090014_INSPECTIONS_20171231

1
JV
17
Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 090014 Facility Status:
Inpsection Type: Compliance Inspection
Reason for Visit: Routine
Date of Visit: 10/26/2017 Entry Time: 11:45 am
Farm Name: A & D Farms
Active Permit AWS090014
Inactive Or Closed Date:
County: Bladen Region
Exit Time: 12:30 pm Incident S
Owner Emall-
Owner. Raymond C Marlowe II Phone:
Mailing Address. PO Box 211 White Oak NC 28399
Physical Address: 615 Culbreth-Smith Rd Elizabethtown NC 28337
Facility Status: Compliant ❑ Not Compliant Integrator. Murphy -Brown LLC
Location of Farm: Latitude: 34'46'01" Longitude: 78° 35'24"
SR 1507 114 mile South of intersection with SR 15D6 and 2 miles South of Ammon.
❑ Denied Access
Fayetteville .
910-876-2899
Question Areas:
Dischrge & Stream Impacts
Records and Documents
Waste Col, Stor, & Treat Waste Application
Other Issues
Certified Operator: Barry D Billups Operator Certification Number. 17943
Secondary OIC(s):
On -Site Representadve(e): Name Title Phone
24 hour contact name Kathy Barker Phone
On-site representative Kathy Barker Phone
Primary Inspector. Bill Dunlap Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Calibration Sept 2015 Sludge Survey Extension to 12-31-2019
page: 1

0
Pen -nit: AWS090014 Owner - Facility: Raymond C Marlowe it Facility Number. 090014
Inspection Date: 10/26/37 Inpsecbon Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
Fff-swine- Feeder to Finish 6,840 6,000
Total Design Capacity: 6,840
Total SSLW: 923,400
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 20.00 1 27.00
page: 2

J"
Permit: AWS090014 Owner - Facility : Raymond C Marlowe II Facility Number: 090014
Inspection Date: 1026117 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
res No No we
10. Are there any required buffers, setbacks, or compliance alternatives that need
1. Is any discharge observed from any part of the operation?
[]
M ❑
❑
Discharge originated at
If yes, check the appropriate box below.
Excessive Ponding?
Structure
❑
❑
Frozen Ground?
Application Field
❑
❑
PAN?
Other
❑
❑
Total Phosphorus?
a. Was conveyance man-made?
0
0 ❑
❑
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?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
■ ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na He
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
❑
0 ❑
❑
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 Ne
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ N ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 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: AWS090014 Owner - Facility : Raymond C Marlowe II Facility Number. 090014
Inspection Date: 10/26/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application You No Na No
Crop Type 1 Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2 Coastal Bermuda Grass w!
Rye Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Kenansville
Soil Type 2
Foreston
Soil Type 3
Centenary
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?
110
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
N ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
❑
❑
18. Is there a lack of properly operating waste application equipment?
E]
■ ❑
❑
Records and Documents
)Aim
No 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?
❑
s ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
E ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

i'
Permit: AWS090014 Owner - Facility : Raymond C Marlowe II Facility Number. 090014
Inspection Date: 10/26/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Stocking?
❑
❑
Crop yields?
❑
and report mortality rates that exceed normal rates?
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
E ❑
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
❑
0 ❑ ❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
E ❑ ❑
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
[❑
Other
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?
❑
E ❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑ ❑
Other Issues
Yes
No Na He
2B. 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,
❑
E ❑
❑
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?
❑
❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
❑
❑
CAWM P?
33. Did the Reviewer/Inspector fail to discuss reviewtiinspection with on-site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑
❑
page: 5

