090036_INSPECTIONS_20171231

l� Z
DivisionTof Water Resources
Facility Number
® ® Division of Soil and Water Conservation
'� ' _ Q Other Agency
Type of Visit: 0 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 0 Denied Access
Date of Visit: Arrival Departure Time:1 County: k
Farm Name: &f—e" �iiiy fk Ste. % r Owner Email:
Owner Name: &"I lee m Ack-1 S ,-X G Phone:
Mailing Address:
Physical Address:
Region: l` -U
Facility Contact: (}iC4-Lr� Ktr►ta4Z--7 Title: Phone: /1
Onsite Representative: k Integrator:
Certified Operator: A / G-42- Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
ne
Wean to Finish
Design Current
Capcty Pap.
Wet PoultryFapacity
Layer
RNIon-Layer
Design
Carrent
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to Feeder
a. Was the conveyance man-made?
Dai Calf
Dai Heifer
Feeder to Finish
Farrow to Wean
Farrow to Feeder
�] NA
D . Poul.
Design
Ca "aci
-
Current
P,o
Cow
Non -Dairy
Farrow to Finish
❑ NE
La ers
Beef Stocker
Gilts
Boars
d_ Does the discharge bypass the waste management system? (If yes, notify DWR)
Non -La ers
Pullets
❑ No
F NA
Beef Feeder
Beef Brood Cow
��'r':: a..P
her�
Other
�F. _.:: "::.J:'e1 :t ..-A'.—:..—••••--:�••
Y.
�
��
pT�'. w:.«,. .. ..-..:yy ..
Turkeys
Turkey Poults
Other
'.44Mw::h:'hFbYaaw'6
=-.---�:-kF'34i1Ws\iM-,
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
Discharzes and Stream ImDAetS
1. Is any discharge observed from any part of the operation?
❑ Yes
EP No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
�] NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No[P
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
F NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[0 No
[:INA
❑ 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 21412015 Continued

lFacility Npmber: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
99 NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �{ 39 -
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
1�5 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
0 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alteratives 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 (R No [DNA
❑ 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?
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 ® No
❑ Yes P No
[:]Yes O No
❑ Yes No
❑ Yes No
❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
DNA ❑NE
❑ 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 El Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes IM No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes [ No
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes [ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

F keili Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes VgNo DNA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes � No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
4 No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
Y]
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
G No
❑ NA
❑ NE
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: U-01 -3300
Date: q If Al
2; 460'15

Type of visit: 0 Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Routine Q Complaint O Follow-up Q Referral Q Emergency Q Other O Denied Access
Date of visit: Arrival Time: Departure Time: Q County: J?LM Region: Eleg
Farm Name: jqtIQeU�� Owner Email:
Owner Name: /�LGjLt�j.�1s^S .�Ltr�, Phone:
Mailing Address:
Physical Address:
Facility Contact: Cep 9-eil IIdY Title: Phone:
Onsite Representative: `, Integrator: SiyIr7Z'1-rlg. f OI
Certified Operator: /f Jiad 6,4Qa.ii1 Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Dischartes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes V] No ED NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes No
❑ Yes No
NA ❑ NE
�NA ❑NE
jnNA
DesignCurrent
❑ NA
Design
Current
Design Current
SwineCapacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
ILayer
IDairy
Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
IT
Current
Dry Cow
Farrow to Feeder7106DD
: P,ouitr.
@a aci
P,a
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
-
Other
Turkey Poults
Other
Other
Dischartes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes V] No ED NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes No
❑ Yes No
NA ❑ NE
�NA ❑NE
jnNA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 214/2015 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No � NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: �?-
Spillway?:
Designed Freeboard (in):
Dk ASN
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 property addressed and/or managed through a
❑ YesNo
[:]NA
❑ NE
waste management or closure plan?
T
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ YesNo
❑ NA
❑ 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)
❑ Outside of Acceptable Window ❑ Evidence of WindDrift ❑ Application Outside of ApprovedArea
Crop
/
12, Crop Type(s): Coac,�d I w�.d4 / /•� • �C
9. Does any part of the waste management system other than the waste structures require
❑ Yes® No
[—]NA
❑ NE
maintenance or improvement?
T
❑ Yes No
❑ NA
Waste Aoplication
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 Window ❑ Evidence of WindDrift ❑ Application Outside of ApprovedArea
Crop
/
12, Crop Type(s): Coac,�d I w�.d4 / /•� • �C
, I,
11 ��6 t��+/ f�`�S
13. Soil Type(s): !aY{1crC:� ��l`rl� ,✓ _`/�-�'s i ��f` 1[s .flh
✓iIle s)4►n
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No
❑ NA
❑ 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 10 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ YesNo
❑ Yes TNo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

[Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑Yes No ❑ NA [] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of fust 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
2$. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [] Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ® No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. T
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ YesNo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
® No
❑ NA
❑ NE
[:]Application Field E]Lagoon/Storage Pond ❑ Other:
T
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA
❑ NE
(refer to questeon(#,) *Explain"agy:YES�answers4nd/or any additional recommendationsYor'"' other c6u►ments.
jC6ntn�eiit:s
- ---= ... z�.�'`i <
Use�drawiniZs ofrfaciutyitolbettertexplam situations::(use additional pages°as�necessary .
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
0
Phone:
Date:
21412015

