820376_INSPECTIONS_20171231

NORTH CAROLINA ..�
Department of Environmental Qual

[Type of visit: ti�i ompliance Inspection
Reason for Visit: ( Routine O Compt
Operation Review U Structure Evaluation V Technical Assistance
O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: fop Departure Time: County: s
Farm Name: `Jj�,�� % Owner Email:
Owner Name: �� -.3 r it At f ILri Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: ao'i15 • Title: Phone:
Onsite Representative: Integrator:
Certified Operator: / a -I 0, vt Certification Number: 19-J62—
Back-up
9-J6ZBack-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Imoacts
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 outer than from a discharge?
❑ Yes QNB❑ NA ❑ NE
[]Yes ❑ No OfiTA ❑ NE
[:]Yes ❑ No [g -MA ❑ NE
❑ Yes
Design Current
[3 A
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Zia e
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
@urrent
Dry Cow
Farrow to Feeder
D , P.onit .
Ca aci
P,o .
Non -Dairy
Farrow to Finish
I Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
jPullets
Beef Brood Cow
Turkeys
Qther
Turkey Poults
Other
Other
Discharges and Stream Imoacts
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 outer than from a discharge?
❑ Yes QNB❑ NA ❑ NE
[]Yes ❑ No OfiTA ❑ NE
[:]Yes ❑ No [g -MA ❑ NE
❑ Yes
0 No
[3 A
❑ NE
❑ Yes
Ep<<o
[] NA
❑ NE
❑ Yes
['No
❑ NA
❑ NE
Page I of 3 214/2015 Continued

iFacility Number: - R 7 IDate of Inspection:
Ej<o
❑ Yes
Eg- o
❑ Yes
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[]'Ito
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑- lgA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3C>
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
®14o_
❑ 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
❑moo
❑ 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
-1
M N -o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0-Vio
❑ 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
I__I qZ
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E3 -No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes EJ<0 ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window f l E] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 3 e -r yk - t7 ez cS(, C)
13. Soil Type(s): Maw v v to
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes
Ej<o
❑ Yes
Eg- o
❑ Yes
02-fio
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes E94o ❑ NA ❑ NE
❑ Yes i<'_
❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes [ <o❑ NA E]NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ ❑No Yes ❑ 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 [;,Nrr_ ❑ 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 E3 -<o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ENo [] NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facili Number: ?2-- 976 Date of Inspection. jW
24. Did the -facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Lj3-?"u ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes - [Ej'1 A� ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a AOA 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 �Vo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? 0 Yes [1>6 ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[� o
❑ 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
g�Ko
❑ 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
No
❑ NA
[] NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[!j'No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EE Ro
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
F2X10
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
F3io
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of facility to better explain situations fuse additional naees as necessarv).
Reviewer/inspector Name:
Reviewer/Inspector Signatu
Page 3 of 3
C7 o 3-t( 3 = 7 N Y67,
U JAO Phone: jID- X3 3- 333
re: ILAQ Date: l
2/4,C 1 S

Type of visit: GrCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 3 j Arrival Time: tls Departure Time: I A9r. County:
Farm Name: �S�ec�c-c�' Owner Email:
Owner Name: F"-YN,L_5. - _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Or, 't� 4.�'[✓c Title:
Onsite Representative:
r/
Certified Operator: ��` �tqc-Z C•r`j�
Back-up Operator:
Location of Farm:
Latitude:
�— J1_ Region: 1K
Phone:
Integrator: IA
Certification Number:
Certification Number:
Longitude:
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?
❑ Yes O-Xv--❑ NA [_]NE
[:]Yes
Destgn Currentki Designs,
�;
Current
Design Current
Swino .
Capac�t3; Pop VVet l?onit .
Capacity.
Pop.
Cattle Capacity Pop.
Finish
La er
Dai Cow
o Feeder
WOO , 10 Non -La er
Dai Calf
Uno
to Finish
�r
Y�
;
`Design
Dai Heifer
to Wean
Current
ll Cow
to Feeder
Dr`Poult ,
Ca act P,o
-Dairy
to Finish
La ers
Beef Stocker
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
M1 Turkeys
JO�therTurke
Points
her
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?
❑ Yes O-Xv--❑ NA [_]NE
[:]Yes
❑ No
❑ NA
EINE
[:]Yes
❑ No
NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
❑ No
❑ Yes
E3"fqo
❑ Yes
E:fNo
❑ rA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 2/4/2015 Continued

Facili Number: , % Date of Inspection: 3 H
OF
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 Ea -11;'X- ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 i
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 Id"'c
❑ 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?
❑ Yesala
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes b3 N
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NA
❑ NE
acres determination?
9. Does any part of the waste management system other than the waste structures require
❑ Yes [a -go-
❑ NA
❑ NE
maintenance or improvement?
❑ Yes
31N o
❑ NA
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes eNo
❑ NA
❑ NE
maintenance or improvement'?
❑ NE
Required Records & Documents
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Q o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, 7n, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): "o :�6- r , L/
13. Soil Type(s): u �a Of
14. Do the receiving crops differ from those designatJin the CAWMP?
❑ Yes
�o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
E"No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[n"'No
❑ NA
❑ NE
acres determination?
17. Docs the facility lack adequate acreage for land application?
❑ Yes
31N o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[1] No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[INo
❑ 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.
❑WUF ❑Checklists [:]Design ❑Maps ❑ Lease Agreements E] Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes E o
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes RfNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes U!�No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA []NE
❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