(Type of Visit: kQrCompliance Inspection O Operation Review U Structure Evaluation O Technical Assistance I
fl Reason for Visit: EYGutine O Complaint 0 Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: Departure Time:
Farm Name: 4 r) Owner Email:
Owner Name: �dy��,..��C�pEye Phone:
Mailing Address:
Region:
Physical Address:
Facility Contact: Kul y a'Lt `�%a Title: Phone:
Onsite Representative: L( Integrator: wig -9
Certified Operator: #�u.r�- (ji {l�l/Jl Certification Number: I M1
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Z-o(c oaoz-f. A�v� zo(6 Pc - 61?L
Design Current
❑ Yes
Design
Current
Design
Current
Swine Capacity Pop.
Wet`Poulfiy:
Capacity
Pop.
Cattle Capacity
Pop.
[a -MA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[:]No
Q NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
Wean to Finish
La er
Da" Cow
[:]Yes
Wean to Feeder
Non -La er
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
Dairy Calf
E�,Pi"o
Feeder to Finish
❑ NE
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D • Poultr.
Ca aci
P,o .
Non -Dairy
Farrow to Finish
Layers.
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
_
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
DNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[a -MA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[:]No
Q 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
Cj�1GA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E�,Pi"o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [—]Yes EI'No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Date of inspection:
❑ Yes
Q�No
❑ NA
Waste Collection & Treatment
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
C31No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[ZLNo— ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No [-KA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NE
Identifier:
Spillway?:
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
eNo
Designed Freeboard (in):
❑ NE
maintenance or improvement?
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
ErNo ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
Q�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
C31No
❑ 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
ER No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
eNo
❑ NA
❑ NE
maintenance or improvement?
I
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes 5;]'No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 3 e rrw4,A S G i7
13. Soil Type(s): 7 D CG
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes &211Vo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [] Fo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [ DXo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [ o ❑ NA ❑ NE
❑ Yes ED No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Edo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [�to ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [;�No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 2N0
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ErNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2014 Candnued

Faci]14 Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [f&"1Go
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes R 'R0
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? []Yes D o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [ o
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Sof (Y
54�"' C�_�_Ztf
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
F] NA E] NE
PK4tt ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes E -1 -No ❑ NA ❑ NE
❑ Yes [a<o ❑ NA ❑ NE
❑ Yes [(]Xo ❑ NA ❑ NE
[]Yes Ej'go ❑ NA ❑ NE
❑ Yes Q.No
❑ Yes Q o
❑ Yes ff No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: 33` V 3 1
Date: 0--7
21412011

Ks _-;2T O«)ss Z o C s
Type of Visit: Q<ompliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 4EYRoutine O Complaint O Follow-up Q Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Tim 1994=
County: Region: �c U
Farm Name-.-v17cff 7i`�i Owner Email:
Owner Name: �C�t1►KLry [[7,✓� Phone:
Mailing Address:
Physical Address:
Facility Contact: 5:� '- K Title: Phone:
Onsite Representative: ( { Integrator: i
Certified Operator: W i 11Ldd C Certification Number: 1 L / efj
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field p Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of 3
❑ Yes c► o [DNA ❑ NE
❑ Yes ❑ No [ A ❑ NE
❑ Yes ❑ No ❑'1A ❑ NE
❑ Yes
Design Current
Eglf1A
Design
Current
Design
Current
❑ NE
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity
Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
j
INon-Layer
I
alf
Feeder to Finish Q
Dai Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D . P.ouI
Ca aci
P.o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other0=0N
Turke Pouits
Other
Other
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field p Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of 3
❑ Yes c► o [DNA ❑ NE
❑ Yes ❑ No [ A ❑ NE
❑ Yes ❑ No ❑'1A ❑ NE
❑ Yes
❑ No
Eglf1A
❑ NE
❑ Yes
[�J"No
❑ NA
❑ NE
[:]Yes
[3-5o
❑ NA
❑ NE
2/412014 Continued

Facility Number: Cy- Date of Inspection-- $Der 71S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Q'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [ ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): oC
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes EKo ❑ 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
[�lo
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
D -11O
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
T Do any of the structures need maintenance or improvement?
❑ Yes
[:T*No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
[�ro
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NA
❑ NE
the appropriate box.
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[3No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[—]Yes
[ 311go
[] NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes EjNo ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground D 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- ❑, LEvidence of ,[Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s) C�%'k�- 1 aid V r�itSl'irc� .SO L%
❑ NE
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EL.R6 ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 0,W— ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes [3 oo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Q'o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
D -11O
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑-#o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [D Design ❑Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes MNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard p Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? El Yes [� N ❑ NA E] NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes
Yes ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Facility Number: I - Date of Inspection:
24. Ifid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [Wo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [Q�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 Cjq4o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes (a'No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
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?
S&JIa ��� d - At C1
6�64
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes [ 0No ❑ NA ❑ NE
❑ Yes [EflNo ❑ NA ❑ NE
❑ Yes [ o ❑ NA ❑ NE
❑ Yes [ZINo ❑ NA ❑ NE
❑ Yes [dNo
[:]Yes [" No
[:]Yes D'SNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: Is .04-- 1s
Date: fg ? 3 ✓ J
2/4/2014

