090064_INSPECTIONS_20171231

"ision of Water Resources
Facility Number] - ® 0 Division of Soil and Water Conservation
� Other Agency
Type of Visit: (D-C6mpliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up O Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: S , j
Arrival Time:
E
Departure Time: r
Farm Name: _ YU r I
ir5
Owner Email:
Owner Name: Shli11w6„t
1 rmo n r_
Phone:
Mailing Address:
Physical Address:
Facility Contact: Ct �r+j s 1 Cr-14Jkti h Title:
Onsite Representative -
I(
Certified Operator: C1 ay D-eV t „t le
I
Back-up Operator:
L�QeA— Region: F& D
Phone:
Integrator: K 13 , .S
Certification Number: e? 9 0 W
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design Current
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
o Finish
r,,,.eeder
Layer
airy Cow
o Feeder
Z
46
Non -La er
Da' Calf
to Finish
Dai Heiferarrow
to Wean
Design
Current
D Cow
Farrow to Feeder
Dr, P,oul
C aci
P,o
Non-DairV
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Othe
ITurkey Poults
Other
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [] No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
C❑. ❑ NE
❑,k2C [] NE
❑ Yes ❑ No ❑'NA ❑ NE
❑ Yes ❑-??6 ❑ NA ❑ NE
❑ YesF3N'*o ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili number: jDate of Inspection:
4
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[D-Ne— ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No [3-D1A--❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): s
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑'No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[]jNcr- ❑ 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
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
E io ❑ NA
❑ NE
maintenance or improvement?
Waste Application
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 NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
0 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): C 13
~ V1re-__ Is 6s`
r
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAW MP?
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 l lYv
❑ Yes 3 q-o
❑ Yes E3 "'o
❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
DNA ❑NE
❑ Yes 0'1�o [DNA ❑ NE
❑ Yes &<�
❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
l-'VU
❑ 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
NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
E3 o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
FNo
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facility N+Lmber: - Ds ection: j j
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [Z] F 0 NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Eg-- v 0 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 [ZLNa_ ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0_N6 ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [D-Ne- ❑ 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 ❑ o ❑ 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
[a-W ❑ 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
[]-NT- ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3-No ^ ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
I"' ❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
q � a
c-z.[( cN o- 3 N4 g s�
Reviewer/Inspector Name: t I
Reviewer/lnspector Signature:.1
V
Phone: !�[� - � �) -3,33 t!
Date:
21412015
Page 3 of 3

� �-� -- a
�
_
�_
Facil�ty$�umb r
N
p�D,v► �.� , r���a� �,� � �� ��.� �. :. � �g.,.� ,����
�' �' � _`stun of�So�I�nd�Water�Conservat�ton - "`
--
type of Visit: ompliance 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: 9' IXGI f7 Arrival Time: Departure Time: ! S County: 731,,e-,-
Farm Name: yp r t tir Nam✓ f Owner Email:
Owner Name: Wt. 0��u�� �"`l� Phone:
Mailing Address:
Physical Address:
Facility Contact: Gt"` - s- 47a�` Title:
Onsite Representative:[' «
Certified Operator: l%�' y`✓ ( c"L�S #A
Back-up Operator:
Location of Farm:
Integrator:
Phone:
act +3 - s
Region:
Certification Number: 4? l i 77Gs
Certification Number:
Latitude: Longitude:
Design Current
Design Current Design Current
Skme - Capacity Pop.
-Wet 1?opltry Capacttyop. _ Cattle gvEicity Pop.
- _
:a
Wean to Finish
Layer
iry Cow
.k
Wean to Feeder
?
Non -La er
iry Calf
Feeder to FinishDairy
Heifer
Farrow to Wean
jDrCow
Dr. I?oultry Ca act Po
Farrow to Feeder
Non -Da'
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
-
Pullets
Beef Brood Cow
"Furke s
Qther: =
Turke 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)?
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 [a -No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [3'No
❑ Yes dNo
D-NA ❑ NE
[fT'NA ❑ NE
ON A ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili Number; - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Q'lQ'o
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[5-NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Q 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
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
E N
❑ NA
❑ NE
$. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�o
❑ 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'lgo
❑ 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 1_31o_ ❑ 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): cf3 S CID
13. Soil Type(s): L-ea9_A C M At
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2 No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement'?
❑ Yes
Q No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[2'<o
❑ NA
❑ NE
acres determination?
17.
Does the facility lack adequate acreage for land application?
❑ Yes
[]"No
D NA
❑ NE
18.
is there a lack of properly operating waste application equipment?
❑ Yes
[ " o-
❑ NA
❑ NE
Required
Records & Documents
19.
Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑1lo
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[�Wo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes No ❑ NA ❑ NE
❑ Waste Application ❑Weekly Freeboard ❑Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑Weather Code
❑ Rainfall D Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [] Yes slo ❑ 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 21412015 Continued

