090156_INSPECTIONS_20171231

17
6
Type of Visit: Q Com liance Inspection V Operation Review U Structure Evaluation
Reason for Visit: &Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency
U Technical Assistance
0 Other 0 Denied Access
Date of Visit: OCT17
Arrival Time: QUO Departure Time: 1--t County: 91 Dt�Aegion:
Farm Name: ,,,1.
LLfwtS 2-rtti
Owner Email:
Owner Name: sia
tt) ,G :r-v"_
Phone:
Mailing Address:
Physical Address:
Facility Contact: �y �'^ Title: Phone:
Onsite Representative: I� Integrator: >JS
Certified Operator: Certification Number: C t E -7 3�
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design
Current
�� "=.�Design
Garrent
Design Current
SwiAe Capacity
Pop.
Wet Poultry -Capacity
Pop.
Cattle _ Capacity Pop.
Wean to Finish
La er
Dai ry Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
1Dairy Heifer
Farrow to Wean
��'�'IDesiga
Current
1Dry Cow
Farrow to Feeder
D . Point .
Ca aei
I:o .' ,
..,
Non-DaiTy
Farrow to Finish
La ers
Beef Stocker
Gilts
Lavers
Beef Feeder
Boars
jPullets
,,
Beef Brood Cow
_
Turkeys
w
Other
v
Turkey Poults
h
,
Other
y .
Other
d
'.`I
r,
•'
M .�isl
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ETINo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes [�JWo
❑ Yes �No
Q NA ❑ NE
!__I N A ❑ NE
NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

Facili Number: Ll - Date of Inspection: OC
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. if yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?: _
Designed Freeboard (in): _
Observed Freeboard (in): 7 _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
D-N-o— ❑NA ❑NE
❑ No f�J`NA ❑ NE
Structure 6
❑ Yes ED'No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes E]"No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [J No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 0 o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes Lallo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Q-lq-o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 53<o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, 7n, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
g]No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
L_l "o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
C9J o
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
0 Yes
L7 "'u
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
,-�.�
L _l �o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? Ifyes, check
❑ Yes
❑-b
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[3-No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
0 Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[rlIo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[E No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

Facilitf Number: - Date of Inspection: • 6G J
24' Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [3 Nb
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes [JTo
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes �o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [7No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
xeviewer/ inspeczor Name:
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes D o ❑ NA ❑ NE
❑ Yes [J175- ❑ NA ❑ NE
❑ Yes Efr90 ❑ NA ❑ NE
❑ Yes [3`1Qo [DNA ❑ NE
❑ Yes 0 No
0 Yes Ea/No
[—]Yes dNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Sigmatur
Page 3 of 3
Date: b oC'T
21412015

Type of Visit: Q<ompliance 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: ^] Arrival Time: Departure Time: cc� County: �1� Region:
Farm Name:�� � ta"/YK-C Owner Email:
Owner Name: 1Z Y ^ -4-1 Phone:
Mailing Address:
Physical Address: (�
Facility Contact: cVQ.0 A — Title: Phone:
Onsite Representative: Integrator: TO ' K r�5
Certified Operator: Q W q6%4 Certification Number: - d O S -7`3(
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design,��Current
Design Current �� .- Design Gnrrent
Swine
CapacItyz _ Pop.
.�
Wet Poultry- - CapacityQop
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Layer
Dairy Calf
Feeder to Finish
pDairyHeifer
Farrow to Wean
urrent
D Cow
Farrow to Feeder
D , foulW.=De5r..01'
a acityi?o
Non -Dairy
Farrow to Finish
Aw
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
I
jPullets
Beef Brood Cow
Turkeys
Otet
.h
Turkey Poults 0 =
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [g-NV— ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No [3-NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge? /1
[:]Yes [:)No
❑ Yes Et -No
❑ Yes ]�No
[aVA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

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

Faclli Number: - Date of Ins ection:75
24. Did the facility fail to calibrate waste application equipment as required by the permit? [—]Yes ONo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes N' o
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes EfNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [—]Yes [�No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30, Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes C2"No ❑ NA ❑ NE
D Yes [2-No ❑ NA ❑ NE
❑ Yes ['No ❑ NA ❑ NE
❑ Yes [2'No ❑ NA ❑ NE
[Yes_ o
❑ Yes ff No
❑ Yes [:JNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question-#),: Explain.any YES answers and/or any additional recommendations or any other comments s
Use drawitfgs: offacility t_o better explain situations (use additional pages as necessary).
C41&.A(:)n- a a /K r
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: E�
21412011

t$ tw 1IGA6 a
r Structure Evaluation Inspection"
Facility Number: 7 -- 1 6 Date: g-t Cab '-6 . „
Time in:f(. obi/ Tine out: /01- (.0 ,
Farm Name: aval v ) Farm 911 address:
�—
Owner Name: •E fcuze,. Ice „�
Facility Contact: 6t ,f< a ,
Onsite Representative: JI 3 Integrator: ,
14_g
Certified Operator: .� ��fitr�n.� Cert. Number r
Is storage capacity less than adequate? Yes ✓No
,
If yes is waste level into the structural freeboard? Yes No G/
Structure: 1 2 3 4 - 5 6
- Identifier:
Spillway?
Designed Freeboard (in.): ."
Observed Freeboard (in.): 17
Are there any immediate threats the integrity of any of the st.ructures
observed? Yes No
•
Do any structures lack adequate markers as required by the permit? Yes No�
Does any part of the waste management system need repair Yes No
Condition of field's (I )e+" ,
Condition,of receiving crop Pe are. '
Comments: ' , \tt'd
r

A r m -9
Af[sue
Rype of visit: n compliance inspection V Operation Keview U structure Evaluation V 'i ecttntcat Assistance
eason for Visit: Q4outine Q Complaint 0 Follow-up 0 Referral Q Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: 81VV�.
Farm Name: „ t "rY [--�.�4 -5 Owner Email:
Owner Name:
;Wee_ �_13— Phone:
Mailing Address:
Physical Address:
Facility Contact: _ ffa attc t Title:
Onsite Representative: f C
Certified Operator: �-('ftjc' i 6 L
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: Pt S
Certification Number:
Certification Number:
Longitude:
Region: �Q
Desiign ,-Current
Design Current
Design Current
Swine Cap iity Pop.
Wet Poultry Capacity Pop.
Cattle.
Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
-Layer
Dairy Calf
Feeder to Finish
®o
`' .
Dai Heifer
Farrow to Wean
DesignCurrent
Dry Cow
D Point Ca aci
La ers
P.
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other - Turke Poults
Yam.
_
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
[—]Yes ❑ No Q'l"A ❑ NE
❑ Yes ❑ No [ -IQA ❑ NE
[]Yes [:]No
❑ Yes Ei]'No
❑ Yes O. 0
[fNA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412014 Continued

