820160_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

61VKs IT
v
Type of Visit: We7Routine
Hance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: lam County: Region:F'40
Farm Name: ae 4% r—Qavt 96-cr=;t Owner Email:
Owner Name: An:&4 Phone:
Mailing Address:
Physical Address:
Facility Contact: ; �t'g Sa,,rW i6jt Title:
Onsite Representative: L(
Certified Operator: Da.Vit-k
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: & /-3—/1/
Certification
—
Certification Number: l g' T70
Certification Number:
Longitude:
Design_' Current
❑ NE
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop:
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
INon-La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
Dr, Inaultr..
Ca Kaci
P.o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Soars L
Pullets
Beef Brood Cow
Turke s
Qther
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 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 [i]'F!o ❑ NA ❑ NE
❑ Yes ❑ No [-ICA ❑ NE
❑ Yes ❑ No NA [] NE
❑ Yes ❑ No
❑ Yes [3-1qo
❑ Yes ETNNo
[]- A
❑ NE
❑ NA
❑ NE
❑NA
❑NE
Page 1 of 3 21412015 Continued

Facility Number: - (� Date of Ins ection:
Waste Collection & Treatment
4. Is storagecapacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑e 4iq- ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No E2 -<A ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 7i
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �o ❑ 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 -3-<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 1No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes Fa�tGo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NE
20. Does the facility fail to have all components of -the CAWMP readily available'? If yes, check
❑ Yes
9. Does any part of the waste management system other than the waste structures require
❑ Yes [ENo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
❑Other:
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes [ NJ o
❑ NA
❑ NE
maintenance or improvement?
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes [2-lQo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ PAN ❑ PAN > 10% or i 0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift p Application Outside of Approved Area
12, Crop Type(s): C f3 — ALL 9(y- c7
13. Soil Type(s): Wq�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes U2�`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 D O ❑ 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?
r-1 Yes [D -Ko- ❑NA 0 N
❑Yes [J <o 0 N 0 N
Required Records & Documents
o
19. Did the facility fail to have the Certificate of Coverage & Permit readily available'?
❑ Yes
[5
❑ NA
❑ NE
20. Does the facility fail to have all components of -the CAWMP readily available'? If yes, check
❑ Yes
[f 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
o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[J"No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'? ❑ Yes 2No ❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facili Number: - Date of Inspection: 7/
24. Did"the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes IPPV U ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Og-Ko ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes g }fl[o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �o ❑ 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 ED,>}6 ❑ NA ❑ NE
❑ Yes n'No ❑ NA ❑ NE
❑ Yes [LIllro— ❑ NA ❑ NE
❑ Yes [Z; -M_
❑ NA ❑ NE
es
[DNA ❑ NE
❑ Yes No
❑ NA ❑ NE
❑ Yes 3fo
❑ NA ❑ NE
Commen�tst(r f yr t queesttow#)v xplaiwany�'YES answers andlor atiy additional recommendations or any other comments.
Use explain. drawln s t►f fac�lity;to getter situations (use;a�dditionaf `ages as necessar ).
s sc,
3� 414ILi)ue.,
{ C -d Go- v�-Os(
Reviewer/inspector Name:
Reviewer/Inspector Signatut
Page 3 of 3
Phone�,�0—��
Date:
21412015

:, � I►� r T �ma� C 7 t?b
C' 0TY' sion of Water Resources
Facility NumUer ®- FAT] fflDivision of Soil and Water Conservation
0• ©then Agency
Type of Visit: QrlCompllance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: t>IRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: � Region: I
Farm Name. ex-4cou -F—C- f • -_ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: �J �/'
Facility Contact: ( '1-L S &C-0- l l � Title: Phone:
Onsite Representative:
L(
Certified Operator: �1
Back-up Operator:
Location of Farm:
Latitude:
Integrator: A 9-S
Certification Number: Ir 1370
Certification Number:
Longitude:
Discharees and Stream Impacts
I . Is any discharge observed from any part of the operation?
Design Current`
�
"Design
NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
�. Current
j
a
�Design Current
Swine
Capacity Pop.
Wet Poultry rCapacity�� Pop
Cattle .• Capacity Pop.
[:]No
['fQA
❑ NE
b. Did the discharge reach waters of the State'? (Ifyes, notify DWR)
Wean to Finish
❑ No
La er �3k
Dai Cow
Wean to Feeder
kV U&V
n -La er '
Dairy Calf
Feeder to Finish
d. Does the discharge bypass the waste management system'? (If yes, notify DWR)
,
Dairy Heifer
Farrow to Wean
❑ NE
Design Current
Da Cow
Farrow to Feeder
❑ NF,
Dr, yj PXu-I' Ca acit P,oP.
Non -Dairy
Fatrow to Finish
Layers
113eefStocker
Gilts
F!!�
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes
[qAl�
NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance ntan-made?
❑ Yes
[:]No
['fQA
❑ NE
b. Did the discharge reach waters of the State'? (Ifyes, notify DWR)
❑ Yes
❑ No
ET �NA
❑ NE
c. What is the estimated volume that reached waters ofthe State (gallons)?
d. Does the discharge bypass the waste management system'? (If yes, notify DWR)
❑ Yes
❑ No
Ej'NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes _P:f'74o
❑ NA
❑ NF,
No
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
F!!�
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facilit [dumber: - a Date of Inspection:
S &ori'
este Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [;J�- ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No � ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): `,7
Sb -
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes V2.Nn ❑ 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 '<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 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes � "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 �lo ❑ NA ❑ N E
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 L__1 No ❑ NA [] NF
❑ 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):
C V tM,.Y— c
13. Soil Type(s): �.✓C� ,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment'?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? Ifyes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22, Did the facility fail to install and maintain a rain gauge`? ❑ Yes 0 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA C—] NE
❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

a
Faclllty Number: - IV 0 Date of Inspection: s
a �
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [3-s~ttx ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [�- 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 provide documentation of an actively certified operator in charge? ❑ Yes �lo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [�10 ❑ NA ❑ NE
Other Issues
2$. 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?
ia+
S(a_A of x �C) et
❑ Yes Ua'No ❑ NA ❑ NE
❑ Yes E)oNo ❑ NA ❑ NE
❑ Yes (?I No ❑ NA ❑ NE
❑ Yes [fNo ❑ NA ❑ NE
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
C'J qw- 3a- 6 "(
Reviewer/Inspector Name: b L ` 6 Phone: 1(0- q%333V
cj
Reviewer/Inspector Signature: SIP aALA Date: f 1 j
Page 3 of 3 21412015