Facility Number: - Date of Inspection:
24 .Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E N ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L;.I Ko ❑ 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 ©'i�o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0-Iqb ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes Q'No ❑ NA ❑ NE
❑Yes Qlo ❑NA ❑NE
❑ Yes []-No ❑ NA ❑ NE
❑ Yes is ❑ NA ❑ NE
❑ Yes ❑-N-o
❑ Yes ❑-N
❑ Yes [3-No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #i): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
71(0
Reviewer/Inspector Name: V t 4
c �l
Reviewer/Inspector Signature: t
.. v
Page 3 of 3
Phone: 0- 43 3 3_�J �
Date: �- o [
214/20 5

I W-3 39 ( 6 A3Q
Type of Visit: A'Compliance Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 01Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: eparture Time: county: Region:
Farm Name: lrjC��✓`t�G� �c�✓�'cz Owner Email:
Owner Name: �/t�y��r/�,(-� 11�yJUt. S L__LcPhone:
Mailing Address:
Physical Address:
Facility Contact: Clk t &1W (N Title:
Onsite Representative:
Certified Operator: [5v-r- j j &t
Back-up Operator:
Location of Farm:
Phone:
Integrator: V U 6S
Certification Number: '7 L / L b _
Certification Number:
Latitude: Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
FTLayer
Design
Capacity
I
Current
Pop.
Design Current
Cattle Capacity Pop.
jDairyCow
Wean to Feeder
6 LV
jNon-La er
I
Design
Ca aci
Current
Po
Dairy Calf
airyHeifer
D Cow
Non -Dairy
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
I
Boars
Pullets
Beef Brood Cow
Other
Turkeys
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 DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [j o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NE
❑ Yes ❑ No 01 fA ❑ NE
r
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes [:]No [+] NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes ETNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [ElNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: _ Date of Inspection:
Waste Collection & Treatment ,--,��
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes I�"o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [g-NA-- ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): -
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[]-Iq'o'
❑ 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
[]�Ko
❑ 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
o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[ -Vo
❑ 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 Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2*<o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E]**N'—o ❑ 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): C 13 s 6 o
❑ NE
13. Soil Type(s): �'e 0&4 f „✓�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1G" '
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2-<o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
gl No
❑ NA
❑ NE
acres determination?
17, Does the facility lack adequate acreage for land application?
❑ Yes
La o
❑ NA
❑ NE
19. Is there a lack of properly operating waste application equipment?
❑ Yes
❑' o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
❑ 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 9No ❑ 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 Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [jNo ❑ NA ❑ NE
23. 1f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

1*1 Facifl , Nltmber: C114 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q'KO
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L_T50
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 L2-50-
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [3lZO
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? ❑ Yes [3-15o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes []J o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [2'No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
C•t,i [1� tto 4 7. i UJ0
a , � d P. q, 5
voter cad
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes 2-150- ❑ NA ❑ NE
[:]Yes �o ❑ NA ❑ NE
❑ Yes [f"lio ❑ NA ❑ NE
❑ Yes [�No ❑ NA ❑ NE
ReviewerlInspector Name: �ULYN Phone:
Reviewer/Inspector Signature: Date: CF, -J
Page 3 of 3 2/4/2011