Facili Number: - S Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑Yes
N�/- , NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
��iA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�'v
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
E3-<o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6'were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
�o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�10
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[]-Nb
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[3 o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
Erlgo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): �p
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[D►NGb
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
L:J 1"o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[D-K'o—
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
l_. Xo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[o o
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[Z3*14o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[]31�o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
C!I<o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[]lo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Flo
❑ NA
❑ NE
Page 2 of 3 21412014 Continued

k'acili Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [c"No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑,110
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes M'�N_o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Q14o
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
af-4o
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
13<0
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[!' No
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
L Q O
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[:]Yes
�No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
E]rNo
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA FINE
❑ NA ❑ NE
Comments (refer to question #): Explainany:YES answers and/or any additional recommendations or any other comments.`. ,fin
Use drawings of facility to better exptam situattons;(use additional pages as necessary).
ou
S� (0- C &'Cr U 4� — JE��)c k"%)ec' ( 7
_�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: � H 3:3W-/
Date: _ `S DMIG
21412014

(Type of Visit: Compliance Inspection O Operation Review O Structure Evaluation p Technical Assistance I
Reason for Visit: Qlioutine 0 Complaint 0 Follow-up Q Referral 0 Emergency O Other 0 Denied Access
Date of Visit: Arrival Time: ® Departure Time: / County: Q `w
Farm Name: lily "f w s Owner Email:
Owner Name: cs (Yil% Phone:
Mailing Address:
Physical Address:
Region: I - Y
Facility Contact: Title: Phone:
Onsite Representative: Integrator: qA
Certified Operator: � j ,� U� �./¢` ��f � Certification Number:
`FfS 7 3�
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pap.
Wet Poultry
Capacity
Pop.
Cattle
Capacity Pop.
can to Finish
ILayer
I
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
airyHeifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D . P,oul
Ca aci .
P,o ..
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes �o ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No []-NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No [TRA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [:]Yes ❑ No EINA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [D"No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes allo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facifi Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [�E] NA ❑ NE
(?U- � a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
grAAA- TIP Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 �/
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Og-N°
E3-N
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
Ergo—
NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[Zj No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
I__i 1qo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
g2-No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑-ble
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [] lw ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ['No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [—]Yes [}'No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
[:]Yes �o ❑ NA ❑ NE
[:]Yes [],No C] NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [3To ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [BKo [DNA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [3'6Io
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking [-]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ETNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [3 No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of Inspection: V
N. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes G!>o ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q" flo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 0jNe ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [j]-Ma ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34_ Does the facility require a follow-up visit by the same agency?
[:]Yes �o ❑ NA ❑ NE
❑ Yes [D-110 ❑ NA ❑ NE
❑ Yes []1Go ❑ NA ❑ NE
❑ Yes [: No ❑ NA ❑ NE
❑ Yes
�o
❑ NA
❑ NE
[—]Yes
[3"No
❑ NA
❑ NE
[:]Yes
[g'No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers;andlor any additional recommendations or.. any other�cnimments?'
Use drawings of facility to better explain situations (use additional pages as necessary).
Sf..P-e S<uy
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
S
X
47
Phone: 3 `3J 3
Date:
2/4/2414

43 t was' 7-7 Dec_
Type of Visit: Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance I
Reason for Visit: apfroutine 0 Complaint O Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name::d K ( rrdLt'i1 Owner Email:
Owner Name: S�e�,-� (,JY'� ��` `� Phone:
Mailing Address:
Physical Address:
Region: '
Facility Contact* ��� c��G✓ Title: ' Phone:
Onsite Representative: (L Integrator:
Certified Operator: sic5t, -r— ! ct j� v� Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pap.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
INon-Layer
I
Dairy Calf
Feeder to Finish
d
Daiiy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . Pouf
Ga aei
P,o .
Non -Dairy
Farrow to Finish
Layers
I
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
E o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[2VA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[]L 1M
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
[f].IA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[Q/No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�o
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Number: - Date of Ins ection: a AACI
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
C] NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
V1 No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
Vo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑Yes
[4 Ny
❑ NA
❑ NE
8. Do any of the structures tack adequate markers as required by the permit?
❑ Yes
0: FW
❑ NA
0 NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
C5<o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
U-bio
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes D"No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): G &vy _
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
. o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[_ "'o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
©-N—o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[]"No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Moo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Epl o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists []Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ' WNo
N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

•a
Facility Number: V- Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ZINo ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L_- i l"o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes I__l • 1"o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes U 1"o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes [3 e—
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
[] Yes EA.Rr
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes UQ Ndoo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes Cg
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes Ko'�
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [ fo
❑ NA
❑ NE
Comments (referto question ff): Explain any.YES answers and/or any additional recommendations or any other comments "
U.se drawings of facility to better explain situations (use additional pages as necessary).
st'&_ -. cd-k-
c(.4CIA911 ,Sys !z
Reviewer/lnspector Name: i� L ti 1 1,) Li. 3
� r
ti
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412011

Type of visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 04roultine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: G ,.�%j Arrival Time: !r , Departure Time: County:
Farm Name: s r(a Ci T`: F�arS c • Owner Email:
Owner Name: s T v—� ��durn Y r%/_ -F Phone:
Mailing Address:
Physical Address:
Facility Contact:
r—
Title: T-t e, Phone:
jV
Onsite Representative:
Certified Operator:i..��
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Region: 'I�V
Certification Number: JI-S73
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Ca aci Po Wet Poury
' P h P
La er
Design
Capacity
Current Design Current
Pap Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Non -Layer
_ 1'
Dr. P.oult ,
Design
Ca aci
Cu re
Trent
P,o
Dairy Calf
Dairy Heifer
Cow
Non -Dairy
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes 0,N0 ❑ NA ❑ NE
[-]Yes [:3 No
❑ Yes [:)No
[]Yes [:)No
❑ Yes 2 -No
[:]Yes EELSIo
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