WW1& ;11;0z�ulvei[6 BU
Type of Visit: aCo Bance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 7Rooutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:,C rAtrival Time Departure Time: County: Region:
Farm Name: _ 6z4,AJ.?-16AFot. Vv4ts k!i !� Owner Email:
Owner Name: VdG Phone:
Mailing Address:
Physical Address:
Facility Contact: C czo_' (S CS a,4/'-j,V Cr Title:
Onsite Representative: �[
Certified Operator: V1�-y�(t LayNjLk
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: l't
Certification Number; l O 3
Certification Number:
Longitude:
Discharges and Stream Imnacts
I. Is any discharge observed from any part of the operation?
Nag=Lfillz�ill
Design.. Current
Q1K5`_
Design
Current.
Design Current
Swe
Capacity Pap.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pap.
[] No
[.-} A
[] NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
Wean to Finish
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
La er
Dai Cowr
Wean to Feeder
❑ No
E:�NA
Non -La er
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[ 14o
Dairy Calf
Feeder to Finish
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�No
❑ NA
❑ NE
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr, Poultr
Ca aci
Po .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
rTBeef Brood Cow
Turkeys
Other
Turkey Poults
OtherI
�-a�smmuminmm�wu:rss-�nriw�niar..re:xaensx*mw�a.ar.mv::w:or•m�ar
oum,k�u
j jother
..
Discharges and Stream Imnacts
I. Is any discharge observed from any part of the operation?
❑ Yes
Q1K5`_
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[] No
[.-} A
[] NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[],NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
E:�NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[ 14o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

'acili Number:KL
- 7V IDate of Inspection: I r'
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 e'N-A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
❑ Yes
No
❑ NA
❑ NE
Observed Freeboard (in):�
❑ Yes
[�No
❑ NA
❑ NE
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
u rvo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[]?<o
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
VNo
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
L;Koo
[3NA
[3NE
& 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)
Po
❑ NA
❑ NE
the appropriate box.
9. Does any part of the waste management system other than the waste structures require ❑ Yes [3'110- ❑ NA ❑ NE
maintenance or improvement?
Waste Anulication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes]YNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [B -<o ❑ 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 WindowEvid�ennccefoff Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �] er t+t{. `—' V t/
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
[�No
❑ 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
[� o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VNo
❑ NA
❑ NE
Rectuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yeso
E] NA
E] NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
Po
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements F] Other: 1.4
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes YNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes TNo
o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? []Yes ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

1xacili "lumber: - fLeW jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [] Yes 29-11oo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [� 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 [3 -Ko ❑ NA 0 NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [31To ❑ 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.
36. 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:
❑ Yes E],Ko ❑ NA ❑ NE
[:]Yes �o ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes 2rNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes eNo ❑ NA [] NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes CErNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency`? ❑ Yes Fj No ❑ NA ❑ NE
Commerits (refer to question #) Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facilitiy. to better explain situations (use additional. pages as necessary).
�i
t�'
�(p�l - q ' k7- I y6J, 2, (T
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
.1 Phone; "l `� 3'�,5
Date: � h(qh
2/4/7011

Q tYAS I.A fl & I S 130
OlDivision of Water Quality
Faci[VNumber u - ® O Division of Soil and Water Conservation
Q Other Agency
Type of Visit:,.,ommpliance Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: utine 0 Complaint 0 Follow-up 0 Referral Q Emergency 0 Other 0 Denied Access
Date of Visit: I IT Arrival Time: Departure Time: I t 17 County:Region:(L
Farm Name:��„ �.tfw`� r Owner Email:
Owner Name: 2,w �a�1 Phone:
Mailing Address:
Physical Address:
Facility Contact:'A�c+-►��vir Title:
Phone:
Onsite Representative: [ ( Integrator: N g !
Certified Operator: KJ(a.ur �✓� Certification Number:
Back-up Operator. Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish
Wean to Feeder Od
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Ea er
Non -Layer
L
ury roultry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
DischarlEes and Stream Imuacts
1. is any discharge observed from any part of the operation?
Discharge originated at: [3 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?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ YesI�J:] NA ❑ NE
[]Yes ❑No
[:]Yes ❑No
[:]Yes ❑No
❑ Yes No
❑ Yes ENo
a*A ❑ NE
[11.A ❑ NE
[3 -GA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 2/412011 Continued

Facility Num er: D Date of Inspection:
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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?: _
Designed Freeboard (in):
Observed Freeboard (in): 3 _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
EjXb_ ❑NA ❑NE
❑ No [3-D;A ❑ NE
Structure 6
❑ Yes [9"Ko ❑ NA ❑ NE
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
io
❑ 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
to
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ 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 �lo ❑ 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): &0&1&Uq1q '56 D
13. Soil Type(s): _�j r'
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [3'1 o- ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [3 -No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑-I-o ❑ 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 E5NK
o
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [ ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes [3<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 al�_o
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield p 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ZNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes eNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
0 NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facility Ndtgber: Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? []Yes
��Qo ❑ NA ❑ NE
25. Is the facility out of compliance,with permit conditions related to sludge? If yes, check ❑ Yes [21 o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge leveis
❑ 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 o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Ldl"" ❑ 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)
❑ Yes To ❑ NA ❑ NE
❑ Yes [ '` o ❑ NA ❑ NE
[:]Yes To ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? (] Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
C't . 6tr 10 V\
5 _ c_> . &4 v e y___
la le-iY t+l
No
❑ NA
❑ NE
D<o❑
NA
❑ NE
11�40
❑ NA
❑ NE
eN o
0 NA
❑ NE
0'/1 _!� P, (�j L-1,
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 2/4/2014

Mks r f&lid 6D
Division of Water Quality
f Facility Number /j ry( - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit:7Routine
Hance Inspection
Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit:
0 Com taint
0 Follow-up 0 Referral 0 Emergency
0 Other 0 Denied Access
Date of Visit:
Arrival Time:
DepartureTime: / County: 54 614 Region:( Gib
Farm Name: ✓pll All Owner Email:
Owner Name: .1 — Phone:
Mailing Address:
Physical Address:
Facility Contact: C-' Q u—T1 5 ��cl`L(J �G Title: fi C� Phone:
Onsite Representative: _ { Integrator: 'A � �-!!�7y
Certified Operator: _4LLa Certification Number: llQ�l L
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Non-Layer
a er
0
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
D Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[:]Yes E3 -11-o ❑ NA ❑ NE
❑ Yes [:]No
[:]Yes ❑No
❑ Yes [:]No
❑ Yes �10
❑ Yes E ]j No
ETNA ❑ NE
[2 -NA ❑ NE
C3 NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 2/4/2011 Continued

