820308_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

I
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit *Rtufine 0 Complai ® Follow 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:� Arrival Time: is 3C 'ap, Departure Time: :p� County: ��"'YRegion: �,
Farm Name: Owner Email:
Owner Name: Frn04= Phone: rA
0) 6 -?R
Mailing Address:
Physical Address:
Facility Contact: " 11'"'L11 `-� -Title:
Onsite Representative: LA
W
Certified Operator:
Back-up Operator:
Phone No:�„,
Integrator: _r ' "wK
oo
Operator Certification Number: ;Zyq
Back-up Certification Number:
Location of Farm: Latitude: = o = I = V Longitude: = o = I = "
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Designs Current's
' Deng = Current
Design Current
Swore.
Capacity Population
WetiPoultry,Capacily�Papulation
rim ��. -
Cat#le Capacity Population
❑ an to Finish
❑ La er
❑Dai Cow
❑ an to Feeder
❑ NA
❑Non -La er
❑Dai Calf
❑ Feeder to Finish
❑ No
"¢
❑ Dairy Heifer
❑ Farrow to Weani
Dry Poultry s4.
E] Dry Cow
❑ Farrow to Feeder
d. Does discharge bypass the waste management system? (I f yes, notify DWQ)
❑ Yes
❑ Non -Dairy
❑ Farrow to Finish
PIE
❑ La ers
❑ Beef Stocker
- ❑Gilts
❑ NA
❑Non -La ers
❑Beef Feeder
❑ Boars
❑ No
El Pullets
❑Beef Brood Co
other than from a discharge?
❑ Turkeys
-
Othier,„
Page 1 of 3
❑ Turkey Poults
Continued
❑ Otheris
❑ Other
z
Number oftructures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
❑ NA
FNE
/(
Discharge originated at: El Structure [I Application Field El Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
TE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
rNE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (I f yes, notify DWQ)
❑ Yes
❑ No
❑ NA
PIE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ No
❑ NA
tM NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
❑ No
❑ NA
%N I,
other than from a discharge?
Page 1 of 3
12/28/04
Continued

r
Facility Number: — `30S Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA QgNE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA WE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
❑ No ❑ NA�NE
(ie/ large trees, severe erosion, seepage, etc.)
❑ NA]
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
❑ No ❑ NANE
In
through a waste management or closure plan?
❑ No
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
❑ No ❑ NA NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
17. Does the facility lack adequate acreage for land application?
9. Does any part of the waste management system other than the waste structures require ❑ Yes
[]No ❑ NA NE
maintenance or improvement?
N NE
Waste Application
❑ Yes
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
❑ No ❑ NA PNE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
❑ No ❑ NA P NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
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
❑ NANE
YM
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
❑ No
❑ NA
VPNE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
N NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
19NE
Reviewer/inspector Name Phone:
ReviewerAnspector Signature: Date: MV -0-9
Page 2 of 3 1.2128/04 Continued

10 i
Facility Number: — Date of Inspection
Re uired 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 ❑ No ❑ NA PNE
the appropirate box.
❑ WUP ❑Checklists El Design [D Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No [INA r.9,&E
❑ 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
❑ No
❑ NA
�JNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
PNE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
;KNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
V3 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
NE
27.
Did the facility fait to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
PNE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
q TE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NANE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern'?
❑ Yes
❑ No
❑ NA
9bNE
If yes, contact a regional Air Quality representative immediately
ff
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NANE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
❑ No
❑ NA
1PNE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
$1NE
Additional Comments and/or DrawingsF'' + E �L"�
�
rJ
a� cop �S CQ Irks o,� S u se Swve-7
recce .. Bn' 1a7 ,
Page 3 of 3 12/28/04