7A
Type of Visit: PCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: aoutine 0 Complaint 0 Follow-up O Referral �0¢�Egmer�gency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: l //' j t) j County: VLRegion: rVo
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: y
Certified Operator: So�c� S
Title:
Phone:
Integrator: �� jrQq ~ 13
Certification Number: (Z
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Discharges and Stream Impacts
Design- Current
Design Current
Design Current
1. Is any discharge observed from any part of the operation?
Swine Ca aei Po
P ty � p.
Wet 111111111;rapacity
:- �, Pop. "
Cattle Capacity Pap.
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
La er
on -Layer
Dry Poul
Layers
DesigpCurrent _'
Cci �Po
Dai Cow
Dai Calf
Dai Heifer
D Cow
Non -Dairy
Beef Stocker
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[:]Yes
❑ No
[R<A
❑ NE
Gilts
Non -Layers
Beef Feeder
Boars
Other
Pullets
Turke s`
Turkey Poults
r
Beef Brood Caw
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
Other
Other
❑ NA
-
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
fo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[]No
E&NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[:]Yes
❑ No
[R<A
❑ 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
U 31NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
�o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
E j '<o
[] NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/412011 Continued

Facili Number: - Date of Inspection: V41
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? D Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
[?167 ❑ NA ❑ NE
❑r •4C6� ❑ NA ❑ NE
Structure 6
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [ado ❑ 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 EWo ❑ 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
(V AQo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E]Joll o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NE
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[gNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
[GAo
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [�Ko ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window++ E] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �0-�[
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMPP
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?
❑ Yes
❑'6
❑ NA
❑ NE
❑ Yes
❑. Xo"
❑ NA
❑ NE
❑ Yes
[]L.Nof
❑ NA
❑ NE
❑ Yes [3db ❑ NA ❑ NE
❑ Yes [&,<o ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Q�Xo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ED?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 [Z],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
23. 1f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes TNo
Page 2 of 3
[] NA D NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
2/412011 Continued

Facifl Number: -LUL10Date of Ins ection:
24, Did the facility fail to Jilibrate waste application equipment as required by the permit? ❑ Yes
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
EKb ❑ NA ❑ NE
[DA -16' ❑ NA ❑ NE
❑ Yes
2<o
❑ NA
❑ NE
❑ Yes
❑K
❑ NA
❑ NE
❑ Yes
E'K
❑ NA
❑ NE
❑ Yes [7,26 ❑ NA ❑ NE
❑ Yes Wo ❑ NA ❑ NE
❑ Yes E!Ko ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [::]Yes o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes E&No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes &o ❑ NA ❑ NE
F
ments (refer to question #t): Egpiain any YES answers and/or any additional recommendations ar any other comments drawings of facility: to better explain.situations (use additional pages as necessary)_
Ca 6 -C
50A,-tt 10 1 OC7 13-I�
Reviewer/Inspector Name: 16 CV L�\Phoo lD V
Reviewer/Inspector Signature:%&�JADate:
ti
Page 3 of 3 1 2/412011