Type of Visit: 4W Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 1 /0 : aD Departure Time: D _ 3o County: Z��N
Farm Name: AC 6kA IPeLN Via,,, -v -Ns 2 Owner Email:
Owner Name: McAtter, Phone:
Mailing Address:
Region: /'-'
JV-
Physical Address:
Facility Contact: �e hylea[. Title: Phone:
Onsite Representative: N Integrator: M V.,V 44ut4
Certified Operator: ct yi.QQ Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes �a No ❑ NA ❑ NE
❑ Yes
Design
Current
❑ NE
Design
Current
Design Current
Swine
Capacity
Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I INon-L21er
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
tt000
9000
Dry Cow
Farrow to Feeder
Zoo
Sup
D Poul ..
Ca act
P,o
Non -Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
X FEM11111111111111
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes �a No ❑ NA ❑ NE
❑ Yes
❑ No
�j NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 2/4/2014 Continued

Facili tNumber: - Date of Inspection:
[�JNo
[:]Yes
[ No
[:]Yes
Waste Collection & Treatment
❑ Yes
EP No
❑ Yes
[�] No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
P NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 2 -
Spillway?, Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 97 ti
5. Are there any immediate threats to the integrity of any of the structures observed?
[D Yes
j�No
E] NA
E] NE
(i.e., large trees, severe erosion, seepage, etc.)
TT'
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
ER No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
M No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[jj 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
P No
❑ NA
❑ NE
maintenance or improvement?
Waste Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
C�j No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [�JNo ❑ NA
❑ 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):
❑ NE
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[�JNo
[:]Yes
[ No
[:]Yes
No
❑ Yes
EP No
❑ Yes
[�] No
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑NA
❑NE
Rimed 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 P No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
[] Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 2/412014 Continued

Flicility Plumber: -M Date of Inspection:417-0,11 5r-
I
24. Did the facility fail to calibrate waste application equipment as required by the permit? [—]Yes P No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes t] No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [�g No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
C] No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
C@ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
IM No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[>j No
❑ NA
❑ NE
Comments (refer to questmn Explain any YES answers,and/or any additional recommendations or any other coirim-_i s&'
Use drawings of faeffloy to:better eaptain-situations (use additional pa es`as necessary) ix_' :: -
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone- %��"%'� ?r 3iop
Date: ,d
2/4/2014

Type of Visit: 0 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 0 Denied Access
Date of Visit: 1 712VI 11- Arrival Time: Zoo Departure Time: County: OLA-PIPAJ Region: P20
I if
Farm Name: /`'(C�t( Q� NiuS,„ Owner Email:
Owner Name: RG ,° e0 Phone:
Mailing Address:
Physical Address:
Facility Contact: Ge i.> t r,o7-e Title:
ee
Onsite Representative:
Certified Operator: "g—, y'
Phone:
Integrator: "yJ� '`�j�p cJ (j
Certification Number: 2—
Back-up
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
o
Design Current �j r �Desl 11" Current 4a k (Design Current
Swine o
Ca ace Po M Wet�Po
.:.�
G.
p. ty. py _ ultry Capacity 1PoP Cattle 1 Capacity Pop.
Wean to Finish Layer Da' Cow
Wean to Feeder Non -La er Da' Calf
Feeder to Finish * . Dai Heifer
Farrow to Wean �f?� - Desegn Current D Cow
Farrow to Feeder 2.mCi� _ b P_oeilt . Ca ace 1'0 . - Non Dairy
Farrow to Finish La ers Beef Stocker
Gilts Non -Layers Beef Feeder
Boars Pullets Beef Brood Cow
-
Turkeys
Other Turkey Poults,
Other Other
Discharges and Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes { No ❑ NA ❑ NE
❑ Yes
❑ No
M NA
❑ NE
[:]Yes
❑No
EP NA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
®No
T5
❑ NA
❑ NE
C] Yes
No
❑ NA
❑ NE
Page 1 of 3 214/2011 Continued

F'acilityNumber: - 3 Date of Ins ection: 7
y
❑ Yes
MNo
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
E3 No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA
LP
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier: ,C3
18. Is there a lack of properly operating waste application equipment? -
❑ Yes
[n No
❑ NA
Spillway?:
Required Records & Documents
Designed Freeboard (in):
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
Observed Freeboard (in): �� u
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
5. Are 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
EP 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
Qg 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
[RNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus [] Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Type(s):op Window oo [j Evidence of Wind Drift Application Outside of ApprovedArea
12. Crop aid
N
13. Soil Type(s): P u/` I (,,-p /< , P
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
MNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E3 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[P No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? -
❑ Yes
[n No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP E] Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21 _ Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �INo ❑ NA [] NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [$)No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 2/4/1011 Continued

Pacili `Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes CR No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
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.
3a. 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
p 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?
t.omments trezer.to question ifs: r.xprain any xnn�.answers annror.
Use drawings of facility to better explain situations .(use additional
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
as
y).
Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes EpNo ❑ NA ❑ NE
L
❑ Yes Y] No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes CF No ❑ NA ❑ NE
❑ Yes 0 No
❑ Yes ® No
❑ Yes Fg No
DNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: 9L�3r�
Date: 7 /
214/2011