IFacility Number: Z -: Date of Inspection: 23 Mi t7
2d. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes R<0
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes DN"D
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 [240
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes L2'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 Rev i ewerA nspector 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 ONo ❑ NA ❑ NE
❑ Yes U No ❑ NA ❑ NE
El Yes PNo ❑ NA ❑ NE
E] Yes �No ❑ NA ❑ NE
❑ Yes Ptoo
❑ Yes 0
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ 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).
�� I trU Pcd r o ✓1 `� Q^.
X3
V )J -Y& 3, Z- f - 3, 6?
-92--La Cg(
Reviewer/Inspector Name:
Reviewer/[nspector Signature:
Page 3 of 3
Phone: %)— T J —, 3
Date: ffic
2/4/2015

Type of Visit: Q"Coriapliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 04to-utine O Complaint O Follow-up O Referral O Emergency Q Other O Denied Access 4
Date of Visit: Arrival Time: Departure Time: County: g hC Region:
;_�7�
Farm Name: 3T= L Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: C4 .a, r, 5 a LC.r " Title: Phone:
Onsite Representative: tt Integrator: 043
Certified Operator:EG Certification Number: / 0.362 -
Back -up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Desegn Current
Swine Capacity .Pop.
Wean to Finish
Wet Pouflry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
on -Layer
Dairy Calf
Feeder to Finish
li'
Dairy Heifer
Farrow to Wean
Desi
urren
Dry Cow
Farrow to Feeder.
a acii
P,a .
Non-DairL
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
f r``
Turkeys
Other t_t." °'s
Turkey Poults
Other
Other
Discharges and Stream Im acts
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)?
[:]Yes R'ITo- ❑ NA ❑ NE
❑ Yes [—]No �❑ NE
❑Yes E]NoA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [-]Yes ❑ No 6NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ��o ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ErNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2015 Continued

FaciliNumber: - nc jDate of Ins ection: Jtic
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [—]Yes Q44o❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [—]Yes ❑No Q-NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[jj'N'5
❑ NA
Spillway?:
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
EJNb
❑ NA
Designed Freeboard (in):
acres determination?
Observed Freeboard (in):
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑-<o
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2 .No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[!I<o
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
g3 -<o
❑ NA
❑ NE
waste management or closure plan?
the appropriate box.
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
C3.N-00
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
Q 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
S -Ko
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
[2 -Ko
❑ NA
❑ NE
maintenance or improvement?
I I . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E3-1 o ❑ 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 Approved Arca
12. Crop Type(s): ,i] 5, 6L�11
13. Soil Type(s):
14. Do the receiving crops differ from those designhted in the CAWMP?
❑ Yes
Uj Xu
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[jj'N'5
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
EJNb
❑ 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
0'90
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[!I<o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[B 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 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes WNo
C] NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Facility Number: Date of tns ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ -NiT- ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes [3-o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? [:]Yes I� Ivo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [B -No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [�o ❑ NA ❑ NE
and report mortality rates that were higher than normal? f
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes 31 ❑ 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 '[DINo ❑ 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 ETNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 8 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes [] o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes eNo ❑ NA ❑ NE
Comments (refer to question #I): Explain any YES answers and/or any additional recommendations or any other,comment's
Use drawings sof Wility to better explain situations (use additional pages as necessary). �W
C t4, 611
t
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: j 4'
Date: L�
2/4/2011

Z
Type of Visit: &Compliance Inspection O Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: Q4outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
13 i
Date of Visit: Arrival Time: Departure Time:! ► d, County: •Ss V �'c Region:
r
Farm Name: v S Owner Email:
Owner Name: 4 t)zz Phone:
Mailing Address:
Physical Address:
Facility Contact: u.S4 s; &^W �f Title:
Onsite Representative:
Certified Operator: R
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: A 61
Certification Number:
Certification Number:
Longitude:
IMp
���1�,� I1
Design Current �I)esign Current'' Design Current
ultry V.Gapacity a
Swine
Capacity Pop r. Wet P , Pop Cattle Capacity Pop:.
Wean to Finish
La er Dairy Cow
Wean to Feeder
00 O Non -Layer ' Dairy Calf
Feeder to Finish,.
Farrow to Wean!
Dairy Heifer
'Design Dry Cow
Farrow to Feeder
I] P. oult Ca aei R_o r. Non -Dairy
Farrow to Finish
ILayers Beef Stocker
Gilts
Non -Layers Beef Feeder
f
BoarsPullets:
Beef Brood Cow
. _,
- k,
Turke s4
Other
Other
_ F ila Turke Poults--
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [3-M--❑ NA ❑ NE
❑ Yes [—]No
[:]Yes ❑ No
❑ Yes [:]No
❑ Yes �fo
❑ Yes
Eq -?4-X ❑ NE
L� <A ❑ NE
ff'NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 2/4/2011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Z.N6 ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [—]No [DNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NE
Identifier:
❑'iso
❑ NA
❑ NE
❑ Yes
Spillway?:
❑ NA
❑ NE
Designed Freeboard (in):
Observed Freeboard (in): tj --
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
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?
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
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
C::�6
❑ NA
ONE
(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
❑-Iqo'—
0 NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2110
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes afo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): _ 13 ey-L 0
13. Soil Type(s):
14. Do the receiving crops differ from those designated Ithe CAWMP?
15. Does the receiving crop and/or land application site need improvement'?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reciuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
(D -No
❑ NA
❑ NE
❑ Yes
❑'iso
❑ NA
❑ NE
❑ Yes
FPT14o
❑ NA
❑ NE
❑ Yes Callo ❑ NA ❑ NE
[:]Yes [?"No ❑ NA ❑ NE
❑ Yes [; kNo ❑ NA ❑ NE
❑ Yes [3 No ❑ NA ❑ NE
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other.
21 _ Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E3"'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes EjrNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Eio ❑ 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 D -No ❑ NA 0 NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Q -No 0 NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[J -Na-
❑ 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
El No
❑ 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
EfrNo
❑ 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
D -i' o—
❑ NA
❑ NE
❑ Application Field 0 Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑.#o ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative? ❑ Yes [ o 0 NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes E o ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
214!2014

