820508_INSPECTIONS_20171231

NUH I H CAHULINA
Department of Environmental Qual

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up O Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Rn. Departure Time: j County: Region:
Farm Name: Owner Email:
Owner Name: e— pp Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone:
Lr
Onsite Representative: Integrator: YLe­9_(C(qr<_
Certified Operator:. Certification Number: P 7 1 96
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Carrent
❑No
Design
Current
Carreot
Swine Capacity Pop.
Wet Poultry
C pacify
Pop:' ,.
Ni"csign
Cattle Capacity Pop.
Wean to Finish
La erI
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
`'
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D . P.oul
Ga aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Lavers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qther: --mmompurkey
Poults
CTtlter
Other
Discharr-es and Stream Impacts
I _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d_ Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[] Yes �No
❑ NA ❑ NE
❑Yes
❑No
10NA
❑NE
[:]Yes
❑ No
NA
❑ NE
❑Yes ❑NoNA []NE
❑Yes No ❑NA ❑NE
❑ Ye No ❑ NA ❑ NE
Palle 1 of 3 2/4/2015 Continued

Facili Number: - Date of Inspection:
t
Waste1ollection, & 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 P NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: j1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(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 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ YesNo ❑ NA C]NE
8_ Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, anchor wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ YesNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Win rift ❑ Application
Outside of Approved Area
12, Crop Type(s): G-y�s (FL
,-,4
13. Soil Type(s): vl1 a -,O
14. Do the receiving crops di er from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ No
❑ NA
❑ NE
1 S. Is there a lack of properly operating waste application equipment?
❑ Yes
No
[] NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
[] NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check 0 Yes
No
❑ NA
❑ NE
the appropriate box_
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ YesNo ❑ NA E]NE
❑ Waste Application ElWeekly Freeboard E]Waste Analysis ❑ Soil Analysis L]Waste Tr sfers ❑ 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 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes fo No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: FLA. Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the pe it? ❑ Yes No [] NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
25. Did the facility fail 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 C�] 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:
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes} No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP? ❑ 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
Cnttttxreuts (refer to; #) >, lain any YES answers and/or any additional recommendations or any dtlf' coniinents.
y
Use drswings of faeinty to'16 t explain sefuatiaas 1, �I�� 4�I i
(use addtttooah.pages. as accessary):ti i,,
Reviewer/inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone: q1,0 —q 3Y-33cl)
Date:
"11412VI S

I ype of visit: ® Uompliance inspection U Operation Review U Structure Evaluation U Technical Assistance 1
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access J
Date of Visit: Z Arrival Time: ' Departure Time: :� County: )'9 � Region4C
Farm Name: J/J Owner Email:
Owner Name: P�qg C41, 5 Phone:
Mailing Address:
Physical Address: !�
Facility Contact: Title: Phone:
u
Onsite Representative:
Certified Operator:a C�/''e-i
rA
Back-up Operator:
Location of Farm:
Latitude:
Integrator: &Ldig
41
Certification Number: 9 9 '7-70o
Certification Number:
Longitude:
Discharges and Stream Impact
1. Is any discharge observed from any pan of the operation?
Discharge originated at: p 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 W No ❑ NA ] NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No
❑ Yes CE No
❑Yes K-7 No
NA
v Design Current
❑ NA
Design Air' of
Design Current
❑ NE
Capacity . 'Pop.
Wet=Poultry
Capacity 1'0
Cattle Capacity Pap.
nish
jTFeedTertoFinisb
Layer
Dai Cow
eeder
Non -Layer
Dai Calf
-
Design Current
Dairy Heifer
Farrow to Wean
D Cow
Farrow to Feeder
D rPou1 ,
Ca ct .0
Non -Dairy
Beef Stocker
Farrow to Finish
Layers
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
ll Other
+ Other
Discharges and Stream Impact
1. Is any discharge observed from any pan of the operation?
Discharge originated at: p 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 W No ❑ NA ] NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No
❑ Yes CE No
❑Yes K-7 No
NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 2/412011 Continued

Facility Number: jDate 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
Structure I Structure 2 Structure 3 Structure 4
Identifier: r
Structure 5
Structure 6
Spillway?:
Designed Freeboard (in):
_
Observed Freeboard (in): '
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ YesNo
❑ 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
[P No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
(� No
0 NA
E] NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
IL`1 No
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 Cop Window Evidence of Win Drift ❑ Application
Outside of Approved Area
12. Crop Type(s): 50
13. Soil Type(s): 1
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
`p No
E] NA
❑ NE
acres determination?
T
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [-]Yes 1� No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 09 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