Date of Visit: Arrival Time: pct Departure Time: 0 County: 134,A!Jt-- Region: 6F:)Z D.
Farm Name., -M 6i.[r 2 �4'+{r-�- _T- nG.
Owner Name: %f� G �z-�-✓L- `�
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: ('�-5-rMD Title: ` =L STYG• Phone:
Onsite Representative: Pt O r Integrator: lffaeP4
Certified Operator:_rC- I G W � Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Desi Current.
Capa ty` Pop _.
Wet Poultry
ILayer
Design
Capacity
I
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
❑ NA
❑ NE
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Non -La er
D s Poul
Layers
Ca �ci
` '
rrent
P':a..
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Beef Brood Cow
Boars Pullets
Other
I I
Turkeys
Turkey Poults
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)
❑ Yes ❑ No ❑ NA CS -NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes [:]No ❑NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑ No ❑ NA 0 NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [:]No ❑ NA $&NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facility Number: ffiite of Inspection: 3-9—' PV
❑ Yes
[] No
❑ NA
Waste Collection & Treatment
18. Is there a lack of property operating waste application equipment?
❑ Yes
❑ No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
® Yes
❑ No
❑ NA ONE
a. If yes, is waste level into the structural freeboard?
[:]Yes
S No
❑ NA ❑ NE
Structure I Structure a j Structure Structureig/Z
Structure 5
Structure 6
Identifier: Mrd �✓ �"- �v�
the appropriate box.
Spillway?. 4.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
Designed Freeboard (in):_It
21. Does record keeping need improvement? If yes, check the appropriate box below.
Observed Freeboard (in): y -_ % ��� 10.
❑ No
❑ NA
J!INE
5. Are 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.)
❑ Sludge Survey
22, Did the facility fail to install and maintain a rain gauge?
❑ Yes
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
PjNo
❑ NA ❑ NE
waste management or closure plan?
❑ No
[DNA
§Z -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
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
[0 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 PKNE
❑ 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):
l3. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA SNE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA �NE
l6. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA JaNE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[] No
❑ NA
MNE
18. Is there a lack of property operating waste application equipment?
❑ Yes
❑ No
❑ NA
Fg-NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
2q�VE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
WE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
J!INE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
0 Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield [] 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22, Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
6,NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[DNA
§Z -NE
Page 2 of 3
214/2011 Continued

Facility Number: j, Date of Inspection: 131
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA E4 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. I f
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
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 ❑ 1-agoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ No
❑ NA
MNE
❑ Yes
❑ No
❑ NA
ONE
❑ Yes
[] No
❑ NA
I'll NE
❑ Yes ❑ No ❑ NA [" NE
❑ Yes []No ❑ NA ELNE
❑ Yes
❑ No
❑ NA
1,5� NE
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
2) No
❑ NA
❑ NE
EO -Yes
❑ No
[DNA
❑ NE
Comments (refer -to question # ): Explain any YES answers and/or any additional recommendations or any other commentso
F
Use drawings of facility to better explain situations (use additional pages as necessary). _ _ , '
/7`7 "r" A�c
o— 74- „za-�'
,r, !.�
rLe
Reviewer/Inspector Name
{y Phone: 3-3J04
Reviewer/Inspector Signature: Date: -9�
Page 3 of 3 2/4/2011

IType of Visit: 0 Compliance Inspection U Operation Review O Structure Evaluation Q Technical Assistance I
Reason for Visit: 4D Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access 1J
Date of Visit:Arrival Time: Departure Time: jh County:
Farm Name: A�Owner Email:
Owner Name: /nGQk e,mat,6,.469 Phone:
if
Mailing Address:
Physical Address:
Region: FjU
Facility Contact: Crya Title: Phone:
Onsite Representative: f Integrator: r-GJt^
Certified Operator: /�'� �t/ Certification Number: 4'15992
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)
❑ Yes D} No ❑ NA ❑ NE
❑ Yes
Design
Currents
Design
Current
Design Current
Swine
Ca aci
p ty
Po p
�� ''
Wet Poaltry
Capacity
Pop.
•
Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish..
'-�
Dai Heifer
Farrow to Wean
0
WOO
4_
Design
Current
Cow
Farrow to Feeder
Z060
D . l?oWtr
Ca aci
l;o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turkeys
Beef Brood Cow
j
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes D} No ❑ NA ❑ NE
❑ Yes
❑ No
M NA
❑ NE
❑ Yes
[:]No
[P 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 [S NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili Number: - ,7 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:]Yes ❑ No [V NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NE
Identifier: jg;yni'
No
❑ NA
❑ NE
❑ Yes
Spillway?:
❑ NA
❑ NE
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
T
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[R 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
tp No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
fB 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? I f yes, check the appropriate box below. [—]Yes [A 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): C5 q 6,N., Sro j ce,,
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
[�j No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
{
[P No
❑ NA
❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
❑ Yes
[b No
❑ NA
0 NE
[:]Yes
� No
❑ NA
❑ NE
❑ WUP ❑Checklists [] Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [] Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
0 Weather Code
❑ Sludge Survey
❑NA 0 N
❑ NA ❑ NE
Page 2 of 3 - 2/4/2011 Continued