Type of Visit:Com ance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
1L
Date of Visit: 1 Arrival Time: Departure Time: c County: irk
Farm Name: %UtP'L + Owner Email:
Owner Name: "ADS �dl 'K_S _ Phone:
Mailing Address:
Physical Address:
Facility Contact:
-�i"
i�L4) C Title:
Phone:
Onsite Representative:
Design Current
Cattle Capacity Pop.
Dai Cow
f
Integrator: y
Certified Operator: 11`ocJlA (wCo &&A Certification Number: / y
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
_D_ischarees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Design .._Current
Swine Capacity Pop.
an to Finish
R'et PouitryF
Layer
Design .Current
Capacity
`Pdp.
Design Current
Cattle Capacity Pop.
Dai Cow
an to Feeder
Non -Layer
D , P,oul .
La ers
Non -La ers
-` ` '
"Design
Ca aei"Non-Dairow
_'
Current
Dai Calf
Dai Heifer
D Cow
ry
Beef Stocker
Beef Feeder
der to Finish
row to Wean
TFarrow
to Feeder
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
to Finish
ts
[D -NA
Boars
Pullets
Beef Brood Cow
Qther
Turkeys
Turkey Poults
❑ No
Other Other'
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
_D_ischarees and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
®-#U`❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[D -NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
2-11A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Q -No
❑ NA
❑ NE
of the State other than from a discharge'?
Page I of 3 2/412011 Continued

FaciliNumber: - Date of Ins ection: (
Waste Collection & Treatment
4. 1s storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes ❑sYa—NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:]yes ❑INo �N , ❑ NE
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 [�"iQo ❑ 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 ago�❑ 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
QV -o'
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
044t-❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
M. [:INA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
9. Does any part of the waste management system other than the waste structures require
❑ Yes
G3
❑ NA
❑ NE
maintenance or improvement?
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[fNo ❑ NA
❑ NE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
EfNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN a 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptab!g Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 11b1r1VKV64V
13. Soil Type(s):Q'�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [T] Nw-1 ] NA ❑ NE
T/
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑bio- ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Q>- ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
M. [:INA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ul>�0 NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[fNo ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9<0 ❑ NA ❑ NE
the appropriate box.
❑WUP [-]Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes o ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facil�Number: Date of Inspection: A
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [Zjbiq— NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 01 10FMNA ❑ 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 ❑ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ 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? ❑ Yes [:]No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes ❑ No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ No ❑ NA ❑ NE
F
mments (refer to question # ): Explain any YES answers and/or any additional recommendations or any-other.com"ments..e drawings_of facility to better explain situations (use additional pages as necessary).
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature: Date: i ---`
Page 3 of 3 2/4/2011

Ii%'ype ui visit: r7Routine
«ance inspection v Lpperanon xeview V Structure ilvaluation U Iecttnical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency Q Other Q Denied Access
Date of Visit: �Aa 1 a Arrival Time: Departure Time: !Od County: 5n fnSa Region: RO
Farm Name: "�ALLWcoe,Owner Email:
Owner Name: APhone:
Mailing Address:
Physical Address:
Facility Contact: CU s- ] � R �� ck Title: 7101" � p Z� r Phone:
Onsite Representative: A) (A ML
Certified Operator: p Ntp tC . �Ai�1iUA�t
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current_ Design Current
Capacity Plop.`°Vet C'oultry Capacity Pop.
Layer
Design C+urgent
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
lNon-La er
c. What is the estimated volume that reached waters of the State (gallons)?
Dairy Calf
Feeder to Finish
❑ Yes
Dairy Heifer
Farrow to Wean,
-F.
Design
Current
Dry Cow
Farrow to Feeder
©ry`:Poul .'
Ca _aci
P,o
Non -Dairy
Farrow to Finish
La ers
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Beef Stocker
Gilts
Non -Layers
of the State other than from a discharge?
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
I IOther
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?
❑ Yes No ❑ NA ❑ NE
❑ Yes [:]No []SNA ❑ 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 the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
[gNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[�No
[:]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 I of 3 2/4/2011 Continued

