090008_INSPECTIONS_20171231

Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 090008 Facility Status: Active Permit- AWS090008
Inpsection Type: Compliance Inspection Inactive Or Closed Date:
Reason for visit: Routine County: Bladen Region:
Date of Visit: 03131 /2017 EntryTime: 10:00 am Exit Time: 11:00 am Incident #
Farm Name: Bladen Springs Owner Email:
Owner. Murphy -Brown LLC Phone:
Nlailing Address: PO Box 487 Warsaw NC 28398
Physical Address: 473 Ls Farm Dr Council NC 28434
Facility Status: 0Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
❑ Denied Access
Fayetteville
910-296-1800
Location of Farm: Latitude: 34' 32' 25" Longitude: 78° 27' 48"
from Elizabethtown take Hwy. 87 east about 11 miles to Bladen Springs, turn left on dirt path across from Registor's store, 1 mile
down path.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, 8 Treat Waste Application
Records and Documents Other Issues
Certified Operator: James C Smith Operator Certification Number: 17907
Secondary OIC(s):
On -Site Representativeisi: Name Title Phone
24 hour contact name Michael Ammons Phone
On -site representative Michael Ammons Phone
Primary Inspector. Robert Marble Phone:
Inspector Signature: Dale:
Secondary Inspector(s):
Inspection Summary:
page: 1

0
Permit: AWS090008 Owner - Facility : Murphy -Brown LLC Facility Number. 090008
Inspection Date: 03/31/17 Inpsection Type; Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean 3,400
Total Design Capacity: 3,400
Total SSLW: 1,472,200
Waste Structures
DWgnated Observed
Type identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00 1 48.00
page: 2

Permit: AWS090008 Owner - Facility : Murphy -Brown LLC Facility Number. 090008
Inspection Date: 03/31/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑ M
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ 0
❑
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)
❑
❑ 0
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Wast@ Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
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 that are not properly addressed and/or managed through a
❑
■ ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (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
❑
❑
❑
maintenance or improvement?
Waste Application
Yea No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 1D%110lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090008 Owner - Facility : Murphy -Brown LLC Facility Number: 090008
Inspection Date: 03/31/17 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste APRlication
Yes no Na No
Crop Type 1
Coastal Bermuda crass w/
Rye Overseed
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Butters fine sand, 0 to 2%
slopes
Soil Type 2
Norfolk loamy rune sand, 0
to 2% slopes
Soil Type 3
Wagram fine sand, 0 to 6%
slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑ ❑
Management Plan(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 acre
❑ 0 ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑ ❑
18. Is there a lack of property operating waste application equipment?
❑ 0 ❑ ❑
Records and Documents
Yes
Na Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
M ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
M ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

r
Permit: AWS090008 Owner - Facility : Murphy -Brown LLC Facility Number. 090008
Inspection Date: 03/31/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
YY, No Na No
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
M ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑M
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
M ❑
❑
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?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
[]
0 ❑
❑
Other Issu
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
MEI
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
[]
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

Division of Water Resources
Division of Soil and Water Conservation
❑ Other Agency
Facility Number.
090008
Facility Status: Active Permit: AWS090008
[] Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Bladen Region:
Fayetteville
Date of visit:
05/15/2015 Entry Time: 02:00 pm Exit Time: 3:00 pm Incident #
Farm Name:
Bladen Springs
Owner Email:
Owner:
Murphy -Brown LLC
Phone:
910-296-1800
Mailing Address:
PO Box 487
Warsaw NC 28398
Physical Address:
473 Ls Farm Or
Council NC 28434
Facility Status:
Compliant ❑
Not Compliant Integrator: Murphy -Brown LLC
Location of Farm:
Latitude: 34° 32' 25" Longitude:
781 27'48"
from Elizabethtown take
Hwy. 87 east about 11
miles to Bladen Springs, turn left on dirt path across from Registor's store, 1 mile
down path.
Question Areas:
Dischrge & Stream Impacts
Waste Col, Stor, & Treat Waste Application
Records and Documents
Other issues
Certified Operator: James C Smith Operator Certification Number: 17907
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Ammons Phone
On -site representative Michael Ammons Phone:
Primary Inspector: Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS090008 Owner - Facility : Murphy -Brown LLC Facility Number. 090008
Inspection Date: 05/15/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
❑ Swine - Farrow to Wean 3,400
Total Design Capacity: 3,400
Total SSLW: 1,472,200
Waste Structures
Dialgnated Observed
Type Identifier Closed Data Start Date Freoboard Freeboard
Lagoon 1 19.00 30,00
page: 2