FaciH6 Number: jDate of Inspection: 113
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
34. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
IM No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[�] No
❑ NA
❑ NE
33. Did the Reviewer/Impector fail to discuss review/inspection with an on-site representative?
❑ Yes
P No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain. any;YES answers and/or any additional .recommendations+or,amy otother comments h.e'_ 41
Use drawings of facility to better explain situations (use. additional pages as,necessary)
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: g/D 3-33oo
Date: S-1103
2/412011

ti .. - .�: �,�,.-"� �• _ ivi'sion of Water Quality - - ,
F' ae E Number ®- ® ®Division of Soil and Water Conservation
Q Other Agency
Type of Visit: ffComphance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Oxoutine 0 Complaint 0 Follow-up 0 Referral O Emerzencv 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: 0 County: f Region:
Farm Name: L' g)et,eeazJ / 5i'jY15 �iL/", Owner Email:
Owner Name: elzn�-��},�,�/ Phone:
Mailing Address:
Physical Address:
Facility Contact:
9,Cf'kGAjn&A Title:
I If
Integrator: _ AL—6
Certification Number: 2jr.7%T!
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone:
Certification Number:
Location of Farm: Latitude: Longitude:
Dischar,zes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes Vo ❑ NA ❑ NE
a_ Was the conveyance man-made? ❑ Yes [:]No Ute-�A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No E;X5( ❑ 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 A ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes 0<0 ❑ NA ❑ NE
3_ Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes UQ o ❑ NA ❑ NE
of the State other than from a discharge?
Page l of 3 21412011 Continued
esign -Curretif-
Dan
Design
,Current
Des':gn Current
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Capacity . Popp ._
Wet Poultry
Layer
Non -La er
Capacity
Pop:
-
Cattle Capacity Pop,
Dairy Cow
Dai Calf
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Design Current'"Dry
ILayers
Non -Layers
Cow
Non -Dai
Beef Stocker
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other`
=
Turkeys
Turkey Poults
Other
Other
Dischar,zes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes Vo ❑ NA ❑ NE
a_ Was the conveyance man-made? ❑ Yes [:]No Ute-�A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No E;X5( ❑ 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 A ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes 0<0 ❑ NA ❑ NE
3_ Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes UQ o ❑ NA ❑ NE
of the State other than from a discharge?
Page l of 3 21412011 Continued

Facility Number: jDate of Inspection: 1017e
�- u-
13. Soil Type(s):
Waste Collection & Treatment
14. Do the receiving crops differ from those designated in the CAWMP?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
0 NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
U2olqlo
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NE
Identifier:
❑ Yes
U<o
❑ NA
❑ NE
Spillway?:
Designed Freeboard (in):
❑ Yes
[KNo
❑ NA
❑ NE
Observed Freeboard (in):
❑ Yes
Wk<o
❑ NA
❑ NE
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Ne
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes
E
❑ 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 To ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes To ❑ 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 E No ❑ NA ❑ NE
maintenance or improvement?
Waste AQalication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 -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 Areaa/+ �����
12. Crop Types): � , ��7�x.1 �.7x�4-- � (jtr�) .1
11
�- u-
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
EfNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
EN o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
U<o
❑ NA
❑ NE
. acres determination?
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
Wk<o
❑ NA
❑ NE
Required Records & Documents
No
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E5 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 EI No [] NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspecti;<0_1_11[:]
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [] No iA ❑ NE
Page 2 of 3 .2/4/2011 Continued
I,

Facili Number:- Date of Inspection: Q 2U
W &9
24. pid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 2014 ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes E 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 ETNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA [t] -i<
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?
mments (refer to. question #) Explain any YES answers and/orany.additional
e drawings of facility to better explain situations (use addition
al pages:as Daces
Reviewer/Inspector Name:
Reviewer/Inspector
Page 3 of 3
❑ Yes No ❑ NA ❑ NE
❑ Yes ®<o ❑ NA ❑ NE
❑ Yes E No [DNA ❑ NE
❑ Yes [D-111* ❑ NA ❑ NE
❑ Yes
2 1 o
❑ NA
❑ NE
[D Yes
ea 1V o❑
NA
E]NE
❑ Yes
No
❑ NA
❑ NE
Phone:
Date:
2✓4/2011

f i,7 tAo/ n
Type of Visit 0-co'mpliance In 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Rnsoutine Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Dale ofvisil. I��—%%�J I ;�rri�ai'fime: j ,9 Departure time: ip (7(� Count�:3 1�r` Region: � v
FarmName: ✓frri ✓ G. Owner Email:
Owner Name: f do .-yl. ��0� �I Phone:
Mailing Address: • fix c;?,g 79 AIL oV23,;;'
Physical Address:
Facility Contact: Genn R=40 r.Title:
Onsite Represent ative:�� L �C�+ t�S-- —•
Certified Operator: s/`� i✓ iIt% � —
Phone No:
Integrator wv�
Operator Certification Number: QL22 Y1
Back-up Operator: Back-up Certification Number:
Locatioit or Farm: Latitude: ❑o Longitude: ❑o ❑f u
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
L Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layet
1 110Non-La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑
I urkeys
❑
Turkey Poults
❑ Other
Discharges 3 Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure RApplication Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dai � Cow
❑
Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
0 -Yes ❑ No ❑ NA ❑ NE
j$ Yes
❑ No
❑ NA
❑ NE
Yes
❑ No
❑ NA
❑ NE
-fit?
f
Yes
❑ No
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE,
❑ Yes
❑ No
❑ NA
,KNE
12128/04 Continued