Facili Number: - -_j jDate of Ins ection:
❑ Yes
[R.Xo
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
[]�Xo
NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
E ,P
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[]<o
E] A
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): i
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
25,l'd'd
❑ 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
[B ' 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 DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
O� o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Ld'""
❑ 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
ED<
❑ NA
❑ NE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
rC o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below, ❑ Yes 2<o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% 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): Z .r 4AM wd S r�
13. Soil Type(s): I n1 d,n V-zt,�n. - -- - -
P-._ .• _• .., .,...._
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[R.Xo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[]�Xo
NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yesro
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? D Yes E>o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Q,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. D 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 [!3�No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [/No ❑ NA ❑ NE
Page 2 of 3 214/2011 Continued

Facili Number: - Date of Inspection:
l4. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M -No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes Q'No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes g No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Ef<o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes � ❑ 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 0,'v ❑ 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 EDXo ❑ 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 Eio ❑ 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'f0 ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative? ❑ Yes 2 No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes F!�No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Cd, 'b
F-,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phon�. o M_' 3 7
Date: LI -q-
21412011

5
In
Type of visit: Wcompliance inspection V Uperation Review V Structure Evaluation V 7 ecttnical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: j ;a. Arrival Time: Departure Time: AIS County:6q�on
Farm Name: DARApn 1='Akm Nyxse-iq Owner Email:
Owner Name: Q^Qnotl�t l7RRDs:r>1 Phone:
Flailing Address:
Region: FRl-7
Physical Address:
Facility Contact: CuR�j a INRuJTCX, Title: Phone:
Onsite Representative: p�q�E Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Discharges and Stream Imnacts
1. Is any discharge observed from any part of the operation?
Design Current
E�rNo
Design
Current
Design
Current
Swine
Capacity Yop.Wet
Poultry
Capacity
Pop.
Cattle Capacity
Pop.
Wean to Finish
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ No
aNA
❑ NE
Dairy Cow
Wean to Feeder
U400
Non -La er
d. Does the discharge bypass the waste management system'? (if yes, notify DWQ)
❑ Yes
❑ No
Dairy Calf
[3 NE
Feeder to Finish
❑ Yeso
gNo
E]NA
❑ NE
Dairy Heifer
❑ Yes
Farrow to Wean
❑ NA
❑ NE
Design
Current
Dry Cow
Farrow to Feeder
i
Po P.
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Co",
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Imnacts
1. Is any discharge observed from any part of the operation?
❑ Yes
E�rNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
M'$4A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
aNA
❑ 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
2 NA
[3 NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yeso
gNo
E]NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

Facili Number: L4_071 I Date of Inspection: C7 t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [v]rNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [] Yes ❑ No ETNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 41 a 410
Spillway?:
Designed Freeboard (in): /5 19
ObservedFreeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [glNo ❑ 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 [3"No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes []"No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [U"&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 <o ❑ NA ❑ NE
maintenance or improvement?
Waste Agplication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes CR(No ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E2"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. CropType(s): £RMy17A G�Ro'z-', Ng=4' A_-
13. Soil Type(s): o - LLP/ -•--
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes []'No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [►. No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [B"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 [EfNo
❑ Yes g No
❑ NA ❑ NE
❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 5 No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps []Lease Agreements ❑Other:
2t. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [KfNo ❑ 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 ZNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [2"'NA ❑ NE
Page 2 of 3 2/412011 Continued

r r
Facility Number: - IUL0 1 jDate of Inspection: 3'p 12
24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ffNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Eg-f�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 provide documentation of an actively certified operator in charge? ❑ Yes [RrNo
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 eNo ❑ NA ❑ NE
❑ Yes eNo ❑ NA [] NE
❑ Yes M"No ❑ NA ❑ NE
❑ Yes ["'No ❑ NA ❑ NE
❑ Yes [2�No
[:]Yes Cl Io
❑ Yes [ErNo
�] NA ❑ NE
❑NA 0 N
❑NA F-1 NE
Reviewer/inspector Signature: Date:
Pabre 3 of 3 2/4/2011

'"$ -7/1VIII a;Ft—
Qli'Division of Water Quality
► Facility Number - © 0 Division of Sail and Water Conservation
0 Other Agency
Type of Visit:om Hance Inspection 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: p�l� County: Jap *,.x
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: tC_`L, Title: Ems, Phone:
Onsite Representative: Integrator:" .
Certified Operator: Q1F,,J Certification Number:
Backup Operator: Certification Number:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder Q
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Latitude:
Design Current
Wet Poultry Capacity Pop.
4,on-Layer a er
Dry Pi
Layers
Non -L
Pullets
Other
Poults
Design Current
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)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dai Calf
Dairy Heifer
DEX Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[]Yes [L.Ko ❑ NA ❑ NE
❑ Yes
❑ No
2<
❑ NE
[—]Yes
❑No
[R]A
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No 20RA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes[�] N NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters F-1YesNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

Facili Number: 5r - Date of inspection:
13. Soil Type(s):
Waste Collection & Treatment
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yeso
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
o
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[Ej-K!(
❑ NE
Structure I Structurer�2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:1 vv—
❑ Yes
to ❑ NA
❑ NE
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Designed Freeboard (in):
❑ NE
Observed Freeboard (in): o2l 3_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
o
0 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
to
❑ 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
io
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
I. ,1414
❑ 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
5;K0
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
Io
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ey<o [DNA ❑ 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): a l L� � 66-0-
IJ /
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yeso
[3NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ YesLies
"'o E] NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑Yes
to ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
to ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
106 ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes AVO ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes G2-'Iqo ❑ 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]� o ❑ NA ❑ NE
❑ Waste Application p 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 OE No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [24A ❑ NE
Page 2 of 3 2/4/2011 Continued

Facility Number: - 7/___/_71 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
� ❑ Yes
[t to
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
lo
❑ NA ❑ NE
the appropriate box(es) below.
❑ Yes
QoKb ❑ NA
❑ NE
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
Usetdra'wings,offaeili' tetter explain:situations (use additional pages as necessary). .''
r�
❑ 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
g-llo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
E] ❑ 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?
24. 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:
❑ Yes [ No ❑ NA ❑ NE
❑ Yes C 110 ❑ NA ❑ NE
❑ Yes ❑<o ❑ NA ❑ NE
❑ Yes �lo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[] Yes
M'Ko_ ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[EKo ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
QoKb ❑ NA
❑ NE
Cotrtments (refer to question #): Explain any YES answers and/or any additional recommendations or any other commentsi`=; ';
Usetdra'wings,offaeili' tetter explain:situations (use additional pages as necessary). .''
r�
,� }I . "�
Reviewer/Inspector Name:
Phone: U)
Reviewer/Inspector Si nature: Date:
Page 3 of 3
2/412011