Permit: AWS090008 Owner - Facility : Murphy -Brown LLC Facility Number: 090008
Inspection Date: 05/15/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yea
No fig Ne
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
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)
❑
❑ 0
❑
2_ Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3_ Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yea
No Na Ne
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (LeJ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (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
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ 0 ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit:
AWS090008
Owner - Facility :
Murphy -Brown LLC
Facility Number:
090008
Inspection Date:
05/15/15
Inppection Type:
Compliance Inspection
Reason for Visit:
Routine
Waste Application
fires No No No
Crop Type 1
Coastal Bermuda Grass wl
Rye Overseed
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Butters fine sand, o to 2%
slopes
Soil Type 2
Norfolk loanry fine sand, p
to 2% slopes
Soil Type 3
Wagram fine sand, Q to fi%
slopes
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑ ❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ 0 ❑ ❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑ ❑
18. Is there a lack of properly operating waste application equipment?
❑ N ❑ ❑
Records and Documents
Yes
_NQ Na No
19. Did the facility fall to have Certificate of Coverage and Permit readily available?
❑
■ ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E Cl ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS090008 Owner - Facility : Murphy -Brown LLC Facility Number: 090008
Inspection Date: 05/15/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Na
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. if selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■ ❑
❑
Other Issues
Yea
No Na Me
28. Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(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
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or ❑ 0 ❑ ❑
CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with on -site representative? ❑ M ❑ ❑
34, Does the facility require a follow-up visit by same agency? ❑ M ❑ ❑
page: 5

Type of Visit: ompGance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 1 Arrival Time: D Departure Time: ' U County: !/r•--
Farm Name: !�i�+r121 Owner Email:
01
Owner Name: /1Lj'drl •ttd� L L Phone:
Mailing Address:
Physical Address:
Region: �� v
Facility Contact: /Ylr,�j Title: 'as. ✓ Phone:
OnsiteRepresentative: ��._� 1 Integrator: �iLx�
1'Bj��rJ<l.
Certified Operator: d`'nr`5 s or,-`t Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current -
- Desigu Current
pacity x Pop.
Wet Poultry r
Capacity
Pop.
Cattle " Capacity Pop.
Wean to Finish
"iI
ILayer
Dairy Cow
Wean to Feeder
on -Layer
Dairy Calf
Feeder to Finish
='» _
"
Dairy Heifer
Earrow to Wean
31jo p
Vo
Desin
-Current
Dry Cow
Farrow to Feeder
D - P.oult
Ca aci
Pao
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
-
Turke s
-
Other -
Turkey Poults
-
Other
Other
-
Discharges and Stream Imuacts
1. Is any discharge observed from any part of the operation?
❑ Yes
E 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
DgNo
❑ 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 1 of 3 21412011 Continued

Facility Number: 9- Date of Inspection: 3 7 /
Waste Collection & Treatment
4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?: _
Designed Freeboard (in): r Icy' _
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
[,&No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
❑ Yes � No ❑ NA ❑ NE
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
0 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
PQ No
❑ NA
❑ NE
maintenance or improvement?
I I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes allo
❑ 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 differ from those designated in the CAWMP?
❑ Yes L�3No
❑ 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%eNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
29-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[!5 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
21 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 [S 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 .S--No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes C&No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facill Number: - 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 JE�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 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
❑ Yes
allo
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
[Q 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
[] Yes
Cg 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
No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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
QNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #t): 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: �70`41'77-3300
Date: 7—;;Z&d(
21412011