01 wt o 7� 4EC s
Type of Visit: CgCompliance Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: (eRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:1 jtX10 Departure Time: County: 8
Farm Name: Vd6-y-v-(K 't!uv(�*t,� Owner Email:
Owner Name: tr.. o, 4A-C— Phone:
Mailing Address:
Physical Address:
Region: FiZO
Facility Contact: .� �p.�IG Title: Phone:
Onsite Representative: << Integrator:
Certified Operator: /- fCai Certification Number: 6 G r] 6
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current Design Current
Design C►urrent
Swine Capacity Pop. Wet Poultry Capacity Pop.
CattleM6inaciymPop.
Wean to Finish Layer
Dairy Cow
Wean to Feeder
0pASYO I lNon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Dry Cow
Farrow to Wean
Farrow to Feeder
D , P,oul Ca aci _ Po ,
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Turkeys
,VBrs
er
Turke Poultser
Other
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? ❑ Yes ❑ No [3-X�V ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? [:]Yes ❑ No ❑ NA �T
b. Did the discharge reach waters of the State? (if yes, notify DWR) ❑ Yes ❑ No ❑ NA ENE
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 Q A ❑ 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 21412014 Continued

Facili Number: Q - Date of Inspection: by
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
CS-No-0 NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[Ej-N7V_-
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
,Ala-.
❑ 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
Eq-M
❑ 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
[2-No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[]-N-o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
o
❑ 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 [ o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12, Crop Type(s): IS
13. Soil Type(s): l-ep C-e-
14. Do the receiving crops differ from those designated in the CAWMP1
❑ Yes
�o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[3'lglo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
dNo
❑ NA
❑ NE
18. 1s there a lack of properly operating waste application equipment?
❑ Yes
[2 o
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑?"moo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E3 No [DNA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [ "No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes eNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [ff'-No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: al - 4111 1 JDate of Inspection: 0 '/
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [E j o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [:kKo' Q 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 [ a-<o- ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Vo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑-lq-o ❑ 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 2No ❑ 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 ENo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below. ❑ Yes [ErNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ETNo ❑ NA ❑ NE
33. Did the Reviewerlinspector fail to discuss review/inspection with an on -site representative? ❑ Yes ZINO
o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA ❑ NE
(Comments (refer to. question#): Explain any YES answers and/or any additional recommendations or any other comments.. I
Use drawings of facility to better explain situations` nse additional ages as necessa
g ty p P g ry)•s
G�('141 � - (0-1y
9W, 7r �_�-(t-t
�eo-oue
Reviewer/Inspector Name:
oIQ HX f
I�esie4 aJ
Reviewer/Inspector Signature:
Page 3 of 3
�l 0 vyl"
-It SA b_ 4C0 L4
Z�rke
G
Phone:
Date: 0 ALII�
2/4/ 014

GIMC
IType of visit: tvuompnance inspection CV operation meview lV Structure Uvaluation V iecnntcal assistance
Reason for Visit: 04outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: c Arrival Time: Departure Time: County:'
Farm Name: '— Owner Email:
Owner Name: Ad
4VIAA4 � l� ,`[ IVi6 Phone:
Mailing Address:
Physical Address:
Region:79-10
Facility Contact: _ C6 L)C&%,4,'t Title: Phone:
Onsite Representative: Integrator:
Certified Operator: t� Certification Number:T'�
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
DesiArrent
Design Current
SwineCapacity Pap.
Wet Poultry
Capaop.
Cattle Capacity Pop.
Wean to Finish
I ILayer
I
Dairy Cow
Wean to Feeder W
Non -La er
I
Daia Calf
Feeder to Finish
Daia Heifer
Farrow to Wean
Dry Cow
`"
Farrow to Feeder
D . P,ou
CO
aei
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
Boars
Turkeys
Qther
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:
❑ Yes ❑6 tea_❑ NA ❑ NE
a. Was the conveyance man-made?
❑ Yes
❑ No
E5NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
2VA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
[!(NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
to
❑ NA
[3 NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
LJ No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3
21412014 Continued