'S .2lz 6/z0/0 R10'r-
tvision of Water Quality
111 1 Facility Number 2, J f(o Q O Division of Soil and Water Conservation
Q Other Agency
Type of Visit GoCrmpliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit outine O Complaint O Follow up 0 Referral O Emergency O Other ❑ Denied Access
Date of Visit: 2-2$-/0 Arrival Time: //; /O it w Departure Time: l2 : 3D County: Region: 17512.0
Farm Name: lb R &— C1 -en1 14*t.-^_ S / /y rS__rT Owner Email:
Owner Name: /7Ny oA,4 4', ,t o,den/ Phone:
Mailing Address:
Physical Address:
Facility Contact: CfAr- ,b S Barc.�r�/c, Title: she(—, Phone No:
Onsite Representative: et' 4'% Integrator: 12f'" )3Y&.JA1
Certified Operator: �"' E• �o'" d` ^' Operator Certification Number: L6370
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Back-up Certification Number:
Latitude: 0 0 =1
=4 Longitude: = o = d =$I
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer I �I ❑ Non -Layer
Other
❑ Other J
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl I
Number of Structures:1�01
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
12/28/04 Continued

8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
GIo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
Facility Number: ,Z—/COQ Date of Inspection 2'25—/U
9. Does any part of the waste management system other than the waste structures require
El Yes
Waste Collection & Treatment
❑ NA ❑ NE
�o
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
[TI�o
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: jz_ % Z
��/
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
Spillway?:
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
Designed Freeboard (in):
12. Crop type(s) Ze JeMAU }
Observed Freeboard (in): —7.0 3e�
13. Soil type(s) W a B
5, Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
to
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
EK
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
01�o
❑ NA
❑ NE
through a waste management or closure plan?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
EJ -116—
❑ 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
No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
GIo
❑ 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
lJ No
DI
❑ NA ❑ NE
maintenance or improvement?
Waste_ Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[T No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application`? If yes, check the appropriate box below.
ElL7 Yes
��/
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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) Ze JeMAU }
13. Soil type(s) W a B
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
O N
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
EK
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ NA [__1NE
17. Does the facility lack adequate acreage for land application?
Yes
El3
,-,<o
No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
EJ -116—
❑ NA ❑ NE
co­mments (refergto questurn'#} Explain any YES answer's and/or any recommendations or any"otheromm
cents F.
Ilse drawings a1 facility to bciter,explam situatioti9'. (use addttinail ,,n
Reviewer/inspector Name _R;c—✓tis rT �`ar Phone: %4,V3.3.3300
Reviewer/inspector Signature: Date: 7—ZS-2 O/O
12/28/04 Continued

./ L - ZS`-/ d
Facility Number: Date of Inspection Z-zs-
Renuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes G o ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
LK
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
ffNo
❑ NA
❑ NE
21
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[:1NA
ElNE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[.E ` o
�
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
LSNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure'a phosphorus loss assessment (PLAT) certification?
❑ Yes
I"No
❑ NA
❑ NE
Other Issues
28. Were anv additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes B<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
ETNo
❑ 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 Revicwer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
to
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
ErNo
❑ NA
❑ NE
12/28/04

1:
gz** - ,�>4ve�[ lo--oz-zoo?
Type of Visit i3—Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visitoutine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: IJO-Ol—d% 1 Arrival Time: ;09 Departure Time: % :s County: Region: `AV
Farm Name: CLVcjr ti/ )C vM S AAIU*,Se_4,7 _ Owner Email:
Owner Name: 4^14pA/ y 15. Phone:
Mailing Address:
Physical Address:
Facility Contact: f `Itis49qVW1 r✓ k Title: �� ��• ,�Phone No:
Onsite Representative: �U t �S � � t� w i`<- ciC— Integrator: AAu rp
Certified Operator:
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Latitude: = [=,
= longitude: =0=6
o❑6 = u
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ Layer
can to Feeder 16400 1(43Sr�E 10 Non-Layet
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Giits
❑ Boars
Other
❑ Other
Dry Poultry
❑ I -a ers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ urkey Poults
❑ Other
Discharges & 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?
Design Current
Cattle Capacity Population
❑ Daia Cow
E3Daia Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dai
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Cowl I
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: 2.
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
L7 NA
❑ NE
❑ Yes
❑ No
E3<A
❑ NE
[3 A
❑NE
C1 Yes
C1 Yes
,❑Ngo
o
❑ NA
❑ NE
❑ Yes
EPTo
❑ NA
❑ NE
12/28/04 Continued

r L
Facility Number: 192 Date of Inspection
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 3<o ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): go
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 2?<o ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes Ell< [:INA ❑ 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 Ell< [:INA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit'? ❑ Yes D -Ko ❑ 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 L�No El NA [I NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Ej-K`o'_ ❑ NA ❑ NE
maintenance/improvement?
11, 1s there evidence of incorrect application? If yes, check the appropriate box below. [:]Yes G11 o ❑ NA [:1 NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Hare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) ©e_VU,,jdeti e"/Ay � ,S,.ur/� e9 rw""I 69, S
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [ErNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes io ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ YesNo NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Reviewer/Inspector Name �rG V� 1. .,ik i §� �� Phone:
r, , _ _ , ..
Reviewer/Inspector Signature e,..al. 1 Date: /4-O/—ZOO
12/28/04 Continued

Facility Number: 82 — //oD Date of Inspection
Reguired Records _& Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes B<o ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑Design El Maps ❑Other
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
2 0
[INA
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
E3<"'[]
NA
❑ NE
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield [3 120 Minute Inspections [:]Monthly and V
Rain Inspections E] Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
Lt7 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Imo
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,_,,
El NA
[__1 NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
�+LlN�o
I" No
❑ NA
❑ NE
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
fo❑
NA
❑ NE
33.
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Io
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
2 0
[INA
[INE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E,❑
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
ETNo
❑ 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
,,�
L7 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
fo❑
NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
E3Yes
Ghgob❑ NA
❑ NE
12128/04