Division of Water t2uanty Pi�O /rZ
Facility Number - L�! �.J ® Division of Soil and Water Conservation S v
OQ OMEN
Type of Visit: ompliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: {tine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ! b Departure Time: 3 D County:
Farm Name: ��,r,� ,, z s Owner Email:
Owner Name: �✓pi=-y �lroW. L I- G Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: j„f�� Phone:
Region: R D
Onsite Representative: S � T _ Integrator: /l'f ., ✓�
Certified Operator: ��Lyj��� _�,yl; Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes E4.No ❑ NA ❑ NE
❑ Yes O No [DNA ❑ 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
allo
❑ 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 1 of 3 21412011 Continued

Facili Number: - Date of Inspection:�--
Waste Collection & Treatment
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes (B-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): i 9
Observed Freeboard (in): 3
5. Arc there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 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
M No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[]Yes
+RNo
❑ 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
IR No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
allo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes �g_No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I 0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Wind/ow ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): /��� +-rc/� ^ --sey �
13. Soil Type(s): gg4 $ `%¢cc. / rb�'[t� r A&7(
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
allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
allo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[&No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [�7'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes (A No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes RNo
DNA ❑NE
❑ Weather Code
❑ Sludge Survey
DNA ❑NE
(DNA ❑ NE
Page 2 of.3 21412011 Continued

Facility Number: -0 Datc of inspection: r
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [gNo ❑ 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
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?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative'?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes RNo ❑ NA ❑ NE
❑ Yes Callo ❑ NA ❑ NE
❑ Yes g No ❑ NA ❑ NE
❑ Yes [allo ❑ NA ❑ NE
[:]Yes K No
❑ Yes Qd No
❑ Yes Callo
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question #):. Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
,79, L /art 'In �`�PD /�.�` u/�d`� t1 r` c-w r.� �l i t: T b S i`fr 1-�—ram / `a ----
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 9/O—y33 .�3 D CD
Date:
21412011
Page 3 of 3

�Diviston,of Water Qyality f
iFacility l umberjMq1nn of Soil and Water Conservation S I
Type of Visit ommpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 04 outine 0 Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ;DO Departure Time: .' l� County:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Region: T z
Physical Address:
Facility Contact: Title: ��� ,�� Phone No:
ell
Onsite Representative: Integrator: f1lii
Certified Operator: Operator Certification Number: 1 21`"© Z
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: 0 0 = I = Longitude: = ° =, =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
.Farrow to Wean
p
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ 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?
Cattle
Design Current
Capacity Population;.
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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 J4 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
[Z No
❑ NA
❑ NE
❑ Yes
gNo
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: — O Date of Inspection �J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [&No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): / q
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes fKNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes E4 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 ER No ❑ NA ❑ NE
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)
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
KNo
❑ 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) Xi/'M"r4la
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
J@ No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
KNo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
RNo
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
KNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
R_No
❑ NA ❑ NE
Reviewer/Inspector Name IrL :. Phone:
Reviewer/Inspector Signature: Date: AV G1
Page 2 of 3 12128104 Continued

Facility Number: —D Date of InspectionA
Reg u ired_ 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 R No ❑ NA ❑ NE
the appropirate box. WUp ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes r7 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
[jNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EANo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[I No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
R No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
E4 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[4 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
[Z No
❑ NA
❑ NE
If yes. contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional olfce of emergency situations as required by
❑ Yes
[ANo
❑ 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
[3 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 -
Page 3 of 3 12128104

t
ivision of Water Qntifity
Facili Number © L=0 Divisuoa otSoil and Water Conservation
r
;: _ . • Q:Other Agency _Z71a
Type of Visit (A'tornpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason far Visit Routine Q Complaint O Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Dale of �'isiu fft arrival'1'imc: F D Departure'I'ime: OD ;ounty: -- Region: �x D
Farin ``ame: h Pn f, Owner Email:
Owner Narne: Phone:
Mailing Address:
Plivsical Address:
Facility- Contact: �/%%j ace _ D1/Title: Phone No:
Onsite Representative: ��-p-- Integrator:
Certified Operator: �rJ4 _ Operator Certification Number: p90
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
Back-up Certification Number:
Latitude: ❑o ��� Longitude: =0=1 ❑�
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
Dry Poultry
Pullets;
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach eaters of the State? (Yves, notify DWQ)
Design Current
Cattle Capacity Population
❑ Mini Cow
❑ Dairy Calf
❑ Dairy Heifet
❑ Dry Cow
❑ Non -Dal
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: a
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidenoe 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 (9No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[j No
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
❑ Yes
JgNo
❑ NA
❑ NE
12128104 Confinued

I Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
9 No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
5Q No
❑ NA
❑ NE
Stnicture I Stnicture 2 Stnicture 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?.
Designed Freeboard (in): I�
Observed freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[YNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
V No
❑ NA
❑ 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
5-kNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
(Z 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
C9No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [3No ❑ NA ❑ NE
maintenance/improvetnent?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [:]Application Outside of Area
12. Crop type(s)y/-rY!
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �9No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes EgNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination' ❑ Yes
3 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
Z No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
0 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):
a
T
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: — I D
1ZI2NI14 [."onnnued

Facility Number: --� Date of Inspection
' Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑-No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes allo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes PNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [2Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections [:]Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes PjNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑-No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[RNO
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
O-No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
0,No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[F.No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
BNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�No
❑ NA
[I NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
La 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/]nspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Pq\No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[&No
❑ NA
❑ NE
12128104

Division of Water Quality f 7
Facility Number O Division of Soil and Water Conservation
O Other Agency
Type of Visit Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 6Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: ? County: r� Regions
Farm Name: OW,14'"t Owner Email:
Owner Name: i Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: ( �Phone No:
O
Onsite Representative: Integrator:
r
Certified Operator: n A,
J Operator Certification Number:
Back-up Operator: ! vI h7 Back-up Certification Number:
r
Location of Farm: Latitude: ❑ o ❑ ❑ Longitude: = e = 6 ❑
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_ ❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the convevance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Co
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 4?§ No ❑ NA ❑ NE
[I Yes
El No
El NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
JANo
❑ NA
❑ NE
❑ Yes
PLNo
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
O-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):
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 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
E!J-No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [31-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 WNo ❑ NA ❑ NE
maintenance or improvement?
Waste Ai mlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes O-No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 4No ❑ 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)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[3No
❑ 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
O-No
❑ NA
❑ NE
IT Does the facility lack adequate acreage for land application?
❑ Yes
2�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
) " o
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name Phone:�y��j�--�XJ�
Reviewer/inspector Signature: Date:
12128104 Continued

Facility Number: — Date of inspection
Rewired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes O10 ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes j$No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes f!�No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes R No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
A.No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
9 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[ENO
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�0 No
❑ NA
❑ NE
Other Issues
28_ Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
allo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
79No
❑ 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
ONo
❑ 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
�lo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑Yes
WD10
❑NA
El NE
Comments and/or Drawings:
12128104

Q
Type of Visit �mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Comptaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: - Arrival Time: .' {�Q Departure Time: r4 � OZ) County: r.-i Region:
Farm Name: �� ��— ���z^ rt 0" Owner Email:
Owner Name: ,twat 1 SriZel, Phone:
Mailing Address:
Physical Address:
r
Facility Contact: r'!`S Title: Phone No:
Onsite Representative: s --ice Integrator: U/dli�
Certified Operator: �u � `� Operator Certification Number: - /`� � 7
Sack -up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ e ❑ 1 = Longitude: = ° = = «
Desi n Current
g
Desi n Current" Design Current
g
Swine
Ca acity Po ulatton met Poult
I?' - P -rW
p �,
Ca achy Po ulateon Cattle Capacity Population
p
to Finish❑Laper
Wean to Feeder
,� ❑Non -La Non -Layer
PFeeder to Finish
4.�� �'
�� }Farrow
to Wean
nt7 t �Ot•y�oury���-'❑
Farrow to Feeder
Ao"❑
Farrow to Finish
❑ La ersGilts
❑ Non -Lavers
oars
PulletsB
,.
urkeys
IOther
❑ 'hurkev Poults❑
Other
❑ Other
t�:Number of Structu❑Wean
Discharges &Stream Impacts
I. Is any discharge observed from any part ol'the operation?
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance rnan-made?
❑ Dairy Cow
❑ Uai 'Calf
❑ Dairy heifer
❑ Dry Cow
❑ Non-Dai '
❑ Beef Stocker
❑ Becf Feeder
❑ Beef Brood Cow
h. Did the discharge reach waters of the State? (If yes. notify D�VQ)
c. What is the estimated Volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (li-yes, nobly DWQ)
2. Is there evidence of a past discharge leont 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 C&No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
)K No
❑ NA
❑ N E
12/28/04 Continued