V,
Facility Number: Date of inspection -
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes RNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes allo
❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes RNo
❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes 0—No
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes (,�RLNo
❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes [&No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10°/a or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
/
12. Crop TYpe(s)
13. Soil Type(s): 4�1_1
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes UNo DNA •❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 4zi No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes 21 No ❑ NA D NE
❑ Yes allo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes CE�No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ®..No ❑ NA ❑ NE
the appropriate box_
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [Z.No
❑ NA [] NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

~ Facility Number: - / Date of Inspection: G-
24. Did the facility fail to calibrate waste application equipment as required by the permit? [] Yes F°No DNA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes N_No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[a No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
I" No
❑ NA
❑ NE
❑ Yes VM No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
O No
❑ NA
❑ NE
[:]Yes
[&No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
Gt 1 r-' (r0 D !�� i�D'�61• �4-�`C a�! r'�,S /t � ✓ C � -ear .tee._- �j ���L� o/!
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

-'11(-PC--sr_>
Type of Visit: ompli nce Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: outine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: � Arrival Time: /� SOD Departure Time: County:
Farm Name: LIJ,t� 1—�[/ ,y� 5 H r _ Owner Email:
Owner Name: `� Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: ��l/ed:-i Title: A[f�o� Phone:
Onsite Representative: Integrator: f
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current ";_
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pope
-
Cattle Capacity Pop.
Wean th
La er
DairyNN Cow
Wean ter
Non -Layer
m
DairyCalf
Feedersh
"`N -
Design
-Curren
Da' Heifer
lFin
Farrowan
D Cow
Farrowder
D . P.oult Ca aci P;a
Non-DairyFarrowsh
Layers
_
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
�'
Turkeys
Turke Poults
�
x'S
Other
Other
.;
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes R] No ❑ NA ❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes 0 No
❑ NA ❑ NE
❑ NA [] NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

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

Facility Number: - G Ds ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes KNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ® Yes o
the appropriate box(es) below.
10 Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes ® No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes [S No ❑ NA ❑ NE
❑ Yes [Z No ❑ NA ❑ NE
[:]Yes LZ No [] NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
[:]Yes � No
❑ Yes ® No
[:]Yes [ C _No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/.or any additional recommendations,or an other coinmen '_.
Use drawings of facility to better explain situations (use additional pages as necessary).
�7/�d�i,✓� ��` DS i �rY U
r
Reviewer/Inspector Name:
Reviewer/Inspector Signature.
Page 3 of 3
Phone: 92L2':413 33ao
Date:
21412011

TwtS ro-09-z00
ion of Water Quality
Facility Number ME
M
0 Division of Soil and Water Conservation
0 Other Ageney
Type of Visit
ompliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: I V -753 ,47o� Departure Time: /O, DSO County: _8X 04'✓ Region: AALA>
Farm Name: --aV 5 2AIC Owner Email:
Owner Name: ___ S'e Ve, /RTUlvr Phone:
Mailing Address:
Physical Address:
Facility Contact: rl A` r. 4 $64�' Title: -7"• ,,/Phone No:
Onsite Representative: &Y4 �✓A►— Integrator: lwzli � .314'Dv✓i✓
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = 4 = « Longitude: = ° = [ = 4
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poulin
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
n
Cattle Capaci
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
EfDry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Plumber of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: Q7-1576
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: Z 6t 4 '1
Spillway?: Nd
Designed Freeboard (in): /9, S
Observed Freeboard (in): —74 "
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?
❑ Yes Now❑ NA ❑ NE
El Yes ff ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes Li'SNo ❑ NA ❑ NE
❑ Yes I<vo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ' V�o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes B o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) �
9. Does any part of the waste management system other than the waste structures require El Yes B<0 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Lei' o ❑ NA ❑ NE
maintenance/improvement? ,._,
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes L*1No I❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) car/V . WAe0.f . ?"-'V S
13. Soil type(s) Or-.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[5'No NA
ElNE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
o ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
ONo NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
��o❑ NA
❑ NE
Comments (refer to gjne`stiou)Expiam anyjES+answers.and/or any recommeIF I
ndationsoer cings offiactlity to ltteFeaplain situon (ei edditiona! pages as necessary):
:.
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: d pate of Inspection
Required Records & Documents ,/
19. Did the facility fail to have Certificate of Coverage & Permit readily available? [I Yes R No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check 0 Yes LRNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
D No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspectionss El Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
ElYes
E7 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[? No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ON
[I NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
//o
o
❑ NA
ElNE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,2
La o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
O No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
GR<o ❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
to ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
To ❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
to ❑ NA
❑ NE
Additiotta! Comments and/or DrawingsM Mid
'
Page 3 of 3 12128104

III gl 0-10/e
Type of Visit tD'Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Qlroutlne 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: / Arrival Time: Departure Time: County: tV 0&"J Region:%
Farm Name: WA H-t 1 i _ r--A r` JMS I LICE . Owner Email:
Owner Name: 61.0 Ue- �Ct-�_hti� Phone:
Mailing Address:
Physical Address:
Facility Contact: 1<.Gll� 3'��� Title: Phone No:
Onsite Representative: Ye Owu bcr1z=,_-, Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 0 =' =" Longitude: = o = 6 =
Design Current
Design C*urrent
Design Current
SRine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Laver
❑ Da' Cow
❑ Wean to Feeder
-Layer
❑ Da' Calf
Feeder to Finish
❑ Da Heifer
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder --
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Non -Layers
❑ Beef Stocker
❑ Gilts
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
❑ Turke s
Other
❑
❑ Turkey Poults
❑ Other
Nurn of Structures: m
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes L}J'No ❑ NA ❑ NE
❑ Yes
❑ No
9KA
❑ NE
❑ Yes
❑ No
2<A
❑ NE
EVNA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ NA
El NE
ElB Yes
,,_�fo
No
❑ NA
❑ NE
Page 1 of 3
12128104 Continued

Facility Number: —(p Date of Inspection
Waste Collection & Treatment
j4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
❑ NA ❑ NE
[I NA ❑NE
S turd 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: /
Spillway?. -
Designed Freeboard (in): Q, S
Observed Freeboard (in):
❑ Yes 2<0
❑ Yes Vo
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ffNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ' No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
Lfd'tvo
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
EK
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Na
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below.
❑ Yes
f o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ElApplication Outside of Area
12. Crop type(s) 0AVr_' ? f W ��e._�' , S.6y'`ec' V 5
13. Soil type(s) G 17
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ,21"N' o ❑ NA El NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes El"No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes YNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes El"No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes JT No ❑ NA ❑ NE
?omments (refer to question #): Explain any YE5 answers and/or any recommendations or any other comments.
Ise drawings of facility to better explain situations. {use additional pages as necessary):
�r
Reviewer/Inspector N
Reviewer/Inspector
Phone: y/U
Date:
Page 2 of 3 12128104 Continued