B
Facility Number: q —L3 1, Date of Inspection
_T ;;Z" l' 'j /+ I%Y f t" r C G o r OIJY� G� cBr{Jr>✓" �'"-_ W : rd"
Waste Collection & Treatment
levy -t! O— rt pvf! 4 ' j 1—D h ra h C.3,; a)V V -j go TO C /an0 . ,sic ca 44 /
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
[�JNo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 1�}
Observed Freeboard (in): A;Z - _ _pZ Q
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
allo ❑ 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
R No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ yes
-K 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
[9yes
low -
allo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No ❑ NA 9 NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
IS Yes
❑ No ❑ NA ❑ NE
(,Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [:]Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No ❑ NA NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No ❑ NA NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination` ❑ yes
❑ No ❑ NA NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No ❑ NA NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
❑ No ❑ NA NE
Comments (refer to question #): 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):
_T ;;Z" l' 'j /+ I%Y f t" r C G o r OIJY� G� cBr{Jr>✓" �'"-_ W : rd"
fG0 t 5 Fv✓1''t o� a a t?�- i,uos l o 7p 4vr✓ . CBr+ >�
levy -t! O— rt pvf! 4 ' j 1—D h ra h C.3,; a)V V -j go TO C /an0 . ,sic ca 44 /
�v•t►«^"
bdcPne— 'ro )-p ata� /410,4( � alas a03 70 -14rqV
Reviewer/inspector Name Phone: g)0-4135-ZO a
Reviewer/Inspector Signature: Date: -gQO/ D
7,f I7./ZS/(14 [.'onnnuea

i -
Facility Number: g -,3 (o Date of Inspection a—!�
a
Re uired Records & Documents
I9. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ® NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA NE
the appropriate box.
❑ WUP ❑Checklists ❑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?
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
2$, Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
® NE
❑ Yes
❑ No
❑ NA
® NE
❑ Yes
❑ No
❑ NA
J0 NE
❑ Yes
❑ No
❑ NA
® NE
❑ Yes
M No
❑ NA
bj 1:319r"-`rn Ta o, m *4- 4-+ ij,, o -o ,n=iA.&
❑ Yes
❑ No
❑ NA
15NE
❑ Yes
E]No
[INA
❑ NE
❑ Yes
❑ No
[INA
D9NE
❑ Yes
Eg-No
❑ NA
f ie
CCJ`rd
® Yes ❑ No ❑ NA ❑ NE
❑ Yes [Z No ❑ NA ❑ NE
3 Yes ❑ No ❑ NA ❑ NE
Additional Comments Mor
%Cr-nrp Y �4
»rr� ✓N� �v✓�- 1-iOJ�iQd PYA �`' /sT�'
J � T/Y 4911""- Bre `: e ms% %•� Lf?o ki
r cul S /
��c
_
f=�t'•- �i fdd,,
,Gt(Iv�frL�a Fr
L r -
f ie
CCJ`rd
,/�d`��iWa3`fz'%vaij
/�/Y[e,�y-� ,gyp{',Lrr P
15 rrvu srve l Do rp �s
vd�
lT
-f�.-r
7 h,e P+ eg d'1 e- L009 s ; `�-W,o� per^ ; �^ �- U e ✓r�V' " ,
7� `ir���� ���
�} Lgo T'Q'^ i 1Fer �vra��"Ih:S T -'►-c..., �1 l�i�vrr/s �/`r`dr�
We sr�{ � -r� r �,-� e AnoA n1l. tt)aAj Ago'
bj 1:319r"-`rn Ta o, m *4- 4-+ ij,, o -o ,n=iA.&
G�'d r '� � /`a r-- �3� [.��h� 1 yl � r� L�J�� � F=rf3�^�'t�•-f Gr r-%� Y-�.^F�28/04 7T r. l�lJ� �
1��01✓� w= ��%/u� 7�n-rhr17`o ,-rv`, a.Pi 74

griifS -7-0y-200V
ivision of Water Quality
Facility Number 03(, O Division of Soil and Water Conservation
- - Q Other Agency
Type of Visit 016ompliance
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
outine O Complaint
O Follow up 0 Referral O Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: >'/� j`O Departure Time:
;
County: &der✓ Region:
Farm Name: /RG n.tej/ ^,.,/%4e(lwMcf'toweer
Email:
Owner Name:
Mailing Address:
Phone:
Physical Address:
Facility Contact: 6e ye) 1<e VA10 Title: Phone No: p
Onsite Representative: (9&ND_! Integrator: �u�44 &MjAl_^_
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =0
=1 ="
Longitude: =0=S
e=S =
Swine
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other ;
1.0 Other
De0ii Current Design Current
Capacity,,Population Wet Poultry CapacityPopulation
❑ Layer
❑ Nan -La et
II �O I I Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design `.Cu
Cattle Capacity Pop.
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Dumber of Structures:
b. Did the discharge reach waters of the State? (if yes. notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes B No ❑ NA ❑ NE
❑ Yes
❑ No
BNA
❑ NE
❑ Yes
❑ No
El 9A
❑ NE
Q1ffA
❑ NE
❑ Yes
❑ No
❑ Yes
El NA
❑ NE
ElLJ Yes
�Q��No
No
❑ NA
❑ NE
12128104 Contin ued