Facili Number: - Date of Inspection:
t Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ej-Na— ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No EgKA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
L`_7 ""'
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[2-No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[3-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
[�
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
EE "I oo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [Slao ❑ 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 +Wiindow ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): N f✓,-,"QV
❑ NE
13, Soil Type(s): 1� ct a
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes D-Nu [] NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [� ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes []'I�o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [3"No ❑ NA ❑ NE
[—]Yes �o ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑'�io
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E3"N--o
❑ 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
dNo
❑ 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 Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
PTNo
[DNA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[3"No
❑ NA
[] NE
Page 2 of 3 21412014 Continued

Facility Number: Date of Inspection.
?24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [34,� ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Ej[4fo ❑ 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 El No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes [2-ls% ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes [:j'1To [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 Q' o—o ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3 l _ Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes [3-No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [:]Yes [/] No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes E] No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [2 o ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional -recommendations or any other comments.
Use drawings of facili to better ex lain situations` use additional pages as necessary).
g tY p ( p g ry)•
t
tt
F,f 1 a-31 -I4
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 3-- 3-3
Date: _ /(2pL�l _
21412014

Type of Visit: Urompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: �/ Arrival Departure Time: /; G% County:
Farm Name. / _�n �✓hZS i`i Grp Owner Email:
Owner Name: /l Phone:
Mailing Address:
Physical Address:
Facility Contact: Cy=w -- Title: Phone:
IZ
Onsite Representative: j'u__.dz_
Certified Operator: �-'--�
Back-up Operator:
Integrator: o ,i Ar
T
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Region:
Design Current
x Design Current
Design Current
Swine Capacity Pop.
Wet Poultry} ; Capacity loop. C*attie
-
Capacity Pog.
Wean to Finish
airy Cow
airy Calf
airy Heifer
ean to Feeder
Feeder to Finish
Farrow to Wean
Design Current Dry Cow
Farrow to Feeder
D : i'`oultr.` Ca aci P,o Non -Dairy
La ers Beef Stocker
Farrow to Finish
Gilts
Non -La ers Beef Feeder
Boars Pullets
Beef Brood Cow
Turkeys
-
Qtber Turkey Poults
Other Other
IBM=
Discharges and Stream ImDBCt5
1. Is any discharge observed from any part of the operation?
[:]Yes
KNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[] No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[�JNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[XNo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection: i
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ig-No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier_
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ Y f
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
[2,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
[Z No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
R'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
•ZLNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Qj No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes ,Q No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): L. eZ f e C I A,—, _
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes [B-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 allo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes Zj_No ❑ NA ❑ NE
[:]Yes allo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [gNo ❑ 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 � 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 14 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - — aeoww
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes JNo [] NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes allo ❑ 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.
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)
❑ Yes JKNo ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
❑ Yes gNo ❑ NA ❑ NE
❑ Yes .1�;LNo ❑ NA ❑ NE
❑ Yes UNo ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
MI No
❑ NA
❑ NE
&No
❑ NA
❑ NE
0,No
❑ NA
❑ NE
P No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional naves as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: j/D'1V3.3--33 Oi�:�
Date: ,;7_
21412011