Facil;ty Number: — Date of Inspection {
dRequired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ETNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 2< ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes @r No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspectionss El Weather Code
22. Did the facility fail to install and maintain a rain gauge? ElN Yes B o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ('No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes P-&o ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ON. ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ErNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes LI No ❑ NA ❑ NE
Other Issues /
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes B No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
2<0
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
��
E No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
0'N-'o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
��/
Nvoo
El NA
❑ NE
33. Does facility require a follow-up visit by same agency`?
Eli Yes
�CIJ
o
❑ NA
❑ NE
Additional Comments and/or Drawings
Page 3 of 3 12128104

c31/tlS e^rk.-c.aL 7- 0 /- 08
Type of Visit er6o-mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: jf-17-O S ArriraI Time: /: 3% ,, Departure Time: / : 59 County: Region: " Fi8O
Farm Name: fJ A Owner Email:
OwnerNarne: ovG /4%4t Phone:
Mailing Address:
Physical Address: Facility Contact: Kwtf , ��Du44n/ Title: G� • SPec:��i r�`��,,//Phone ho:
Onsite Representative: g',al- t//, S cz N Integrator: /� '"W A I �rc a.!/✓
T�
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Humber:
Location of Farm: Latitude: =o =I =,; Longitude: 00 [�d [= "
Swine
Design Curretft
Capacity Population VI',et P4 K'N'
F
Design Current Design Current
Capacity Population- Cattle Capacity Population
�_ ,ram,
❑ Wean to Finish
❑ La er
❑ DairyCow
❑ Wean to Feeder
e'"` ❑Non -La er
❑Dai Calf
eeder to Flnlsh
S O�
DairyHeifer
I?#tiy Poultry
. r ❑ D Cow
❑ Non -Dairy
❑ La ers
❑ Beef Stocker
❑ Non -La ers
❑ Beef Feeder
❑ Pullets
; : ❑ Beef Brood Cowl I
II 4110-PI
Uthcr,,
❑ Turkeys
❑ Turkc Points
❑ Other
❑ Other
Number of Structures:
s
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑Gilts
❑ Boars
Discharges &Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes
El"No
❑ NA
❑ NE
Discharge originated at: El Structure ❑Application Field El Other
a. Was the conveyance man-made?
El Yes
El� No
�-
I� tvA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
❑ No
ET -NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (1 f yes. notify DWQ)
El Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
2iVo
NSA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
❑ No
�❑
(DNA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

-r -.
Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. if yes, is waste level into the structural freeboard?
Structure i
Identifier:
Structure 2 Structure 3 Structure 4
❑ Yes E✓J No El NNA� El NE
L7 :
❑ Yes ❑ No A ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 24
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes tJ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ETNo �❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes ❑ No L7 NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No B<A ❑ NE
maintenance or improvement?
Waste Application �.,/
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes [3 o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s) L0 r tj �cLX-
13.
Soil type(s) Cr
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
3 o
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
2No
❑ NA
❑ NE
16.
Did the facility tail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
El NA
El NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
,�30
2<
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or anvireeommendations orfanyiother e�omrnents�
Use drawings of facility to better explain situations ,(use additional pages as necessary)
"Q y
Reviewerllnspector Name�I���KRzy 5:
Phone: 9�0`�33. 3300
Reviewer/Inspector Signature:
Date: '54 —/ 7
—Z00E
Page 2 of-3 12128104 Continued

Facility Number: D 9 —!S! Date of inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps ❑Other
❑ Yes O No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield [1120 Minute Inspections ❑ Monthly and 1" Rain Inspectionss E]
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
B o
[] NA
El NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes
No
L7 NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the pennit?
ElE Yes
�❑
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
LI No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
9 o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
ErNA
❑ NE
Other Issues ��
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes L7 tvo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
O tvo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
��
L7 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
315o
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
B<oo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
2Ko
❑ NA
❑ NE
Additionsl Cotninents and/or-Drawings'XU q�R..
. w . � =.ten
Page 3 of 3 12128104

L 19!5�A�d 67 i2.0— 8-IV—z 00 7
Type of Visit @rt__ornp''liance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit &y routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: -p7-p7
Arrival Time:
/1: SS
Departure Time: D/; jp County:
Farm Name: , 1 +
j3,,,
s ZN
G . Owner Email:
j
C)wnpr Namp 'q7t✓G
1Fa►rrvv
74
phnnr-
Mailing Address:
Physical Address:
Facility Contact: Kct4i s, Dy6ktj Title:
Onsite Representative:
Certified Operator: S��✓tn1 �• 114UA4
Back-up Operator:
Location of Farm:
Region:
Phone No:
Integrator: A&�4 , &D ra/A✓
Operator Certification Number: 9937-3j
Back-up Certification Number:
Latitude: a o = ' ❑ Longitude: = o ❑ 6 = it
Design Current Design Current kx' Design Current
Swine
Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
t: ❑ Dairy Cow
❑ Wean to Feeder
❑ Non -La on -Layer
`% ❑ Dairy Calf
Feeder to Finish
G"�
s
d �,
Dry�Poultry�
El Da' Heifer
Farrow to Wean
.
❑ D Cow
❑ Non -Da
❑ Farrow to Feeder
❑ Layers
h= ❑ Beef Stocker
ElFarrow to Finish
: ❑ Non -Layers
❑ Gilts
❑ Beef Feeder
❑ Boars
❑ Pullets
- ❑ Turkeys
. ❑ Beef Brood Cowl
Ot IF
10 Turkey Poults
Number of Structures:
❑ Other
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2_ Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page l of 3
❑ Yes [$No ❑ NA ❑ NE
❑ Yes
IIINo
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
2f No
❑ Yes
VNo
❑ NA
❑ NE
[]Yes
KjNo
❑ NA
❑ NE
12128104 Continued

