040007_INSPECTIONS_20171231

.,4,11ffDivi"sign aiWa#er Resources
FSic, Number - ®Division of Soil and Water Ganservatiou
Q Other Agency
hype of Visit: 4P Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: I I
e f Arrival Timc: D F Departure Time: d p.�, County:
Farm Name: % C "rT Owner Email:
r -
Owner Name: y92✓i / Phone:
Mailing Address:
Physical Address:
Facility Contact: / f-qm S
Onsite Representative:
4
Certified Operator: &4
Back-up Operator:
Location of Farm:
Title:
Latitude:
Region: P20
Phone: %�
Integrator: j as'- 9 4WY
Certification Number: 'L'LQi %T _
Certification Number:
Longitude:
Discharges and Stream Impacts
Design Current ' ''"'.
Design
Garrent
Design Carrent
-ne
Gapacity Pop. Wet Poultry
54
Capacity
Pop.
Cattle ' Capacity Pap.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Z-
Non -La er
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
Dai Calf
Feeder to Finish
Ep NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
Dai Heifer
Farrow to Wean
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
Design
Current
Dry Cow
Farrow to Feeder
2. Is there evidence of a past discharge from any part of the operation?
D P,oult ,
Ga aei
P,o -
Non -Dairy
Farrow to Finish
❑ Yes
La ers
❑ NA
❑ NE
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
_
I�.'
Turke s
Other
Turkey Poults
Other
Is' Other
1 Aw-
_- %-
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
f413No
�1T'
[—]NA
❑ NE
Discharge originated at: F] Structure E] Application Field E] 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
Ep NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
[] Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
T 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 2/4/2015 Continued

Facai Npmber: Lf - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No [] NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 311
❑ Yes
[P No
❑ NA
V
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 10 No
[] NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ NE
Required Records & Documents
6. Are there structures on-site which are not properly addressed and/or managed through a
[:]Yes 0 No
❑ NA
❑ NE
waste management or closure plan?
[�q 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 � No
E] NA
[:]NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes (N 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?
TT
Waste AuRfication
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes V] No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes ONo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Meavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs_ ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable C ;op Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. CropType(s): C-.OA.S`WA bWIr1''AAA Lhmz A0-202 js-j_r_UyT 1, (yiW'5,~
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ® No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 5;a No ❑ NA ❑ NE
acres determination?
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
[5j No
❑ NA
❑ NE
Required Records & Documents
19_ Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[�q 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 W1 N
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield El 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
No
❑ NA ❑ NE
[] Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Fpcility Number: Ll - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes EP No
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No
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 ❑ YesI�No
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below. ❑ Yes j No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: TT
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes © No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ® No
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑NA F] NE
F] NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[j NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
E:] NA ❑NE
Phone: /Q-
Date:
v
21412015

Z ((c
TIOvision g Wife Resources
F.acili Number yt/SA
OOp 0.
No f Soil and Water Conservation
v
ncy
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 A Emergency 0 Other 0 Denied Access
L' &
Date of Visit: VS_C>&IArrival Time: 0,'�S� Departure Time: County: #A/sgLt/
Farm Name: 6a=p crQriFx Owner Email:
Owner Name: f2,E V1 1 1,r�my /� Phone: - yp q. �9O -,o 4 7 -1
Region: 15<4Q
Mailing Address:
Physical Address:
Facility Contact: J�J&1 S I_ODK A-BI4L Title: PZ� I J C:41�ghone: j�Q4; &5"Di e4l1
Onsite Representative:
Certified Operator: �±05 LJt7,�'i,CL_ L_
I —
Back-up Operator:
Location of Farm:
Integrator: <,m 11-74 FIL=L/)
Certification Number: Z Z5__L ?L -
Certification Number:
Latitude: P 34_04'SZ Longitude: Wdo. /V/6
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge`?
❑ Yes W No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
N NA ❑ NE
EA NA ❑ NE
❑ Yes
❑ No
Current '
Design
Current
:: Design Current
❑ NA
lED.—esign
Swine
ei Po WeY PouEtry
ty p
Capacity
Pop.
Cattle Capaeity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
`L Non La er
Dai Calf
Feeder to Finish
-_''
Dai Heifer
Farrow to Wean
� � �'���
Design
Current
D Cow
Farrow to Feeder
D Poult , ;�
Ca aeity
Po
Non -Dai
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qther
Turkey Poults
Other
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge`?
❑ Yes W No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
N NA ❑ NE
EA NA ❑ NE
❑ Yes
❑ No
Z.NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
Page 1 of 3 214/1015 Continued

I.
Faciti Number: - op Date of Ins ection: pGr
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
L4t,t7o v
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 6 f
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?
❑ 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
�, 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
Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): ,,1og-s-r+,, J3 4
"m,,,P - % ,0e-
13. Soil Type(s): 45�,a�,2/�-'
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 T No D 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
00 No
❑ NA
❑ NE
❑ Yes
on No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Vq No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes W No ❑ NA ❑ NE
the appropriate box_
❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? I 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 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
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
21412015 Continued