Facility Number: Q -3&
5--- 2 / -oj
Date of Inspection
Waste Collection & Treatment ,�
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,L��7,, Ng�o ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes L7No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 4,r,:5.
Spillway?: Al() NO
Designed Freeboard (in): ! I / C�
Observed Freeboard (in): _F/ -3/1-
5.
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ yes Q 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 E3<o ❑ 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 ET
o El NA [__1 NE
S. Do any of the stuctures lack adequate markers as required by the permit? El Yes LJ 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 0 No El NA El 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 [3No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window p❑ Evidence of Wind Drift El Application Outside of Area
12. Crop type(s)W _ j3E4l�.e-�:2c
/U ,td ct i �� �:�+.iL� �► 3 r`s,J �i3 ��N
T-'
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes l -7<o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ER<o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. is there a lack of properly operating waste application equipment?
❑ Yes
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) -
El NA
El NE
,[�'1<10
LTNo
❑ NA
❑ NE
Ea'No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary) -
AL
Reviewer/inspector name evG1-1�9 Phone: q1,p, 1e33. 33JV
Reviewer/Inspector Signature: ¢,� ��, Date: S-21-zeb l
12/18/04 Continued

Facility Number: D 7 - Date of Inspection __77
Renuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EKo_ ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Dlo ❑ 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 3<o ❑ 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
[ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
B No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
01 o
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[2<o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
D10
❑ 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
❑ NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
�-�/Io
E3 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?
El Yes
!!
D 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
,,��,,//
BNo
❑ 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
El NA
El NE
33. Does facility require a follow-up visit by same agency?
ElL7 Yes
No
❑ NA
❑ NE
Comments. and/or Drawings:
12/28/04

RIMS (1--0q-0e R -a- -
--- Q Division of Water Quality
Flity Number 9 , -i �(a 0 Division of Soil and Water Conservati
acion
Other Agency
Jim
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: 93D��... Departure Time: County: Region: �100
Farm Name: ��u* r -.cam , Owner Email:
Owner Name: �G���✓ ___ [_d�aD�Jt�/ Phone:
Mailing Address:
Physical Address:
Facility Contact: GGVD kiNi✓cd� Title: / ._ r®r C ` Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [:j'
=' =" Longitude: [_—] ° =+ = u
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
I Jill
Current Design Current. Design Current
Swine
Papulahon
Wet Poultry
CapacityPgpnlahon _Cattle Capacity Population
❑ Wean to Finish
76-day.p.im-
❑ La er
❑ Dai Cow
❑ Wean to Feeder
❑Non -La er
❑ Dai Calf
❑ Feeder to Finish
a. Was the conveyance man-made?
El Yes
❑ Dai Heifer
40 Farrow to Wean
[INE
ioulto❑
D Cow
�
Farrow to Feeder
..., ❑ Non -Dairy
Farrow to Finish
[I No
Layers
rE]Non-Layers
El Beef Stocker
❑GiltsBeef
Feeder
❑ Boars
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
El s
� El Beef Brood Co
��
LINA
-- --
s
� e _
Other,
��
+ r . fi
❑ Turkey Poults
❑ Other
❑ Other
_ Number of Structures: 2
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
[I Yes
2<0
NMI
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
LJ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
El Yes
❑ No
,��
[INE
K Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
[I No
�LINA
[ NAI
❑ 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)
El Yes
❑0NNo
��
LINA
[_1 NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ErNo
❑ NA
E3 NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
[I Yes
2<0
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12128/04
Continued

Facility Number: OFT(e Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ffNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: % �4
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Q 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 ETNo ❑ 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 E3 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes eNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑yes Q No ❑ NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes EJ�No ❑ NA ❑ NE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes To ❑ 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes []'No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes [j`No ❑ NA ❑ NE
I7. Does the facility lack adequate acreage for land application? ❑ Yes [SN. ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes EJ�No ❑ NA ❑ NE
a;�, ..."Mil —
.e drawuags;�ofifactlity to better explain stfuah(use addthonal�pa�ges,as�n�ece�
Good
Alok i J�/er-SQ- /w i, A-7 Tq, vt 7',_y Js 1 A/.0.- `tfj4GL� %4{[NI e-,;
Alok : 6 ra 55 a va -,u d 6,, i /d ;-,)7 s -,"d ye, d eve � Vo 6 GST ,ud vc. re
� qra i%j �
Reviewer/Inspector Name F f�� C_ �� v 4 ks : Phone: 91.9, 30
Reviewer/Inspector Signature: �.+-r-�-� Date:
—
Page 2 of 3 12/28/04 Continued