A
N
Type of Visit: Compliance Inspection Z3 Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit: outine 0 Complaint Q Follow-up Q Referral 0 Emergency O Other Q Denied Access
Date of Visit: Arrival Time: ; .3p Departure Time:app County:
Farm Name: Aq-c—p rQryts Owner Email:
Owner Name: �� y D� Phone:
Mailing Address:
Physical Address:
Region: D
Facility Contact: ?U r -k -e T Title: re Phone:
Onsite Representative: 4t- Integrator: zi�rjea:�
Certified Operator: y��.--r,/ �j t�lu, Certification Number: L
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)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
E)Yes ❑ No E]NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[] Yes [:]No
❑ Yes C, No
❑ Yes U] No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 2/4/2011 Continued
Design C►urrent
Design Current
Design Curreut
Swine
Capacity Pop.
Wet Poultry
Capacity Pop.
Cattle Capacity Pop.
Wean to Finish
I
JI-ayer
IDai
Cow
Wean to Feeder
Nan -La er
Dai Caif
Feeder to Finish
a a
Dai Heifer
Farrow to Wean
Design : Current -
Dry Cow
Farrow to Feeder
Dr Point >
;Ca acity ;:; X1'0
Non -Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
M.
Turkey Poults
Other
I 10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
E)Yes ❑ No E]NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[] Yes [:]No
❑ Yes C, No
❑ Yes U] No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 2/4/2011 Continued

4
❑ Yes
[3 No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Facifl Number: - Date of Ins ection: S
allo
❑ NA ❑ NE
the appropriate box.
' Waste Collection & Treatment
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
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
❑ NA ❑ NE
Identifier:
Spillway?:
Designed Freeboard (in): 9 -
Observed
Observed Freeboard (in): —73
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
CS No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
® Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [&No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [:]Application Outside of Approved Area
12. Crop Type(s): �e_Xn[M(AJl i[Ct 3-r -2n
13. Soil Type(s): D
C I-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes gj 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?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes ® No ❑ NA ❑ NE
❑ Yes [g No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[3 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 ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below_
❑ Yes
[3 No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [] Soil Analysis
[] Waste Transfers
❑ Weather Code
❑ Rainfall F1 Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[—]Yes
g No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ® No [:INA ❑ NE
Page 2 of 3 2/4/2011 Continued

y
Facili Number: - Date of Inspection:Ir —/
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [R No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes W No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑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 [B 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 S No ❑ NA ❑ NE
❑ Yes [R No ❑ NA ❑ NE
❑ Yes [4 No ❑ NA ❑ NE
❑ Yes
[a No
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
DA. -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 neeessdry)
/•� �?� ir�tr�W�`r't h�rL��S
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1T_ -a c)
Date:
2/4/2011

// - /S- ?z,,o lam'
Type of Visit QrCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for VisitRou tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑Denied Access
Date of Visit: Arrival Time: �{ � Departure Time: % i SS County: / GRegion: F/ZQ
i
Farm Name: 26 r Owner Email:
Owner Name: b, .8f //"ay, Phone:
Mailing Address:
Physical Address:
Facility Contact: --tJ Lb - &j II 1 Title: Phone No:
Onsite Representative: fit/ ,atr- �� Integrator: 19
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: Longitude:
Design Current
Swine Capacity Population
Design C+urrent
V!`et Poultry Capacity Population
Design C►urrent
Cattle Capacity Population
❑ Wean to Finish
10 Layer
❑ No
P'NA
❑ Dairy Cow
❑ We, to Feeder
10 Non -Layer-
❑ Dairy Calf
® Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Dry Poultry
❑ Layers
❑ Dairy Heifer
❑ Dry Cow
El Non -Dai
El Beef Stocker
❑yes
N
[:INA
❑ Farrow to Finish
ElYes
❑ Non-Layers Pullets
❑
❑ Turke s
❑ lurke Poults
❑ Other I
El Beef Feeder
❑ Beef Brood Cowl
umber of Structures:
❑ Gilts
❑ Boars
Uther
❑ Other
Discharges & Stream Impacts
1 _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
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 21 o ❑ NA EINE
❑ Yes
❑ No
O<A
❑ NE
❑ Yes
❑ No
P'NA
❑ NE
RIA
❑ NE
❑ Yes
❑ No
❑yes
N
[:INA
ElNE
ElYes
No
❑ NA
❑ NE
Page I of 3 12/28/04 Continued

