040033_INSPECTIONS_20171231

type of visit: W uompoance inspection v operation Keview U structure Lvaivation U I ecnnical Assistance
Reason for Visit: 40 Routine Q Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: hi Arrival Timer Departure Time: r' County: Region:
Farm Name: oa1e_� & Owner Email:
Owner Name: 46L&.LM41LLC— Phone:
Mailing Address:
Physical Address:
Facility Contact: rzjzL PL4,_CC-� Title: Phone:
Onsite Representative: L { ,1 c�'l-t _ Integrator: �;, , C
Certified Operator: (TbStl'. Certification Number: ?9-M43
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Design Garrent I
Capacity Pop. Wet PoultryCapacity
La er
Design
CI rent
Pop
Design Current
Cattle w Capacity Pap.
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
-
Feeder to Finish
�_-�
3'". Design
0 It ' Ca ac'
Carret�t
1?0
Dairy Heifer
U Cow
Non -Dairy
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
11-avers.
Beef Stocker
Beef Feeder
Beef Brood Cow
Non -Layers
Boars
Outer
Other
Pullets
Turke s
Turkey Poults
Other
IV
ill
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes Q? No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? [:]Yes ❑No [�j NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No [)5 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 $g NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes M No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes PQ No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

[Facility Number;- Date of Inspection:
Waste Coliection & Treatment
[:]Yes
[ No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
r---' 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: [
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
�3 No
❑ NA
Designed Freeboard (in):
Required Records & Documents
Observed Freeboard (in): _
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
[] Yes
[� No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
the appropriate box.
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?
It 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
[U No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
O 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
❑ Yesp
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
cP No
❑ NA
❑ N E
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [aNo ❑ 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 ro Window ❑ Evidence Wind Dr'ft ❑ Application Outs'de f Approved Area
12. Crop Types)=S5�:
13. Soil Type(s): 1w g,,joqa
14. Do the receiving crops differ from those designated in the CAWMP?
[:]Yes
[ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[� No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[] Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�3 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
O WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste "transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? E] Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes � No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
0 NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection: 27
24?Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Q� No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check
❑ Yes
® No
[] NA E3 NE
the appropriate box(es) below.
❑ Yes
ii��
❑ NA ❑ NE
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
❑ Yes
t�pNo
❑ NA ❑ NE
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
P No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[4 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
W 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
t�pNo
❑ NA ❑ NE
permit? (Le., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[P No
❑ NA [] NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Yom' No
❑ NA ❑ NE
Comments' refer to" uestiou'� : Fx lain any.'YES answers and/ou'ab AdditionRl' rec6midend4tions or aOy' Other Comments.
Use drawings of facility to better explain situations (use additional pages as neceWry).
0
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1104Y 3'7eV
Date: LlZT
2/4/2015

IType of Visit: ® Compliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergencv 0 Other 0 Denied Access
Date of Visit:— Arrival Time:�.� Departure Time: 7a,r3 County: Region:
Farm Name T Y1 ©Q S w► Owner Email:
Owner Name: r"'t ""S LL C Phone:
Mailing Address:
Physical Address:
Facility Contact:
:Kd pv -tA,— Title:
Onsite Representative: "' TOS `
Certified Operator: U
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: �L�.iQh.,--0tpt..JH
Certification Number: VOL
Certification Number:
Longitude:
gn Current
Design
Current
Design Current
Swine
rmlep!c�ty Pop.
Wet Poultry
Capaeity
Pap.
e FettlCapacity Pop.
Wean to Finish
Layer
airy Cow
Wean to Feeder
Non -La er
I
ai Calf
Feeder to Finish
_
Dai Heifer
Farrow to Wean Z
Design
Current
Dry Cow
Farrow to Feeder
D , P,o
Ca a. `
P.o
Non -Dalry
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
BoarsPullets
Beef Brood Cow
. _ . _. _..- ._
a,
Turkeys
---_.
Other
Turkey Poults
Other I I
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a_ Was the conveyance man-made? ❑ Yes ❑ No ® NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? T
d. Does the discharge bypass the waste management system? (if yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/42014 Continued

