine 0 Poultry 10 Cattle D Horse Latitude ...._____.!• .... 1 _ __.r L..l -~'" Longitude .______.I• ._I _ __,~ .... 1 _ __,I" Discharges & Stream Impacts 1. Is any discharge observed from any pan of the operation? Discharge originated at.: 0 Lagoon 0 Spray Field 0 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 State other than from a discharge? Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway Structure I Structure 2 Structure 3 Structure 4 Structure 5 Identifier: f>c='i"'Yri""( _ $c ynJ, c>( ··----- Freeboard (inches): _ ............ \....~,~-[.gr;'" 12112103 DYes ~No DYes 0No DYes DNo DYes ONo DYes t:i[No DYes D!(No DYes ~No Structure 6 Date of Inspection ltolz. ~14tf .. 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 +6 was answered yes, and the situation poses au immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenanceftmprovement? 8. Does any part of the waste ~aement system other than waste structures require maintenancefunprovement? 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? Waste Application 10. Are there any buffers that need maintenance/"unprovement? 11. Is there evidence of over application? If yes, check the appropriate box below. 0 Excessive Ponding D PAN 0 Hydraulic Overload 0 Frozen Ground D Copper and/or Zinc 12. Croptype be.r-MyAA J snaaU seQ,~~ 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 detenninalion? c) This facility is pended for a wettable acre determination? 15. Does the receiving crop need improvement? 16. Is there a lack of adequate waste application equipment? Odor~ 17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlar 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 8._No DYes s.No DYes 19Jlo DYes Q(No DYes !B';No DYes ISNo DYes JSNo DYes fiiNo DYes R_No DYes fiiNo DYes 64,No DYes 61No DYes &No DYes 0No DYes IS. No DYes fi[No DYes mNo 1· A\\ ~ ~ ~ l~ ~ ~ re..te.~., lou+ ~~~ ks. ~ Vf' 't .•. :'"". ~~-vt... ~~~ ~ ~~-!,'ve-~. . Reviewu/lnspec:t.or Name Reviewer/lnspec:t.or Signature: 12112103 j Facility Number: 8 z. -~li 'ZJ Date of Inspection 11~ /z:t/0 I( I Reauired Records & DocumenLo; 21. Fail to have Certificate of Coverage & General Pennit or other Pennit readily available? 22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ieJ WUP, checklists, design, maps, etc.) 23. Does record keeping need improvement? If yes, check the appropriate box below. D Waste Applicati~D Freeboar4/t] Waste Analysi("D Soil Samplinv 24. Is facility not in 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? (ieJ discharge, freeboard problems, over application) 27. Did Reviewer/Inspector fail to discuss reviewfmspection 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? NPDES 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 rainbreak.ers 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 Stocking Fomv1J Crop Yield F~D RainfaM.'""[] Inspection After 1" ~ D 120 Minute lnspecti~ Annual Certification F~ DYes IRJ..No DYes ~No DYes MNo DYes §a No DYes IS.No DYes B.No DYes SNo DYes Ill. No DYes ~No IS. Yes DNo DYes l)lNo DYes JiQ.No DYes 5iaNo DYes ~No DYes !&No z:;. Pk.osp~ ~ ~~~ levd.s CAJere fA".rl'f "'~&k ~"' o.. c .. ei~s. 1(~~ ~ ey~ CMo\. -tkos.e.. ~ ~+ ~'t. J...o.,...·f-c..r~ t.,.~~k.r. ?,s. '""Tky ~,...,e. s~~ ~~ ~~ ~--s ~ ~ ~ CAlL~;" ~-{-k..~ -\t, ~ ~. "'-0~ ~ • Fo-r-~ ~u-l c.~-g ~+;.,_I -.fL....y ~~v«--~ '(~ ~V\M.~ af-~ ~~~ ~~«:> . r re..c;~Y ~+ ~ U:;IOI{ S~'( ~ "i~~ ~~ ~ t"""e..~$ for. _,_"f- ~ .. y -ca.c....r-s. ( ~ ... ~e..c--h'""'""" . 12112103 I l Date of Inspection 11.-1-n I Facility Number I ~H ~ I Time of Inspection I 15 :eJd 124 hr.· (hh:mm) Total Time (in fraction of hours I I D Registered 0 Applied for Permit (ex:l .2S for 1 hr IS min)) Spent on Review :r Farm Status: • Certified 0 Pennitted or Inwection (includes travel and processin~) 0 Not Operational Date Last Operated: ---------····---····-····--·---··-····-··- Farm Name: __ -z:;,~~..iJ~~,z..~~ ____ County: _..