F%
12. Crop type(s) f I»wc' / �5. 6—. 0-
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
Facility Number: Date of Inspection 5 v
o
El NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ffa"No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
514o ❑ NA ❑ NE
Structure i Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier- 2e Z
EfNo
❑ NA
Spillway?: 1Uy
18. Is there a lack of properly operating waste application equipment?
❑ Yes
_
Designed Freeboard (in): /9nen
❑ NA
❑ NE
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[i3<o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
El Yes
�,�^
LST 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 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
RrNo ❑ 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
O No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
�
10. Are there any required buffers, setbacks, or compliance alternatives that need
ElE 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 [--IPAN > 10%or ]0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) f I»wc' / �5. 6—. 0-
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
El NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
,09
E No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
u No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
EfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E7 No
❑ NA
❑ NE
pjtzo ' �t w�� Z> !c/� S� r c� ti St i . -- �
6U 0.,4
Reviewer/Inspector Name-'-"� cis • Phone• a
Reviewer/Inspector Sig re: Date -/Z � 4
Page 2 of 3 12/18/04 Continued

Facility Number: — Date of Inspection /
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,BK ❑ NA EINE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [Ko ❑ NA ❑ NE
the appropriate box. [I WUP ❑ Checklists
❑ Design ❑Maps [:1 Other
21.
Does record keeping need improvement? if yes, check the appropriate box below.
❑ Yes
L7 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Yes
❑ 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
B<
❑ 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
❑ Yes
❑ NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
,[a'1�o
B No
❑ NA
❑ NE
26_
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ErNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
LrS1vo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [*o ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
B<o ❑ 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
E3090 ❑ 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
��,�!
L_7 ivo ❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
El Yes
,.,_,!
0?<o ❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA
❑ NE
Page 3 of 3 12/28/04

3 r�S 7-0y-0009
ivision of Water Quality
Facility Number Q �% 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit ompliance Inspection Q Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit0-90"u-tine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: -0�r Arrival Time: //, S Departure Time: .'.7r � County: �O� Region: �/
Farm Name: -b Q f` -/M S Owner Email:
Owner Name: 9-aerte Phone:
Mailing Address:
Physical Address: ��®
Facility Contact: /k//`qrt H &rAe-y Title: 7� • &f -C- _ _ Phone No:
Onsite Representative: tl4444 &VICe W, Integrator:
Certified Operator: &'v BIT Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = e =' = « Longitude: =] e =
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
�❑ Wean to Finish
❑ Wean to Feeder
ErFeeder to Finish a
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Soars
Other
❑ Other
Fa er
on -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑
Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Cattle
Design Current.:, 'a
Capacity Population
❑Dai Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (1f yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes L'1 No ❑ NA ❑ NE
❑ Yes
[:]No
9'NA
❑ NE
❑ Yes
❑ No
ENA
❑ NE
❑ Yes
❑ No
E NA
❑ NE
❑ Yes
❑'lqo-
❑ NA
❑ NE
❑ Yes ETNo ❑ NA ❑ NE
12/28/04 Continued

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 3 No ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? 1:1E 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 [:1 Yes Ll'No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDI1C2tiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Lf No ❑ NA ❑ NE
mai ntenance/improvement? //
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 3 o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) L5 e d c>%- G -a �i�•4t' �s v�, Al
Facility Number: DDate of inspection
Soil type(s) Ke- ro Cc-
Waste Collection & Treatment
l4.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
__,,,__//
ONo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
3 No
[INA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
❑ Yes
IT NNo
El NA
El NE
Spillway?:
Is there a lack of properly operating waste application equipment?
ElQ Yes
,
No
❑ NA
Designed Freeboard (in):
Observed Freeboard (in): Q
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E_ _/ No
❑ NA
❑ NE
(icl large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
����
E 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 3 No ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? 1:1E 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 [:1 Yes Ll'No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDI1C2tiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Lf No ❑ NA ❑ NE
mai ntenance/improvement? //
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 3 o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) L5 e d c>%- G -a �i�•4t' �s v�, Al
13.
Soil type(s) Ke- ro Cc-
l4.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
__,,,__//
ONo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
G"No
ElNA
ElNE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:]Yes
D//o
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
IT NNo
El NA
El NE
18.
Is there a lack of properly operating waste application equipment?
ElQ 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):
Reviewer/inspector Name K'e_ k" Re—✓eJ's
Reviewer/inspector Signature:
Phone: 1AP, V33. 333
Date: '� 9
12/28/04 Continued