Facility Number: jJ 9 — /st'o Date of inspection - 67-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [4 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 51No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 9. S
Observed Freeboard (in): L�LS
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 40 No El NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 2fNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes IV No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes V3 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E3No ❑ NA ❑ NE
maintenance or improvement?
Waste Apulication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes V No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes LffNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s) Cop-,J
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
V No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[R No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
.? No
❑ NA
❑ NE
IT
Does the facility lack adequate acreage for land application?
❑ Yes
14 No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
[RNo
❑ NA
❑ NE
Reviewer/Inspector Name Phone: 110, el33. 3300
Reviewer/Inspector Signature: < e-'X� Date: $- 07- Z 00 7
Page 2 of 5 12128104 Gonffnued

Facility Number: Q 9 — ts(o I Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes K No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes (A No ❑ NA ❑ NE
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 9 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
1%No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[� No
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[A No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
`� No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
W No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[P No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
5? No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[A No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
E4 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
R No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

IType of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit a Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: /z'/ O(o Arrival Time: 2 � Departure Time: County: Region:
If
Farm Name: Owner Email:
�- j
Owner Name: .7Tw L Phone:
Mailing Address:
Physical Address:
�t
Facility Contact: a +ti Z>. �'//�G Title: Phone No:
Onsite Representative: � � �u Integrator: /ily;�, Rrn 'Qnz
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = I ❑ " Longitude: = ° = I = "
Design Current
Design Current
Design Current
Swine
Capacity. Population
WetePoultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
El Dairy Cow
❑ Wean to Feeder
1
n-La er
❑ Dairy Calf
Dairy Heifer
Feeder to Finish
jppQ
Farrow to Wean
Dry Poultry
`'`"
❑ La ers
�:
-
❑ Dry Cow
❑ Non -Dairy
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Non -La ers
❑ Pullets
ElTurkeys
❑ Beef Stocker
❑Beef Feeder
❑ Beef Brood Co
❑ Gilts
❑ Boars
- a
Other
❑ Other
❑ Turkey Poults
❑Other
Dumber of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
VNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
P No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[XNo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
;U No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
N No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
(WNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: 0 --fS Date of Inspection 1 -V4,1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[$No
❑ NA ❑ NE
a. If yes, is waste level into the structural Freeboard?
❑ Yes
No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: Z A f5
Spillway?: ^(O
Designed Freeboard (in):
Observed Freeboard (in): 2 `]
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
E� No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [XNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [XNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [ No ❑ NA El NE
maintenance or improvement?
Waste Application
10, Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [kNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)G�--
13. Soil type(s)
14_ Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
�No
❑ NA
❑ NE
�No
El NA
[I NE
No
❑ NA
❑ NE
14 No
❑ NA
❑ NE
M No
❑ NA
❑ NE
;Comments refer to question Ex Iain.an YES answers and/or an recommendations5or'atiy-othercomments
( q �� P y� �-
Use drawings of facility to better explain situations. (use additional pages as necessary):x
7
Reviewer/Inspector Name ��; �a!`c.�5 Phone:
Reviewer/Inspector Signature: /C Date:
— 13 - zoo L
Page 2 of 12128104 Continued

Facility Number: 09 — f (o Date of Inspection
Reguired Records & Documents ( )
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Ud No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps
p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [PNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[4 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[U No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[VNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
09 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[A No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
$! No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
rWNo
El NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[`No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

,Feb 02 00 03:21p Sonora Barber 910-645-6758 p.3
Quality Farm
P.O. Box 1416
Elizabethtown, NC 28337
February 1, 2000
ATTN: Jeffrey Brown
Division of Water Quality
225 Green Street Suite 704
Fayetteville, NC 28314
Dear Mr. Brown,
To comply with the most recent Division of Water Quality policy, this letter is to inform
you of the freeboard level at Quality Farm. The recent cold and wet weather has prevented
irrigation and the precipitation amounts have exceeded 10 inches in the past two weeks. As
reported to you on January 31, 2000, tlie lagoon level is 18". The following plan of action has
been initiated to lower and maintain the lagoon levels to the required 19" freeboard.
* Monitoring lagoon levels on a daily basis.
* Monitoring and minimizing fresh water usage within the farm to prevent additional
accumulation of liquid in lagoons.
* Storing as much lagoon liquid as possible in pit recharge buildings to prevent higher
lagoon levels.
* Irrigating as soon as possible'on the winter crop in the driest sprayfields available at the
farm using frequent and light applications to reduce potential for run-off or pondiag.
We are committed to operating in an envuonmcntally safe manner and will do all that is
possible to lower and maintain the lagoon levels at an appropriate level. if there are additional
practices which you recommend, please contact me at [phone].
Sincerely,
Stevie Tatum

Facility Number / c-G Date of Visit.: %a �a o Time:/.'� a
_ O Not Operational O Below Threshold
[Permitted 13 Certified 0 Conditionally Certified 0 Registered Date Last Operated
or Above Threshold.• ._ _ ...
Farm Name: fd �11 G '' ms T 0v County- . _'d1R .�.._.� -^! Lkc7
Owner Name: /�_ Phone No:
Bailing Address: P D ZI -A _ ���� .. _ _ �"
Facility Contact: 8 R 706"Y l� as -------- Title:. _ ..�. �: .. Phone No:
Onsite Representative- Integrator. 1 nig %1 4 o A)
Certified Operator:.. L,L =Ib G i �+ Operator Certification Number.
Location of Farm:
L
Oj Swine ❑ Poultry ❑ Cattle © Horse Latitude Longitude
DesV3
Current Desiign
tnrrmt
CC
a
Swine
Po ` isore.:, .,
Po lion. Came_
aeon.
Wean to Feeder
Layer
Dairy
Feeder to Finish ,$'
qg s Non -Layer
Non -Dairy
-
Farrow to Wean
Farrow to Feeder
= Other
=
Farrow to Finish
Gilts_-.
Boars
TOW
j
Ntimiter L290M
Discharges - StreamImpacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at_ ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4- Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
12112103 Contvtued