acili Number: q-3 Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yesjam, No
a. if yes, is waste level into the structural freeboard? ❑ Yes 7❑ No
Structure 1
Identifier:
Spillway?:
Designed Freeboard (in):
H
Observed Freeboard (in):
❑ NA ❑ NE
®NA ❑NE
Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes—No
❑ Yes 1�9 No
❑ NA ❑ NE
❑NA E] 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 ❑ 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 Lam! No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land 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 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑Evidence f Wind Drift ❑ Application Outside of Approved Ar
�Q
12. Crop Type(s):--+ra''WQ
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
9DNo
❑ NA
❑ NE
[:]Yes
P No
® NA
❑ NE
❑ Yes No C] NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑WUP ❑Checklists ❑ Design 0 Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes j No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑Waste Tra sfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes n No
Ir
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes y
No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

F`acili Number: 33 jDate of Ins ectiom,
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 1)�p No ❑ NA ❑ NE
25- Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ❑ No r3 NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 10 No ❑ NA ❑ NE
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
❑ Yes
0 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
h 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
M No
❑ NA ONE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�] No
❑ NA ❑ NE
33. Did the ReviewerAnspector fail to discuss review/inspection with an on-site representative?
❑ Yes
qq No
❑ NA ONE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
rM No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. -]
Use drawings of facility to better explain situations (use additional pages as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1/D�7 33 a0
Date: (�
2/4/2014

l'ype of visit: M Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: tj 2 Arrival Time: Departure Time: I j0: County:
Farm Name: Owner Email:
Owner Name: w o t lr" ,-,g L -CC Phone:
Mailing Address:
Physical Address:
Facility Contact: 4�ti Title:
Onsite Representative: L1 3 U� ? SAY
--
Certified Operator:1
Region:
Phone: /
Integrator: /�l�j ��lf�c •�1�1
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ® Iff No [DNA ❑ NE
❑ Yes
Des' Current -
0 NA
Design
Current
Design Current
•:m :y..
Swine -
Ca aci Pow`
P tYh P
Wet Poult .
ry
Ca aci
P t3'
Po P•
Cattle Ca aci Po
P h' P-
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
2-L. $ 19DO
Dry Cow
Farrow to Feeders
_'
D . Moult .
Ca aci
P,o
Non -Dairy
Farrow to Finish
I Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars��
Pullets
Beef Brood Cow
I JillTM
Turke s
t3tlter"
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ® Iff No [DNA ❑ NE
❑ Yes
❑ No
0 NA
❑ NE
❑ Yes
0 No
[P NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
[] No
q] NA
❑ NE
❑ Yes
[*No
❑ NA
❑ NE
❑ Yes
[V No
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facili Number: JlDate of inspection; q 1 Z 7-113
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
j NA
❑ NE
Stru ture I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(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
io 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
T
❑ 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
-W No
[3 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
k u+.
Si.cs
12. Crop Type(s): ba S Qa
13. Soil Type(s): i `^ � C -d ct'
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Io No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
`P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[0 No
❑ NA
E] 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
No
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ YesNo
IF
❑ 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 Q0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and i" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes .0 No
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes � No
1 Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
2/4/2011 Continued

Facili Number: - Date of lnspection:��/ I
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes W No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? []Yes [PNo ❑ 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, aver -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA ❑ NE
❑ Yes 9 No ❑ NA ❑ NE
❑ Yes T No ❑ NA ❑ NE
❑ Yes T No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes T No ❑ NA ❑ NE
33_ Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes � No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone: '7P �` 3 37iDb
Date:
21412011