G
Type of Visit: O-Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: @rT routine O Complaint O Follow-up p Referral O iEmeraenev O Other O Denied Access
Date of Visit: ® Arrival Time: : D Departure Time: County:
Farm Name: ;.t Fa Lypr=IcA ].Ju,-_5= Owner Email:
Owner Name: }� 17 r` �Q v+�s T_ a Phone:
Mailing Address:
Physical Address:
Facility Contact: 140� Title: Phone:
Onsite Representative: S_—
Certified Operator: e^
Back-up Operator:
Location of Farm:
Latitude:
Integrator: r.
Certification Number:
Certification Number:
Longitude:
Region: ,� o
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Capacity Pop.
O lei
=*
`Wet.P�oultry
FLa er
Layer
'.
D ,Paitlt �.
Layers
Design
Capacity
Design
Ca aei
Current
Pop.
C►urrent
P,o
Design Current
Cattle Capacity Pop.
DairyCow
Dai Calf
Dai Heifer
D Cow
Non -Da'
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turke s
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 L�q No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
[] Yes [:]No
❑ Yes 125 No
❑ Yes E�JNo
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facili Number: - (9 jDate of Inspection: • ��— f3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes El No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in) -
Observed Freeboard (in): 31
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
R No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
❑ NE
S. 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
[2 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc-)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑
Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop TYlte(s): xa i 4 'oal_/frx_
13. Soil Type(s): f� PY�_Y
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes M No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
O Yes ❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes Z No
DNA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes No
[:]Yes No
❑ Yes Lallo
❑ Yes gL No
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [2� No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes C&No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
[:]Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - 2, T71 jDate of Inspection: f
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 ® 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?
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?
Reviewer/inspector Name:
Reviewer/Inspector Signature:
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes ® No
[:]Yes ® No
[:]Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone:/C? ✓-��
Date: AL_
-
2/4/20II
Page 3 of 3

i ype of visit: tv iLompuance inspection V vperarion tceview v structure Evaluation V 1ecanecai Assistance
Reason for Visit: outine O Complaint O Follow-up 0 Referral 0 Emergency O Other 0 Denied Access
Date of Visit: —/ Arrival Time: Departure Time: / '3p County:,D-�— Region:1
Farm Name: ; rt Owner Email:
Owner Name: ✓Iy, Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: tea►-,,� _ _ _ _ _ Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current - Design Current
Design Current
Swine Capacity Pop. Wet P,oultryCapactty Pop.
Cattle Capacity Pop.
Finish
La er
Dai Cow
Feeder [7
Non -La er
Dai Calf
Finish
E
Dai heifer
o Wean
'- Design Current
D Cow
o Feeder
D . Foul C>a i Po
Layers
Non -Dairy
Farrow to Finish
Beef Stocker
Beef Feeder
Gilts
Non -Layers
Boars
Beef Brood Cow
Pullets
Turkeys
Other
Turkey Poults
Other
Other
Dischar es and Stream Im acts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes CE1,No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [:]No
❑ Yes �jNo
❑ Yes allo
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
3
Page I of 3
21412011 Continued

Facility Number: - Date of Inspection: --
p
Waste Collection & Treatment
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in): _ Z9
Observed Freeboard (in): X 7
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
allo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E, No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
MNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
R3 No
❑ NA
❑ NE
maintenance or improvement?
1 L Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [, No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload [] Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [] PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
[] Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Ie,46 .� /
13. Soil Type(s): _ Z�� / 4"-a
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [g No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? Yes ! To ❑ 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
F;X No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
CaNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
[] Yes
Z[ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[Z No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ED No
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Z;PFacili Number: Date of Inspection: p-
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
2] 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
jj4 No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
® No
❑ NA [D NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
JR] 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
S No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
M No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
®. No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[�j 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
[RNo
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
-57/7
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: t%D-�`-33 cP
Date: S_—�Ta
21412011
Page 3 of 3

Type of Visit Q-Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
V� !j
Date of Visit: ll Arrival Time: ,'Dp Departure Time: County: Region:
Farm Name: & ; n 'erg < L / GI\ Val-"0 ner Email:
Owner Name: /�%% ,i �2arr1't-S /1 C _ _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: �llJ/t �J , Phone No.
Onsite Representative: �� _ _ _ _ __ _� Integrator: r
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: E=] e =' =" Longitude: = ° = ` = "
Swine
❑ Wean to Finish
Design C u nt DesigA Cnrrent
Capacity PopWet Poultry Capacity Population
❑ Layer
Design Current
Cattle Capacity Population
❑ DairyCow
Wean to Feeder
DO ❑ Non -Layer
❑ DairyCalf
❑ Feeder to Finish
❑ DairyHeifer
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
' ❑ Gilts
❑Non -La Non -Layers
❑ Beef Feeder
?
ElBoars
❑ Pullets
❑ Beef Brood Co
�k ❑ Turke s
Other
�� ❑ TurkeyPoults
❑ Other
❑ Other
Numiler of 5tructures:llllll
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
[--]Yes
ANo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
29.No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
§;LNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