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes [1) No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelunprovement? OQ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancefunprovement? [3 Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes M No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancefmprovement? ❑ Yes ® No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponnd+ing ❑ PAN ❑ Hydraulic Overload J❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes M No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes EO No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement? 14 Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes KI No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes [WNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes [ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? if yes, contact a regional ❑ Yes J No
Air Quality representative immediately.
�F 40 � -"tom= `1 xyjc Feld Copy ❑ Final Notes
'7 We-k1c►�DAti 17
DwJ t- NL bG�^� ScGr+. A: Gr,+G ��C TQ Yh�S PFCC7�f:irh.
L Y1O41.tGS 1-%CILV waatc ��o�'J 1c��r 1nt\Y' Ott.-dCacT10:L
tPR.r t4N�s�
tv Cn1!
a
w� hlG�i4 i
C.ArO:iol...��
ReviewerfInspector Name
ReviewerAnspector Signature:
77177mq
Date: /a7/_2Ole

Facility Number: Date of Inspection
Rdquired'Reeords & Documents
21 _ Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes }XNo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes B3 No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes j] No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes KI No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ,❑ No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 00 No
28. Does facility require a follow-up visit by same agency? ❑ Yes [3 No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes % No
NIFDES Permitted Faahties
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) lE Yes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes CO No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ONo
34. Did the facility fail to calibres waste application equipment? ❑ Yes P No
35_ Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. EM Yes JE1 No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
10 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
uNc-1e�-- r 'I� -C, r,, %� cn. ra%e,6 -<.'fvorr,-�rV'-OQ4, r-1-1'
NPS- rCS..toNrU +�n wea_� tC- re.z w.c.�t scts--cr+ -ta b
1iJs �Zr✓�t� n�-!c�/ C`. u ►^a i +\ 09 Y—W-i�-
b 'Z o�cy Cr. 1Y►� c + c� a l vt . ��� n i i n �- t {� P ,' J 'J C f o r ya. U rl'.M 44-
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12112103

x�
❑DSWC Animal,Feedlot Operation Review°
i "�`� "•'°�
• � u�d0� 5'i,4` Ym, "°'x`: 'f' � � � J/} f>?� fi r [Ma; r. 9"� >V'�" xp�h' '-
„5 r+�a}'°.
`l
�- �, � „at�to.�fi
s^l rt. r
°
DWQ'�Aiumal Feedlot Operation Slte Inspection �� k
?',"'
® Routine O Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection
Facility NumberD / s
Time of Inspection / - v p 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review 0
❑ Certified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:
Farm Name: �t,�e!'`� . County:
Land Owner Name: ........ .... _..,... ... Phone No: fZe�j P 2r'2 ` 2-S- ...
FacilityConetact:.- .��!� 1,e F ./.... _. T/itle Phone No•
Mailing Address: L:.._�.:_ 1`.�fz .... _..lf
Onsite Representative:.. Integrator:
^'
-''- L�1!, is.1//..e��....._.........._.......�_...._..._.._.._ Int ator:
Certified Operator:..... f'�'..'/...� ...........___.. ... Operator Certification Number: _ ..... ....
Location of Farm:
Latitude 0 4 Longitude • 4 �K
Type of Operation and Design Capacity
IieSignCx"r
w'
,�,�t�'Cent
w �.. ^r .0 ;:Ca ace Po elation k . oul#ry Ca 2 ' Po elation: Attie v @a aci -Po ulatton ::>
❑Wean to Feeder t�s La er � ❑ D '
Feeder to Finish ;�❑ Non [a erg ❑ Non-Dairy
to Wean �� "`�" � �, � • �„ ;.�� `"`p � �;�k � � ���
Farrow to Feeder �To61,Design Capac Ey 4
to Farrow Finish
�:.. �.
`", ❑ Other
tea_
Number of Lagoons�HoldingmPonds 1 azt£ ❑Subsurface Drains Present �, ,'
s `� ❑
❑Lagoon Area .� Spray Field Area
fdneral
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes ,W No
❑ Yes x No
❑ Yes �[1 No
❑ Yes `Mo
❑ Yes
No
❑ Yes
No
❑ Yes
'O-No
❑ Yes
No
Continued on back

Facility Number:...
6.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
k No
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
kNo
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
�[No
,�truchtre
La . Qoonand/or Holding_Pondsl
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
Yes
❑ No
Freeboard (8): Structure I Structure 2 Structure 3 Structure 4 Structure 5
7) -
Structure
6
10.
..._.... ..._.... ......... ....... _ ._.... ...._ . _ .
Is seepage observed from any of the structures?
.... .�_
❑ Yes XNo
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
XNo
12.
Do any of the structures need maintenance/improvement?
)�_Yes
[:]No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
�No
Waste Apulication
14.
Is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP, or runoff entering waters of the State, o ify DWQ)
LL ll�
15.
Crop type '! q�.fIA/ zg: ..lC!
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
Yes
❑ No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
KNo
18.
Does the receiving crop need improvement?
Yes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
No
20.
Does facility require a follow-up visit by same agency?
>(Yes
❑ No
21.
Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑ Yes
JVNO
Fo;,!Certified
Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑Yes o
23. Were any additional problems noted which cause noncompliance of the Certified AWMP? No
24. Does record keeping need improvement? Yes ❑ No
Continents" refer to` eshon Ex Lora an YES'answers+and/or an recommendations -or an other comments s
(.. 4u F Y Y Y «`
R
Use niav�nngs o€facility to better explarn situations `(use addihona! pages as necessary)
z , sw ,or.�ar .-� /a� c�or-c•�Es { !ma's-� ��� ,
a
Reviewer/Inspector Name�.�
Reviewer/Inspector Signature: Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