Facility Number: D `% — J Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes El<o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Ej No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes B o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
[:]Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
B o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
D'Cvo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
L Xo'
El NA
El NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�
L7N//o
El NA
[:1 NE
26. Did the facility fail to have an actively certified operator in charge?
El Yes
o
El NA
[j NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
�D
l� No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CJ No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
El"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
,_ �
B o
❑ 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
r—,,N�
tom, o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
��,,__//
E o
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[moo
❑ NA
❑ NE
Comments and/or Drawings:
12/28/04

Type of Visit
ompliance Inspection
O Operation Review O Structure Evaluation
Q Technical Assistance
Reason for Visit
Routine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: I — i Arrival Time: Departure Time: j 1 County: "W't-- Region:
Farm [Name: 2±3L.0 r a rids Owner Email:
Owner Name: Aggerx _ _ fji 11-k12s Phone:
Mailing Address:
Physical Address:..
Facility Contact: .+f-�' e zqt CID 76 I 1 ia � S Title: Phone No:
Onsite Representative: Integrator: r
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [::] 6 =' = Longitude: = ° =' = «
_
Swine
Wean to Finish
[PEI Wean to Feeder
Design Current
Capacity Population.
Design Current
Wet Pouitry Capacity Population
❑ La er
❑Non -La er
Design Current
Ca11111 ttle Capacity Population
❑ Dai Cow
❑ Dai Calf
EK Feeder to Finish
O
❑Dai Heifer
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ La ers
❑ Farrow to Finish
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ Beef Stocker
❑ Gilts
❑ NE
❑ Non -La ers
❑ Beef Feeder
P': ❑ Boars
❑ Pullets
❑ Beef Brood Co
r
❑ No
❑ Turke s
❑ NE
Others
❑ Yes
'. ❑ Turkey Poults
❑ NA
❑ Other
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Other
Number of Structures:EE
❑ NA
n bm
other than from a discharge?
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[RNo
❑ 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 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
5tNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
J4 No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
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 1 Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in): f
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
1Z 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
rQNo
yal
ElNA
ElNE
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?
21 Yes
❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
MNo
❑ 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
[9No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
CgNo
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E&No [:1 NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ]O 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) ;`Pyr aL_ r p(Ie-!5e--d
13. Soil type(s) ,e ,+ IFO ZC_,:� Z W o
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ENo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'? ❑ Yes F[No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes QS No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 2 of 3
❑ Yes CANo
❑ Yes 10 No
El NA El NE
El NA El NE
Phone: i) - 3 0 0
Date:rte^
12/28/04 Continued

Facility Number: — y Date of Inspection l
' Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (Z No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9 N ❑ NA [IN E
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement'? If yes, check the appropriate box below. ❑ Yes EZ 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 D4No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes RNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
UffNo
❑ 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
[9No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
EgNo
[INA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ZNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E9 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
allo
❑ 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
MNo
❑ 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
JgNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
21 No
❑ NA
❑ NE
Additional Gotnmepts andloir DraRings
Page 3 of 3 12/28/04

e(Division of Water QualityZOOK
'i Facility Number O Division of Soil and Water Conservation
Q Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: © Arrival Time: 17 Departure Time: i P—p County:
Farm Name: ,� Owner Email:
Owner Name: _ ZQ! ✓ ✓J lk A S Phone: _
Mailing Address.
Physical Address:
Facility Contact: &121 i Ykjz Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: ❑ o ❑ I ❑ u Longitude: ❑ o ❑ ' Q "
Design Current Design . Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ La er
ElWean to Feeder 10 Non -Laver
® Feeder to Finish I &Iff_4 0 1 If 5-00
❑ Farrow to Wean
❑ 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
_7,7Design :Current '.
Cattle Capacity Population 'w
❑ Dairy Cow k
ia.
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry CowW"
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow .
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any pan 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
Ci�No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes 6No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes MNo ❑ NA ❑ NE
❑ Yes %No ❑ NA ❑ NE
12/28/04 Continued