Type of Visit: 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: �(itjt� C1a.--5 gwwn Owner Email:
Owner Name: weer-� loCIL S LLC Phone:
Mailing Address:
Physical Address: �J
Facility Contact:Title: Phone:
N
Onsite Representative:
Certified Operator:,/
Back-up Operator:
Location of Farm:
Latitude:
Integrator: g l ki42"u 12& .-tl LL -C
Certification Number:
Certification Number:
Longitude:
DischarL,es and Stream Imnacts
1. Is any discharge observed from any part of the operation? ❑ Yes IQ No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No C!I)NA ❑ NE
b. Did the discharge reach waters of the State? (If yes. notify DWQ) ❑ Yes ❑ No EgNA ❑ 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
fvl�NA
Design
❑NA
❑NE
0 N
❑NE
me
Pop.
Wet Poultry
.. Capacity
Pop.
Cattle Capacity Pap.
�apacity
Wean to Finish
I 11-ayer
Dairy Cow
Wean to Feeder
I INon-Layer
I
Dairy Calf
Feeder to Finish`
Dairy Heifer
Farrow to Wean
Design
.
.Current
Dry Cow
Farrow to Feeder
1)t;� P�o_ul
Ca aei
P,o
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Putlets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
I
Other
DischarL,es and Stream Imnacts
1. Is any discharge observed from any part of the operation? ❑ Yes IQ No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No C!I)NA ❑ NE
b. Did the discharge reach waters of the State? (If yes. notify DWQ) ❑ Yes ❑ No EgNA ❑ 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
fvl�NA
❑ NE
❑NA
❑NE
0 N
❑NE
Page 1 of 3 21412011 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes L�ZNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No '5 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: t
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes V 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�]�j No [:]NA [:]NE
waste management or closure plan? r
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 f9 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Q No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Ep No ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [9 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 ofA�fpproved Area
12. Crop Type(s): Coa57 W1 r�CX 4► 4 �-f ��—� �7 � �Ir.►+ 4c �'
13. Soil Type(s): 11' 1a�L_
TT
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
[ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
� No
❑ NA
E]NE
the appropriate box.
T
❑WUP ❑Checklists [—]Design ❑ Maps ❑ Lease Agreements E] Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �p No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [:]Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge`? ❑ Yes ( No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

`Facili `Number:
jDate of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box(es) below.
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 fait provide documentation of an actively certified operator in charge?
❑ Yes
[0 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
[9 NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes M 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 toNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes (] No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface 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?
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?
(refer to question #):
as of facility to better
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
any YES answers and/or any addi
situations [rise additional pages as
❑ Yes �] No ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
❑ Yes [)D No ❑ NA ❑ NE
ons or any other comments.
Phone: i I C) —y3,5 --33 CR:Z)
Date: +2--l-2-
21412011
2-rlZ2/4/2011

- — � Division of Nater Qu
Facility Number _ _` __ Q Division of Soil and Water Conservation
Other Agency
Type of Visit ® Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit ®Routine 0 Complaint 0 Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: I Z(*f I I
Farm Name:
Arrival Time: Departure Time: a t County: -o Region:
Owner Email:
Owner Name: Px* i xk ft iN S LL-._ Phone:
Mailing Address:
Physical Address:
Facility Contact: ' Title: Phone No:
Onsite Representative:`` Integrator:
Certified Operator: x211 16L, Operator Certification Number: �91
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: =' =' = « Longitude: [=] n ='
='
4 act Po ulation Wet Poult . Ca aci Po lahouiCa ...
Design Current DesEgn Current . Design Current
Swine Cap ty pF" ry p ty p le Cap ty Population
❑ Wean to Finish ❑ La er ❑ Dai Cow
❑ Wean to Feeder ❑ Non -Layer [] Dai Calf
❑ Feeder to Finish " `; ❑ Daily,Heifer
Farrow to Wean I?ry Poultry _��`� [] D Cow
_y Farrow to Feeder " ❑ Non -Dai
❑ Farrow to Finish
a,- ❑ La ers ❑Beef Stocker
[] Gilts ❑
Non -Layers
=:„ [] Beef Feeder
❑ Boars ❑Pullets
' Beef Brood Co
❑
Turkeys
Other'
- �.,�,�- ,� ❑ Turkey Poults �.
❑ Other ❑ Other Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
io
ll
El NA
El NE
Discharge originated at: ❑ Structure El Application Field El Other
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
Q9 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[PNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
tJPNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment I T
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
S cture I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway? -
Designed Freeboard (in):
Observed Freeboard (in): H
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes .M 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
53 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ YesNo
No
❑ NA
[__1NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
10 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
4. Does any part of the waste management system other than the waste structures require❑Yes
No
y
No
❑ NA
❑ NE
maintenance or improvement?
W No
❑ NA
❑ NE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ YesNo
91
ElNA
❑ NE
maintenance/improvement?
11 _ Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes W No
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN 7 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soi
❑ Outside of Acceptable Crop Window ❑ Evidence of W"id Drift ❑ Application Outside of Area
12. Crop type(s) S -L' Q 1
, 1�1�Q. 5t�'laf✓l
13. Soil type(s) lft4 pof QVj
0 N ONE
l4. 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
10 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
y
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
W No
❑ NA
❑ NE
Reviewer/Inspector Name T v : j r Phone: J/O �SOw
Reviewer/Inspector Signature: L Date: _;PV/
Page 2 of 3 12/28/04 Con inued