.J'

Facility Number: — Date of Inspection
I Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a_ If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
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 ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
IN No
❑ NA ❑ NE
(blot 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
El 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?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
EK No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)d'
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
EffNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? CKYes
❑ No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
LKNo
❑ 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 YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
�L�ils�f/' / �r`/ �%� / �r�� l..S GCHO►�r ��'K/ !�/��dj��/fi/l�iG� GZ•?UI-.,��i'Yl�� t/t?IX�
/latf� ���•z- iJ7,?'/" / O arm. -4D !/� -aS % 'r,T✓r �TT.��
T
Reviewer/inspector flame v`e Phone:��3 33t
Reviewer/Inspector Signature: Date: p��/ OL
<� 12128104 Continued

Facility Number: T— Date of Inspection Ftw
} —
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [S 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 ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [.No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes t,No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes tO No El NA El NE
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�No
❑ NA
El NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
CK No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
ANo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
INo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
JqNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E4 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern'?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes&No
❑ NA
❑ NE
33, Does facility require a follow-up visit by same agency?
® Yes
9 hlo
❑ NA
❑ NE
Additional Comments and/or Drawinns:
Est
. 06 �;.��u
h
12128104

Division of Water Quality
Ea
cility Number 0 Division of Soil and Water Conservation S ✓
0 Other Agency
Type of Visit 4k,ompliance
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
outine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: [ Arrival Time: Departure Time: 1= County: Region:
Farm Name: t Owner Email:
Owner Name: L -Ff-r7 C V Phone:
Mailing Address:
Physical Address: ��1Z
Facility Contact: . 2.t S c!a%__Title:
Onsite Representative: 5141�
Certified Operator: -kfr /l7iilx�✓
Back-up Operator:
Phone No: Ov�::!59� :��JrV
Integrator: ty t _/ 1'r ,-- �
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o [� 4 [� ff Longitude: = ° ❑ a ❑
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Layer
❑ Non -La et
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean WOO 3 c j�o
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design 'Current
Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Co
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 D,No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑NA
[:]NE
[-]Yes
❑No
❑ Yes
JXNo
❑ NA
❑ NE
❑ Yes
JRNo
[]NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection eq-O
3 Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate`? ❑ Yes D4 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): 3a
5. Are there any immediate threats to the integrity of any of the structures observed? [] Yes 29 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 j4No ❑ 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? J, Yes ❑ No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
[] Yes
EQ 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
PqNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
4 No
❑ NA ❑ NE
maintenance/improvement?
It. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
El No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) /
j
13. Soil type(s) -ram S
14. Do the receiving crops differ from those designated in the CAWMP?
[--]Yes
�R No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'?
PYes
❑ No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑
Yes
ONo
❑ 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
JKNo
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone:
Reviewer/inspector Signature: Date: Q
12128/04 Continued

Facility Number: — Date of Inspection
Re aired 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 E,No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes R 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
�?No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[9 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
5�No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ZNo
❑ 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
[3 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
V1 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Ul 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
WA No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
0 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
IM No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
I.Yes
❑ No
❑ NA
❑ NE
Comments and/or Drawings:
W eP54, i cS as! ��''n r� `�yf `� � 5 l� � � ` J' e
C
de,n`e -A3- P 1 v K --cam -rrv,-� h ,111 r " u V­ doer m Jo
r
�� meter sus -i OGcJ� w' 1 J C T5
y
w P a %�ic l�i�( f fl K 17k'G v
�v�r ru n.. �•
A +S Fro
12128104