FatilittyNumber: Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes q3 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below. TT
❑ 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
❑ Yes
V0 No
❑ 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?
❑ YesNo
❑ 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
❑ YesNo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
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
Comments (refer to question #1): Explain any YES answers and/or any additional recommendations or any other commlibti tl
Use drawings of facility to better explain situations (use additional oases as necessarv).
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:���
214/20;1

IType 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 0 Denied Access
Date of Visit: I LLn//�/p I Arrival Time:fj J�' yy�j,. Departure Time:Y4�EiCounty: SA%4-101� Region:
Farm Name: I"�*�Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: �� ��,� Title:
Onsite Representative:
Certified Operator: 'R �r{h
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: 77th
Certification Number:
Longitude:
I'll I:Design
Swine
Curren `
t
Capacity Irop..,.:.,
Wet Poultry
Design - Current
Capacity Pop.
Design
Cattle Capacity
c. What is the estimated volume that reached waters of the State (gallons)?
Current
Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish"
Farrow to Wean5
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
FINon-Layer
Layer
i,
D , P`oul o
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
�, �'
Design
Ca aci
, - .
'"�I_
:Current .
P,o P.
Dairy Cow
D ' Calf
Da'X Heifer
Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
Discharges and 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 DWR)
❑ Yes
❑ No
® NA
T
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
NA
❑ 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 2/4/2014 Continued

If acili T umber: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes [ No
M No
NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
� No
NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
No
Identifier:
❑ NE
acres determination?
Spillway?:
17. Does the facility lack adequate acreage for land application?
Designed Freeboard (in):
No
❑ NA
❑ NE
Observed Freeboard (in):
❑ Yes
No
T
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
[—]Yes No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
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?
No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes [g No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes ® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] YesNo
NJ
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land 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 Cron Window n Evidence of Wind Drift n Aanlication Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
M No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
� No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
1$. is there a lack of properly operating waste application equipment?
❑ Yes
No
T
❑ NA
❑ NE
Ree uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP [:]Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? 1 f yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2014 Condnued

FIcili ' Number: Date of Inspection: f
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
[—]Yes W No ❑ NA ❑ NE
❑ Yes MI No [:]NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
[:]Yes 2 No
❑ Yes ® No
❑ Yes Fig] No
❑NA 0 N
❑NA 0 N
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or -any oth&kdmments
Use drawings of facility to better explain situations (use additional pales as necessary)._
Reviewer/Inspector Name:
Reviewer/Inspector Signature: OLS �I_Y
Page 3 of 3
Phone: L7,/0gr33-33C)
Date:
2/4/2014

1,

I
ype of visit: JP Compliance Inspection U Operation Review U Structure Evaluation U 7 echnical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: LZ j Arrival Time: d ; q7 Departure Time: p County: R4" WQ OIJ
Farm Name: 13 Owner Email:
Owner Name: res _ S 4Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: t4 anC6 Title: Phone:
Onsite Representative: ��/M�^P� L Integrator:
Certified Operator: e� Certification Number: T7 96
Back-up Operator:
Location of Farm:
Latitude:
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 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 ' No ❑ NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
❑ Yes ❑ No eq NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
[PNo
❑ NA
❑ NE
Design
Curr..ent
Design
Current
Design Current
Swine
Capacity
`Pop. Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
175]g
Dry Cow
Farrow to Feeder
D It ,
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
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ' No ❑ NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
❑ Yes ❑ No eq NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
[PNo
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Facili lumber: - Date of Ins eetion: 2-1
Waste Collection & Treatment
D Yes
® No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
)1�3 NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier-
17. Does the facility lack adequate acreage for land application?
❑ Yes
T No
❑ NA
❑ NE
Spillway?:
❑ Yes
09 No
❑ NA
❑ NE
Designed Freeboard (in):
'j w
Observed Freeboard (in): 43
❑ Yes
No
❑ NA
❑ NE
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
[] NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
D. NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
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 Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
M No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land 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 E]Evidence of Wind
Drift ❑ Application Outside of Approved Area
12. Crop Type(s): CouSQ �l �S> MSI! 1 Sm,
13. Soil Type(s): p(�
14. Do the receiving crops differ from those designated in the CAWMP?
D Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
M No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
T No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
09 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑WUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking 0 Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes [�] No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility hiumber: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? []Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE
Other Issues
2$. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes r:;_R No ❑ 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?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes P No ❑ NA ❑ NE
❑ Yes [,_0 No [3 NA ❑ NE
❑ Yes R] No ❑ NA ❑ NE
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
[;B No
❑ NA
❑ NE
Comments {refer to question #): Explain any YES answers and/or any additional recommendations or,any other comments m
Use drawings offaEili tyto°better explain situations(use ad3itioaal pages as necessary)- w
R y
Reviewer/Inspector Name: _ "90be4(_+ jV1Q r61 f_ Phone: JL :1b3 -330a
Reviewer/Inspector Signature: ��/� Date: 17/v7L
Page 3 of 3 2/4/2011