[Facility Number: b cl 7 Date of Inspection: tl a5'
❑ Yes
[]i 'No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[2"No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
FZNA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier: �]
Required Records & Documents
Spillway?:
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[2No
❑ NA
Designed Freeboard (in): t
20. Does the facility fail to have all components of the CAWW readily available? If yes, check
[:]Yes
[5No
❑ NA
Observed Freeboard (in): 'a V
the appropriate box.
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
ff No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
21. Does record keeping need improvement? If yes, check the appropriate box below.
[—]Yes
[dNo
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[]'No
❑ NA
❑ NE
waste management or closure plan?
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[3/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
ff No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
gNo
❑ 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
E!fNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
gNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [—]Yes [gNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN 7 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): F R p
13. Soil Type(s): W` Pq Re. - Q- ({0
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [gNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[]i '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?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
D No
❑ NA
❑ WE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[2No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWW readily available? If yes, check
[:]Yes
[5No
❑ 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
[dNo
❑ 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
[3/No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[:]No
gNA
❑ NE
Page 2 of 3
2/42011 Continued

Facili Number: ya- �7 '74 1 jDate of Inspection: Lj l
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes CgrNo
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 Iagoon
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 [OoNo
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 p 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 gNo ❑ NA ❑ NE
❑ Yes [y No 0 NA ❑ NE
[:]Yes [�(No ❑ NA ❑ NE
❑ Yes gNo ❑ NA 0 NE
❑ Yes
dNo
❑ NA
❑ NE
❑ Yes
[dNo
❑ NA
❑ NE
❑ Yes
[yNo
❑ NA
❑ NE
tac�c�C S �-g-�S Oce �rszA� p� 1-nsoor.� cv�a� p�r�p �'�£A. ~sb.� R�sr
to �hL ic�� �� o� ia�cc�s.� l vvcZ�p �a�S�rZ�+-� �o Q -T
G -P
ReviewerlInspector Name
ReviewerlInspector Signature:
Page 3 of 3
Phone: Gila 3US3` Cori51
c
Date: %'as
2/4/2011

Visit: WCompliance Inspection V Operation Review V Structure Evaluation Q Technical Assistance
for Visit: �utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: eparture Time: �j� ; County: Region:
Farm Name:/ Owner Email:
Owner Name: AT I tJc_ Phone:
Mailing Address:
Physical Address:
Facility Contact: 5 `3GLt_Lt 1 L C—L_ Title: eL 15_e—_ Phone:
Onsite Representative: 6'(A rnr e_ Integrator: l )
—izCertified Operator: vd_Certification Number: o�
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
❑No
Design
Current
Design Current
Swine @apaci#y Pop.
Wet Poultry
Capaciky
P.op.
Cattle Capacity Pop.
❑ NA
Wean to Finish
La er
Da' Cow
Wean to Feeder
Non -La er
Da Calf
Feeder to Finish
_
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . P,oult .
Ca aci.
P,o -
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
MI Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system`? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[]Yes Rlo ❑ NA ❑ NE
[—]Yes
❑No
P4A
❑ NE
❑ Yes
❑ No
[J WA
❑ NE
❑ Yes
❑ No
P_?�A
❑ NE
❑ Yes
g -No
❑ NA
❑ NE
❑ Yes
UR -No
❑ NA
❑ NE
Page 1 of 3 214/2011 Continued

Facifi Number: jDate of Ins ection: p
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes EfNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [}. KA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):•—
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
B<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
031<
❑ 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
[L. fo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
(D'ITo
❑ 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
[214o
❑ 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
Pld""'
❑ 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): S b
13. Soil Type(s): (,1Ara r.�
14. Do the receiving crops differ from those designated in the AWMP?
❑ Yes
IRKO
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
J2'Ko—
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
g�Ko
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E3<o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Bl<o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
LJ 1"O
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[Z4_NK
❑ 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 a Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E<o ❑ NSA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No [R'111A ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: 62
•24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q ],No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ISO ❑ 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 L�J'"ivo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No B-lqX'-❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[] Yes
luso
❑ 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
IJ'rao
❑ 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
Q -Mo'
❑ 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
[R -Ko
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EjWo'
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[Z] -No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[gNT
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any -additional recommendations oranyiother-comments 4
Use:drawings of facility to better explain situations (use additionalpages as necessary). ,, £
e c i A.-scc
L l'.It del r�5
Reviewer/Inspector N
Reviewer/inspector
Page 3 of 3
Phone:
Date:
/ZA Z 4Z
2/4/2011

BzHIS 2 - 05,- zO io
Type of Visit (E'Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine O Complaint 0 Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit:ZSn-/O Arrival Time: �,0� Departure Time: �Z %3o County: 0 Region: AW
Farm Name: 1 D T
Owner Email:
Owner Name: �{ft' L✓ VA -e.-/ _ Phone:
Mailing Address:
Physical Address:
J ef,F t..IQYY�N owwr�v-
Facility Contact:—C__ix,Kk`s !;vk -ws4L� Title: —7'4c� • S ,�c�. Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: E__10 1=1' EJu Longitude: E=101='
u
PDesij Current
Design Current
Design Current
Swine Capacity Population
Wet Paaltry Capaeif, Populatiou
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
' "Wean to Feeder 00 1 (p70 d
❑Non -La er
❑ Yes
❑ Dai Calf
❑ Feeder to Finish
G o
❑ Dairy Heifer
❑ Farrow to Wean
Dry poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ NE
ElNon-Dairy
El Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turke s
Uther
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes L"J No ❑ NA ❑ NE
❑ Yes
[--]No
A
[:1NE
❑ Yes
❑ No
�BIN
L 3 NA
❑ NE
LINA
❑ NE
❑ Yes
[--]No
❑ Yes
G o
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128/04 Continued