Facility lumber: 211— Date of Inspection
` Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
❑ Yes [A No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): � 0
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes El 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 54 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? 9Yes ❑ 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
215-vo
❑ NA ❑ NE
maintenance or improvement?
Date:
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
9No
❑ NA ❑ NE
maintenance/improvement?
]I. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
F.No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc_)
❑ PAN [:IPAN > 10% or ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Q
13. Soil type(s) &A ZZE0 Z W g2
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
RNo
❑ NA ❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[-] Yes
R No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
®.No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
J91 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):
1W
Reviewer/Inspector Name
G 9 *�-- Phone: Md
Reviewer/Inspector Signature:
Date:
12/28/04 Continued

` Facility Number: — Date of Inspection v 7
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [gNo ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 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 fO No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes allo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[I Yes
VX.No
❑ NA
[:] NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[X 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
CANo
[JNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
M 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
fA 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
F 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
fO No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
54 No
❑ NA
❑ NE
Comments and/or Drawings:
12128/04

Type of Visit JgeC,.ommpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Q
Reason for Visit outine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
.Date of Visit: Arrival Time: %r %37 Departure Time: County: Region: _/ 0
Farm Name: Owner T�s_s- } ¢ r �f7�+� Owner Email•
Owner Name: ���s�/>3 �%— Phone:
Mailing Address:
Physical Address:
Facility Contact: �� �'�/ i��l�®S Title:
Onsite Representative: A
Certified Operator: ;L e fZ?
Back-up Operator:
Phone
/No:
Integrator -
Operator Certification Number: 04.2
Back-up Certification Number:
Location of Farm: Latitude: [=O =[
❑ « Longitude: E:10=1 ="
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
Design Current
Design Curren#
Design ourrent
Swine
Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ NA
❑ Layer
❑Dai Cow
Wean to Feeder
EN No
❑ Non -Layer
❑ Dai Calf
EFeeder to Finish
��
❑ Dai Heifer
❑ Farrow to Wean
d_ Does discharge bypass the waste management system? (If yes, notify DWQ)
Dry Paultr�y
❑ Cow
❑ Farrow to Feeder
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Non -Dairy
❑ Farrow to Finish
❑ NA
❑ La ers
❑ Beef Stocker
❑ Gilts
JM No
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
10 Beef Brood Co
— ---
El Turkeys
Continued
Other"``
❑ Other
❑ Turkey Poults
10 Other
Number of Structures:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
®..No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
EN 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
allo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
CRNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
JM No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

Facility Number: Date of Inspection F EW -2-F 4
`�. 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 P,No [:INA ❑ NE
❑ Yes ERNo ❑ NA ❑ NE
Structure 5 Structure 6
Identifier:
Crop type(s) r Nt44,01.c- �.ty�r lar jf �� 9�yr✓��zd
Spillway?:
Designed Freeboard (in): /
Observed Freeboard (in): 3V
Soil type(s) CT Z EQ Z �kJD
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
VkNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
14.
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
ZNo ❑ NA ❑ NE
through a waste management or closure plan?
❑ NA
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? ZYes
❑ No ❑ NA ❑ NE
S. 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)
❑ NE
9. Does any part of the waste management system other than the waste structures require Yes
❑ No ❑ NA ❑ NE
maintenance or improvement?
No
Waste Application
❑ NE
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
JK No ❑ NA ❑ NE
maintenance/improvement?
K No
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.)
Is there a lack of properly operating waste application equipment?
❑ 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
❑ NA
12.
Crop type(s) r Nt44,01.c- �.ty�r lar jf �� 9�yr✓��zd
13.
Soil type(s) CT Z EQ Z �kJD
Reviewer/Inspector Name �7`-� [�.�+-�� -� Phone:
/
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[KNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
j,No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
K No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
54 -No
❑ NA
❑ NE
z
Comments (refer to question #): Explain any YES answers and/or; any recommendations orany other commentsrx `
Use drawings of facility.to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name �7`-� [�.�+-�� -� Phone:
/
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/04 Continued