' Type of visit: w uompiiance inspection V operation iceview U btructure Evaluation U "iecbnical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: B: 3D Departure Time: / ' County:✓ Region:^
Farm Name: ��J _ Owner Email:
Owner Name: ��-YL CC3a( (YDS Phone:
Mailing Address:
Physical Address:
Facility Contact: ��Y`rS 1. t� Title:
Onsite Representative:
Certified Operator:?'�6 ��� a I
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: -
Certification Number: T47 77 0'0
Certification Number:
Longitude:
Discharees and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at- ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
[] No
® NA
❑ NE
Design . Current
❑ No
Design Curren#
Design Ceu rent
Svrine Capacity Pop.
R'et Poultry
capacity Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Da' Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Da Heifer
Farrow to Wean 'r[ 11
Design Current
Cow
Farrow to Feeder
D . P,oalt ,
Ca aci P,d
Non -Da
Farrow to Finish
Layers
Beef Stocker
Gilts
Nan -La ers
Beef Feeder
Boats
Pullets
Beef Brood Cow
-
Turkeys
Turk Poults
Other :.- _
Other
Other
Discharees and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at- ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
[] No
® NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes Ej No
[:]Yes Ej No
® NA ❑ NE
❑ NA ❑ NE
E] NA ❑NE
Page 1 of 3 214/1014 Continued

• Facility Number: - Date of inspection: 17,JUJIT
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 01 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):an f4
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
[a 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
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
[:]Yes
ENo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[-]Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[—]Yes
® No
❑ NA
❑ NE
maintenance or improvement?
Waste ARPlicatiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Q No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 1+ 3No ❑ 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): ex�rlsk-k t"`4rmve��C-,Y�ss W01) S, , &-Li r1
� 1
13. Soil Type(s): 1 . L"23CZAS
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 29 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Eg No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes Ej No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes EE� No ❑ NA ❑ NE
❑ Yes [a No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [-]Yes ® No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists E] Design ❑ Maps ❑ Lease Agreements El Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes e5 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? []Yes ?B No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Facili Number: jDate of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Lg No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey E] Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes Cg No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ®No ❑ NA ❑ NE
[:]Yes ® No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes No
❑ Yes ® No
[:]Yes ® No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
(Comments (refer.to question #): ExpWn any YES, answers and/or any additional recommendations or any other�comments.
y
Use drawiniis,of,facility to better explain `situattons.(use`additional naees:as necessarvi: ` ��
..
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: J/ V — 32 r 33CV
Date: C `(
2/4/2014

Date of Visit: Arrival Time: Departure Time: County: 39!i!�N Region: -
Farm Name: (3
Owner Name: �
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: 'C�014Title: Phone:
Onsite Representative: Integrator: Tres4zt
Certified Operator: Certification Number:Y17%
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
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)
e. 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
E4 No
#aD gCur._rent�
` Desig Cur nt -
Desigtt Current
[jS No
Swerve �a act o
C4 t3 pip
Wet Poult Ca act P,o
r3
Cattle Ca aei Po .
p`
0 No
4
❑ NE
FP=
❑ No
NA
Wean to Finish
Wean to Feeder
Feeder to Finish
er
Fpca-La cr
^ x - :� t
Dai Cow
Dai Calf
Dai Heifer
Farrow to Wean
T7
- : 6A, ` Cu' rreat`4
D Cow
Farrow to Feeder
.T1�
D . Poultrvi.;.Ca acrril'o
Non -Dai
Farrow to Finish
Gilts
Layers
Non -Layers
Beef Stocker
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke 5
Qthcr
Turkey Ponits
Ocher
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)
e. 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
E4 No
❑ NA
❑ NE
❑ Yes
[jS No
❑ NA
❑ NE
❑ Yes
0 No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑Yes
❑No
�NA
❑NE
❑ Yes
[jS No
❑ NA
❑ NE
�] YeslZM
LP No
❑ NA
❑ NE
Page I of 3 2/4/2011 Continued