Facifl Nuniber: - Pp Date of Inspection: s /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 14 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes W 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 fust survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes rVf 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
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?
❑ Yes
[ No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
19 No
❑ 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
[ 0 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
EX No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
4 No
❑ NA ❑ NE
Reviewer/Inspector Name: k iLAgrim Phone: 9/0, ;1-3 l d
Reviewer/Inspector Signature: �j _ _ Date: yS QGI 1��h
Page 3 of 3 21412015

Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Routine O Complaint 0 Follow-up O Referral O Emergency Q Other O Denied Access
Date of Visit:Arrival Time: O : w� ADaDeparture Time: ©County: SO Region: Ago
Farm Name: 6:�ld Ccr pk . Owner Email:
�I
Owner Name: Q V LBo `� _ Phone:
Mailing Address:
Physical Address:
Facility Contact: �jr.6wJS �i O Title: Phone:
Onsite Representative: Integrator: c�Js?
Certified Operator: Certification Number: 2 2-5-6 7
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Discharges and Stream Imuacts
1. Is any discharge observed from any part of the operation?
Design Current
CQ No
Design
Current
ii
. Design Current
Swine
Capacity Pap.
Wet Pointry
Capacity
Pop.
rattle Capacity Pop.
® NA
Wean to Finish
b. Did the discharge reach waters of the State? (If yes, notify DWR)
Layer
❑ No
® NA
❑ NE
Dai Cow
Wean to Feeder
Non -La er
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
[]Yes
[] No
Dai Calf
❑ NE
Feeder to Finish
[3 Yes
E] No
❑ NA
❑ NE
Da' Heifer
[:]Yes
Farrow to Wean
❑ NA
❑ NE
Design
Current
Cow
Farrow to Feeder
D . P,oul
Ca ac'
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
113eef Brood Co—
owTurke
Turkeys
s
Other
Turke Points
Other
Other
Discharges and Stream Imuacts
1. Is any discharge observed from any part of the operation?
❑ Yes
CQ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
Q No
® NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
® NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
[]Yes
[] No
[�j NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
[3 Yes
E] 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

'[Facility Number: jDate of Inspection: o
❑ Yes
�0 No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Waste Collection & Treatment
❑ Yes
FXJ No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P'7'1 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
❑ Weather Code
Identifier:' -
17. Does the facility lack adequate acreage for land application?
❑ Yes
[] No
❑ NA
Spillway?:
18. Is there a lack of properly operating waste application equipment?
[] Yes
Tg] No
❑ NA
Designed Freeboard (in):
2/4/2014 Continued
w
Observed Freeboard (in): X
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
Q 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
�] 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
Q No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
© No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop QW�in�dow � �❑1 Evidences off Wind DriiftL ❑] 1Appliccaa_tion Outside of Approved Area
12. Crop Type(s): ngS41IXd/1•.041'a 6?� _f✓r C.J`'e- ��Q� /. `�'�e'.)
13. Soil Type(s): _A~0_r14'
❑ Yes
�0 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
FXJ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�g No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
ac, -res determination?
[:]Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
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
Tg] No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�0 No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
5a 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 I " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[] Yes
M No
[:]NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P No
[DNA ❑NE
Page 2 of 3
2/4/2014 Continued

jVacility Number: y -'7 jDate of Inspection: !� 34jq
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes IM 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? ❑ 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 © 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? ❑ Yes M No ❑ NA ❑ NE
yu
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface 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 5& No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes [3d No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes P�l No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations: or any other comments p, - -
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone. AIM
Date: y 30
214120h

t ype of visit: O compliance inspection V Vperanon Review u structure Lvaivation V i ecnntcat Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 17.1►7/lArrival Time: B ' 30Q Departure Timer County: SBIJ Region: F-00
77�
Farm Name: Owner Email:
�
Owner Name: �lrt�.l I S o [i�f Phone:
Mailing Address:
Physical Address:
Facility Contact: LWi S Title: Phone:
Onsite Representative: u
Certified Operator:
L,
Integrator: AAa.PjWMWk
T
Certification Number: zz�i
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?
Design
Current
❑ NA
Design
Current
Design Current
T
Swine
Capacity
Pop.
Wet Poultry
Capacity
Pop.:.:_
Cattle Capacity Pop.
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Wean to Finish
❑ No
r" NA
Layer
c. What is the estimated volume that reached waters of the State (gallons)?
Dairy Cow
Wean to Feeder Z. Z Won -Layer
Dairy Calf
Feeder to Finish
Farrow to Wean
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
Design
Current'
Dairy Heifer
Dry Cow
❑ NE
Farrow to Feeder
❑ Yes
[55 No
Di, P■oultry
Ca aci
Pio P.
Non -Dairy
Farrow to Finish
'Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turke Poults
Other Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
MR No
❑ NA
❑ NE
Discharge originated at: [❑ Structure ❑ Application Field ❑ Other:
T
a. Was the conveyance man-made?
❑ Yes
❑ No
DD NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
r" NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
[] Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
C6 No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[55 No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili Number: -Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes I? No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No N NA ❑ NE
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
y
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes M No ❑ NA ❑ NE
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes PD No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes � No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ YesNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) `P
9. Does any part of the waste management system other than the waste structures require ❑ Yes [�3 No ❑ NA ❑ NE
maintenance or improvement?
Waste AvUlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes T No [:]NA ❑ NE
maintenance or improvement? TT
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 ❑ Evidence of Wind Drift _ I❑ Application Outside of Approved Area /
12. Crop Type(s): Cc�t��-I ( > 27 G—tcT. 01a,i l S )/ S., • �L, 6yz/L r•!
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes M 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?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes [ No
❑ Yes ® No
❑NA ❑NE
❑NA ❑NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes QD 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes 10 No
❑ Yes $ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