❑ Division of Soil and Water Conservation [3Other Agency
ja Division of Water Quality
10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-u of DSWC review 0 Other
r Facility Number Date of Inspection
Time of Inspection / .' Sa 24 hr. (hh:mm)
13 g pp 0 Not O erational Date Last Operated: ..........................
Re Registered Certified/ Applied for Permit [� Permitted
Farm Name:.........�}�+�'.--.�C.tt .... ---- County:..-.......1.Q�.................................................
' tom•..-..-..---- �...................... ....... ............... �
... .- /p ram,
Owner Name:........... ...... ......................................................... Phone No L // �...��`F Z �i7�..................
Facility Contact........ . . .... Phone No:
.... .................... Title:...---..............................-...-......................................................................
w` z 7
Mailing Address:........ d�./ h._.1 ,,� f.... l2�rA..'Q�.. �'v..� 1VG 83, �.................................. .............. .
............................I...... .....
Onsite Representative:...... `.!f.,44 AAA .......(,.rri< Integrator:.....- ��✓•✓ r , �r•f,{P !1
' / .............................. ..... -.......
Certified Operator;. --..AA,..#... --------................................................................ Operator Certification Number: .... ..... ......................
Location of Farm:
Latitude ' 4 " Longitude • ' "
p
Desi ;Current:xDizstgn=Curtrertt"
gn �K3a <.
.S�vme a w Capacity Popuiahon
Paaltry .CapicttyPopulatton, Gat#ie' 4 x CapacityPoptilatian ,f
.. ,.4..,
❑ Wean to Feeder
., . ..
❑Layer ❑Dairy
Feeder to Finish S6DTj
❑Non Layer ❑Nan Dairy
',.
Farrow to Wean
-".: ❑ Other
Ww
❑ Farrow to Feeder
_ . rt.�. .
Total Desi<ga Capactty
El Farrow to Finishes
❑ Gilts;
.
l F F�•
Boars
d ^-'i^'%Lv
-� L F`
van;
-,.- ..r...... ...... ..... .._.._-.
oons ! Holdtng:Ponds �' ❑ Subsurface Drains Present ❑ Lagoon Area Spray Field Area Z
,a, y z °°A' � aK,su '���, ya,sex.. #ems € .,� ejN �.�- � a �° g ❑ No Liquid Waste Management System'-"k; •-..
1MMt"r*iWMK:i
u�a.
`'Yk'�,�`�E ...F,$s„=S�Yws ,.."P..✓.a� .re.,�e`h»�.-: ..z �' ...-„ee.,;, _-�, :.. x...s S. .v.,..�.,,
General
1. Are there any buffers that need maintenancelimprovement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, was the conveyance man-made?
b. If discharge is observed, dial it reach Surface Water? (If yes, notify, DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes- notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoonslholding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes N No
❑ Yes R No
❑ Yes KNo
❑ Yes igNo
❑ Yes PNo
❑ Yes J•No
❑ Yes M No
❑ Yes I&No
❑ Yes K No
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes In No
Continued on back

Facility Number: d —
8. Are there laeoons or storage ponds on site which need to be properly closed? El Yes IR No
Structures (Lagoons,tiolding Ponds. Flush Pits. etc:1
9. Is storage capacity (freeboard plus storm storage) less than adequate? $'Yes ❑ No
Structure 1 Structure ? Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..............................
Freeboard(ft):.............. l.,S..�........ ........ ............................ ................................... .................................... .......
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13- Do any of the structures lack 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)
15. Crop type f A...... GA71.:.Z................................................... ............. .... ...... .... .......... .......... ............ ... I...............
16. Do the receiving crops_differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facili ' l
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes A No
❑ Yes IR No
❑ Yes ® No
❑ Yes KNo
CF Yes ❑ No
XYes ❑ No
eeYes ❑ No
,( Yes ❑ No
❑ Yes No
Yes ❑ No
❑ Yes No
❑ Yes ❑ No
0-No.violations•or' deficiencies wereenoted-during' this:visit:- Yon:will recei've-no further-: -
.. � corresporideiii 6aliout this:visit:- .
Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
7/25/97
Reviewer nspector Name `* " « u
">,�� ate,#
Reviewer/Inspector Signature: Date:

Facility Number Date of Inspection
I Time of Inspection p 24 hr. (hh:mm)
0 Permitted EyCertified E3 Conditionally Certified E3 Registered JE3 Not Operational Date Last Operated: .........................
Farm Name: .................. m/)45......-F�!rL . County:..-.1 ................ . .... .. ..........
........................... ........
OwnerName: Phone No: .................... 1?/0 — rz-,a — 91 .................. . ---------- ...... ................................ -- ... - ........................................................
Facility Conta.ct: .............. 15�no et ... Title:..............
Mailing Address: ............... I-P.,10-f ........ 9 _0 ... . ............ 1#11 .......................................
Onsitc Representative: .................. ..........................
Certified Operator: ............ -5*44:!!-n. ........ K . ..................
Location of Farm:
....... ...................... Phone No:
............ . .........
Integrator: .......
Operator Certification Number: .......... 1.7-1/3 ........
................................................................................................. 1. ................................................................................................................................ ..... .............
..................................... ............. ........................................................... . ...... ......................... ............................................. ..........
Latitude Longitude
Desigq' CuIrrent,
Design Current-." Design.Current ... ...... ­--1
Poultry I
ap
-
Swine Uipacity Population ou U Cattle: Pop
ulation
1" : acfty.'� P60iiiation Capacity. Popu a
❑ Wean to*Feeder 11 Layer I f ❑ Dairy
gFeeder to Finish - ,I[] Non -Layer ILI Non -Dairy
Farrow to Wean -77:
El Farrow to Feeder ❑Other
Farrow
-
o Finish ".`Total -Design Capacity --M-2.
❑
Gilts,
Boars Total'SSLW-
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon [I Spray Field E] 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 discharee is observed, what is the estimated flow in gal/min?
d. Discs discharge bypass a lagoon system? (If yes, notify DWQ)
2- Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? El Spillway
[] Yes to
0 Yes
O No
E3 Yes
X.- No
AM
El Yes
0 No
[3 Yes
Po
E] Yes
No
[] Yes
d&
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): .............
.....-, . ....... I'll ........................ ............... .................. ................................... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
................. I .............
[I Yes 9(No
Continued on back

Facility Number: — Date ut' inspection
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan'?
❑Yes
IgNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
O(Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
%No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
0 No
Waste Application
dNo
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
Q(No
12.
Crop type
13.
Do the receiving crops differ with those designated in the tificd Animal Waste Management Plan (CAWMP)?
❑ Yes
[�No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
IX No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
[xYes
❑ No
15.
Does the receiving crop need improvement?
[9Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21, Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
�cio violafi�ris or deCcienc{es were nO(je . citrrinii Phis:visit. You wit..66e ye iiti i`urther
correspondeirce. abatis. this visit- - • • . , . , . • . • . • _ . • . - . -.. • . - •
fits
❑ Yes 4No
❑ Yes [?(No
❑ Yes RNo
❑ Yes R No
❑ Yes
No
gNO
❑ Yes
❑ Yes
ONo
❑ Yes
VN0
4 k- 0-43A w�� „r P w, Pam' an s c-� m•to of p4mwel,
d-J no4 �wkJ 4- by ,.� {�.«.�, .
Reviewer/inspector Name _ - fUR.
,
Reviewer/Inspector Signature: Date: — 9frff
3/23/99