Facility Number: — Date of Inspection 1
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No [-I NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design El Maps [:1 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes R] No ❑ NA EINE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
9 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
RNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
'I'M No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
&No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
fes' 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
00 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
[JNo
❑ 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
F9 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA
❑ NE
Additional Comrhents and/or Drawings: "
Page 3 of 3 12/28/04

W Division of Water Quality
iFacility Number ��-- 0 Division of Soil and Water Conservation
�— Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: /S Q Arrival Time: I 0q!5&jjj Departure Time: County: 3r��" Region:
Farm Name: t,-1, S Owner Email:
Owner Name: I tit -r Phone:
Mailing Address:
Physical Address:
Facility Contact: t _ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
L 7:_ �-CJ k%-
Operator Certification Number: W �[[f
Back-up Certification Number:
Location of Farm: Latitude: =' ='
=" Longitude: = o =' = N
Design CurrentM–-
Design Current
Design Current
Swine Capacity Populationy
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder I
ID Non -La er
I
Dairy Calf
❑ Feeder to Finish
❑ No
❑ Dairy Heifer
Farrow to Wean Wl 9j 2 20nDry
Poultry
❑ Dry Cow
Farrow to Feeder
11 Layers
ElNon-Dairy
❑ NE
El Farrow to Finish
El Beef Stocker
❑ Gilts
El Non-Laers
E] Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turke Poults
Humber of Structures:
❑ Other
nom.
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
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 MNo ❑ NA EINE
❑ Yes
❑ No
9 NA
❑ NE
❑ Yes
❑ No
C�NA
❑ NE
NA
❑ NE
❑ Yes
❑ No
❑ Yes
99 No
❑ NA
El NE
❑ Yes
V No
❑ NA
❑ NE
Page 1 of 3 12/28/04 Continued

Facility Number: — Date of Inspection
❑ Yes
[P No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
OpNo
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0 No
[INA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
P?PNA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 30"
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement'?
❑ Yes
Vj No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
P§ No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[9 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
❑ Evidence of Wind Drift ❑ Ap�pl`ic�ation Outside
❑ Outside of Acceptable Cr Window El
of Area
12. Croptype(s) F-erjCc.Q 6) n-ze
�✓r�
�'t
St1oi„n�Y
�'U ✓
13. Soiltype(s) /'1 oG�
-
r
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
® 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
E�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E&No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Fxce Oe-,� rec" KVQ�o ";O -L 1
Reviewer/Inspector Name F Phone: 9/Q -y33-3362
Reviewer/Inspector Signature: MA Date: 3,Lls
Page 2 of 3 12/28/04 Continued

Facility Number: — Date of Inspection ClJ
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 [$a No ❑ NA ❑ NE
the appropriate box. ❑ WDP ❑ Checklists
❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
N No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
;9 NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
T No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Wo
❑ NA
❑ NE
27_
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
§dNA
❑ 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
1?9 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 i.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�3No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
Page 3 of 3 12/28/04