$I-y1t s 9-0 f- o e
Type of Visit CMompliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit & outlne O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: T TV—OA Arrival Time: Departure Time: /Z: County: Q i-SoA1 Region: F
Farm Name: b° vej e-tir V.44 -S /1"41A'S8_,o'`i Owner Email:
Owner Name: Phone:
Mailing Address: 306 % ��r/� dr. C/�:v7•y , Me— ZIT32 S
Physical Address: JJ `` ]}
Facility Contact: rlNdi, L)Mk-de^1 Title:
Onsite Representative: „�uY1i s' aaYlJ�
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
i❑ Boars
Other
❑ Other
Phone No:
"U"I' 047 Bim„✓,v
Integrator
Operator Certification Number:
Back-up Certification Number:
Latitude: =0 = = Longitude. =0=1 ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
IEEII La er
4 3 ❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑
Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ DaiEX Heifer
❑ Dry Cow
❑ Non -Dairy I
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: EZI
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. DTd 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 I of 3
❑ Yes L7 No ❑ NA ❑ NE
❑ Yes
❑ No
[TNA
❑ NE
❑ Yes
❑ No
❑<A
❑ NE
2 A
❑ NE
❑ Yes
❑ No
❑ Yes
B-Iqo--
❑ NA
❑ NE
[3 Yes
2<o—
❑NA
❑NE
12/28/04 Continued

i11
9-28-0e
Facility Number: Date of Inspection 1V' -Z5? -09
Waste Collection & Treatment �,�,//
I-7
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 Talo ❑ NA ❑ NE
Structured) Structure Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
❑ Yes
NNNo/o
Spillway?:
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Designed Freeboard (in):
❑ NA
[:1 NE
Observed Freeboard (in):
,LSNo
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
D<o
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
NA
[:1 NE
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
Leo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
❑<oo
❑ 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
❑ N"o
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
0 No
❑ NA ❑ NE
maintenance/ improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
�
B o
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > l0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindow❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �ir�t ad 1�u Cg���^I �4. S.
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
NNNo/o
[INA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�[
❑ NA
[:1 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
,LSNo
❑ NA
[:1 NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
�Dll'o
L�1'No❑
NA
[:1 NE
18. Is there a lack of properly operating waste application equipment?
El Yes
l-?<�❑ NA
❑ NE
Reviewer/[ nspector Name , ,Phone: 'V
��1033.333O
/<_-;_-V.,G S �,3�
Reviewer/[nspector Signature: Date: j? -2s-0 $
Page 2 of 3 12128/04 Continued

$ - z$ -O 8
Facility Number: T2 — Date of Inspection 'L O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists
❑ Design El Maps El Other
❑ Yes No []NA ❑ NE
❑ Yes ❑'No [JNA ❑NE
2l. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
D<o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
3<o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ YesL9'o
[:1NA
ElNE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
Yes
Elr-
I,,-?<oo
❑ NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit'?
❑ Yes
D o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge'?
❑ Yes
2<o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[T5o
❑ NA
❑ NE
Other Issues
2$. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 91`fo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E3,5o
❑ 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
0 Vo
❑ 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
❑-fTo-
❑ 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
0
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
El<o
❑ NA
❑ NE
i Y]J OwlAdditfonalrCnmment�an[ilorDrawingsh�kRil! 'lk�,fish:t.�rP'IP�I"I;I a�+
Page 3 of 3 12/28/04
Page 3 of 3 12/28/04

�rr
[at eS ,;;,r. -40 g i7 -o - +�L
Date of Visit: 1 IN3 - Arrival Time: Departure Time: 3 : ZS` County: o
Farm Name: Ea.,tainy;e,4- �tr1A_S Alurj-fd_* Owner Email:
Owner Name: A.Wsw/F a Dyi c Phone:
Mailing Address:
Region:
Physical Address:
Facility Contact: A1fQV.7L.11 f -q1, A V I C.G. Title: Phone No:
Onsite Representative: Ccxy4,-& 13cay-w i (_k Integrator: Cinlkt yi -r— !—y_­V'AA S _. .
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = =1
= Longitude: =0=1 =
Design Current
,Des�gn'h Current t; ;;Y Design. Current
�pQ
WeP
ine Ca aci Po ulatioii
h P
W„et Poultr y
Ca acs_ elation =�1
�. p� h A
RWean to Finish
❑ La er
. .aP : �,
❑ Dai Cow
Wean to Feeder ()
❑Non -La eI
❑ Dai Calf
❑ Feeder to Finish
K °' El Dairy Heifer
❑ Farrow to Wean
Dry Poultry ”. ❑ D Cow
1",
❑ Farrow to Feeder
❑ Yes
❑ Non-Daity
❑ Farrow to Finish
❑ La ersR
El Beef Stocker
❑ Gilts
❑ Non -Layers
,-
❑ Beef Feeder
❑ Boars
Pullets
R. ❑ Beef Brood Cow
Other y
❑ Turkeys
El Turkey Poults
sr
❑ Other 7
1 JEJ Other
6 s
ber"
.�,� Num�tof Structures:
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[A No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[RNo
❑ 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
[f' No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
CWNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
91 No
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

'ti r
Facility Number: gz — /( O Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Q0 No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
96 No
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 5_0
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
1% 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
M No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the pen -nit?
❑ 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
W No
❑ NA EINE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
P 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 El Evidence of Wind Drif3 ❑ Application Outside of Area
12. Crop type(s) �- M l id w �t'V e,
/
f o.S
13. Sail types)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
06No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[9 No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑
Yes
V No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[�j No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
U No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewerllnspector Name F t cel /' Phone: 9tj0 4133 r V�Q
Reviewer/inspector Signature: Date: °i - ZO"b 7
12128104 Continued

Facility Number: g —/&ODate of Inspection —/�—
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 1W No ❑ NA ❑ NE
If -
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design El Maps F-1 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 ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge`?
❑ Yes
rU 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
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 [)B No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes 5 No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 0 No ❑ 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
M 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
[4 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
[0 No
❑ NA ❑ NE
12/28/04

Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint Q f=ollow up 0 Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: Jr D9'!1t'p Arrival Time: Departure Time: County:. sem/ Region: /5K -y
Farm Name: Z Ar -r 4NOwner Email:
Owner Name: TgJ�`e4 !/�4 Vr Phone:
Mailing Address:
Physical Address: ��aa
Facility Contact: Ozrhi5 9,ww ck, Title: Phone No:
Onsite Representative: Cq,,- 7"< gdri j [_K integrator: 0,014, "<-
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 0 0 Longitude: = o= i
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder I
❑ Farrow to Finish '
❑ Gilts
❑ Boars
Other
❑ Other 1 77 11
❑ Layer
❑ Non -La ei
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
[ITurke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy I-leifej
❑ Dry Cow
❑
Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl I
Number of Structures: E�D[
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 [N No ❑ NA ❑ NE
❑ Yes
KI No
❑ NA
❑ NE
❑ Yes
MNo
El NA
El NE
❑ NA
EINE
❑ Yes
[4 No
❑ Yes
[3?No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
12/18104 Continued

.y
Facl W ty Number: gZ—/!pp Date of Inspection -49-0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'? ❑ Yes [8 No U NA ❑ NE
a. If yes, is waste level into the structural freeboard? []Yes r7I No ❑ NA EINE
Structure I :Structure 2 Structure 3 Structure 4. Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): / q �./9 9
Observed Freeboard (in): 3-sy.3Z
5. Are there any immediate threats to the integrity of any of the structures observed'? ❑ Yes ®No [INA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes 7No ❑ 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? ElYes [vNo ❑ 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 1� No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes VNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [7No ❑ 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 Drifl ❑ Application Outside of Area
12. Crop type(s) Al
13. Soil type(s)
r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PjNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
PgNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acre determination, C3 Yes
PNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
tgNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
fA,,��+e ... ; .,
Comments (refer. to}�question 1) Explain any VES answersland) anyorecommendations or any other cmm�nenta.
�� 1 t t lVu��, i t �itip n i1i2Are X
Use drawIngsiof frac_ lel, to h ep u ial,Rlltu,atioas �l 5dditlona��pa*; � necc5�saryy
Reviewer/inspector Name �. j` r ✓c tom`' r°" � : a i ' }. Phone: 9�0 r1//
Reviewer/Inspector Signature: Date: s d S —2 -aa to
12128104 Continued

Facility Number: SZ -- Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (RNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check []Yes NNo [INA ❑NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design El Maps C1 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes N 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal'?
30. At the time of the inspection did the facility pose an odor or air quality concern'?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector faii to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
[,29 No
❑ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
[§ No
❑ NA
❑ NE
❑ Yes ❑ No ® NA ❑ NE
❑ Yes MNo fg-NA EINE
❑ Yes N No ❑ NA ❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
®No
[INA
❑ NE
❑ Yes
9 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
Addittona! CommenWantl/or Dt4w i3gs
u... ,.
12128/04

Type of Visit 41 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: o Departure Time: County: Slat!t� Region: 6 O
Farm Name: Wede,,-4 W , -4 f mj ' s �a+ - ___ v�serY Un,'�s__ _ Owner Email:
Owner Name: lVarsha/Z Falabovre4 _ Phone: yne: IM - Sf1 Sh- -
Mailing Address: 'I tO Qeaver 10QM Q �,'✓e A'.ts ; , NC ?8.3 ag__
Physical Address:
Facility Contact: Title:
Onsite Representative: C
Certified Operator: _ RoPc Q 'idyt. We -14
Back-up Operator:
Phone No:
Integrator: Cor,'r ram, s
Operator Certification Number: 21VI-x/
Back-up Certification Number:
Location of Farm: Latitude: =0
= =16 Longitude: =0=1
°01 = rr
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish 1 ❑ Layer 1 11 Eli
-Wean to Feedere' p ❑ Non -La er
❑ Feeder to Finish
❑ Farrow to Wean
❑Farrow to Feeder
❑ Farrow to Finish ❑ Layers
❑ Gilts ❑ Non -Layers
❑ Boars ❑ Pullets
❑ Turke s
Other
1:11 urkey Poults
❑ Other -- - 4 ❑ Other
Dry Poultry
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity :Population
❑ Dairy Cow
❑ Dai a Calf
❑ Daia Heifei
❑
Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: []�]I
b. Did the discharge reach waters of the State'? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑Yes PKo El NA El NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
RoNo
❑ NA
❑ NE
❑ Yes
D'Slo
❑ NA
❑ NE
12/18/04 Continued

Facility Number: 8. — /(,o Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 9-110 ❑ 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: C
Spillway?: '6
Designed Freeboard (in):
Observed Freeboard (in): 3 l { .2
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes [Q -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? [Kes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
a'No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
2 -No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
['NO
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
O'N' o
❑ 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 Drifl ❑ Application Outside of Area
93,;- goo
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[ o
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
El Yes
❑ No
❑ NA 2<E
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA [R NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ONo
❑ NA ❑ NE
7, ple4se o4i.,ve f& word/ o, bore 4,h utiv.iPl 1,g9e a �. esA.61,il 5ade/ graay eourr•
is prerer,-' 1-1-05.n,
U:a 'r L' it # ;- Y
Reviewer/inspector Name, .` f , , 5 ,_ ; '� Ar, ;. Phone: 91o�y!lb /�LjI Cr7t730
Reviewer/Inspector Signature: Date:
12/28/04 Continued

Facility Dumber: Z — /(,v Date of Inspection 3 0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes G Io ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check 2 Yes ❑ No ❑ NA ❑ NE
the appropirate box.
❑ ❑Che fists EjIlesign ❑ Ajat< ❑ OpCi ,�, /
21. Does record keeping need improvement'? 1 f yes, check the appropriate box below. ❑ Yes L�'Ho ❑ NA ❑ NE
❑ Waste kTr6ea"n ❑ Weeld- FFeelaefcl ❑ ❑ Soi-Armlofsis ❑ ❑
❑ Ra&nfnli ❑fig ❑ �- ❑e n ' s ❑i eatherGede-
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit'?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concem?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
[les ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA 91� E
❑ Yes ❑ No ❑ NA 2VE
❑ Yes El No ElNA D'16E
ElYes Ell< ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA G3,dE
❑ Yes
2'No
❑ NA
❑ NE
❑ Yes
S No
❑ NA
❑ NE
❑ Yes ErNo ❑ NA ❑ NE
❑ Yes [9' o ❑ NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes Plgo ❑ NA ❑ NE
12128/04
. . ,
� ( IQe ✓"e.4w Crop ril, rOPwj
�� Pleusc ,ga 11 a Ra;,, 6,tto�c° R,f SMI 'es Ross;V/ ,
/please �G� a Leder p'!C L0100A A16:.11 40r LA10111 4*1 O el P�rsee i'7 rZ1r.. �teOr�
S
12128/04
. . ,