Facility Number: -56 jDate of Inspection: �(
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: -
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): 2-8
u
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
No ❑ NA ❑ NE
❑ No NA ❑ NE
Structure 6
[:]Yes P No ❑ NA ❑ NE
❑ Yes I? No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [P No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes a No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN 0 PAN a 10% or 10 lbs. ❑ Total Phosphorus [D Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift E]Applicca+tiio�n�Outside of Approved Area
12. Crop Type(s): �e.[��' kp 9 �S & 4,) t sM. C fair`
13. Soil Type(s): t t/'Q9
❑ Yes
W No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
❑ Waste Transfers
❑ Weather Code
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
IT Does the facility lack adequate acreage for land application?
❑ Yes
[9 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
K No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
W No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[ No
❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
[--]Other-.
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[i No
❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
❑ NA ❑ NE
Page 2 of 3
2/412011 Continued

I♦acili Number: 0.11- 1 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
[] Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
[:]Yes
No
❑ NA
❑ NE
❑ Yes � No [:]NA E] NE
[] Yes � No E] NA [3 NE
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ;2 No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Q No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes ,0 No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ;g No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
lComments (refer to question ft Explain any YES answers and/or any additional recommendations or -any otherfcomments.
Usedrawings of facility to better explain situations (use additional palles as necessary). ;x '
fFEr_aVjs v 1 i 9'�`J,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 7t io—`i33-33cD
o
p
Date: r ` r6— 11
Page 3 of 3 2/4/2011

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: Q
Arrival Time: 1 Departure Time: ��County:
Farm Name: Owner Email:
Owner Name: MS% Phone:
Mailing Address:
Region:
Physical Address:
[PNo
Facility Contact:
Title: Phone No:
Onsite Representative:_
Integrator:i
Certified Operator: �
'R' _ . Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: =0
=6 ="
Longitude: =0=1 = u
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
[PNo
[--INA
Design Current
Design Current
Design C►urrent
Swine Capacity Population
Wet Pouttry Capacity Population
Cattle Capacity Papulation
❑ Wean to Finish
❑ Layer
❑ Dai Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dai Calf
❑ Feeder to Finish
NA
❑ Dai Heifer
Farrow to Wean 'I (
Dry Poultry
❑ D Cow
Farrow to Feeder
❑ Layers
❑ Non -Dairy
❑ Farrow to Finish
El Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turke s
Other
❑ Other
❑ Turkey Poults
❑Other
plumber 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
[PNo
[--INA
❑ NE
❑ Yes
❑ No
'T NA
❑ NE
Yes
❑ No
1P NA
❑ NE
rr❑
NA
❑ NE
❑ Yes
❑ No
❑ Yes No
❑ Yes ® No
❑ NA ❑ NE
El NA El NE
Page 1 of 3 12/28/04 Continued

I
` Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Struct r
1 Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes r No
❑ Yes ❑ No
Structure 5
El NA 0 N
NA ❑ NE
S cture 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes P 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 IT 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 $1 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 4
9. Does any part of the waste management system other than the waste structures require ❑ Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Aumlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes � No El NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes V No [INA ❑ NE
El Excessive Ponding C1 Hydraulic Overload El Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ll
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Windowr El Evidence of Wind
+ Drift El Application Outside of Area
12. Crop type(s) C04slQ��n•. [y� ` q4 , 5/m `i9,• „, 0&,,Qa
13. Sail type(s) 17
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
t�
lU 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
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
&3 No
❑ NA
❑ NE
Comiiients (refer to ghestian #): Explarn any YES ansRers and/pr ariy recommendatronsorany other comments
Ilse drawings of fac!iity to better explain situanous�'(use additional pages as necessary) � .
K-�c 5 ✓'� �`ec„
f 91110
Reviewer/Inspector NamcD
. r51
Phone:
Reviewer/Inspector Signature:
Date: /O
%1?
Page 2 of 3 12/28/04 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IR No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes T No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design 6 [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [21 No ❑ NA ❑ N E
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
P 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
�9 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
t3 No
❑ NA
❑ NE
2& Did the facility fail to have an actively certified operator in charge?
❑ Yes
h No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
D9 No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
TP No
❑ NA
❑ N£
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
�] 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
CR 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
b No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
IM No
❑ NA
❑ NE
Additional Comments "and/or Drawings. WWI
Page 3 of 3 12128104