[""&=)r'~ .. ---·-· Land Ownrr Name'-~ fo~~~----Phone No' ..[gu..)_~FJ.2.::-..2_J /.!• __ :__ Facility Conctact: _...P..d.. . ..G~.~~ ···---Title: -·--.. -····-· .. ·-·--Phone No: ----··-···----- Mailing Address: _ .... ...P..._!?..:_: .. l.i:.~£r...Z.S.4 ... 2.P.E.J£:. .. a~l.t.. .. ~ ..... _g.£.~ .[Jl_····-····-···· -····----·--··· Onsite Representative: . ..3.-/~~-~~-···-·--··-----Integrator:~-~~-¥-.£~ Certified Operator: _ .&~.~~~--------·· .. -·. Operator Certification Number: .LULZ ____ _ Location of Farm: Longitude .____.I• ._I _ _.I · ..... 1 _ _.I .. General 1. Are there any buffers that need maintenance/improvement? 2. Is any discharge observed from any part of the operation? Discharge originated at : 0 Lagoon D Spray field 0 Other a. If discharge is observed, was the conveyance man-made? b . If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) c. If discharge is observe d, what is the estima ted flow in gaVmin? d . Does discharge bypas s a lagoon sys tem? (If yes, notify DWQ) 3. Is there evidence of past dis charge from any part of the operation? 4. Were there any adverse impacts to the waters of the State other than from a discharge? 5. Does any part of the waste management system (other than lagoons/holding ponds) require 4/30/97 maintenance/improvement? DYes BINo DYes SNo DYes mNo DYes J'~No DYes ~!}No DYes ~No DYes tiNo DYes P8No Continued on back I Facility Number: .~2...-ff.Z I 6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 7. Did the facility fail to have a certified operator in responsible charge? 8. J:ue there lagoons or storage ponds on site which need to be properly closed? Structures (l,az:oons and/or Boldin& Ponds) 9. Is storage capacity (freeboard plus storm storage) less than adequate? DYes Ji'No DYes Da'No DYes ~No DYes SINo Freeboard (ft.): Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 --·-Itt.::_. ·---Z .. t:. ~... -····-····---- 1 0. Is seepage observed from any of the structures? 11. Is erosion, or any other threats to the integrity of any of the structures observed? 12. Do any of the structures need maintenance/improvement? (If any of questions 9-12 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 13. Do any of the structures lack adequate minimum or maximum liquid level markers? Waste Applicntjog 14. Is there physical evidence of over application? (If in excess of WMP, or runoff entering waters of the State, notify DWQ) 15. Crop type _.LJLA:!..d,__·-·-·····---·-····-····--····-·····-·--··-····-···--····-·-·····--····-····-·····-·-·- 16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (A WMP)? 17. Does the facility have a lack of adequate acreage for land application? 18 . Does the receiving crop need improvement? 19. Is there a lack of available waste application equipment? 20. Does facility require a follow-up visit by same agency? 21 . Did Reviewer/Inspector fail to d iscuss review/inspection with on-site representative? For Certifird Facilities Only 22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? 23. Were any additional problems noted which cause noncompliance of the Certified A WMP? 24. Does record keeping need improvement? Reviewer/Inspector Signature: c c: Division of Water Quality, Water Quality Section, Facility Assessment Unit Date: 0 Yes 6aNo DYes gNo fiaYes DNo DYes tR'No DYes J[JNo BIYes DNo DYes Iii! No ~!~Yes ONo E!Yes DNo DYes 8No DYes ~0 '!lJYes DNo DYes JiNo DYes ~No 4/30/97 . . ' .• . . ... : .. ~ .. .. ..... ~ 4 .. ..., • . t , • • • ·~ ' I I Date of Inspection I ~~t-~7 I Facility Number I ~ H .n:l I Time of Inspection 1 15 :e>d jl4 hr. (bb:mm) Total Time (in fraction of hours I 0 Registered 0 Applied for Permit (ex :1.25 for 1 hr .IS min)) Spent on Review I ::r Farm Status: 1!J Certified 0 Permitted or Inspection (includes travel and oroceSsine) 0 Not Operational Date Last Operated: ···-····--··--····-····----·-·-····-·-·-···-····-·-·----····-····-·--···· Farm Name: --. .... -LA.p.