Division of Water Quality
=Acilityber 33 Division of Soil and Water Conservation
O OtheC Agency
Type of Visit 0 Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit *Routine O Complaint Q Follow up O Referral O Emergency 0 Other +�❑ Denied Access
Date of Visit: 3'JV (T{ Arrival 'r.me: �r. Departure Time: �� County: �S�r" Re ion' + Q ^�
Farm Name: _ ' ti N
oaD,� r,_l
Owner Email:
Owner Name: ht' Imo—RIILLc— Phone: _
Mailing Address:
Physical Address:
Facility Contact: Ser' _ Title: Phone No:
S
if
Onsite Representative: Integrator: ,!p
Certified Operator: u Operator Certification Number: 1?6 - I
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =' [:�J' ="
Longitude: =] ° =' = u
Swine,"�
❑ an to Finish❑
"Design Current
Capacity Population
.:, _
Design Current
Wet Poultry Capacity Population
Layer
Design Current
Cattle Capacity Population
❑ Dai Cow
❑ an to Feeder
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
❑ Non -Layer
El Calf
❑ Feeder to Finish
a. Was the conveyance man-made?
❑ Dai Heifer
Farrow to Wean
10 NA
Dry Poultry
❑ D Cow
El Farrow to Feeder
❑ No
❑ La ers
❑ Non -Dairy
❑ Farrow to Finish
❑Non -La ers
❑ Beef Stocker
❑ Gilts
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
El Beef Feeder
❑ Boars
❑ NE
❑ Pullets
❑ Beef Brood Cowl
a No
❑ NA
❑ Turke s
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
Other
No
❑ Turkey Po ults
E] NE
❑Other
_
❑ Other
dumber of Structures:
Page 1 of 3
12/18104
Continued
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
10 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
EINE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
a No
❑ NA
[:1 NE
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes`�
No
El NA
E] NE
other than from a discharge?
r
Page 1 of 3
12/18104
Continued

Facility Number: q— Date of Inspection
❑ Yes
P No
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
MNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes enNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
ONA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
❑ Yes
E6No
❑ NA
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes V 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 rWNo
❑ NA
El 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 A No
[INA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ 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 > l 0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Hare Soil
❑ Outside of Acceptable Crop Window ❑ Evide jnce� off,Wind Drift ❑ ApplicationlOutside of Area It
�� /�12. Crop types) r�Xst�i r1a4r�i5 � 7`IA+ +�YVhtfO[Q Lit A5� ! SLurvwer, ALxL," ""'h4tr r .L&a f
13. Soil type(s)
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
MNo
El NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
PNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
EANo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E6No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations os any other comments.
Use drawings of facility to better explain situations. {use additional pages as necessary):
rxce l j&� recoyd
Reviewer/inspector Name �� Phone: 1910 -q33 -33c-_>
Reviewer/inspector Signature: Date:
Page 2 of 3 12/28/04 Continued

Facility Number: — Date of Inspection
R_eouired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes toNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 09 No ❑ NA EINE
❑ 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
00 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
r9 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
T3 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
(I No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Lei No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
IS No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[�?No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
IgNo
❑ 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
E 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
JpNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did ReviewerAnspector 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
Wo
❑ NA
❑ NE
AddittanalComments andlor Drawtn a+_',
ate- mer T7'_
Page 3 of 3 12/28104
Page 3 of 3 12/28104

Division of Water Quality
Facility Number 33 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 4& Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I } ';LeArrival Time:
Tim e: Departure Time: County: �AI Region: 'r—go--
Farm Name: �lal&A (12k$ F wni Owner Email:
Owner Name: Wh t k RDCk_ F2t''MS LLC— Phone:
Mailing Address:
Physical Address:
Facility Contact: faA If4i __ 'Title: Phone No:
L �Zfl
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
904110
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =0
=c ❑ « Longitude: =0=.
°=. = H
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
I❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑
Turkey Poults
❑ Other
Dischar es & 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 Curreni`
Cattle Capacity Population-
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Ca
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �'No [:INA ❑ NE
❑ Yes
❑ No
F] NA
❑ NE
❑ Yes
❑ No
1�4NA
❑ NE
C!fNA
❑ NE
❑ Yes
❑ No
❑ Yes
W No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
12/28/04 Continued

Facility Number: -33 Date of Inspection aS
❑ Yes
No
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement`?
❑ Yes
[BNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[TNo
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[:]No
%NA [:INE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
(9 No
❑ NA
❑ NE
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): !�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
liallo
❑ NA EINE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
(kNo
❑ 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
IRNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
19 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
P9 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[�[No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
((9 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manurc/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window of Wind Drifi ❑ Application
of Area
f�; (14
f❑ Evidence (Outside
12. Croptype(s) TPSCtLL,� (d", f"As4n ), Cois- t Oermult 1�iSt� f�,0t,,
,� r
rixnt-li-&L""�'1
i"
13. Soil type(s)
t
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
[BNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
X No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
VD No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
(9 No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): .
Reviewer/Inspector Name cy,Phone: p 3-900
Reviewerllnspector Signature: Date:
12128104 Continued