0 Division of Water Quality
Facility Number 3Dg 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 7 as O Arrival Time: Departure Time: lo`,00 la+e County: � Gam` Region: A1W
Farm Name: � J, �_ Owner Email:
Owner Name: �� I `y , CJa`�Mn Phone:
Mailing Address:
Physical Address:
Facility Contact: 4l, b1lU PA Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator -
Operator Certification Number: gcoqU
Back-up Certification Number:
Location of Farm: Latitude: [—]0 0' M" Longitude: [:::]OM' M"
St. PDA Design CurrentDesign
❑ Yes on No
Current
—ulatioit
C1NE
Design Current
Swine tCapacity Population
�Wet'Poultry ' ,Cepactty�P,opr
Cattle
Capacity Population
❑ Wean to Finish
❑ Layer
® NA
❑ Dairy Cow
b. Did the discharge reach waters of the State? (if yes.. notify DWQ)
❑ Yes
❑ Wean to Feeder
10 Non -Layer I
❑ NE
❑ Dairy Calf
Feeder to Finis.; �3
hQ
""
El Dairy Heifer
❑ Yes
Farrow to WeanY 1 Dry Poult
ElD Cow
❑ Yes
❑ Farrow to Feeder
"
El Non -Dairy
❑ Yes
ElFarrow to Finish
❑ Layers
❑ NE
El Stocker
11PulleGilts
ayers
❑ Non-tLs
❑ Beef Feeder
12/28/04
ElBoars
❑
❑ Beef Brood Ca
.:
Other �+
❑ Turkeys
❑ Turkey Poults
❑Other
❑Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes on No
ElNA
C1NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
® NA
❑ NE
b. Did the discharge reach waters of the State? (if yes.. notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ipNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
1jTNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

r
Soil type(s) 42L)e fl I AV ; & 6, "gy�i►yt
Facility Number: Date of Inspection 7 D
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
CRNo
Waste Collection & Treatment
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
VNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
JJ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Is there a lack of properly operating waste application equipment?
❑ Yes
9 No
❑ NA
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
X 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
N 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?ym
Yes
❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
[:INA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes M 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 [:1 Application Outside of Area
12. Crop type(s) &-K,L�l�1QG�`J / So -,6,2 r_5
13.
Soil type(s) 42L)e fl I AV ; & 6, "gy�i►yt
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
CRNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
T No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
V1 No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
10 No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
9 No
❑ NA
❑ NE
6, MOO) fa-ypn kaAVS ard S(Bjal�
015 56011- 45- -Rs4 le.
Reviewer/Inspector Name �� --� Phone:
Reviewer/Inspector Signature: Date: 7 D�
Page 2 of 3 12/28/04 Continued

Facility Number: ;�r Q Date of Inspection
Required 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 No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design g C1 Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No [:INA ❑ 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
)� No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,9 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?
F,Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
4 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
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?
❑ YesNo
Ir
ElNA
[__1NE
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
`P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did ReviewerAnspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional C. 6mments add/or Draws gs mss"
�L
I(iJc-lm caw
CD� x, + C
Id
Page 3 of 3 12/28/04

0 Division of Water Quality
Facility Number $ a 0 Division of Soil and Water Conservation
- - 0 Other Agency -
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Q r] Arrival Time: Departure Time: County: s� Region:
Farm Name: Owner Email:
Owner Name:'y_1 Phone:
Mailing Address:
Physical Address:
Facility Contact: Fl �eL f `GLS. �'? Title: Phone No:
Onsite Representative: Integrator: _ YA UA f0yln
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 09 =d =14 Longitude: =1 o =I =
"Design ..Cc
swine`Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish 12,900
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Design Current
Wet Poultry Capacity Population
❑
Layer
❑ Non -La et
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?
r�
Design Currents :i
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
e. 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
❑ Yes ❑ No [PNA
❑ NE
❑ Yes qLNo ❑ NA
❑ NE
❑ Yes IPNo ❑ NA
EINE
12/28/04 Continued

4
Facility Number: —�306 Date of inspection
❑ Yes
EF No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
1P No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�No
ElNA
ElNE
a. if yes, is waste level into the structural freeboard?
❑Yes
❑No
YNA
❑ NE
Str cture 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: d�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): SO a R
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
R 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
U1 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ YesNo ElNA ElNE
(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/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
EF No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
P No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
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):
Reviewer/Inspector Name '4-~
/v 16 Phone: ,V��`3349
ReviewerAnspector Signature: Date:
12/28/04 Continued

I
D �
Facility Number: a — Date of Inspection
Re uired 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 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes JQNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[WNo
❑ 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
ftNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
UNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
nNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
W 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
EpNo
❑ 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
EP 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
`INo
[:1 NA
El NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
1RNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
12/28/04