Type of visit OrCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (2rAoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time. �� QO Departure Time: Q County: Region: D
Farm Name: __LBdW.- ri Owner Email:
Owner Name: -A L rr'�{ _ �h7 i A. Phone:
Mailing Address: 0- �.
Physical Address:
Facility Contact: __Ta rt 4 r .S �rQr_�ltlQ!jTitle:
Onsite Representative: /l
Certified Operator: -rst
ff
Back-up Operator:
Phone No•do j 0
Integrator: &CZ5W jam_ 09 W,
Operator Certification Number: .2 S9/ C
Back-up Certification Number:
Location of Farm: Latitude: ❑ a = , =4 Longitude: ❑ o =' = N
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non-Layet
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non-Laye"
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heife3
DDry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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 KNo ❑ NA ❑ NE
❑ Yes
kNo
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
10 No
❑ Yes
[No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(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 plan?
❑ Yes [9 No ❑ NA ❑ NE
❑ Yes C4No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes � No ❑ NA El NE
❑ Yes KNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Q No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 9 No ❑ NA ❑ NE
maintenance or improvement?
Wastc Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes t4 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. M 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 zWindDrift ElApplicationOutside of Area
12. Crop rype(s) 4s n &ra; of DV rrf e r! 5k � rirt.L. " I.-,- f r`r t-, u kf ?A s r r c
13. Soil type(s)
v
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
J,No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
X Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
R1 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
fia No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[4 No
❑ NA
❑ NE
Comments (refer`to question ft- Explain 'any -YES answers and/or any recommendations or aay tither co_ nment&
Use drawings of facility to better explain situations. (use additional gages as necessary): _
/) .f�dtrf a � L'' OIL L.e�. p►� t3.� A � ��►r.� lZ+rsr�� i rL�- .
pk // �G n PCs c u �/7']l� �i o fi s c.► ��rv,s. •� a "� ; ,.,, �. s t w� f A -
/O — 3 17-05—&- i D —v2 1 �o f A To7t—,( vy' 33, a H /6s/* wss J1,01
ckpq
Reviewer/Inspector Name Phone: y
Redewer/Inspector Signature: Date:
12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes BNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 10 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑yes 19 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 9 No ❑ NA ❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Pallo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
N No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
DO No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
E9 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
jo 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
U 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
XNo
❑ 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
R No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
[I Yes
� No
❑ NA
❑ NE
Additiiogal Comments and/or Drawings:
12128104

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 Date of Visit: Tune: 9' 00
•• O Not Operational Q Below Threshold
Wermitted [rCertified [] Conditionally Certified E3 Registered Date -Last Operated or Above Threshold:
Farm Name: _ 161401en rI'! S _ County: 61aj1e17
Owner Name: - f% l Fr � (... - gym e _ _. Phone No: _r1 /O - 5� � `9? 3 W _
Vl biling Address: _ P. v. (3 yl I���l NC $ Yyl
Qrv-Sat-Ls�^j
Facility Contact: —Ter... e^'V- :.�� . _. Title:.._ _ . _ Phone No: ^ - A-W- A 2w- 3ar -e o r
Onsite Representative: ? ere."- l/,fi------------ - -- --- --------- --. Integrator. 6LC,. .'ka
Certified Operator: _ _ Ge.,p _ Z »i.►e _ _ Operator Certification Number.,,,,,,
Location of Farm:
I�
["Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �" Longitude
Number o€.Iagooas : - ;
Dischames $ StrramImpacts
1. Is any discharge observed from any part 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 observed, what is the estimated flow in galimin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes BITo
❑ Yes 21fo
❑ Yes E3NO
❑ Yes alo
❑ Yes BNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [a No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes UNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
12/12103 _ Continued