~~ ... -d~~-.. .6..!.?.:!::::::::. ... _ .... _ ... ,_ County: __ .. U.e'~~·-· .. ·--· ........... -... ·--· Land Owner Name~~¢~.. -:~.~::e.;;;.. ... 5..-:5..~-r.. .......... -Phone No: lflLP)~ $. 9 ..:-~/ (!.~ -····-- ,.;;.1. Facility Conctact: ..... ~~ /. ... ..&_~£.~.!/........... Title: -·····-· .. ·--· .. ·--.. ··--.. ··-Phone No: .... -···--.. -····-····-.. ··-··· .. Mailing Address: ___ ,..J?__t?.,.:... ..... 8..g:;::r._Z..S..tz..J .... .J.?~~-.. .6{£~.~ .. , ...... g.f :(££. ..... _ ...... _ ...... _ .... -.... -..... f . / ~~site _Repr~eotative: ... 3.~/ ~~~~.d.__ .. ______ .... _....... Integrator: ~~~:--~::f .. .G~~ S , ·Certified Operator: .... ..B.dL~..!~C~.~--·····-............. --.. ··-·:/'Operator Certification Number: .1. .. ~7..1...2._ .... _. _....... ~ Location of Farm: Longitude General I. Are there any buffers that need maintenance/improvement? 2. Is any di scharge observed from any part of the operation? Discharge originated at: 0 Lagoon 0 Spray field 0 Other a . If discharge is observed, was the conveyance man-made? '• b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) c. If discharge is observed, what is the estimated flow in gal/min? d. Doe s discharge bypass a la goon system? (If yes, notify DWQ) 3. Is there evidence of past discharge from any part of the operation? 4. Were th ere any advers e impacts to the waters of the State other than from a discharge? 5. Does any part of the waste management system (other than lagoon s/holding ponds) require 4/3 0/97 maintenance/improvement? DYes ~No DYes ~No DYes ~No DYes NNo DYes l8No DYes 1,)a No DYes IE No DYes ~No Continued on back -I Facility Number: .... R-.2..-~2'.2.J 6. Is facility not in compliance with any_ applicable setback criteria in effect at the time of design? -· -·· 7. Did the facility fail to have a certified operator in responsible charge? 8. Are there lagoons or storage ponds on site which need to be properly closed? Structures (La~oons and/or Holdin& Ponds) 9. Is storage capacity (freeboard plus storm storage) less than adequate? Freeboard (ft): Structure 1 Structure 2 Structure 3 ···----. .Iff..::__ __ .... -z. .. C.... ·-···----... -...... - I 0. Is seepage observed from any of the structures? Structw-e 4 l 1. Is erosion, or any other threats to the integrity of any of the structures observed? 12. Do any of the structures need maintenance/improvement? (If any of questions 9-12 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 13. Do any of the structures Jack adequate minimum or maximum liquid level markers? Waste Application 14. Is there physical evidence of over application? (If in excess of WMP, or runoff entering waters of the State, notify DWQ) Structure 5 15. Crop type __ .f1Lt:l.dJ". ______ ......... _ .... _ .... -.... -_ ................. _ ........ _., .. _., .... ___ , .... --.. ··-.. ·-····--·····--.. ··- 16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (A WMP)? 17. Docs the facility have a lack of adequate acreage for land application? 18. Does the receiving crop need improvement? 19. Is there a lack of available waste application equipment? 20. Does facility require a follow-up visit by same agency? 21. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? For Certified Facilities Onlv 22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? 23. Were any additional problems noted which cause noncompliance of the Certified A WMP? 24. Does record keeping need improvement? Reviewer/Inspector Name ·~. ~~~ Reviewer/Inspector Signature: cc: Division of Water Quality, Water QualifJ' Section, Facility Assessme nt Unit D Yes ,Jia No DYes ~No DYes JSitNo DYes ti~No Structure 6 DYes Eii:~No DYes IS No 6aYes ONo DYes ~>!'No DYes ~No ,laYes ONo . . . •. : ~ ~~--i:i :, .. 0 :Ves ,. 6iP~o'~ · :. mYes O~o ~Yes ONo DYes nsiNo 0 Yes (»'No )ijYes DNo 0 Yes l,i!No DYes QNo 4/30/97 �O� /�,� f �� r �� - �Y. R�' �? } i ./ f� &� l . y,. �,7 '�}��1. ~L __ r �a� a�'K � _ ' '�� , a� ., j< — _ f �.. - _. r.'s a ��.��. �v�� 'fit•',; - Ago