Facility Number: Q — date of Inspection
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
❑Yes
KNO
liquid level of lagoon or storage pond with no agitation?
27_
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
o
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
KNO
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
o
31.
Do the animals feed storage bins fail to have appropriate cover?
El Yeso
tN
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
ElYeso
140d Tonal-l_omments and/or'Vraw�n
�;4 .' 's.. -
47
OUT kok P &4-' 41 +r; / "IL
e4� iLL
f9i �Ik -6rrVx'1%J as UJJ
or- 4.
5M,ri wrask-,
3/23/99

Division of Environmental Management -(S
Animal Feedlot Operations Site Visitation Record
. Dane:_
- rBe information:
Farm Name: Coanty' t
Owner Name:, " _ �' _ ,�^, _ _ _done No; 6a - aS7 I
On Site Representative: <_;u y.o, b 4 s jntegrator:_ffA C_ —
Mailing Address: P 0, Go M I G
�i4Za awe rr�.]G 2�33�
Physical AddressILocatiow
Latitude: 1�1 Lon de: 1 I
Qpgrationpescilpti2n: (based on design ebamcterMa)
7jpe of Swine No. of AMinmb Type of Pouivy No. of ArSie=4 Type of Coale No. of Murals
o saw o Laya a Dairy
0 Nmscy 0 Noa)--Layer 0 Beef
O Fart
OtherType of Lick Number of AnirrraIs: 00
Number of Lagoons: Imo. - (include in the Drawings and Observations the freeboard of each lagoon)
Fart y Impgoon:
Lagoon
Is lagoon(s) freeboard less than 1 foot + 25 year 24 hour storm storage?:
Is seepage observed from the. lagoon?.
Is erosion observed?:
Is any discharge observed?
O Man -node D Nor Man -mode
Cover Crop
Does the facility need more acmage for spraying?:
Does the cover crop need hWovcmaat?:
list the crops which aced imp j
Crop type. r W Acreage: _
Setback Criteria , .
Is a dwelling Iocated within 200 feet of waste application?
Is a well located within 100 feet of waste application?
I; animal waste stockpiled within 100 feet of USGS Blue Line Stream?
'Is animal waste land applied of spray iaigat,ed within 25 fees of Blue Line Stiram?
AOI — January 17P%
C:U::N:O:C
Yes ❑ Nc�E
Yes%q!) Not
Yes Cl Nab
Yes Cl No C
Yt . No C
7�es a Nq�
.Yes ❑ . Vo�
Yes ❑ NBC
Yes ❑ Nc g

Maintenance
Does the fw ity maintenance need impra
Is there evidence of past discharge from any part of the Operation?
F Does zecord keeping need improvement?
Did the facility fail to have a copy of the Animal Waste Management Plan on sike?
Explain any Yes answer:
cc.FaabyAsseL eat unit
j2rawing$ -or • _Dbservations:
Yes 0
No3
Yes 0
Nar
Yes O
No
Yes 0
No
Dane: - IF
IlseAm=&%v= jfNetded
CAL �aAdt�Yt cav%.S TrJJIL*0+�
- ina �/ii •�J :'�= • • .. .. . w•. �i r.�•- w ��a-.. �n �» rr �• :�1.e�p���NM�'+'nY+. v�+.w r �L.
ADI -- JanuW7 174M .

BROWS
OFCAAOUNA�
mm:
QUALITY FARMS, INC. - GROWER #.59
STEVIE TATUINA - 7 (800) FINIS=G HOUSES
HIGHWAY 87 - BLADEN COUNTY
KAM
JEW
s
un
un
STEVM TATUM FA;W
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DIRECTIONS: FROM ELIzABOWN T_kXE a -WY. 41137 TOWARD
DIIBLIN. FARM ENTRANCE WILL BE PVRO TYYATZLY FOUR MILES ON LEFT_
MAILING ADDRESS:
STEVIE TATUM
POST OFFICE BOX 1416
ELIZABETHTOWN, NC 28337
WORK: [phone]
HOME: [phone]
SHIPPING ADDRESS:
STEVIE TATUM
HWY . 8 7
ELIZABETHTOWN, NC 28337_
BRO'INrs C:.;_�:r.:. ,tic
303 EAST COLLEGE S-i REF • P.O. BCX 487 • W?2SAV1 `.'C 2?:3= -c7 • CFFICE ;7 -0) 293.2181 • FAX: [phone]

DXV%=CN OF S;Q5igH3Z9bIDS+i'1'AL MARAGBMBM
November 4, 1994
SUHJWT: Compliance ya8pection
C=Mty
Dear
On , , an ion of your saimal operation was performed by the
Fayetteville P4Miiaaa Office (FRO). Kease find enclosed s copy oz our
Compliance Inspection Report for your information. it is the opinion of this
office that this facility is in compliance with 15t1 NCAC ZH, Fart .0217, and
that Animal Nasty Management is being properly parfo=ed.
Should you have any questions regarding this matter, feel free to contact
me at i910) 485-15+41.
Sincerely,
Eualesur8
cc: Facility Compliance Group

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NMTH CAROLINA DBPAR . OF EwnummmT, HEALTA & iRATunaL RwouRCEs
DYVISIOW OF
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
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All questions answered negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
Sam-aN I
Animal Operation, Type:
Horses, cattle, swine, poultry, or sheep
1. Does the number and type of animal meet or exceed
the (.0217) criteria? (Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system) 3
2. Does this facility meet criteria for
Animal Operation RBCISTRATION?
3. Are an4-als confined fed or maintained
in this facility for a 12-month period?
4. Does this facility have a ANIMAL
NAM PLAN?
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6. Does this facility meet the SC5 minimum
setback criteria for neighboring houses,
wells, etc?
7
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SB=ON XXX
Y i H
Eield Site Ifpmgement
i_ 2s animal waste stockpiled or lagoon
construction within 100 ft. of a uSGS
May Blue Line Stream?
2. is animal waste land applied or spray
irrigated within 25 ft. of a USGS Map
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application site have a
cover crop in accordan a with the
CE.RTXFZT _ FLAW
5. is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
6. Does the animal waste management at this
farm adhere to Best Management Practices
(BM) of the approved CffitTIFICATI9?
7. Does animal waste lagoon have sufficient
freeboard? How much? (Approximately 5 .� ?
B. is the general condition of this CAFO facility,
including management and operation,
satisfactory? 17,00
t