IType of Visit *Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance I
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: 40'd0"' County: aQd Region: _LCAD-
Farm Name: P— o
Owner Name: ?res Iti'1S la G
Mailing Address: _
Physical Address:
Facility Contact: Title:
Onsite Representative: S
Certified Operator:
Back-up Operator:
Owner Email:
Phone:
�j] Phone No:
Integrator• "I rf GP_ !,___„
Operator Certification Number: J 7ilq`F'
Back-up Certification Number:
Location of Farm: Latitude: =0
=6 =66 Longitude: 0 o = S =
Design Current
Swine Capacity Population
Design Current
Aet Poultry Capacity Population
Design Current
CattleCapacity Population
to Finish
❑ Layer ��
❑ Dai Cow
to Feeder
❑ Non -Layer
❑ Dai Calf
r to Finish
a. Was the conveyance man-made?
❑ Dai Heifer
to Wean
DrY Poultry
❑ D Cow
w to Feeder
❑ Yes
❑ Non -Dairy
w to Finish
FGilts
❑ Layers
❑ Beef Stocker
❑ Non -Layers
❑ Beef Feeder
❑ Pullets
❑ Beef Brood Co❑
0 No
Turke s
❑ NE
2. Is there evidence of a past discharge from any part of the operation? -
❑ Turke Poults
❑ Other FEE]
Numher of Structures:
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
J�bNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
�9NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
PNA
❑ 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
0 No
qT-NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation? -
❑ Yes,)RNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Wo
❑ NA
❑ NE
other than from a discharge'?
12/28/04
Continued

U
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Facility Number: Date of Inspection
f
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
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 [INA ❑ NE
Struc4ure I Stnicture 2 Structure ? Structure •1
Structure { 1 Fracture G
Identifier: f
❑ NA
spillway?:
17. Does the facility lack adequate acreage for land application?
Designed Freeboard (in):
(n No
TIT
Observed Freeboard (in):
❑ NE
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes No ❑ 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 stuctttres lack adequate markers as required by the permit?
❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes Itp No ❑ NA ❑ NE
maintenancelimprovement?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes f�d No ❑ NA ❑ NE
❑ Excessive Ponding ❑ hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[--]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindow ❑ Evidence of Wind Drift C3Application Outside of Area
12. CroptyPe(s) J flrr�' Cr ^ MuA �J J r v -�j'`A
13. Soil type(s) YiTJ'ti? B r'VrGu'1 Ar%s
U
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
nNo
❑ 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
(n No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
�1 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):
AL
Reviewer/Inspector Name Phone: 3 3 -33tx3
Reviewer/inspector Signature: Date: glqlrq
1utai614 Lonnnuea

• Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 00 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes G�N0 ❑ 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 QTNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 0 NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�RNo
❑ 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
5j�No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
@ No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
91 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
9 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
RNo
❑ 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
5?PNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
PgNo
❑ NA
❑ NE
12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time:F31-15-0 nti Departure Time: i �{' County: _cA,,-PS-o-1 Region: 11;40
Farm Name: �
0-13 Owner Email:
j
Owner Name: ?reg 4,z– S l i Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =0
=6 = Longitude: = ° =I = u
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Design.. Current
Pallo
Design Current'„ ` Design Current
Swine
Ca act Po ulation
p tY
Wet Pault
Ca aci a Po ` u"Iatton ' ` Cat#le Ga aci Po ulation
p .u� P.. P ty p
❑ Wean to Finish
❑ Layer
❑ Dai Cow
❑ Wean to Feeder
P NA
❑ Non -Layer
❑ Da' Calf
❑ Feeder to Finish
❑ No
PNA
❑ Dai Heifer
Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
" ❑Non -Dai
❑ Farrow to Finish
❑ NE
❑ Layers
❑ Beef Stocker
Gilts
❑ NA
❑ ers
Non-LayersHol
El Beef Feeder
Boars
FINo
ll is
. Pullets
❑ Beef Brood Co
other than from a discharge'?
-
❑ Turkeys
,
Other
Page I of 3
1E1Turke Pou Its
Continued
❑ Other
_
JILaOther
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Pallo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
PNA
❑ 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
FFNA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
rpNo
❑ NA
❑ NE
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
FINo
[__1 NA
[:1 NE
other than from a discharge'?
ll
Page I of 3
12128104
Continued