Facility Number: 8Z 37(o Date of Inspection I-213—/0
❑ NA
❑ NE
Waste Collection & Treatment
[INA
ElNE
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ffrNo [INA [__1 NE
a. If yes, is waste level into the structural freeboard?
El Yes
,f,
Bl o ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z �f
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
D<o ❑ NA EINE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
2<- ❑ 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
2<0 El NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
Qj< ❑ 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
ElL�
,�
'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
ElL7 Yes
��
No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ONo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 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. Croptype(s) Bc✓iKuc�a. �t.�) 5,,,,4r1 G,+�,`N �p�S.�
.
13. Soil type(s) q /Yt 44-- s!
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination', ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
R—No
❑ NA
❑ NE
Er<oo
[INA
ElNE
0No
[:1 NA
El NE
VNN [__1NA ElNE
❑ NA ❑ NE
Reviewer/Inspector Name r"c I g S _ . Phone: 914. X133.3 ?>0a
Reviewer/Inspector Signature: Date: 1-219 — ZQl O
12/28/04 Continued

C , J
Facility Number: 92 -37i, 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 D leo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Io ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfer; ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rain Inspections ❑ W er 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 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?
Comments and/or Drawings:
❑ Yes Z<o ❑ NA' ❑ NE
❑ Yes
No
❑ NA
El NE
El Yes
�©<
L7 No
❑ NA
❑ NE
❑ Yes
R Z
❑ NA
❑ NE
❑ Yes
D<o
❑ NA
❑ NE
❑ Yes LJ No ❑ NA ❑ NE
❑ Yes Z rNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
HTNo
❑ NA
❑ NE
❑ Yes
E No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12/28/(4

$.ZWS /D-67- Z66'?
0_6i'V'i­s-on of Water Quality
Facility Number Z 37 0 Division of Soil and Water Conservation
-- - -- 0 Other Agency
I
Type of Visit Otompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 9�I(p -b`% Arrival Time: /2i W. Departure Time: //T County. -� ~ Region: ZE-460
Farm Name: Ab S /ars!! z # � Owner Email:
Owner Name: _ t G'frt�,�r //j4 we Nj Phone:
Mailing Address:
Physical Address:
W a
Facility Contact:
Title: �Iex4. Ss-,� f Phone No:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Operator Certification Number:
Back-up Certification Number:
Latitude: 0o
=4
Longitude: =0=' °=
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Wfan to Finish I❑ La er
PI'Vean to Feeder 2,d0 1 &07 1 IEI_Nori-Laycj
❑ Feeder to Finish 11
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -La ers
❑ 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 than -made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: FLI
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 TNo ❑ NA ❑ NE
❑ Yes
❑ No
hIA
EINE
❑ Yes
El No
�,
IA
EINE
ETNA
❑ NE
❑ Yes
No
El Yes
�❑l
L'7 No
❑ NA
EINE
❑ Yes 2<o' ❑ NA ❑ NE
11/28104 Continued

Facility Number: j7(p Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes B'lq—o- ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes Eoo [INA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z ��
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Eva ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes [JITo ❑ 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? [:1 Yes B<o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes G;�<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 [}<b_ ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes BIZ ❑ NA ❑ NE
maintenance/improvement? ,�
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ElLsd
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 ElApplication Outside of Area
12. Crop type(s) ��"�, uda� (�)S l� Gtr-fi✓ "/Q, 5.�>
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[Ko
0 NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
to
[_1NA
❑ NE
17. Does the facility lack adequate acreage for land application?
C1 Yes Yes
2
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Z<o
❑ NA
❑ NE
��----
Laar30
Reviewer/Inspector Nameq/0�33• X33 j�
+nr S Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/04 Continued

cl:te -o9
Facility Number: e2 -371p 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 availabic? If yes, check ❑ Yes L"I'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 Gni o ❑ 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,_, El❑ Weather Code
ElL
22. Did the facility fail to install and maintain a rain gauge? Yes ` 1, o NA El NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes B_9N0 ❑ NA ❑ NE
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?
❑ Yes
3.1 off❑ NA
[3-110
El NE
El Yes
El NA
[3 NE
El Yes
,L�-1"�No//
o I --]NA
El NE
El Yes
,E3-1
3.1Qo [:INA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes
o El NA
❑ NE
[I Yes
,2
214 [INA
EINE
❑ Yes
LSNo ❑ NA
❑ NE
❑ Yes:0�0
NA
❑ NE
El Yes
NA
❑ NE
El Yes
�, o �
Lf LJ NA
EINE
12/28/04