1
IFacili Number: - Date of Inspection: 7
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(cs) 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 lust survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE ci
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [] Yes [P 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 the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes C' No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes rj,4 No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes T� No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments ::;.,',;
Use drawings of fadlitV6 better explain situations (use additional pages as necessary).
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes [�q No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: T/0 ?3-33oo
Date: 2_/j 7 /
2/4/2011

(Type of Visit: • Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: 0 Routine O Complaint O Follow-up 0 Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: 2041 �jj;E] Departure Time: /10; 7CE9 County/s'a^J
Farm Name: G41Ck xia s7 a/—/ Owner Email:
Owner Name: - rLLdr� aea�l�r l/ Phone:
Mailing Address:
Physical Address:
Facility Contact: a r' 1r- Title:
Onsite Reuresentative: Integrator:
Certified Operator: d
Region: /Z
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Wet Poultry
Layer
Non -Layer
D . P.oaltr
Layers
algRign
Capacity
Design
Caaci
CurrentDesign
Pop.
i�
U*`U en
Po
Current
Cattle Capacity Pop.
Dai Cow
iry Calf
Dairy Heifer
jDry Cow
Non -Dairy
Beef Stocker
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Gilts
Non -Layers
❑ No
® NA
Beef Feeder
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Boars
Pullets
® NA
❑ NE
Beef Brood Cow
O#her
Other
Turke s
Turkey Poults
Other
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
[:]Yes
❑No
[ NA
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
n No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
® NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
® NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
[:]Yes
❑No
[ 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
�5 No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 214/2011 Continued

Facili umber:- Date of Inspection: Z
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 [RNA ❑ NE
Structure i Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): W4
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 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 Avolication
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 Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops didr from those designated in the CAWMP?
❑ Yes
Ea 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
EP No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
[3 Yes
[P No
TT
E]NA
E]NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
T No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[g No
❑ NA
❑ NE
the appropriate box.
❑WUP E] Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q No ❑ NA J—]NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

j'aci ' umber: - Date of Ins ection: Z
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes �] No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes EP No
the appropriate box(es) below. T
❑ 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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
r S!/►�� t!v-p� D
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
cs�
o � nuc✓
CvG
� �,r�,,,,°�
❑ Yes -
[?] No
❑ NA
❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
EJ Yes Lp No ❑ NA ❑ NE
[:)Yes M No 0 NA ❑ NE
❑ Yes [8 No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes
[n No
❑ NA
❑ NE
❑ Yes -
[?] No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
4C. --a„/
Phone: 9l0, -At.? � Co
Date: y 4 Z
/4/2011

Type of Visit A Compliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine O Complaint Q Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: !s Arrival Time, `g' ,y 4 eparture Time: County: _ "7 Region: ^
Farm Name: _ GO ti rte'^` _ Owner Email:
Owner Name: _ --rrA V l S Lop lLA�(�1 Phone: `
Mailing Address:
Physical Address:
Faeility Cnntart- { .-Q UN l-d'LaYlt d Title- Dhnno Nn -
Onsite Representative: Integrator: UC
W� UC
rj 7Certified Operator: Operator Certification Number: o"
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = e =I 0 N Longitude: =0=6
°=` = "
Design Current
Swine Capacity Population
Wet Poultry
_--noCurrent
Capacity Population
Design C*urreut
Cattle Capacity Population
❑ Yes
❑ Wean to Finish
I0 Laver
❑ NE
❑ Dairy Cow
Wean to Feeder 3157J2, 25W❑
Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
❑ Yes
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
-
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
Pullets.
❑ Beef Brood Co
❑ Turke s
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
❑ No
§a NA
❑ NE
❑ Yes
❑ No
1P NA
❑ NE
❑ Yes
❑ No
5NA
❑ NE
❑ Yes
EANo
❑ NA
❑ NE
El Yes
� No
❑ NA
❑ NE
Page 1 of 3 12/28/04 Continued

Facility Number: —� _ Date of Inspection
❑ Yes
V No
Waste Collection & Treatment
❑ NE
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 �A No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
1P NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
❑ NA
❑ NE
Spillway?:
❑ Yes
No
Designed Freeboard (in):
❑ NE
Comments (refer to question,##): Explain any YES; answers andlor any recommendations or any
N
Observed Freeboard (in):
Usedrawingof faclity to better explain situations. ( use additional pages, as necessary):7
`
...
5. Are there any inunediate 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
[INA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes No
❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
[] Yes No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require❑
Yes (3 No
ElNA ❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes EP 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 > t0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑Evidence of Wind Drift El Application Outside of
Area
Coa i J�afM416-mS (1 fl?54he),5,ti 6v?2-�
OwwSaj
12. Crop type(s) 5-t ,
44 FV
13. Soil type(s) �, . , r�'o0'r"a
14_ Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
V No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
09 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
0 No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
1p No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question,##): Explain any YES; answers andlor any recommendations or any
othef comments. - ,*
Usedrawingof faclity to better explain situations. ( use additional pages, as necessary):7
`
...
Reviewer/Inspector Name* Phone: 3 "3Gp
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