Type of Visit 0 Compliance Inspection O Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Fallow up 0 Emergency Notification O Other ❑ Denied Access
Facility Number
i)ate of Visit: 5 5 Time: Q©
a
Q Not Operational 0 Below Threshold
[�'ermitted VCerdfied 13 Conditionally Certified ^13 Registered Date Last Operated or Above Threshold: .........................
FarmName: .........414`w ......... .....d.. ..`..................................... County:......,rAYt.....................................................
Owner Name:........ �1t Ka-40Vl�n Phone No:...... �4 5rb43
...I........................................................................... n f..................................................................
MailingAddress:.......410.......�...... ...........�................................... .....1..IE!1F 4*....................... C' ......................... .... ��i...
Facility Contact: ........`.�.".rS+!!!l r�..........^ f01e .........Title:.......0..!.'...!....................I.,................ Phone No:...................................................
OnsiteRepresentative:........cw*-�..............t&no kX........................................... Integrator:... '*.!...................... ............ I.......................
Certified Operator: ................ jam............................. `I5.................................. Operator Cert'if'ication Number:......�.7.���................
Location of Farm- 1
wine ❑ Poultry ❑ Cattle ❑ Horse Latitude e ' it Longitude • 4 44
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑Yes P14a
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 [91 o
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 2090
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................ I................. ............... ...........................................................................
................................................................................
Freeboard (inches): 21 etr.0
12112103 Continued

Facility Number: VA— J(,p Date of Inspection
. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Rf4o
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or ❑ Yes 000no
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [moo
8. Does any part of the waste management system other than waste structures require maintenancermprovement? ❑ Yes 2110
4. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes 20rio
elevation markings?
_Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ErNo
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes [+fNo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type *x6!'r"KA. 'qp c e , S;*W1 v'air opmeSeeed
13. Do the receiving crops differ wild those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
OR090
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
[Kio
b) Does the facility need a wettable acre determination?
❑ Yes
ENO
c) This facility is pended for a wettable acre determination?
❑ Yes
[2090
15. Does the receiving crop need improvement?
❑ Yes
[�lo
16. Is there a lack of adequate waste application equipment?
❑ Yes
20&o
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes GrNo
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 21<o
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 21g10
Air Quality representative immediately.
J
Reviewer/Inspector Name I
Reviewedlnspector Signature:
12112103
Date:
Final Notes
Cnnlinaed

Facility Number: jg _ %bc Date of Inspection.B +�Ib
Required Records & Documents
21 . Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ 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?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form [:]Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes [+ O&O
❑ Yes Zlgo
❑ Yes ffo
❑ Yes RNo
❑ Yes 2No
❑ Yes @05o
❑ Yes G;PNo
❑ Yes 2'No
❑ Yes OTI�o
❑ Yes [wf4o
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gr No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
d 1 1.....E ! I € r' . y I r , I� . iji r I 'I :I 4 E ¢�: it IIS' ! i I L . ''i I f 3
d t an Coriinnettts `and/ori Drawtrij1 i1, r I( 0i {{ j!�'II'M1;. , Py i �:; 111 ]I1 . Ii �� :if�� i ({14-
0 : a 4r I�, „ • , � ,, 13 r: ��
•c.i'i�:i��f=7.�, f,t� 4':fsi�W�.tai���.Ei .l�;l�pS��3�..�1,��;�.:. ...x�xttlf:`L...i�ld.�t.�:tt4ltli�id'�.��tis�3..�liilFli.r�liA1..�F�}w.�L<I�J�..��..Lu1�F��':f�.t'��lfc}Jui.. ...�
sli r>ws
AL
cwy:) nt�.�ds .•� J&4c &J k. 61"pes
e" WJ bK t �iras e Key M LJ 4r 41.
1
12112103

l
Type of Visit 9`ompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 4,,eRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility dumber Z f4 t)
Date of Visit: /`t d Time:
10 Not -Operational Q Below Threshold
Permitted 0 Certified [] Conditionally Certified [] Registered Date Last Operated or Above Threshold:
Farm Name: JC C. Ar 43Q tuft$ County: _ _�&�rl�psa.J
Owner Name:
Mailing Address:
Phone No:
Facility Contact: Title: Phone No:
Onsite Representative: b"AW r'` C(t CJ/ZT-, S7A42_,J='- Integrator: a Aj{���
Certified Operator: Operator Certification Number: T Z g71
Location of Farm:
❑ swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 N Longitude ' •4
Design Current Design Current Design Current
Swine Ca acity Population Poultry Capacity Population Cattle Capacity Po ulation
❑ Wean to Feeder I LqW1 10 Laver I ❑ Dairy I
❑ Feeder to Finish ❑ Non -Laver ❑ Non -Dairy
Farrow to Wean
El Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ® ❑ Subsurface Drains Present ❑ La oon Area 10 S rav Field Area
Holding Ponds / Solid Traps ❑ No Liq uid Waste Mana ement Svstem
Discharges & Stream 1mPacts
1. Is any discharge observed from any part of the operation?
Dischar,e orieinated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. is there evidence of past discharge from any 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 ollec i 8Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: C
Freeboard (inches): Z3
❑ Yes 11� No
❑ Yes A No
El Yes PNo
❑ Yes
;,Z No
❑ Yes
PdNo
❑ Yes
P No
❑ Yes
?"No
Structure 6
05/03/01 Continued

Facility Number: RZ, -- & a I Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -sitz which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pan of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Apniication
10. Are there an,. buffers that need maintenanceiimprovement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
z;S /aO
12. Crop type G . Q, G S.
13. Do the receiving crops differ with those designated itl the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Renuired Records & Documents
17. Fail to have Certificate of Coverage &: General Permit or other Permfiitt rfeadily available?
18. Does the facility fail to bave all components of the Certified Anirg Waste Management Plan r7diiy�vatilable?
y t+
(ie/ WUP, checklists, design. maps, etc.) $ �,
19. Does record keeping need improvement? (ie/ i _ation. frg�foard, waste anaiysis & soil sami poo
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 D`1WQ of emergency situations as required by General Permit?
(ie.' discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review•iinspection 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?
Cl Yes Zq0
❑ Yes [;�No
❑ Yes eNo
❑ Yes P "o
❑ Yes exo
❑ Yes ZNo
❑ Yes [2<0
❑ Yes 7 N
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ON.0
❑ Yes P�Nlo
❑ Yes ,�ZNo
❑ Yes 0 No
❑ Yes -i No
❑ Yes —JAdNo
❑ Yes 211�0
❑ Yes Ino
❑ Yes ONO
❑ Yes 0 0
❑ Yes _20. o
13 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments(r'efei to`''gnesb'an. `Eire]sini:any YE5aeswei s and/v� flay reenmren edstieas organ other eommetifsy ' „�pp,,` `"'�� �e'
Use drawings of facility to better exp. am situations :(use addltionaf pages as necemr) f 41 �, , Field Copv ❑ Final Notes
�f4.�Jifl+:L'..:t...t���talr..l+.:4i�!�lli+C.s1i.I.•.::A�---.:J..x:,ik.'thPu.#'an�l:Ii:I�ilSte..tttnc.�:t. si+ _
>r Arro *Y DRAJIJ (;- G r as ,� � J> A.>_s,.rC. el18 Z03
+,W P, TiC, krig-4.I or— Z1103 SG: L, 5A"?L E:�
Reviewer/Inspector Name #�' , •' ` " {yry s ,f{°
!' .iY, fIi•MNI 4,flfl k'I.SIM'1++�11" lil!' :4:dt A!{4�i !:.m:'W715, +; i0.Y�M.l:, + •.i�4r° :. n � ud�ahRffi:SR--� Spd�
Reviewer/Inspector Signature: Date: z /
05/03/01 1 F Continued