Facility Number: 4 —3 I Date of Inspection 12
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IFLNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists
❑ Design [j 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 I " Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �9 No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes PgNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
5d No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
(V1 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
[:]Yes
C.No
❑ NA
EINE
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
ANo
❑ 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
ANo
❑ 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
[,'9 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
M No
❑ NA
❑ NE
33.
Docs facility require a follow-up visit by same agency?
❑ Yes
K No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 007 Arrival Time: Departure Time: County:
Farm Name: alt/! n f S Owner Email:
Owner Name:Phone: _
Mailing Address:
*10` Region:
Physical Address:
Facility Contact: h Title: Phone No:
Onsite Representative: I� Integrator: rem"f
"9 day
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = V E--] ` =" Longitude: =] ° ❑ ` EJ
Design Current
Design Current
Design Current
Swine Capacity Papulation
Wet Poultry' C*opacity Population
Fettle Capacity Population
El Wean to Finish
❑ La er
El DaiCow
❑ Wean to Feeder
❑Non -La er
❑ Dair Calf
El NE
❑ Feeder to Finish
_
❑ Dairy Heifer
Farrow to WeanElD
❑ NE
Cow
❑ Farrow to Feeder
Dry Poultry��.
❑ Non -Dairy
ElFarrow t o Finish
❑ Layers
ElLa
Beef Stocker
❑ Gilts
❑ Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl I
❑ NA
❑ Turkeys
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
Other
❑ Other❑Other
❑ Turke Poults
Number a# Structures:
❑ NE
other than from a discharge?
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Ye No
�NA
El NE
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
❑ Y
�m No
N 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
[I NA
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
$ No
❑ NA
❑ N E
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[ 3 No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: — Date of Inspection
❑ Yes
1 ] No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
Q9 No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[� NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �7
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
No
❑ NA
❑ NE
through a waste management or closure pian?
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
0 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
JK 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
q] No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
& No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of W' d Drift El Application Outside
of Area
VeSC:,.t (Aam) " f" 14
12. Crop type(s) /iN 1�t{�G� `-+ruiS
11S
f�I�i�
13. Soil type(s) L! t"OQ Q;1
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1 ] No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Q9 No
❑ NA
❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
W No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
W No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
M No
❑ NA
❑ NE
Comments (refer to questiop'#f) Explain any�YES answers and/air any^recom
gsof famendations or any other comments,
Use�drawincility to better explain situations. (ase additional pages!asjnecessary):
Reviewer/inspector Name
Phone: 9� X133 300
Reviewer/Inspector Signature:
Date: AwaO07
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 [:o No ❑ NA EINE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ YeS EjNo [:INA ❑NE
the appropriate box.
❑ WUP El Checklists El Design El Maps [:1 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Pq 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 Q9 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA EINE
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
® No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
9 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
[:1 NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
a] No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30_
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[I.No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
M No
❑ NA
❑ NE
Additional Comments and/or' Drawyngsr
Page 3 of 3 12/28104

Type of Visit j2Mompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine Q Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: V;1�_
Farm Name: / i(L`tn- n� --5 'raf +ti'L' Owner Email:
Owner Name: U) Lf T7aeda_f _ZZ L Phone:
Mailing Address:
Phvsical Address: j
Facility Contact: jjEiff,f PUr3r-/--'Title:
Onsite Representative:
Certified Operator: 5_4& -to
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Region��
Integrator: /'`t'%htt S%r s✓ `_�
Operator Certification Number: 9.0�7
Back-up Certification Number:
Latitude: =0
=1 longitude: =0=1 o❑1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Nan -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Cu"rrenf
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Plumber 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 dischar0e bypass the waste management system? (If yes. notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes r No ❑ NA El NE
❑ Yes
29 No
❑ NA
❑ NE
❑ Yes
j4 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
Z No
❑ Yes
[X No
❑ NA
❑ NE
❑ Yes
JO No
❑ NA
❑ NE
12128104 Continued

r
Facility Number: " —3 Date of Inspection 7—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural Freeboard?
Structure l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): �g
Observed Freeboard (in): a2,;;�
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure pian?
❑ Yes � No [INA [:1 NE
❑ Yes [,RNo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [.No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? [:]Yes [KNo ❑ NA EINE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [g No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require❑Yes � No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes K7'No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) rz_- Ce_u" 1T"I / J�z7/ aZZ..-
r - -
13. Soil type(s) AVQd iX.W
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
R.No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination[]
Yes
MNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
JR No
❑ NA
❑ NE
Reviewer/Inspector Name-:"��.�: � ��� �'�� , ��,,. , .DvV"�"r`��'�� ;;e Phone:
Reviewer/inspector Signature: Date: p9' O
12128/04 Continued