■.
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [A No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
P No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[0 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
N No
❑ NA
EINE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
1P No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
T No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
W No
❑ NA
EINE
Other lssues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
❑ NA
EINE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P No
❑ NA
EINE
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
Ep 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
[ANo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
tgNo
❑ NA
❑ NE
Additional Comments,',ancllor, Drawings _ ::. �v Z Z `- � , ; 159
Page 3 of 3 12/28/04
Page 3 of 3 12/28/04

Type of Visit *Compliance Inspection Q Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: VD.r Departure Time: % County: �� Region:
Id Farm Name: Hn Owner Email: _
Owner Name:ynyl 5 LDOJ�SL" (l Phone:
Mailing Address:
Physical Address:
Facility Contact: _T�AVc �
Title:
Onsite Representative: II
Certified Operator: �
Back-up Operator:
/��
Phone No:
Integrator• Mtn- —i' 11 �C
Operator Certification Number: 22
cation 2
Back-up Certification Number:
Location of Farm: Latitude: =0
=4
=46 Longitude: = ° = i = u
Design Curren
❑ NE
❑ Yes ❑ No NA
❑ NE
[:]Yes ❑ No PSNA
Design Current
Design
EXU01111111111
Swine Capacity Papulation
❑ Yes No ❑ NA
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish I
I JE1 Layer
❑ Dairy Cow
0,Weanto Feeder 1 3
ILI Non -Layer
❑ Dairy Calf
Feeder to Finish I I
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish
❑ Layers
El Beef Stocker
❑ Gilts
❑Non -La Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
ElBeef Brood Cowl I
El Turkeys
Other
❑ Turkey Poults
❑ Other
❑ Other
Nunn er of Structures:
Discharges & Stream Impacts
t. 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 fiAo ❑ NA ❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
[:]Yes ❑ No PSNA
EINE
❑ Yes M No ❑ NA
EINE
❑ Yes No ❑ NA
❑ NE
12128/04 Continued

Reviewer/Inspector Name Phone: %ID``+'`S IE'_LV V
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128/04 Continued
Facility Number: — Date of Inspection f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
P No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes
❑ NoNA
[:]NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
S cture 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 371t
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes(�
No
[INA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
[
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
0 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
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
El NA ❑ NE
maintenance or improvement?
�
Waste Avolication
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
[INA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload El Frozen Ground El Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus [:]Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)&2-s,5-
VSS
13. Soil type(s) G f'y+sy�
13.
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
[P No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
�Vo
❑ 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
C�No
❑ NA ❑ NE
Comments (refer to question #) Explain any YESans►aers andlor any recommendations or aay other cowmen#s
Use drawings gf facility to: better explain situations (use aildihonai pages as necessary)
Reviewer/Inspector Name Phone: %ID``+'`S IE'_LV V
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128/04 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Ep 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 ❑ Desi l
gn ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ YesNo ElNA ❑ NE
❑ Waste Application ElWeekly Freeboard ElWaste Analysis ❑ Soil Analysis ElWaste 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
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
J�FNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
0 Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
NA
❑ NE
Other tissues
28.
Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
T No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�INo
-❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
EpNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31,
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
IP 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
P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
V No
❑ NA
❑ NE
Additional. Comments and/or Drawings �
--
� � ��� ,�� _ -�• ,
� ,�i�l �. � J -
AL
Page 3 of 3 12/28/04

r
1
Division of Water Quality
iFacility Number 0 Division of Soil and Water Conservatiou
Q Other Agency
Type of Visit 40 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit JWRoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: rrival Time: f -?.O Departure Time: County: Region: COM
3-17-09 I
Farm Name: f Owner Email:
Owner Name: trQ1i i S l.[�ob r l _ Phone:
Mailing Address:
Physical Address: T f j
Facility Contact: I rte! S _�-�6�10r �1 Title:
Onsite Representative: h
Certified Operator:
Back-up Operator:
k
Phone No:
V LYN
Integrator: �Ukly, " �Y73W n
Operator Certification Number: os��
Back-up Certification Number:
Location of Farm: Latitude: [::] e =' = Longitude: = ° [=' = u
Design Current
Design Current
Design Current
e Capacity P-opulation
�'�'et Poultry Capacity Population
.00
Cattle Capty Population
to Finish
❑ La er
❑ Da' Cow
rEean
ean to Feeder ?j 3000
❑Non -La er
❑ No
❑Dai Calf
eeder to Finish
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Dai Heifer
arrow to Wean
Dry Ponlfry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑Beef Feeder
El Boars
❑ Pullets
❑ Beef Brood Co
_ - _
��
Other M� .�
❑ Turkeys
❑ TurkeyPoults
�,_...
, ,
❑ Other
❑ Other
Number of Structures:
❑ NA
❑ NE
other than from a discharge?
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
FNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
RNA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
P NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
;RNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
P9 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
N No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28104
Continued