1�
k�. IL
tacttity Nwn&er _ jL,
Division of Environmental Management 6 z
Animal Feedlot Operations Site Visitation Record
Date -
Tim ?�
General labrm ion:
Farm Name: ESCounty;
Owner Name•-- _,.. 111 I�,rs F�� GJ o V %c �. _Phone No: 59,E - 8 G`f
On Site Representative: Integrator
Mailing Address:/v J3 t--04 a,� b L
G�&A 11 &L- C�-)Y 2L-
Physical AddresslLocation: -5p pg -z - S "r bS
Latitude:95 1. 02-J-20— Longitude. -_29 I Z_ ±2.
operation Description: (based on design characteristics)
Type of Swine No. of Animals Type of Poultry No. of Animals Tjpe of Cattle No. of Animals
O Sow O Layer O Dairy
ursery (o o O Non -Layer O Beef
D Feeder
OtherType of'Livestock Number ofAnimals:
Number of Lagoons: •T'— (include in the Drawings and Observations the freeboard of each lagoon)
wilily Inspection:
Lagoon
Is lagoon(s) fizeboard less than 1 -foot + 25 year 24 hour storm storage?:
Is seepage observed from the, lagoon?:
Is erosion observed?:
Is any discharge observed?
0 Man-made D Not Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover crop need improvement?:
( list the crops which need improvement)
Crop type: elz j
Setback Criteria
Acreage:
Yes 0
NoM
Yes ❑
NoM-
Yes a
Nod2'
Yes 0
Noa-
Yes ❑ Nom
Yes ❑ Na. &
Is a dwelling located within' 200 feet of waste application? Yes a Nolo
Is a well Iocated within 100 feet of waste application? Yes 0 -Nord`
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream? Yes 4 No T'
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? Yes 0 No 13
AOI -- January 17,19%

REGISTRATION FORM FOR ANIMAL FEEDLOT OPERATIONSOepartment of Environment, Health and Natural Resources
Division of Environmental Management
Water Quality Section
if the animal waste management system for your feedlot operation is
desianed to serve more than or equal to 100 head of cattle, 75
horses, 250 swine, 1,000 sheep, or 30,000 birds that are served by
a liquid waste system, then this form must be filled out and mailed
by December 31, 1993 pursuant to 15A NCAC 2H. 0217 (c) in order to be
deemed permitted by DEM. Please print clearly.
Farm Name: -,Q�� o �G`l a►'rn j A
Mail' ng Address : 14 1 V
" ovr
County : -50111"'a _ Phone No. /o -
Owner (s) Name:
Managers) Name:
Lessee Name:
Farm Location (Be as specific as. possible:' road names, direction,
milepost, e,tc ) � !O .,•,,�r s _/Y -�' 11, � z.. ,,,_, n�, S-� I � � I _r 4- <.....,.
Latitude/Longitude if known:_
Design capacity of animal waste management system (Number and type
cf can -:nevi animal (s)) _ �aD o r -IL" 4'
Average animal population on the farm (Number and type of animal (s)
.raised) 3.*P-4 D fedi, rr4�,.,—.,
Year Production Began: ASCS Tract No.: a ?a9
Type o:: Waste Management System Used: -12 a
Acres Available for Land
Application of Waste:
Owner (s) Signature(s): �'< 11� _ DALE
//�'�r_� �- �/ DATE
afJ4A'apo Ju t 761 Al �3 � C�L �rK � +��+t_G� �a r+- /e -f -it- 0 ►L /l Pe,,Po -

Site Requires Immediate Attention: U N
FacilityNo.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: -% It:, , 1995
Time: k' k S
Farm Name/Owner: `Fa 1 a t"a v • C_ . �C' - W"rstr.
Mailing Address•.,�`_ 4?Cku �� �w A�.,�.. r ct•�tcr. c Z�3z8
County: S�+--nsat.)
Integrator: C 0\n e, r- � Phone: o o
On Site Representative: 1"�.,��a��.�4.1�'�o�.a_ • _ Phone: 4&-ht�- %4 Lk
Physical Address/Location: l Lam'
Type of Operation: Swine 'xe Poultry Cattle
Design Capacity: `--A-e7d Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon ha sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No al Freeboard: 3 Ft. Inches
Was any seepage observed from the l n(s 9 Yes No Was any erosion o ed? Yes or fOo
Is adequate land available for spray. Ye Is the cover crop adequate? Ye or No
Crop(s) being utilized: t�
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelli�Y&or
a or No
100 Feet from Wells? No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes oro
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes o No
Is animal waste discharged into water of fhe state by man-made ditch, flushing system, or other
similar man-made devices? Yes o No If Yes, Please Explain.
Does the facility maintain adequate waste management rec9 (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? or No
Additional Comments: Z c.,r r% s
/2 0.e.r��ck-aprl
. '_'yj 4 *.l W � G h,,r— i'
Inspector Name -
y' l� W )-�
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

aintenmwe
Does the facility maintenance need improvemegt? Yes ❑ Nod'
Is there evidence of past discharge from any part of the operation? Yes ❑ NoW
Does record keeping need improvement? Yes ❑ Nq W
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes U NoM
Explain any Yes answers;
cc: Facility Assessment Unit
Drawings or Observations:
0
AOI — January 17,1996
i
Date:' b
Use Attachmenu (f Needed