Facility Number: 8,% Date of Inspection
Waste Collection & Treatment
Reviewer/Inspector Name ': Phone: D 33 JU00
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�9 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ONA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure
5 tructure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 u
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
JkNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
❑ 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
�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
1ANo El NA [__1 NE
maintenance or improvement?
11
Waste Analication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
NNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below.
❑ Yes
FJ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside ofAcceptable Crop Window [I Evidence of Wind Drift ❑ Application Outside of
Area
12. Crop type(s) xzsabt r 6", t'
G
ZiNU5
13. Soil type(s) ` 5r[LQ To Ir -4-- rfo LAJNrqy.,,,- &JaB
14. Do the receiving crops differ from those designated in the CAWMP?
El Yes
No El NA [:1 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
P No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[K] No ❑ NA ❑ NE
W
Cor invents (refer to questron'#) Explarn�any YES answers and/orFany�recommendati,D s'ar any other comments.
Use drsw�iyyngs of facility to better egplatn"s�tnanons. (use additional pagarytry).
' 1��-,. i :.M1-'�. x.t+.. :�F - �-0'ts •Ne_^.n�k-.,. .2'�kA7'd%"k�.a.4wi'.�.
Reviewer/Inspector Name ': Phone: D 33 JU00
Reviewer/Inspector Signature: Date:i0
Page 2 of 3 112/28/04 Continued

Facility Number: s Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes D -No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes eNo ❑ NA ❑ NE
the appropriate box.
❑ WUP 1:1 Checklists El Design El Maps E] Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes O§No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? [:]Yes 'pNo [INA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �9 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
19 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
5No
❑ NA
[:INE
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
p1t9i No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[9 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
C,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
29 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
KNo
❑ NA
❑ NE
AdditroniUComments and/or Drawings: r r
Page 3 of 3 12128104

W
0 Division of Water Quality
Facility Number U] O Division of Soil and Water Conservation
O Other Agency 1 0
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: R D Arrival Time: ii_ �, sa F Departure Time: County: Sh-r1nj0S0^? Region: �d
Farm Name: PDQ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: C'e C1 Title: Phone No:
Onsite Representative:
Integrator* YPS e e
Certified Operator: Operator Certification Number:
Back-up Operator -
Back -up Certification Number:
Location of Farm: Latitude: 0' [=]' =" Longitude: F --J'=' ❑"
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑
Layers
❑
Non -Layers
❑ Pullets
❑
Turkeys
❑
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?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: al
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 PQInfo ❑ NA EINE
❑ Yes
❑ No
KNA
❑ NE
❑ Yes
❑ No
A NA
❑ NE
--
0 Yes
—❑Yes El No JONA
ONE
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12/28/44 Continued
�l

Facility Number:
Date of inspection E00
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier_
❑ Yes 0 No
❑ Yes 19 No
Structure 5
El NA El NE
El NA 0 N
Structure 6
Spillway?:
❑ Yes
N No
[INA
❑ NE
Designed Freeboard (in):
❑ Yes
No
❑ NA
❑ NE
Observed Freeboard (in):
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
(� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
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
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
ANo
❑ NA
❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
kNo
[:INA
❑ 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
1A No
❑ NA
❑ NE
maintenance or improvement?
Waste Annlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Leavy 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 Drill ❑ Application Outside of Area
12. Crop type(s) B ) I , -6Ti 61
13. Soil type(s) 04,.4&6
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
N No
[INA
❑ 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
(� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
M No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone: 16,
f
Reviewer/Inspector Signature: Date: Q ��
1212104 Continued

Facility Number:— Date of Inspection
Re aired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [a No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check Q Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
a No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
NJ No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�jNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the pernnit?
❑ Yes
8 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
M 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
MNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Rd No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
0
❑ 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
[P 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
(A No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128/04

W A 7'FR
4G
Michael E. Easley
Governor
William G. Ross Jr., Secretary
Department of Environment and Natural Resources
001444I "C Alan W. Klimek, P.E. Director
INd Division of Water Cluality
June 6, 2003
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Prestage Farms
PO Box 438
Clinton NC 28329
SUBJECT: Request for Information
Inadequate Freeboard
P-13
#82-508
Sampson County
Dear Sir or Madam:
OUN 71 3 2003
I
On May 27, 2003, a representative of your farm informed the Division of Water Quality
(DWQ) that there was high freeboard in your .lagoon(s). DWQ needs more information to
determine the site-specific factors that resulted in the high freeboard at your farm.
Please provide the Fayetteville Regional Office with the reasons for the high freeboard
and your plan to prevent future freeboard violation(s). This explanation and plan must include
but is not limited to the following:
• Current freeboard level(s)
• Freeboard records for the past 12 months
• Spraying records for the past 12 months
• Rainfall records for the past 12 months for your farm (if available)
• A copy of your waste utilization plan (WUP) If your crops did not comply with your
WUP, provide details of the crops you did have for the past 12 months.
h
RMEM
Customer Service. Mailing Address: Telephone [phone]a3 Location:
1-877-623-6748 1617 Mail Service Center Fax [phone] N. Salisbury 5t.
Raleigh, North Carolina 27699-1617 State Courier #52-01.01 Raleigh, NC 27699-1617
An Equal Opportunity t Affumative Action Employer
50% recycled/ 10% post -consumer paper
h t tpYlh2o. en r, s to t e. nc. us