- 3-i70�
Soil type(s) Erika
i
Facility Number: — Date of inspection
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes VNo
Waste Collection & Treatment
❑ NE
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
PNo
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
193 NA ❑ NE
Strulture l Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Is there a lack of properly operating waste application equipment?
❑ Yes J},No
❑ NA
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
(--]Yes
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
L'�3 No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
V5No
❑ NA EINE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
93No
❑ 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
;EjNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ YesNo
[INA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Windrow ❑ Evidence of Wind Drift l Application Outside of Area
12. Crop type(s) 6- s- 7i l � tYLudQ �SS & ._IAS`FW�P 1 j SMt lXa O
13.
Soil type(s) Erika
i
P
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes VNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes )RNo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes [ANo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes M No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes J},No
❑ NA
❑ NE
....
fath� � #o he# �E Iarn an answers and/ a
neshon tte X lam situations. use addict©nal pages,as necessary):
g or alnyl'recom�.'mendations or any other comments.
U e drawm sof �
i
P
ReviewerlInspector Name Phone: 33 3 300
,q
Reviewer/Inspector Signature: I Date:
Page 2 of 3 1228/04 V C'onfinued

t
s
Facility Number: — M Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the approprrate box. ❑ WUP ❑ Checklists ❑ Design g [:1 Maps El Other
El Yes F No El NA 0 N
❑ Yes 19 No ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes PONo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. 1 f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
0 N
[:INA
❑ NE
❑ Yes
09 No
❑ NA
❑ NE
❑ Yes
151No
❑ NA
❑ NE
❑ Yes
�&No
❑ NA
EINE
❑ Yes
]9 No
❑ NA
❑ NE
❑ Yes PNo ❑ NA ❑ NE
❑ Yes P9 No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ;DNo ❑ NA ❑ NE
❑ Yes
(;io
❑ NA
❑ NE
❑ Yes
;!;No
❑ NA
❑ NE
❑ Yes
V3 No
❑ NA
❑ NE
Additional.;Cflmments and/.or Drar�mgs ',;,, ,.
A,
H
Page 3 of 3 12128/04

0 Division of Water Quality
Facility Number �--� 0 Division of Soil and Water Conservation
0 Other Agency
IType of Visit & Compliance Inspection O Operation Review Q Structure Evaluation 0 Technical Assistance I
Reason for Visit • Routine O Complaint O Follow up 0 Referral O Emergency O Other ❑ Denied Access
. I
Date of Visit: 1 Arrival Time: �8@M Departure Time: County:SpN Region: FRO
Farm Name: Gold cttL &1ZMS #� I _ Owner Email: � 1
Owner Name: lira V to , LW Phone: l `70q) a5 - q y9T
Mailing Address: Lo4 69q - f t o
Physical Address: I
Facility Contact: Trayi 5 L poka6 I1 1 Title:
Onsite Representative:
�I
Certified Operator: li
Back-up Operator:
Location of Farm:
Design Current
swine uapactry ropulatton'
❑ Wean to Finish
Wean to Feeder 3�D
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Gilts
Other
❑ Other
M Phone No:
Integrator: / ' t Lw
Operator Certification Number: �;QS6
Back-up Certification Number:
Latitude: =0 =6 0 Longitude: = o= 0
Design Current
Wet Poultry Capacity Population
❑ La er
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults IF EEI
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Currnnt
Cattle Capacity Population`.
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Ca
Dumber of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
El Yes PNo ❑N
❑NE
❑ Yes �9 No [:IN A
❑ NE
12/28/04 Continued

[Facility Number: Lj — Date of Inspection 29
Ilk
Waste Collection & Treatment
Reviewer/Inspector Name Phone 33'3300
a
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
O No ElNA ElNE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No [53NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Frceboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
N 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
Q No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[1) No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
E] 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 [INA ❑ 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
FXbNo ❑ 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 Window ❑ Evidence ofi Wind ❑ Application Outside
of Area
"Crop \Drift
,
12. Crop type(s) GUS PC�Lr" UJ4 t% a Si �C(GY.7� A <4u(A 5, m - &11-" o "y_$QQd
-
13. Soil type(s) ,t}}�`Q -a
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [5?No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Q 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes �INo ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers andlor any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Ilk
Reviewer/Inspector Name Phone 33'3300
a
Reviewer/Inspector Signature: Date:
12/1810 Continued