Facility Number: — 33
Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes U� No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes KNo ❑ 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
RNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
LKNo
ETNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
(RNO
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�jNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
MNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
❑ Yes
❑ No
0NA
❑ 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
4 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
El 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
4No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
RLNo
❑ NA
❑ NE
12128/04

r
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ®Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
E Facility Number Date of Visit: 3 Time:
� -.„ ,,. Not O erational Below• i'hreshold
Permitted ® Certified © Conditionally Certified ❑ Registered Date Last Operated or Above Threshold
Farm Name: G�rnn Counts-: __ &A -gaa l tri
Owner Name: T C Phone No: Iq �2jj 13
Mailing Address: _ RA- z R ox I Ra C loec c "jj j �Aj_C, '„8 133
Facility Contact: _ j_6.'rr„ G Son Title: Phone No:
Onsite Representative: L ekrrL - CX rkg- - Integrator:
Certified Operator: Operator Certification number:
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 z " Longitude ' �• .4
Design
Desiign Current
Design Current Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle Capacity- PoiDulation
❑ Wean to Feeder 1
10 Laver
I 1
❑ Dairy
❑ Feeder to Finish I
IEJ Non -Laver
I I
ILI
Non -Dain-
® Farrow to Wean a 3 Sa
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Bow
Total SSLW
Number of Lagoons 10Subsurface Drains Present ❑ La ooa Area ❑ Sp,., Field Area
Holding Ponds / Solid Traps FF�d❑ No Liquid Waste Management System
Discharges & Stream lmpacis
1 _ Is any discharge observed from any part of the operation?
❑Yes ( No
Discharge originated ar: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discnarae is observed, was the conveyance man-made?
El Yes ❑ No
b. If discharse is obsen-ed, did it reach Water of the State? (If ves, notif., DWQ) ❑ Yes ❑ No
c. If discharse is observed. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (if yes. notiN, DWQ) ❑ Yes ❑ No
2_ Is there evidence of past discharge from any part of the operation? ❑ yeso
3. Were there anti• adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes R No
Waste llection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway ❑ Yes 14 No
Structure 1 Structure ? Structure 3 Structure 4 Structure ; Structure 6
Identifier:
Freeboard (inches): t
05/03/01
Continued

Facility ]number: 4— Date of Inspection l3 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type [ elrf C r% u Ck,n C wC
❑ Yes M No
❑ Yes QkNo
❑ Yes PNo
❑ Yes [Z,No
❑ Yes N V0
Cl Yes Wo
❑ Yes � No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
Wo
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
�j No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
99,No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
Io
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
RNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
RNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
allo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
JKI No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
1,qNo
(ie/ discharge, freeboard problems, over application)
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
C3
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑ Field Copy ❑ Final Notes
Reviewer/Inspector NameK+ , ,� O a� _ ,
Reviewer/Inspector Signature: Date: d
05/03/01 Continued

Facility lumber: — Date of Inspectimi
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior 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 permanent/temporary cover?
❑ Yes ❑ No
❑ Yes 41 No
❑ Yes 9 No
❑ Yes �R No
❑ Yes P�-1 No
❑ Yes No
❑ Yes ❑ No
Additional Commenl%�snd/or:Drawings: - - .
05/03/01