Inadequate Freeboard
Page 2
• A summary of actions taken to lower the freeboard such as using additional irrigation
equipment, using third -party spray fields, buying additional land, removing animals from
the farm, delaying restocking, pumping and hauling waste to another site (please state the
location of the other site), etc.
• A description of water conservation measures in -use at the farm and the date(s) installed
• If the freeboard level(s) are still in violation, provide an updated Plan of Action as to how
the farm will return to compliance.
• Provide a detailed description of the actions you have taken or will be taking to reduce
the possibility of freeboard violations at your farm in the future.
DWQ will look at each case on its merits. Your efforts to notify DWQ of the problem,
the efforts you made to resolve the problem and the actions taken to prevent future problems will
work to your benefit. However, please be advised that civil penalties may be assessed if
warranted.
This information must be received by the Fayetteville Regional Office at the following
address no later than 10 days after receipt of this letter.
Division of Water Quality
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5043
We know that gathering this information will take additional effort. If you have
circumstances that will make meeting the 10 -day deadline very difficult for you, please contact
your regional DWQ office. If appropriate, you may get a short extension of time. If you have
any questions regarding this letter, please do not hesitate to contact our Fayetteville Regional
Office Staff at [phone].
Sincerely,
,�40Alan W. Klimek P. 7.7f
Director
cc: Fayetteville Regional Office
Non -Discharge Compliance/Enforcement Unit
Central Files

IType of Visit 'Com fiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Foliow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: yArrival Time: Departure Time:
Farm Name: l
Owner Name:
Mailing Address:
Physical Address:
County: S Region:
Owner Email:
Phone:
Facility Contact: Title: pPhone No:
Onsite Representativ .L _ Integrator: rw �a
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number: -
Location of Farm: Latitude: [=O
=5
=is Longitude: 0 ° 1--] ' 0
Discharges & Stream Impacts
1- Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes dNo ❑ NA ❑ NE
❑ Yes
❑ No
EJ'NA
❑ NE
❑ Yes
❑ No
LJ NA
❑ NE
ENA
El NE
El Yes
El No
❑ Yes IA ❑ NA ❑ NE
❑ Yes IJ Ido ❑ NA ❑ NE
12/28/04 Continued

FaciW Number Z,—
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?
Struc re 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes '04'o El NA ❑ NE
ElYes [INo (_ 4<A"S ❑ NE
Structure 5 Structure 6
❑ Yes N ❑ NA ElNE
[:]Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes dN ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [u No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes L!�'lVo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% ori 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes�N
❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
El 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
[2 No ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Q/No ❑ NA
❑ NE
Comments (refer to question ff): Explain any YES answers and/or any recommendations or any othercomments .
Use drawings of facility to better explain situations. use additional pages as necessary):
>• .
Reviewer/Inspector Nam, I Phone',
hone ',
Reviewer/Inspector Signature: Date: 1
Page 2 of 3 1
Continued

Facility Number: Z — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWNV readily available? If yes, check
the appropriate box_
❑ WUP ❑Checklists ❑Design ❑Maps ❑Other
❑ Yes
L No
❑ NA
❑ NE
❑ Yes
UfNo
❑ NA
❑ NE
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 [:1120 Minute Inspections ❑ Monthly and V
Rain Inspections
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on a ui
irrigation equipment? q P
❑ Yes
No
NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
]" o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
LI No
❑ NA
❑ NE
26_
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ENo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
O No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes P o ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ao
❑ 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?
El Yes
,,_,,__,,/
91'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
VIN o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
�/
32. Did Reviewer/inspector fail to discuss review/inspection with an on-site representative?
13 yes
N
El NA
C3 NE
33_ Does facility require a follow-up visit by same agency?
El Yes
No
❑ NA
❑ NE
Additional _Comments andlor Drawings:
1z
H
Page 3 of 3 12/28/04

,Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit ®Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: S�rj Region:
Farm Name:
Owner Email:
Owner Name: P,C 5 jra 9 e F,,,. )' Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative:
R a � CAO
av c-ZA_
Certified Operator: 2 ',Q"
t'•t.-
❑ NA
❑ NE
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
Latitude:
n°
Phone No:
Integrator:
Operator Certification Number: 17794
Back-up Certification Number:
I--]„ Longitude: E-1° =' ="
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
� ❑Non -Layer
Other
❑.Other ----------. __-.
Dry Poultry
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑
Dairy Heife,
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
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 [10 No ❑ NA EINE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
W No
❑ NA
❑ NE
❑ Yes
[M No
❑ NA
❑ NE
12/28/04 Continued