Facility Number: V— 7 Date of inspection 1 y9
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [INo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Z3 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps p El Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes 12 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 1P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes KI No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes 10 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes JU No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes U 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
EM No
El NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
12 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
0 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NF_
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
91 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
K] No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit 49 Compliance Inspection Q Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 1:21A190671Arrival Time: ® Departure Time: /0;M't t� County: Or7�
n Region:
Farm Name: &id Fa mS*-) Owner Email:
Owner Name: _ -rr vi S L -Loo kara. r( Phone:
Mailing Address:
Physical Address:
,
Facility Contact: —Fr-ets,I 5 Lto Title: Phone No:
Onsite Representative: 0 Integrator: " `Y40A,
1 11
Certified Operator: V Operator Certification Number:a�
Back-up Operator -
Back -up Certification Number:
Location of Farm: Latitude: =0 =1 ="
Longitude: 0 ° =' E__1 u
DesignME.ju—rren
Design Currentillill
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Yes
❑ No
Wean to Feeder I 3S52
❑Non -La er
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Dairy Calf
❑ No
❑ Feeder to Finish
❑ NE
❑ Dairy Heifer
❑ Farrow to Wean
It
❑ Dry Cow
❑ Farrow to Feeder
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Cilts
❑ Non -La ers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Yes
❑ Turkeys
-
Other
❑ Other
❑ Turkey Poults
❑ Qther
Dumber of Structures:
tt
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
lNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[� NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
ERNA
❑ 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
PNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
EANo
❑ NA
❑ NE
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
MbNo
❑ NA
❑ NE
other than from a discharge'?
tt
Page I of 3
12/28104
Continued

Facility Number: — Date of Inspection aC1EJ'y
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes CP No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 tructure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 23
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes *o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes P 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? ❑ YesNo ElNA [INE
(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 El NA El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes T No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of
Acceptable Crop" Window ❑ Evidence of Wind Driift� ❑ Application Outside of Area
12. Crop type(s) CQ251GLI �,r MJ4 �� r .Sen l -1Y'• dt/P,
e
13. Soil type(s) jry pg
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ yes No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes [No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Comments (refer: to question ft Explain any YESAnswers and/or any recommendations:ortany�.otiter comments
Use drawmgs.of:facility to better egplaEn.sifuahons: (use additional pages as necessary)—l"4,
T a4' M _
%o 6f I h�
Phone /0
Reviewer/Inspector Name i " '�
`3
Reviewer/Inspector Signature. . Date:
Page 2 of 3 12128164 Continued

Facility Number: — Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes `F" No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes UNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists
❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V 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
LpLNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1p No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
1 ]!No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
IU�No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
EkNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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)
!l
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
�No
ElNA
ElNE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA
❑ NE
Additional Comments�andtor Drawings:
Page 3 of 3 12/28/04

Type of Visit (�Mompliance Inspection O Operation Review O Structure Evaluation O 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: Departure Time: `�, 3 County: /i'ir Region: CEO
Farm Name- "iJ 11:arrrx_ _--T-- Owner Email:
Owner Name:. �/`au� s /i�e�a r �-Q fll� _ Phone:
Nailing Address:
Physical Address:
Facility Contact: _ S! -, Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Integrator:17�4r
Operator Certification Number: _S G %
Back-up Certification }Number:
Latitude: [—] o[::]'F__j Longitude: 0 0 0 u
Design , Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish
a Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
1.0 Other
❑ Layer
❑ Non -La ct
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharge & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ 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:
TJ _.
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 ;M No El NA ❑NE
❑ Yes
E� No
❑ NA
❑ NE
❑ Yes
[&No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
® No
❑ Yes
®,No
❑ NA
❑ NE
❑ Yes
(allo
❑ NA
❑ NE
12/28/01 Continued

Facility Number: —7-1 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 29 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [0 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: -
Spillway?: Y�5
Designed Freeboard (in):
Observed Freeboard (in): 30
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [91 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 Ej 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 Qa No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes � No ❑ NA El 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 LRrNo ❑ 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/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 4 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) 7tv
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
6�No
❑ NA
❑ NE
15- Does the receiving crop and/or land application site need improvement?
® Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
i ❑ Yes
19 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
MNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[KNo
❑ NA
❑ NE
1.e- / ; m, a3 Ca, l/ -,-%r &__ �L7^rs+
G rlm &-At J5 7;; ' Ac/t- of -- ✓U �-
Reviewer/Inspector Name y�� F =�' Phone:p-�/
Reviewer/Inspector Signature: Date: ;Z;7 -P_7 Do o7�
12/18/04 Continued

22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
ZLNo
Facility Number: — Date of Inspection l
❑ NE
23.
Required
Records & Documents
El No
❑ NA
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
RNo ❑ NA ❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No ❑ NA ❑ NE
Did the facility fail to conduct a sludge survey as required by the permit?
the appropirate box.
❑ WUP El Checklists El Design El Maps El Other
EQ No
❑ NA
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
® No ❑ NA ❑ NE
Eq No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
27.
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
ZLNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
El No
❑ NA
❑ NE
24_
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
EQ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Eq No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
RNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29,
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[ 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
❑ YesMNo
❑ NA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
P] No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,Q No
❑ NA
❑ NE
Addehonal Co``mments,andlomBrawutgs�, F
12/28/04
12/28/04