Facility Number: Q —,�6 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
the appropirate box. ❑ VVTJp ❑ Checklists ❑ Design ❑ Maps p El Other
❑ Yes
E No
❑ NA
❑ NE
❑ Yes
E No
❑ NA
❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
B 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?
ElYes
�❑
0 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
ErNNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
El NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
ALJ:No
Ll No
ElNA
ElNE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
D N" o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
E No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes:No
N ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ❑ 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)
3 suss p
2. Did Reviewer/Inspector fail to discuss review/inspection with an on-site re resentative? ElYes l=1 No ElNA [3NE
33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE
Additional.Co dtstaiidlor Drawings `s. E� c ;
Hw
Page 3 of 3 12/28/04

f,4ic lect b„ Z,'11 TvcJ
• Division of Water Quality
Facility Number (� -I 3 0 Division of Soil and Water Conservation
0 Other Agency 11
Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine O Complaint 0 Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: �f'0� Departure Time: z . SD County: ���"� Region:
Farm Name:„CEJ a u cc 'a �1 £ ?, Owner Emad:
Owner Name: /r!C Qc(c tn/ Phone:
Mailing Address:
Physical Address: �/ �,,/ /
Facility Contact: �[�O `�t��`� i, Title: 464 _ �pe� Phone No:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: =0
Longitude: = °
Design Current Design Current Design Current;'
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population`
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
101 Farrow to Wean 000
Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -Layer
Dry Poultry
❑
Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey 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?
❑ Dairy Cow
❑
Dairy Calf
❑
Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
” 4 _
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 V] No ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
[9 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
I9 No
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
29 No
❑ NA
❑ NE
12128104 Continued

Facili?y Number: O — 36 Date of Inspection 5-23-0
❑ Yes
No
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ No
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
EP No
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: ZL4 S
99 No
❑ NA
❑ NE
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 9 r 4�3 /
3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[y No
❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
INo
❑ 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
Q� No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[P No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
q No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
(p No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[P No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 5e t'tic µ gn! — #e,-1COrAl _ SB v4,w.T kf kt4 7' S ti+ U 10 kre v
13. Soil type(s) / r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[--] Yes
1P No
❑ 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
99 No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name 91'r -K, TPhone: Sia• 533 , 33.30_
Reviewer/Inspector Signature: Date: s- Z 3 — ZU 07
12/28/04 Continued

Facility Number: 0 9 —36 Date of Inspection 5-31-0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [%No ❑ NA []NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes d No ❑ NA EINE
the appropriate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [A No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
1� No
❑ NA
EINE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[4 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
[4 No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
[2q No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0 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
[M 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
�dNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
P No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
V9 No
❑ NA
❑ NE
AdditionaUComments andlor Drawings:, ��,.• 4
Page 3 of 3 12/28/04
Page 3 of 3 12/28/04

Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: O Departure Time: County: Z4�r^_ Region: rA8
Farm Name:��G Owner Email:
Owner Name: __ /!�nIt �-1-*f ��Phone:
Mailing Address: f17 a., . ja"ak �`r7 i '64',
Physical Address: ���77's7l-X yI/G 6
Facility Contact: Title:
Onsite Representative: .44
Certified Operator: 'V"'& " i'z ��/'�r•
Back-up Operator:
Phone No,����G HY
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =0
=1
=6. Longitude: =0=1 = u
_
rents r ..) Design Current
DesignFOP
- Design Current
Swine
Capacityatr_on Wet�Poultry Capacity Population
Cattle - Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dai Cow
❑ Wean to Feeder
❑Non -Layer
El Dairy Calf
❑ Feeder to Finish
❑ NA
❑ Dai I-leife)
Farrow to Wean
0 C Oo�
❑ D Cow
Farrow to Feeder
�� - "'
❑ Layers
❑Non -Dai
❑ Farrow to Finish'
❑ Beef Stocker
❑ Gilts
4 ❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑Pullets
❑ Beef Brood Co
2. Is there evidence of a past discharge from any part of the operation?
Turkeys
0 No
Other.
g ❑ Turke Poults
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Others
a ❑Other
NumherFof Structures:
❑ NE
� ' �?":'%err..-` -,..� .•
E� ^
Dischar:Yes & 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
5QNo
❑ NA
❑ NE
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
OQ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)`?
d. Does discharge bypass the waste management system? (i€yes. notify DWQ)
❑ Yes
EA No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
0 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[,No
❑ NA
❑ NE
other than from a discharge?
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:
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 � No [11 NA ❑ NE
❑ Yes K No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 5d No ❑ NA ❑ NE
❑ Yes [X No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? []Yes [KNo ❑ NA [:INE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Dd 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 [R No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes W No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes XNo ❑ 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) C& r
13. Soil type(s)
L -
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
JR No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
[R Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`!❑ Yes
CKNo
❑ 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
IXNo
❑ NA
❑ NE
'n W r�Q in t rsa� i n� Hu /'r eZ04L ,
f
Phone: Name !LTV/
Reviewer/Inspector Signature: Date: &n.9F NQS
12/28/04 Continued

Facility Number: — G Date of Inspection " 3 ,_T_
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,4 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes §0 No ❑ NA ❑ NE
the appropirate box.
❑ WUP [1 Checklists El Design E] Maps [:1 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
allo
❑ 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
CKNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
CKNo
❑ 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
KNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
;q No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
09 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
N No
❑ NA
❑ NE
Addi�ibnal Comments.and/or Drawings•^"
1 'ate
ot,'
C�Bmw-�r�I
Br►�- un der
f
72118/04