3 -EMS �3T2_q-06 rr-
Type of Visit (5Co_mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 19-13 09 Arrival Time: //� 20 Departure Time /; County: �" Region: `W
Farm Name: 14.b 1 1 Lt rSe4er4 4 % Owner Email:
If
Owner Name: ?,bT 44VS-t, -7;VG • Phone:
Mailing Address:
Physical Address:
Facility Contact: Caa."wt c -k Title: Kine__ � _ Phone No -
Onsite
Onsite Representative: C �c integrator: C6 A4 1-1, 4 � rwe S
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
Boars
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: =0
=1 ="
Longitude: 0 ° = =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
5,Vit3 ❑ on -Layer
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 I
❑ 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?
Page 1 of 3
❑ Yes Vo ❑ NA ❑ NE
❑ Yes
❑ No
[1IA
❑ NE
❑ Yes
❑ No
8-9A
❑ NE
B
El NE
E-1 Yes
El No
❑ Yes
3 -go
❑ NA
❑ NE
❑ Yes
❑lVo
❑ NA
❑ NE
12/28/04 Continued

Facitity Number: 92-376
9-13-999
Date of Inspection V-13-- 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure l Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes E No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Soil type(s) _ 1JO-8 C _
Designed Freeboard (in):
14.
Do the receiving crops differ from those designated in the CAWMP?
El Yes
//
E No
Observed Freeboard (in):
EINE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
LSNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
16.
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
ETNo
❑ NA
❑ NE
through a waste management or closure plan?
ElL� Yes
3,
No
❑ NA
❑ NE
If any of questions 4fi 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
fNNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
LT 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
�,�
L3No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement'?
❑ Yes l_TNo ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes D<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 Drift ❑ Application Outside of Area
12. Crop type(s) Re )--c,dc, . i/A, J Suallg;W,i ✓ O.S.
13.
Soil type(s) _ 1JO-8 C _
14.
Do the receiving crops differ from those designated in the CAWMP?
El Yes
//
E No
❑ NA
EINE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
LJ No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
El NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
ElL� Yes
3,
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
6<o
❑ NA
❑ NE
�cellrtit 12ee rd,_
i
Reviewer/Inspector NameiC GilCGPhone: Wo. X33.3330
Reviewer/Inspector Signature: Date: S'—
Page 2 of 3 12128/04 Continued

Facility Number: 72 —,37(p Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,3, N*o ❑ NA E] NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes 0 ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ 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
9 -go—
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ET l�o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ NA
[INE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�2�
[3 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
9<oo -
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3'9o-
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0-5o
❑ 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
❑<
❑ 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
[I NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
�/
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
E] Yes
[No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
BINo
❑ NA
❑ NE
Page 3 of 3 72/28/04

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: R7 -Q/- D7 Arrival Time: /3.'�S Departure Time: /,'/f" County: s'a.y Region: .0�'2
1X
Farm Name: Owner Email:
Owner Name: r tUaY c.v Phone:
Mailing Address:
Physical Address:
Facility Contact: C'k- s Title: ��� /y�y Phone No
Onsite Representative: 4fv.41 S &P-kh'`Ck Integrator: 4rO�{'
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =o =]' =" Longitude: EJo [--],
y Design Current. Design, , CurrentDesigu C►urgent
Swine CapacityPopulation 3V!'et ult . ,C pa ity Population Cattle Capacity Population
❑ Wean to Finish ❑ La er ❑Dai Cow
Wean to Feeder -7200 -5--/ (10 1s ❑ Non -La et ❑iry Calf
❑ Feeder to Finish' ❑ Dairy Heifej
❑ Farrow to Wean Dry'Poirltry a ,� ❑ Dry Cow
❑Farrow to Feeder ❑Non- Dairy
❑ Farrow to Finish ❑ La ers
❑ Beef Stocker
❑ GiltsElNon-Layers
t ❑Beef Feeder
El Pullets
❑ Boars ❑ Beef Brood Cowl I
❑
Turkeys
Other x El Turkey Poults
❑Other Numbe�roMI., f
❑ Other a Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[� No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
ER 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
No
❑ NA
❑ NE
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
RNo
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility Number: $Z —3 7(v
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1
Identifier:
Structure 2 Structure 3 Structure 4
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [�No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
i/
Observed Freeboard (in): el Z
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 [3 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [;3 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 I No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes W No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) _1,A .d rUjtjDi S.
13. Soil type(s) _ At t I 'J's
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes (A No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 0 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 [7No ❑ NA ❑ NE
18_ Is there a lack of properly operating waste application equipment'? ❑ Yes P 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):
6.100 j t -o v�_� man
Reviewer/Inspector Name T -Z' i° Phone: WO, y33, 3360
Reviewer/Inspector Signature: Date: t6— a { —zoo -7
12/28/04 Continued

Facility Number: $z Date of Inspection 1/0-01-0-7
Re wired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [Z No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes J No ❑ NA ❑ NE
the appropirate box. ❑ WTJp ❑ Checklists ❑ Design ❑ Maps ❑ 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 1" Rain inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
PNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
M No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M 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
/[ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
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
[g 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
5 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
Comments and/or Drawings:
12/28/04

---- ®Division of Water Qus[ity
iFacili Number � � ^
f3' gZ „'� -] (p Q Division of 5oii and Water Conservation
Other Agene-
Type of Visit ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: S -OS -Q (C Arrival Time: /. sii M Departure Time: Count- ��� Sb!✓ Region: /:-;;20
Farm Name: s -m Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: arfr 5 - S4 V i�li-c K _ .__ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
aw][He capacity ropuianon
❑ Wean to Finish
® Wean to Feeder -7ZOO I &V
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder ji
❑ Farrow to Finish
Boars
Other
❑ Other
_ Phone No:
C-0 it x i, C_
Operator Certification Number:
Back-up Certification Number:
Latitude: [= 0 0,
0 Longitude: =o=, o=,
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non-Layet
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:
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
[7 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[2 No
❑ Yes
[ZNo
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
12/28/04 Continued