Type of Visit r♦ Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of visit:I 1 3 o Arrival Time: DCiOaf Departure Time: County: OlJ Region:
Farm Name: -odum a Owner Email:
Owner Name: _ Frn I"i .. %C0C3 um Phone: CIO, 5qa b'd. t _
Mailing Address: 49q p oseb 'r o 4.�/ t� 4M1TOr 13 C11
�3 d -B
Pbvsical Address:
Facility Contact: A'.;n tieu ahL M Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Curren'
Swine Capacity Populatic
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone No:
Integrator:
Operator Certification Number: C2-wyy
Back-up Certification Number:
Latitude: E�] o =' = Longitude: ❑ ° ❑ A
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ iurkey 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?
Cattle
Design ` Current
Capacity.. Population:._.
❑ Dai Cow
❑ Dairy Calf
❑ Dairy Heifek
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood CoNd
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes R No ❑ NA ❑ NE
❑ Yes
❑ No
§a NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
�9 NA
EINE
❑ Yes
❑ No
❑ Yes
F� No
❑ NA
❑ NE
❑ Yes
q,No
❑ NA
❑ NE
12/28/04 Continued

Facility Number: g.rk 3 Date of Inspection tl Ob
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [�iA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a u aviol
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
rP 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
V No
❑ NA EINE
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
In No
❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[P_ No
❑ 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.
❑ Yes
[� No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of
Area
12. Crop type(s)
Qqs
4
13. Soil type(s) Nei A 00 � Wa16
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
N No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[j] No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'
j Yes
QQ No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[P No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PNo
❑ NA ❑ NE
Comments (refer to question ft Explain. any YES answers andfor any recommendations or any -other comment&
Use drawings of facility to better explain situations. (use additional pages as necessary): n
ReAewer/inspector Name Marbte. Phone: amp3Uov
Reviewer/inspector Signature: Date: /4/5/21) 6
Continued

Facility Number: —3 Date of Inspection
Required 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 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design g ❑Maps E] 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 tp 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
[ONo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
5
W No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P9 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
0 NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
LYNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
IKI 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
0 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 I.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings: p r=4.
12/28/04
12/28/04

r.
Type of Visit a Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival
Time: D'r70 Departure Time: County: Region: Flo
Farm Name: _ ��.[u, _rL Owner Email:
Owner Name: .. '/'ncST _t�c�un, Phone: 9/D` S9a - G2..ze
Mailing Address: 5/71/0 - Qjpl7oro Hiah c✓a . C/11 932 NL — _ X 832 �
Physical Address:
Facility Contact: Xs�le.. OriurnTitle:
Onsite Representative: 14JA/11 U /a,
Certified Operator: _ �sjt%� _ 42CLM
Back-up Operator:
Phone No:
Integrator: ev A)e " drOi.117
Operator Certification Number: _2b0 `1!Y
Back-up Certification Number:
Location of Farm: Latitude: 0 n F—J ' ❑ « Longitude: E�] ° =' ='
Swine.
❑ Wean to Finish
❑ Wean to Feeder
�eeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other.
❑ Other
Design Current Design Current
Capacity Population Wet Poultry . Capacity Population
I ❑ La er
❑ Non -La el
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 Heifei j
QDry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
_ Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
El Yes 04o" El NA El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
El NE
❑ Yes
El Yes
�❑ VNNo
1/o
El NA
El NE
El Yes
hJ�
L� No
❑ NA
❑ NE
12/28/04 Continued