Facility Number: cl— 8 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [allo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or yes alio
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes EKo
8. Does any part of the waste management system other than waste structures require maintenancerimprovement? ❑ Yes B140
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
j] Yes
ONO
elevation markings?
Waste Application
10. Are there any buffers that need maintenanceJimprovement?
❑ Yes
BT40
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
Ergo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
So -73r /tea
12, Crop type _5 L /I
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
2No
16. is there a lack of adequate waste application equipment? ❑ Yes B'No
Odor Issues
I7. Does the discharge pipe from the confinement building W the storage pond or lagoon fail to discharge at/or below ❑yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑'Ko
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 9-Ko
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ yes UNo
Air Quality representative immediately-
0 Final Notes
tr&lLiS
P/L Gvr.gq
!t3 4e
/irmt,I
A/`. r'T , /1
7 A. �
+Ae .',
e.r! �p�O.rS
TO T iC 7�,i� �G/C G✓��►! Gre..+r �f ��P
rrt�0ln,
H�
�l e,�n
5 y "tv 4olc.I
�P�SO�/ ati� Jew rssJ SOr� lsria�
9 us�
lw
V �Af}
Co,i�r To /r!✓�n�
GldSr"i1,
Reviewer/Inspector Name
ReviewerAWspector Signature: Date: / _23 -Q`�
12112f03 Confinued

Facility Number: cl _ 8 Date of Inspection -o
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
Q4 o
22. Does the facility f ' have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
rg*o
OetVMlr,`ch ts, deisigii_ mafs-, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
&No
❑ Application. ❑+mebeard ❑ W*5w Analysis -
II -I-> l.G q-i&->M( 8-s->I_L '7-> ?.0
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[}4?6
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
MMo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
❑ Yes
QNO_
27. Did ReviewerAnspector fail to discuss review/inspection with on -site representative?
❑ Yes
QJ�
28. Does facility require a follow-up visit by same agency?
❑ Yes
E?Ko
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[jXo
NI MES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) S Tes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0wo"
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes Qw
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ M
34. Did the facility fail to calibrate waste application equipment? ❑ Yes 9Wo
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ EIRAnda—❑ inspection After 1" Rain
❑ 120 Minute Inspections ❑
12112103

Facility Number Date or visit: �v d/ Time: F Printed on: 7/21/2000
F0 Not Operational Q Below Threshold
jp Permitted R Certified © Conditionally Certified 13 Registered Date Last Operated or Above Threshold: ...................
Farm Name: ............... 's ... County:...........! r ....._.....
77 qc� 44
Owner Name:............. ��/A�...� ...... Phone No:,t5 . /....`..1.......
....
�%/
FacilityContact: 1T ` - ................ Title: Phone No:................................................................ •...................................................
MailingAddress: ...........!-......D._.................!!...C....T.................... ..........................
Onsite Representative................................................................................................... Integrator:....., .. r
............ .t+y� .N'
......_............................._ Operator Certification umber:._......._...................._...........
Certified Operator :.........�j.10ax._..�r.
Location'of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' & 4& Longitude • 6 «
Design Current Design Current '. Desigh .. Current
S,- Poultry Cattle
tCa cPopulation
- Wean to Feeder [I Layer ❑ Dairy
Feeder to Finish ❑ Non -Layer ❑ Non -Da; —
Farrow to Wean OD DD -
Farrow to Feeder JE1 Other
Farrow to Finish Total Design Ca
Gilts Capacity.
Boars Total SSLVV
7 N_ ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Ponds-l5t3ltd.Tra No Liquid Waste Management System "
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ONo
Discharge originated at: ❑ Lagoon [ISpray Field ❑ Other
a. If discharge is observed, was the conveyance ntan-made? ❑ Yes OtNo
b. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes 5tNo
c. If discharge; is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes EKNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ��o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes P6No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes IN:No
Structure I Structure 2 Structure ; Structure 4 Structure 5 Structure 6
Identifier; '�+.a......... ............................ ................................... .................................... ........ ............................ ....................................
Frechoard (inches):
5100 Continued on back