Facility Number: �z. -37& 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 ® No ❑ NA ❑ NE
gtnicture 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33 `
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 El 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? ❑ Yes ® No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes U1 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. 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. 1s 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) Ij er,1ri u.,l a_ Ham" _ -"rl a!/ �.�•: �;
13. Soiltype(s) /ZTa C LJa�
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 acre determination`
❑ Yes
®No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
m No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer*to question+#) Exgls�nrany YES. answers and/or any;i ecommendi tions or an_ y other comments.
Use drawmgsFofo-facil�ty to better explasn�sgtEiahons (use addrtional,pages as+eecessary):��e�,
Reviewer/inspectorName Phone: (`)fb ` S6 -/5,f/
Reviewer/Inspector Signature: Date: 5—a3 - Zoo ('
12128/04 Continued

Facility Number: 82 — 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 El Checklists F-1 Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [I No ❑ NA EINE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
C9 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
® No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
2$. 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?
❑ Yes
I No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[� No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[�i No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA
❑ NE
Additional Comments a�dlor I3rawings�a
12128/04
12128/04

Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up Q Referral O Emergency O Other ❑ Denied Access
Date of Visit: arrival Time: Departure Time: I� County: ti Region:
Farm Name: Fn Owner Email:
r
Owner Name: .� C_ � _ — -!W ar r<_" _ _ _ Phone: i o 5� - 4.2c:>7
Nailing Address: /_3C %_ �a�c 10 k,- & �e� bprC� . /`6Q a�3 Fr.?
Physical Address: Z/ 10-3 o1 -f.( o __P C li..14.41
Facility Contact: Title:
Onsite Representative: Cu - k.
Certified Operator: e _' -Q
Back-up Operator:
Location of Farm:
Phone No:
Integrator: C .1 4 0-r
Operator Certification Number:
Back-up Certification Number:
Latitude: [= 0 0' 0 « Longitude: 0 0 [—] ' =
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population � Cattle
❑ Wean to Finish
i
® Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars j
Other
❑ Other
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & 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?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ DEy Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Design Current
Capacity Population
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?
1\
❑ Yes M No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
[I No
El NA
0 N
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
© No
❑ NA
❑ NE
❑ Yes
R3 No
❑ NA
❑ NE
12128/04 Continued

Facility Number:, — 37G Date of Inspection F3 TZ Tas
Waste Collection & Treatment
13. Soil type(s)
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA ❑ NE
a. If yes, is waste level into the structural Freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: / 1
❑ Yes
[ No
Spillway?:
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes
Designed Freeboard (in): �9. Z/O/-2N% 0-1,
❑ NA
❑ NE
Observed Freeboard (in): if J'
❑ Yes
[XNo
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
qNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
[ffNo
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
[A 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
W No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
91 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
[;g No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
00 No ❑ NA ❑ NE
maintenance/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 ❑ Evidence of Wind Dri$ ❑ 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
❑ 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?
❑ Yes
[XNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ffNo
❑ NA
❑ NE
Reviewer/Inspector Name �,
s , Phone: j%a
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: g —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 E4 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 JX] 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 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No g NA EINE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
JU NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
[-]Yes
❑ No
❑ NA
(ONE
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
❑ No
❑ NA
ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
U No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0 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
0 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
J] No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[Z No
❑ NA
❑ NE
12/28/04

Type of Visit CICompli nspection 0 Operation review 0 Lagoon Evaluation
Reason for Visit outine 0 Complaint 0 f=ollow up 0 Emergency Notification 0 Other ❑ Denied Access
Date of \'fait: a'Z a Time:
Facilit% lumber
t N t operational Q Below Threshold
ermitted 'Certified 0 Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: _ _ t"��-•+S County: fit
Owner Name: 7t'(� L�a�r�.,. Phone No: �-� p
Mailing Address: _ 13GG� I'*1f-[ f�• -- �rv�3git
Facility- Contact: �C Title: Phone \a:
Onsite Representative: ��"^ G Integrator:
Certified Operator: C'� W "r -C, Operator Certification Number:
Location of Farm:
0?90wine ❑ Poultry []Cattle ❑ Horse Latitude Longitude �� �• K
Design Current Design Current Design Current
Swin Ca acih Population Poultry Capacity Population Cattle Ca achy Po ulation
can to Feeder ❑ Laver I I ❑ Dairy I I _1�d
❑ Feeder to Finish 10 Non -Laver I I ILI Non -Dain
❑ Farrow to Wean �
❑ Farrowto Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons
Holding Ponds / Solid Traps
No
Discharges 8 min Impacts
1. Is anv discharge observed from any part of the operation?
Discharge originated at: ❑ Laaoan ❑ SDray 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, notif}' DWQ)
c. if discharse is observed. what is the estimated flow in eat/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 Collection g Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure ? Structure 3 Structure 4
Identifier:
Freeboard (inchesh _ 30. _.
05/03/01
Structure 5
Spray Field Area
❑ Yes ❑.WV---
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Egiw`
❑ YesGidr-'
❑ Yes 31ro_
Structure 6
Continued