Facility ]Number: —Sod Date of Inspection I V.? 7os
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ® No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): -c2a7. C" 7030 / 5
Observed Freeboard (in): 41S
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
® 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
Q No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drifl Ll Application Outside of Area
12. Crop type(s) e r rn-,�a = ho N / 'aS
U
13. Soil type(s) (,c_%Q %� 7'- �a
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 determinations❑ Yes
CO No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA ❑ NE
I& Is there a lack of properly operating waste application equipment?
❑ Yes
© No
❑ NA ❑ NE
((0
quer-,eip�aw �tauuuuns::tuse:aaar>,onai pages�astnecessary.�:
�G Jv -'tt .� Cp•s OL.s�, Q Qb C r Y-- (�� �. �! C� I CX� � � �'1 Ck S W c � CtJ i•�-�J G.� ��t
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: _ Date: / Z -2 7/,0 -1-
12128104
Q,1-
12/28/04 Continued

Facility Number:�1 _70sr pate of Inspection
kequirA Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M 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 EJ Checklists [:1 Design El Maps El Other
21. Does record keeping need improvement? If yes, check the ap propriate box below. El Yes ® No E:1 NA El NE
.2. 3
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
® No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
0a No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
V 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 CA WMP?
❑ Yes
® No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
(] Yes
[R No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
W No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
IM No
El NA
El NE
e t Iii. 'J[.`r _ . .: o] # 'sS� K, 4
Additional Comments aa�or'Drawiiegs�
12128104
12128104

V
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 4D Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: "3 - sme:
__ 0 Not Operational O Below
__,, Threshold
'Permitted U..ertified ©pConditionally Certified [3 Registered Date Last Operated or Above Threshold:
FarmName: ............................... -- - - ...�.�.__.......... .
Owner Name:
Mailing Address: _._C . d -lox_ �
Facility Contact: .......
Onsite Representative:.._._ji'....._..................
Certified
ass !Je �e�_..._.___._.........._...............
Location of Farm: Svr1
County
Phone No:
Phone No:
Integrator:
Operator Certification Number: _. �. ...
'2-a LIU^7
g4w-ine ❑ Poultry ❑ Cattle ❑ Horse Latitude i ° 46 Longitude ' 4 64
Discharges & Stream Ira acts
1. Is any discharge observed from any part of the operation? ❑ Yes Eo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes G -No
c. If discharge is observed, what is the estimated flow in gal min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 04W6
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Gwo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes GWO
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes QNct
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............ j. -- •......_ ........ .....W_ --- --_------------ -----....
Freeboard (inches):
12112103 Continued

• Facility Number: 5 �t
Date of Inspection U o
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. Does 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? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type c ex, tik / , S r;, a f
❑ Yes EkNo
❑ Yes [.jNo
❑ Yes Eg 90
❑ Yes [M
❑ Yes Flo
❑ Yes O'No
i
❑ �s M -Ko
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [j10'"
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ['o
b) Does the facility need a wettable acre determination? ❑ Yes [-To
c) This facility is pended for a wettable acre determination? ❑ Yes [}iq'b
15. Does the receiving crop need improvement? ❑ Yes [►moo
16. Is there a lack of adequate waste application equipment? ❑ Yes [31go
Odor I +sues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes oqqo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes E"o
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes UNo
Air Quality representative immediately.
°Commence (r er to gitestian #} Expiaut Y.. answsr recvmmeodatsons or any other, tomments._
Use drawrngs iaf iact7ity to better explasn srtnaboas. (use,additronai pages as necessary) field Co Final Notes
ReviewerllnspectorName /Yier-(
.
Reviewer/Inspector Signature: Q Date:
12112103 0 Continued

f Facility Number: Date of Inspection -/ G
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
GWO,
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[-fo
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
MIG
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
l�ecc,rds rte/( y ��
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
E o
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
MIgo-
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
Yes
EaXo
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
BNo
28. Does facility require a follow-up visit by same agency?
❑ Yes
MWo
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Mgo
NPDES Permitted Facilities
34. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) D-Ves ❑ No
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ,[bio
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes Levo
33. Did the facility fail to conduct an annual sludge survey? des ❑ No
34. Did the facility fail to calibrate waste application equipment? [2 -Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes To
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
o violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ddmciiial Comments and/or 13rawtngs _ `�
`Y - x
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