IM ❑Division of Soil and Water Conservation []Other Agency
#� �3' S +a➢`X M:,, h y'a R'
Division of Water Quality
12 1
Routine 0 Complaint 0 Fonow-u of 1)%V ins [cation 0 Follow-up of DSWC review• 0 Other,
Date of Inspection
Facilih• `umber p�--����
Time of Inspection 24 hr. (hh:mm)
13 Registered Certified © Applied for Permit Permitted E3 Not Operational Date Last Operated: •
FarmName:... ......!! /Afe.....L...Q.r1Y�.................. County:.............. ....................................... .....................
%� _ ff h
Owner Name: .J�.q. r.... .0 q .5_o /� ... Phone No: 71)q.....22z..-....L.I,.3l....................•
Facility Contact:...{�.`'4..X'.. C� r�eti Title:...QGe1rl..r. Ph ne No: .....................................
+ � ... .------.../.....Z.�.G ............ .etc%- yil Edi 3
P
Mailing Address: ,.�y....i... ... .......................5...�....................._..
t - �.` .
Onsite Representative:... ,,. Integrator: ...... CGL.r:q' 1. .......
Certified Operator:... G f f*' .. ............ ..Cc?Ld1 d!�....... ............. Operator Certification Number:...._.. �.� ............
Lnratian of Farm: It G rS h =ffe i 1
nJA&i.i.n. 6P......4.0T.. 3 T....1Z.%.7.... at .... r -.O .o.Srt,
1.: ....._ . ............................................................ .............................................................. ___.............................. .._................................ ............. _................
.......
Latitude • =° r�46 Longitude 0' & "
Design' �� Ct�rent �. ; ::`Resign Current ra r DesignerC�rent
" Svvme,, r Ca
„: Caparety Population ;Cattle01i4iion
pt�eity,4opulation
.Poultry
❑Wean to Feeder
M ❑ Layer .410 Dairy°
❑ Feeder to Finish
10 Non -Layer ❑Nou-Dairy
Farrow to Wean 257
❑ Farrow to Feeder
fl>.�
10 I
❑ Farrow to Finish
n TotA , e51gn Capacity' —571
:4 ❑ Gifts
a
Boars
T©tal SSLW, no
" r .... �.. w.w...�- . » - �a
Number of Lagoons/-Holdutg Ponds Subsurface Drains Present 1JU Lagoon Area ILI Spray Field Area
r
❑ No Liquid Waste Management System . . ,
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
qNo
2. Is any discharge observed from any part of the operation?
❑ Yes
,No
!
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
\\
a. If discharge is observed, was the conveyance man-made?
❑ Yes
❑ No
b- if discharge is observed, did it reach Surfacc: Water? (If yes, notify, DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon systein'? (If yes, notify DWQ)
❑ Yes
❑ No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
97No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
9No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
RNo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[ o
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
�,ef No
7/25197
Continued on back

f
F' Fatility Number:
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes No
Structures fLa¢oons and/or Holding Ponds)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes WNa
In i Cel
'1,ts4[ied 10LI be 31/ 197
Freeboard (ft): Structuie 1 Structure 2 Structure 3 Structure 4 Structure 5
3
Structure 6
10.
Is seepage observed from any of the structures?
❑ Yes 9 N
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes No
12.
Do any of the structures need maintenance/improvement?
❑ Yes No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
[Yes ❑ No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes KNo
(If in excess of WMP, or runoff entering! of the State, notify DWQ)
15.
waters
................................._............................. _ ........................
Crop typeJose
16.
Do the receiving crops differ with designated in the Animal Waste Management Plan (AWMP)?
❑ Yes ❑ No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes XNo
18.
Does the receiving crop need improvement?
❑ Yes 0KNo.
19.
Is there a lack of available waste application equipment?
❑ Yes No
20.
Does facility require a follow-up visit by same agency?
❑ Yes gNo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes )�(No
For
Certified, Facilities Only
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes P(No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
o
❑ Yesto
24.
Does record keeping need improvement?
❑ Yes
Comments refer to r uestion: Ex larn'an YES` -answers and/dr an ,recommendations or an oth' r 66mmerits. `
q P Y y y
Use drawings of faetItty to hetteiwexplatn situations: (use additional pages as necessary);:;, `.
-
�111r. %►ri50.� kS +0 r-ep(r—• r4L7 0. I+ kas M� +S e
4
In i Cel
'1,ts4[ied 10LI be 31/ 197
MoLr- er 4�e- -c. /,
13.
U and q roSS coua r" 6-h_ eOs� Ila-••kS.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: _2LAl -- q`
cc: Division of Water Quality tWater Quality Section, Facilh), AssL4ssment Unit 4/30/97