• Facility Number: — Date of Inspection
Dl o
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
Waste Collection & Treatment
9. Does any part of the waste management system other than the waste structures require ❑ Yes
9<O
❑ NA ❑ NE
maintenance or improvement?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
allo
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure i Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
�/- r
Identifier:
❑ PAN ❑ PAN > l0% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
Spillway?: 2 AO
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
73 4—Op ioy ) 7� �� v
12. Crop type(s) � ar n &14e cc SOec..j S
Designed Freeboard (in):
--
13. Soil type(s) 6V,
Observed Freeboard (in): AT
❑ No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
a`No
❑ NA ❑ NE
I6. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'![] Yes
El -No
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
21' o
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
❑ NA ❑ NE
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
ON—o
❑ 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
[2io
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
Dl 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
9<O
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
ENo
❑ NA ❑ NE
maintenance/improvement?
1 I . Is there evidence of incorrect application? 1 f yes, check the appropriate box below. ❑ Yes
EjNO
[]NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
73 4—Op ioy ) 7� �� v
12. Crop type(s) � ar n &14e cc SOec..j S
--
13. Soil type(s) 6V,
14. Do the receiving crops differ from those designated in the CAWMP? les
❑ No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
a`No
❑ NA ❑ NE
I6. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'![] Yes
El -No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
[�I No
❑ NA Q'NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
L-�'No
❑ NA ❑ NE
141, /Q Ile t -;{A UAn �Qa:��, at V1� elle =/PR -r27�'drr,�s . 4 -7 r OvtrkPd s I• rJ'rcS e� F
—,RRdor.., 6ul 'Vi Ale waste *o/110/7, Ple,tse c, ecC 1,4e N /law/es also,
Reviewer/Inspector Name I/1'jQr-k Qr� P✓ f";= �g Phone: DO -l8t:`IS`1/ eei73o
Reviewer/Inspector Signature: Date:
i.611.401U1# *-UMA"Ur"

Facility Number-, ,,�L — O Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available'?
9 -fes ❑ No ❑ NA ❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
[t. -'¢es
❑ No
❑ NA
❑ NE
s
the appropirate box. ❑ ❑ C fists 0k�esign ❑ Chef
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
21-
Does record keeping need improvement? If yes, check the appropriate box below.
<0 4y4C-,O. (,g ,d r5 -J l.,;- 2-ifj> 0.Iq
❑ Yes
W4o
❑ NA
❑ NE
❑ Witste App4uatien ❑ W4elcLy_Ewx)_eard ❑psis ❑ Sei.l-�is ❑ W-as{eTTansfers
❑
❑ Yes
tion
❑ NA
❑ Rainfall ❑ Steeking ❑ Grep-*ield ❑ 120 Minute hispeMMIT ❑t
nspec ions,
Weath6r"�Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
�❑
MHlo'
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
M -Mo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M -Ko
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
9Nf
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Q No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
2F4 E
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes '(' No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
9 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
s
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
�No
El NA
El 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
2 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
2,<o
El NA
❑ NE
33. Does facility require a follow-up visit by same agency?
Yes
El2
No
❑ NA
❑ NE
QQ�Q � z
Addihona]ECotnmentsand/ar.Drawin s '
10 er r,, 71 r.,.as P, -,os e, �Ae Cer �, �`, �k �c � f Cou��a� e w4.s .:of
O- Need d 010re
y S w1CGrrin /'fear
s
12/28/04

I
Type of Visit 4B Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit ®Routine O Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
(late of Visit: t '0 i Time: ,1 V
Facility Number
EK
,.7.,/ Not erational Below Threshold
E� Permitted LCertified [3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: oa&n Furor jqr.2 County: Sd7P"4 cdj3 D
Owner Name: rged De/dvn Phone No: Wo - ,S'1-9�7- 38_
Mailing Address: y71f0 /Qd100-idr10 a,'4 A wa v C/-' NL 2J392
Facility Contact: _ 45AI6 Ddy+n Title: Phone No:
Onsite Representative: — 19s4/0x Integrator: IVV TAv/ - A rOW4
Certified Operator: 144k0_1 CIc%v n, Operator Certification Number: 240 '1!Y
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �` Longitude rte'
xNiimbtr of Lagaibns '` [] Subsurface Drains Present ❑ La oon Area ❑ 5 rsv Field Areae
Holding Ponds 1 Solid' -Traps ❑ No Liquid Waste Mana ement System
Discharges S Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Lagoon El Spray Field El 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 DV1'Q)
c. If discharge is observed. what is the estimated flow' in pal/min?
d. Does discharge bypass a lagoon system? (If yes, notifv DWQ)
2. Is there evidence of past discharge from any pan of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection d: Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05/03/01
❑ Yes ❑-K0,
❑ Yes Eo
❑ Yes PNO
❑ Yes
ED.N6-
❑ Yes
EEKo
❑ Yes
El Yes
�[..lNoo
L} -No
Structure 6
Continued