Facility Number: /y Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IN No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 29 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 14 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 DF No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
19 No
❑ NA
❑ NE
Other Issues
B� r,�rrr,s�fiP s��s •�6�r,�
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
JS No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Ed 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
29 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
INNo
❑ 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
0 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,KNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
AL
jet �i''rr� �d rr�D 2ts ure m,:13�'K� w� k� r -sl �ylsrr�i�fn'✓/� r '
Aor0
B� r,�rrr,s�fiP s��s •�6�r,�
LAW
Page 3 of 3 12128/04

Facility Number Date of Visit: P &— Tune: !/ :�
10 Not rational O Below Threshold
® Permitted 11 Certified 13 Conditionally Certified 0 Registered Date -Last Operated or Above Threshold:
Farm Name: _ . .__ r Q County:
Owner Name: Phone No:.9
Mailing Address: _ .. .
Facility Contact:
Title:
Phone No:
Onsite Representative: � !�X , , c, s a 4.4--- , _ _ _ Integrator. ,.,,,,,,/
Certified Operator: Operator Certification Number:
Location of Farm:
14 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Discharges & Stream Ln cts
1. Is any discharge observed from any part of the operation? ❑ Yes C1 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 Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gamin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [X No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes It No
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier -
Freeboard (inches): T � � j� —_ ............._ �_...
12/12103 Co hued

Facility Number:
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 46 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?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes 10 No
❑ Yes [U No
Yes ❑ No
❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes [19 No
elevation markings?
Waste Anylication
10. Are there any buffers that need maintenance/improvement? ❑ Yes (P No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes D9 No
❑ Excessive Ponding [3 PAN [3 Hydraulic Overload ❑ F zen Ground ❑ Copper and/or Zinc
12. Clop type d/ 4� r r►� a r� b t n s_ c_cf' / -SH'1 t f 1 r` G , w_1 i 0S
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes [}No
16. Is there a lack of adequate waste application equipment? ❑ Yes Q No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes 0 No
liquid level of lagoon or storage pond with no agitation?
1$. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
I9. Is thele any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑Yes No
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 No
Air Quality representative immediately.
♦rifi�i{{�L1 �ILi� tW A'1I) Uwan
i�sr of fsnTLLy m F�Stss� 9Y Feld Copy Final Notes 41r
(�Ofj-iJ 'M -i-
i -11v
11 v
c
ReviewerAnspector Name
Reviewer/Inspector Signature:- Date:
12/12103 C Condnued

Facility Number: _ Jcy Date of inspection
Required Records & Document`s
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis [oil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27_ Did Reviewer/hupector fail to discuss review/inspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
24. Were any additional problems noted which cause noncompliance of t} a Certified AWMP?
NPDES Permitted Facilities
34. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form W Rainfall �3 Inspection After I - Rain
[� 120 Minute inspections ❑ Annual Certification Form
❑ Yes [b No
❑ Yes 10 No
�j Yes QO No
EA Yes 0 No
❑ Yes ® No
❑ Yes 01 No
❑ Yes 49 No
❑ Yes No
❑ Yes �J No
Yes ❑ No
❑ Yes ❑ No
Q Yes EXNo
❑ Yes 1X No
❑ Yes 10 No
U Yes ❑ No
Q No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
_x - y---
$ - _==
\ }� ,
C%JC��F O'T1 � yr •'�� Cc,+[r- �n- -.k i'ir yrs
�titLk� �uspc��iow.
��•� p y � �.�, c n a� b c�� �- � kT h y' c, -t .
J) � o � 1 � C. v-- �► �� .J -� e r
r
12112103

Inspection notes:
This facility consists of
Nine (9) 720 Swine finishing barns
1 Lagoon 4 to 5 acres in size
Lagoon Location
Lat 34 45' 56"
Lon 78 35' 23"
Photo Time 15:26- 15:00
Follow-up note:
There is a fresh water pond in front of this facility.