0� WTFiQ Michael F_ Easley, Governor
William G_ Ross Jr., Secretary
CO North Carolina Department of Environment and Natural Resources
Q Alan W. Klimek, P.E. Director
Division of Water Quality
September 15, 2004
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Mr. Travis McRae Lookabill
PO Box 954 - - - . . - . -
Wadesboro, North Carolina 28170
Subject: NOTICE OF VIOLATION/NOTICE OF INTENT
Administrative Code 15A NCAC 2H.0217'
Gold Creek Farm
Facility No. 4 - 07
Anson County
Dear Mr..Lookabill:
You are hereby notified that, having been permitted to have a non -discharge permit for the subject animal waste
disposalsystem pursuant to 15A NCAC 2H .0217, you have been found to be in violation of your 2H.0217 Permit.
Violation 1: Failure to notify Division of Water Quality of inadequate freeboard in the lagoon within 24
hours. (Permit No. AWSO40007 Section 3 condition 6e and Section 5 condition 3 of the
facility's General Permit)
This violation is in reference to Gold Creek Farm (facility # 04 - 07) being in the storm storage according to your
CAWMP and failure to report.
Required Corrective Action for Violation 1:
Please notify the Division of Water Quality of any high freeboard occurrences within twenty fours hours.
The Division of Water Quality requests that in addition to the specified corrective action above, please submit the
following items on or before September 30, 2004:
1. Copies of all lagoon levels and rainfall records for this farm from January 1, 2004 to the present along with
a current copy of your CAWMP.
2. Please have the OIC for this farm include an explanation as to how this violation occurred.
3. Please have the OIC include a list of the steps that will be taken to prevent this violation from occurring in
the future_
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 2 7699-1 61 7
Internet: h2o.enr.state.nc.us 512 N. Salisbury St. - Raleigh, NC 27604
An Equal Opportunity/Affirmative Action Employer - 50°1. Recycledl109% Post Cortsurner Paper
Ncai-
�1UaCarolinatura!!r�
Phone [phone] Customer Service
FAX [phone]

Mr. Lookabill
September 15, 2004
Page 2
Please be advised that this notice does not prevent the Division of Water Quality from taking enforcement actions
for these violation or any past or future violation. Furthermore, the Division of Water Quality has the authority to
levy a civil penalty of not more than $25,000.00 per day per violation_
If you have an explanation for this violation that you wish to present to this office, please forward a detailed
explanation, in writing, of the event noted and why you feel that this office should not proceed with recommendation
for enforcement_ This office on or before September 30, 2004 should receive this response_ Information provided
to this office will be reviewed and, if enforcement is still deemed appropriate, your explanation will be forwarded to
the Director with the enforcement package for his consideration.
If you have any questions concerning this matter, please do not hesitate to contact Mr. Larry C. Baxley, .
Environmental Specialist, or myself at [phone].
Sincerely,
l
Barnhardt
quifer Protection Supervisor
cc: Keith Larick - Compliance Group
Stephanie Goglia-Anson Co. NRCS
Trent Allen — SWC, FRO
Central Files - Raleigh

Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Dale of Visit: EEUii] Time:
MO Not O erational Q Below Threshold
O Permitted M Certified 13Conditionally Certified 0 Registered Date Last Operated or Above Threshold-
Farm Name: G6 1A C— VC7n County: :4t,ia-n ;F42.n
Owner Name:
Mailing _address:
Facll►ty Contact: Title:
Onsite Representative: r- ¢;
Certified Operator:
Location of Farm:
Pbone No:
Phone No:
Integrator:
Operator Certification Number:
Swine ❑Poultry ❑Cattle ❑ Horse Latitude Longitude C�' �•
Design Current Design Current Design Current
Swine Capacity Population Poultry Caglaciltv Population Cattle Ca acith• Population
M Wean to Feeder 10 Laver ❑ Dairy
❑ Feeder to Finish JE3 Non -Laver I I on -Dairy
❑ Farrow to Wean
❑ Farrov,- to Feeder Other
rFarTou' to Finish Total Design Capacity
GiltsTotalTotal SSLW
Number of Lagoons ❑ Sul
Holding Ponds I Solid Traps ❑ No
Discharges & Stream Impacts
1. Is anv discharge observed from any part of the operation?
Discharge originated at: ❑ La$oon ❑ Spray Field ❑ Other
a. If discharge is obsen-ed, was the conveyance mar} -made?
b. If discharge is obsmed, did it reach Water of the State? (If ves, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notifj, DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: "
Freeboard (inches):
05/03101 Continued
❑ Yes
No
❑ Yes
❑ No
ED Yes
El No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
Structure 6
05/03101 Continued

4
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan? E3 Yes [I No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reuuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative'? ❑ Yes ❑ No
24. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [--]No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
vJivJivi [,onunuea

Information contained in this database is from non agency sources and is considered unconfirmed.
.
Animal Operation Telephone Log
DWQ Facility Number 04 07
Farm Name IGold Creek Farm J
Caller's Name No call/ Inspector visit
O Reporting Q Complaint
Caller's Phone # NIA
Access to Farm
Farm Accessible
from main road 10 Yes O No
Animal Population
Confined 10 Yes O No
Depop O Yes O No
Feed Available 10 Yes O No
Mortality 10 Yes O No
Spray Availability
Pumping
Equipment
10 Yes O No
Inundated
Available
Fields
Overtopped
10 Yes O No
Date 9/9/2004
Time 12:50
Control Number P622
Region JFRO
Lazoon Ouestions
Breached
10 Yes O No
Inundated
O Yes O NO
Overtopped
10 Yes O No
Water on
O Yes O No
Outside Wall
Lagoon3
Dike Conditions
O Yes O No
Freeboard Level
Freeboard
Plan Due Date Date Plan Date Freeboard
Inches
(? equals blank) Received Level OK
Lagoon/ 18.5
9/11/2004 0 ��
Lagoon2
Lagoon3
Lagoon4
Lagoons
Lagoon6
Farm visited as result of storm storage lagoon checks being conducted by DWQ staff. No notification
1rceiued..fxam.permitee.........................................................................................................................................................................................................................
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Pierson taking, cat/ NIA
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Comments2