a
Facility Number:
Date of inspection '7 O
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Q -Ko
seepage, etc.)' " "
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or ❑ Yes ElNo
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 [3io
8_ Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes G -Ko
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes C3,No
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes UX0
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes EaNo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type C vrn . W�ea d Zp,<
I3. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes EM
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
I9. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes Edo
❑ Yes ®.W
❑ Yes [ .Ncr
❑ Yes B -No
❑ Yes MNo
❑ Yes ❑ No
❑ Yes [91To
❑ Yes 01-wo
❑ Yes 0.1140
Comments (mer W guestsoa _P! any YESanswess andlor a� recom�adaizons trr anp ot6ernommrnts.�
f
ilse drawuegs of fariLty to better elaxa 5ttiilahoas. (ase addibanal psgesyas necessa:}'i field COPY ❑Final Note,
' T
} T
Reviewer ector Name �y
IInsp �LtI'A Al Ile
ReviewerAnspector Signature: Date: 7-1- 0'y
12112103 Continued

Facility Number: g' — a Date of inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[c }-Pitt
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
rhe Sa.0
I'
� S U1ell
a'"
(ie/)bG ; cbaeit f; deeigr maps, etc.)
❑ Yes
0446
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes'
❑ tc on ❑ r3 ❑ Wasw1 is ysysis ❑ S liTg
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
dc'S%, 1109 Oedv d 10900 1,
25. Did Did the facility fail to have a actively certified operator in charge?
❑ Yes
[JNe
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
[tea
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
28. Does facility require a follow-up visit by same agency?
❑ Yes
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Epq6-
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required fomes need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crap Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visiL
dditioaal Comments and/or Dravvmgs - -
rhe Sa.0
I'
� S U1ell
a'"
A,
Pit. 0a/✓r �s
WO.'f�.n9 i GI�Pi,�9 SO,r•a �vna� �v od� fv A.S
tvaSit/w,7
J/af pttcns Ta
dc'S%, 1109 Oedv d 10900 1,
12112103

Facility Number.-_& 3 0
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
. Date -,) /0 4 04
Time: Id- • 10
General Info
Faun Name: _ )!R)S Fw-,, _ /w County: s
Owner. Nam• �a,,. r � c:.1 -c •e.r- C' Phone NOS' ,17a y
On Site Representativez r -t; Lrtegrmr. ( 'k.,
MailingAddress: /.�66,�L��S
Physical
Latitude:3qS5-0_ Longitude: '7$ / 2;2_ l.2 7
erati n Description: (based on design eharaeteristim)
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
O sow O Layer O Dalry
❑ Nwusay O Non -Layer O Beef I,
O Feeder
GtherType of ,livestock J: , •�' s Number of Animals:
Number of LagooIIS: •..9- _ (include is the Drawings and Observations the freebamd of each lagoon)
aciii ns •
Lagoon
Is Iagoon(s) freeboard less than I foot + 25 year 24 hour storm storage?: Yes ❑ N01W
Is seepage observed from the Iagoon?: - Yes 0 Na`R—
Is erosion observed?: Yes ❑ Not
Is any discharge observed? Yes O NOW
© Man-made ❑ Not Man-made
Cover Chop
Does the facility need more acreage for spraying?:
Does the cover crop need improvement?:
( list the crops which rued irnproveniettt)
Crop type, - na ,4.-p Acreage:
Setback Criteria
Is a dwelling located within 200 feet of waste application?
Is a well located within 100 feet of waste application?
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream?
AOI -- January 17AM
Yes D No)S
Yes 0 No
Yes O
Yes ❑
Yes O
Yes ❑
NdA3-,
No &F
Nop
No,i3
01�

aintenance
-.Does the facility maintenance need improvement? Yes ❑ Nco;C
Is them evidence of past discharge from any part of the operation? Yes D Nok
Does record keeping need improvement? Yes © NoV
Did the facility fail to have a copy of the Animal Waste Management Plan on see? Yes 0 NoA
Explain any Yes answers: --
Signature: Date:'
cc Facility Assessment Unit
Drawings or �Observatio
L, f
ADI — January 17,19%
Use Attachments ¢Needed