Facility Number: D 5 — Date of Inspection � Printed on.• 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes UMo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes Wo
(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 maintenancelimprovement? ❑ Yes XNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes P'No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes MO
Waste Application
10. Are there any buffers that need maintenancelimprovement'? ❑ Yes )K No
11. Is there evidence of
over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes gNo
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes S No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes 11710
b) Does the facility need a wettable acre determination? ❑ Yes Wo
c) This facility is pended for a wettable acre determination? ❑ Yes fiR-No
15- Does the receiving crop need improvement? )R.Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes PkNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ,(No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUV, checklists, design,maps,etc.) /
❑ Yes
"No
19.
Does record keeping need improvement? (1 /irrigation eeb6a`rd, waste antal/ysis & soil sample
XYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design'?
❑ Yes
J9No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22.
Faii to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
RNo
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
RNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
RNo
tgd' otii.ii:iilteyiNd—olaigen"'reddWiothsyst•Yo�wl-eeieRwto fi><i-ther
corres deuce: ib"f this visit. :::::: :
Comments (refer to questboit #): `Ezphun'any YES answers and/or any recommendations -:'or - other comments �F R
oUdrawugofaclty:to better explain situations. (use additinal. paes aesay
JS, ,�r)
r
r
. S _,0// vAC /
/
%z 91Z��/C
/l/ks�.tf
ReviewerAnspector Name `
Reviewer/Inspector Signature: Date: Q/ 900

!Facility Number: — Date of l uspection O/ Printed on: 7/21 /2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below Yes Wko
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �CNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes <No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes kNo
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.) ❑ Yes pv-qo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes j rNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes IUNo
Additional omments an orDrawings:
A.
A) lZl.IXI115- 117
Ila
5100

Revised April 20, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number (,Operation is flagged for a wettable
Farm Name: acre determination due to fail r of
On -Site Representative: Part // eligibility item(s) F1 FV F3 F4
Inspector/Reviewer's Name: _S6ha_n
Date of site visit: G— R5- 9�
Date of most recent WUP: Wo ha� d .�
Annual farm PAN deficit: pounds
Operation not required to secure WA
determination at this time based on
exemption E7 E2 E3 E4
Operation pended for wettable acre
determination based on P1 P2 P3
Irrigation System(s) - circle #0hard-hose traveler; 2. center pivot system; 3. linear move system;
4. stationary sprinkler system w/permanent pipe; 5. stationary sprinkler system w/portable pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system wlportable pipe
PART 1_ WA Determination Exemptions (Eligibility failure, Part 11, overrides Part I exemption.)
El Adequate irrigation design, including map depicting wettable acresjs complete
and signed by an i or PE.
E2 Adequate D, and D21D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ili. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part 11. Complete eligibility
checklist, Part II - F'I F2 F3, before completing computational table in Part 111).
PART 11.75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Determination required because operation fails one of the eligibility
requirements listed below:
F1 Lack of acreage which resulted in over application of wastewater (PAN) on -spray
field(s) according to farm's last two years -of irrigation- records.-
J. F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations .(numerous.ditches; failure to deduct required
buffer/setback acreage;-or_25% of total acreage identified in CAWMP includes::: .
small, irregularly shaped fields = fields less than 5 acres for travelers -.or less -than
2 acres for stationary sprinklers).
F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part III.

Revised April 20, 1999
Facility Number �- 07
Part Ill. Field by Field Determination of
75% Exemption Rule for WA Determination
TRACT
[NUMBER
FIELD
NUMBER1,2
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP.,
ACRES
FIELD
%
COMMENTS3
090
FIELD NUMBER'
- hvdrant. Dull. zone. or Doint numbers may be used in olace of field numbers
deDendina on CAWMP
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption; otherwise operation will be subject to WA determination.
FIELD NUMBER2 - must be clearly delineated on map.
COMMENTS' - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less Phan 50%
of its annual PAN as documented in the farm's previous two years' (1997 & 1998) of irrigation records cannot serve as the
sole basis for requiring a WA Determination..Back-upfields-must.be noted inthe comment section and must be -accessible
by irrigation system. -
Part IV. Pending WA Determinations
P1 Plan lacks following -information: _
P2 Plan revision -may satisfy75% rule based -on -adequate -overall PAN deficit'and by
adjusting all field acreage to_below'75% userate-..
P3 Other (ieAn process of installing new irrigation system):