"4000,
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0
0100—

Type of Visit ® compliance inspection Q Operation Review C) Lagoon Evaluation
Reason for Visit ® Routine O Complaint 0 Follow up O Emergency Notification O Other ❑ Denied Access
Facility_• Number Datc orvisit: t Time: Q
>\ot O erational Below Threshold
® Permitted ® Certified 0 Conditionally Certified [3Registered Date Last Operated or Above Threshold:
Farm Name: eraict C.re_etc._ F6 rrrv. County: ,'&4'r n,- 1k 0
Owner Name: I �GUtS llt��. f? Ca�� o��c.�r i I Phone No:6!t69 4, /D
Mailing Address: l'D., Bng SEi _- — i [i. be C� d Ill C l�( 7b
Facility Contact: i Lcl cb i I k Title: Phone No:
Onsite Representative: r,-. 'j C L ON Ln L; Q Integrator: C,6LCt]ll S
Certified Operator: Lo f'L A_6; L 1 Operator Certification Dumber:
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a ° 0" Longitude ' • �K
Design Current
Swine ranarifv Pnnniatinn
❑ Wean to Feeder 1.3 i 5a 13 2o O
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Ca achy Population Cattle Capacity Population
❑ LaverI ❑ Dairy
❑ Non -Laver I I EEI Non -Dain
❑ Other
Total Design Capacity
Total SSLW
jLI Subsurface Drains PresentJU Lagoon area W SPr
❑ No Liquid Waste Manatrement Svstem
Discharges & Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. If discharge is obsmed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste olleetion & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure ? Structure 3 Structure 4 Structure S
Identifier:
Freeboard (inches):
05/03/01
❑ Yes ( ' No
❑ Yes ❑ No
E) Yes El No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
❑Yes qNo
Structure 6
Continued

Facility Number: — Date of Inspection [
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [Boo
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes Q9 No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [� No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [;a.No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes [;t No
Waste Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes 1P No
U- _
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
M No
12.
Crop type j3 n, ra �4 •� 4e;. C�
❑ Yes
No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
1�3 No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
[3 No
20.
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
21.
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Docs the receiving crop need improvement?
❑ Yes
PQ No
16.
is there a lack of adequate waste application equipment?
❑ Yes
[P No
Reouired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�R No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
No
24.
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
offacility' o Ibetter ezplain situations: (use addihoni - pages as necessary)
El Field Copy ElFinal Notes
me -Ord,:, d- I & Atrr`.. 1io til c _ i d 50" ,
Reviewer/inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued
(ic/ discharge, freeboard problems, over application)
❑ Yes[
No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes[�]+
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[] No
Q
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
offacility' o Ibetter ezplain situations: (use addihoni - pages as necessary)
El Field Copy ElFinal Notes
me -Ord,:, d- I & Atrr`.. 1io til c _ i d 50" ,
Reviewer/inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: 4 — Date of inspection r2 t t O
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a parmanent/temporary cover?
❑ Yes ❑ No
❑ Yes 1P No
❑ Yes PNo
❑ Yes ED No
❑ Yes ® No
❑ Yes No
❑ Yes ❑ No
Additmtn.1,Comments.and1or
AL
05/03/01

Site Requires Immediate Attention:
Facility No. c)4
DIVISION OF ENVIRONI EMAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SrM VISITATION RECORD
DATE: 1995
Time: _..;,' S 10
Farm NanWOwner: _ 1- r 4f -,A0.
?Mailing Aft=: LR E wades bass _ NC � Z 17Q ('2C4 ) 65 q Vie?&�f
County: Amason
Integrator: Phone:
On Site Representative: Phone:
Physical Address/Location: 5 CZ l X03 % t-; , t -Pas 6 5.4- .5 R E 60 3 4- 41 I
Type of Operation: Swine x Poultry Cattle
Design Capacity: 35� Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Sb
0 ;B * Longitude: C- ° "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) Yes or No Actual Freeboard:4:Ce,_,Ft. —2 . -Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or i (Seepage Was
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No Not Evaluated)
Crop(s) being utilized: Spray Field or cover crop was not evaluated)
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No*
k Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No
Is animal waste discharged into water of the state by man-made ditch, flushing system, orbther
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No(Waste management records were not
Additional Comments:
_nis was a vea brief inspection. a more thorough inspection will he conducted in the ure.
Please contact..DEM should any condition. arise that poses _a danger to surface waters.
* This farm was not located on a USGS TOPO map to determine `.'Blue Line" status.
If you have questions_ concerning this report please do not hesitate to .contact the inspector
at [phone]. Please contact the inspector if the above information is incorrect.
' ' -
P
I � �s
Inspector Name
21 k�L
Signature
cc: Facility Assessment Unit Use Attachments if Needed.