Facility Number: q 9. — S 14 1 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-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Docs any part 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 Application
10. Are there any buffers that need maintenance/improvement?
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
13. Do the receiving crops differ with those de gnated in 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 tack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes IJ iso
❑ Yes L7 No
❑ Yes
❑ Yes leo
❑ Yes No
❑ Yes ,�, o
El Yes LtNao
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes GKo
❑ Yes ❑ o
❑ Yes ,0,,^l o
❑ Yes �o
ElYes rl No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
i"oo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
,B�
24.
Does facility require a follow-up visit by same agency?
El Yes
,
l,—�1Wr—"
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
LTNo
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Cammentsy(referto question: Explatn:any YES answers and/or any recomme `n'dations'or ariy otfte
i'better explain situations. (use additional pages as necessary): field Copy El Final Notes
Reviewer/Inspector Name r d
Reviewer/Inspector Signature: Date: �� D
05/03/01 Continued

Facility Number: Date of Inspection
Qdor Issues
26. 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?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentltemporary cover?
1�
❑ Yes 2<0 zz
❑ Yes
❑ YesNo
❑ Yes o
❑ Yes No
❑ Yes
❑ Yes OX0
-Additirinal C6Af 4"= C 'oNwaa4 �"
01
�iCt f�►�- ? �o f` cb�5 /*
i
05103101

I
High Freeboard Evaluation Form
Facility Name: Ab7 9 kesc.! g -7 _ Facility Number: _go
Person Completing Form:—[ to . Date Form Completed:
Date Information Due to DWQ: Date information received 5,;L --,P.?
Extension Due Date:
Information Received:
Current Freeboard Yes / No Level(s) (in inches) a I f
Freeboard Levels for Previous 12 Months Yes -""No Incomplete.__._
Spraying Records for Past 12 Months Yes v, No _ Incomplete
Rainfall Records- For the Past 12 Months Yes ✓ No — N/A Incomplete
Cropping and PAN Information Yes _ No Incomplete
Summary of Actions Taken to Restore the Needed Freeboard(s)
Yes _ No Incomplete
Description of Water Conservation Measures In Use
.Yes _ No — Incomplete
An updated FOA if the Freeboard is still in Violation Yes _ No NIA
Detailed Description of Actions Taken or Proposed to be Yes ✓ No
Taken to Prevent Future Freeboard Violations Incomplete
Date High Freeboard Level Was First Reported to DWQ by Producer +- 10-D-1
Date of First Violation from Farm Records H - 17 -D
Items proposed in the Plan of Actions to Bring the Facility Back into Compliance
Pump and Haul Remove Animals Delay Restocking
Add Land to NMP ✓ Add Application Equipment V
Spray when site is acceptable ✓ Others (Please Specify)
HFEF 5-12-03

Information for Lagoon(s) or Storage Basin(s) (Add Additional Pages as needed)
Lagoon ,/ Storage Basin (Check as Appropriate)
Lagoon or Storage Basin Identifier
Design Total Days of Storage for the Facility (From CAWMP)
Stop Pump Level for lagoons or the bottom of the storage basin (inches)
Lowest Liquid Levels Reported in the month of:
Month Date Level (in inches)
August
`a3 - 17 - a,.
September
9- S-0.2
October
I 0 - I C, - a2
November
//- 4-0.2
Required Minimum Freeboard (red zone in inches):
2`7"
a7•,
Does the Minimum Include a Chronic Rainfall Factor Yes
Recorded Freeboard Violations
Date
Y-�7-y3
Level (in inches)
lh
Date POA Submitted
HFEF 5-12-03 2
No
5 or 30 day
N/A

Facility PAN Balance From the CAWMP (pounds)
Did the Facility Comply with its NMP for the Past 12 Months Yes No
If No, What Violations Were Identified:
From the review of the facilities irrigation records, does it appear that the facility made
optimal use of the days when irrigation should have taken place. If not, please explain:
TIN G b Lo v% c- c-- /kms µ n. l
If the Facility has Installed Water Conservation Devices, what devices were installed and
when: ^!cw irrijg'1-;�a s4Af = 03
What Actions have been taken or proposed to be taken by the Facility to Prevent Future
High Freeboard Violations (check appropriate items):
Better Management of the System ✓
Add Additional Storage Volume
Add Lagoon Covers
Add Additional Land Application Sites ✓
Add Additional Irrigation Equipment
Install Water Conservation Equipment
Reduce the Number of Animal at the Facility
Change Type of Operation
Others (please explain)n-
X G •� a• m ;i
HFEF 5-12-03 3

If applicable, recorded rainfall data from August 2002 through April 2003 at
Facility # Xj -376 :
Month
Amount of rainfall
per month (in inches)
# of days it rained
per month
August 2002
q/19
Out of 31 days
September 2002
sh0
3
Out of 30 days
October 2002
Out of 31 days
November 2002
'�'�p
3
Out of 30 days
December 2002
'i 1,
1r
Out of 31 days
January 2003
Out of 31 days
February 2003
Out of 29 days
March 2003
1
Out of 31 days
April 2003
r
Out of 30 days
Total Rainfall
-7
out of 274 days
Comments from Producer:
Comments by Reviewer: Ve- t CCr,u-fr �k-^1 a a 40
D/ ice. �u Qwntr,�,1 /i0_
HFEF 5-12-03 4