El
Type of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation !
Reason for Visit • Routine 0 Complaint O Follow up O Emergency Notification O Other ❑ Denied Access I
Facility Number --
Date of Visit: ( 4 Tune: ! o
Q
Q Not Operational 0 Below Threshold
Permitted (Certified Q Conditionally Certified © Registered Date Last Operated or Above Threshold -
/+b
_..... ...._. _......-.-..-
Farm Name: ..... County:��...........
Owner Name:.F�.. ..�.....
Phone No: !QJ 86.2 8 �t'cTG
Mailing Address: _.. R 0 .. !Qo,Xc2 ? ll "1.4 I'l., A.,' �Q
................................ .......
Facility Contact: Title: ............. . . .... . .......... . . _.. _.... Phone No:.xS.? Se. 4 �f�.....
Onsite Representative: --L� s .....!�. b�........................................... Integrator:--_4!��
Certified Operator:, .� ,l ]C a - .s�r1L_�Fl.. �!� /� --------------------- - Operator Certification Number: +2S'_2 -Y-2
„
Location of Farm:
[Swine ❑ Poultry ❑ Cattle
Swine-;...._Canac
❑ Horse Latitude • 4 166 Longitude • 6 'C4
El Wean to Feeder
Feeder to Finish
Farrow to Wean y two % opo
Farrow to Feeder pop .2poo
El Farrow to Finish
El Gilts
El Boars
Ponitr3 _
Lay
_ Desiga Gnrr�t Desiga Cnrret
psiaty-
Ca Po "ulatio I, Cattle _ Ca'=Po �ilatton'
Dairy
r, ❑ Non -Layer
Nan -Dairy
'Total DestgaCapactity
_
Tu#alSSLW G
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 00 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 gal/min?
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 00 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes P No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes WM No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ... ''. �t�oQ Ez...............I... _...
Freeboard (inches).-
3c? aG
12/12103 Continued

ILI
Facility Number: 0 g — ? G Date of Inspection O D
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or ❑ Yes No
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 No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes j No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Aaolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes V No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes JU No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type - (w�!!c a'i�' l so v A ca.. t C: � e,tn / A r op" kola //.., f S w, o // �•�d: ,�
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?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality representative immediately.
❑ Yes M No
❑ Yes ® No
❑ Yes ONO
�] Yes ❑ No
❑ Yes M No
❑ Yes 91 No
[:]Yes j$j No
❑ Yes' ( No
❑ Yes M No
_ s 7---�y� _.*., M n. 3 +..-e""ty'"�..s' t - ate..- .. .�.. '--••*.,: v"" - e.�"'�..Y-:...r-v, - __ '; .r x -a-F �4.i,: ,�-
Comments`(reler to gnes�on} �Een any YES:attswe�rs and/or any trecommeadsbons or any other, comments.Uin
Final Notes � ,- se drawing`s of fatty to better ezglaea - - -
srtuattoa�s. (use addttronal pages as necessary) � ; ®Field Co
(�%ast� li�n..,l7,t� we.. GK►�4�-f a�d� c} C.11e�.a,c. D•►tcs 9' /a3� /.?/03
�
314- fu;r,.��..f 1..� ...t bc�++ c�l;6rtfc,o(? .��+. Ck-`•' 1s'c!= 1,q
MV, 4Cftf%e_e1 34s+as L.'Pard-Al }L.4_SC- L
ejC,ks Si MT 0- b, e-c--isICttA q] sOOA aj4EIa.WI-
/O' bpc rr IC.►f, [clot poar wGt+�IC�'^+-�.crL ca—r- jptl.ke 1 4zti&kL �.rGila �a� 'Paco,
iGt�'%Yi�nq wroA. T'f' 4.11I/ >f?� Wr.t��Cyt'f iA.1 SdMG. GKe.4s *6 Oi'iw* baG� �'ht
e,
4rowir►gI SG4ssrv,
f ��o�►�w,fi AilGrGd 11 rkC-.- t:.� 01-10-1j"j ►.aQ �s rcrG�`l �a3CcQ der i*t�4a�[
"
r
Reviewer/Inspector Name :'`p..'<X
Reviewer/Inspector Signature: Date: 7' d 6' a Y
12112103 Continued

•I Facility Number: 09 T 3� 1 Date of Inspection4
Required Records & Document.~
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 ❑ Soil Sampling
24. Is facility riot 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)
Z7. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. 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 ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes X No
❑ Yes 10 No
❑ Yes ® No
❑ Yes No
❑ Yes No
❑ Yes ❑ No
❑ Yes No
CM Yes ❑ No
❑ Yes No
9 Yes ❑ No
❑ Yes ❑ No
❑ Yes [QNo
❑ Yes EdNo
Og Yes ❑ No
❑ Yes ❑ No
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
,1Y
dditiona! Cainments and/or=Drawings —
r'
a$� �6��4W._�4� �a0K Gf CrO�pJ J►7p4�'�"IGw.Cc�lt t�� bctl� � la�{rr
L
C AJ ON .
W {� G�+tL� or, C)wq 04',je— Ggo;.^a-1- rct6oa*aQ record +- r•.+{c�
C2G^
.r s' � tw..) Q t►-► std r� a+� �`. t e� .
1 1� eaN bQ�ks.
we�IL o,. 6ar� sr��� 6 ri T J
raw c ra/no ar C t i ov cr �►A7,lcfs
6N4 at�-
7�
Ct��t•�GY GY'C.Mr�o�iDIJ 1� C�♦s�V-Pte.� 0Gr"ae 'Eforr6VC_ .
12112103