V
ty Number: — Date of Inspection
e Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): , 3�
Structure 2 Structure 3 Structure 4
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 R No ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes g No ❑ NA ❑ NE
❑ Yes .® No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes C4 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 ❑ Yes &No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes Jam' No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes J9 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) G
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 iKNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes S No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
"Z J. gla*, rgralf ys `►-6
❑ Yes
C'No
❑ NA
❑ NE
❑ Yes
CATo
❑ NA
❑ NE
Reviewer/Inspector Name y, _ L , Phone:
RetilewerlInspector Signature: Date:
Pine 2 of 3 11/15IU4 uonunuea

P,Faci lity Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 5�[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. MYes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard $4 Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. 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
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
JK No
❑ NA
❑ NE
❑ Yes
10 No
❑ NA
❑ NE
❑ Yes
fjNo
❑ NA
❑ NE
❑ Yes
JO No
❑ NA
❑ NE
❑ Yes D.No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes 10 No ❑ NA ❑ NE
❑ Yes P,No ❑ NA ❑ NE
❑ Yes
;& No
❑ NA
❑ NE
❑ Yes
6No
❑ NA
❑ NE
12128104

t -� �= � Division of Water Quality
Maciiliiy Number O Division of Soil and Water Conservation
Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: a� Departure Time: County: SLAHN-d Region: RQ
Farm Name: /y n, USt�-+•1 _ Owner Email:
Owner Name: , 2! t r—ZUt*4 S� e-• Phone:
Mailing Address:
Physical Address:
Facility Contact: t� Z � Alln'^Q Title: Phone No:
Ci
Onsite Representative: `' Integrator Gs! u C
Certified Operator: Operator Certification Number:$ 7`t q
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 e = I = u Longitude: = ° 0 g Q 6i
KM MeskE. Design Current
ation Wet Poultry Capacity Population
Design ►urrent
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
Wean to Feeder110
Non -Layer
❑ Dairy Calf
Feeder to Finish
❑ Farrow to Wean
❑Farrow to Feeder
Dry Poultry
❑ Dairy Heifer
❑ D Cow
❑Non-Dai
Farrow to Finish
❑ Gilts
❑ Layers
Non -Layers
Beef Stocker
❑Beef Feeder
Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Qther Turkey Poults
❑Other ❑ Other
Humber of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Wo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
EP NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
EP NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
1� NA
❑ NE
Z_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
1q No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
1P
❑ NA
ElNE
other than from a discharge?
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes (ONo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ONA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):3
Cf
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
LTV 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
ff No
❑ NA ❑ NE
through a waste management or closure plan'?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
�No
[I NA [I NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[�DNo
❑ 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
[4 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
%No
❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
VNo
❑ 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 ElApplication Outside of Area
(�)OSJat
5wt. �-
RY" f(&)
12. Crop type(s)
I
13.
Soil type(s) CeGj ,
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
6No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
P No
❑ NA
❑ NE
lb.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[a 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
Wo
❑ NA
❑ NE
Comments (refer fa (jnestton1#) Ezpliin any YES ansRers and/or any°recommendatioosporxan};other comments.
Use drawings:of facilityto lietter explain situations. (use additio al pages as necessary)= t `�
AL
God
Reviewer/Inspector Name �t_ - — — W ` y3 Phone: r%r33oB
Reviewer/Inspector Signature: pit" Date:
12128104 Continued

1
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes YhNo ElNA ElNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes &No ElNA ElNE
�
the appropriate box. ❑ p ❑ Checklists ❑ Desig
n El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes p No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
y❑ No
[[ _P
El NA
El NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
.p No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
PNo
❑ NA
❑ NE
2T
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
14No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
tgNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[j Yes
O 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
PNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
" No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
/
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
J&No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
VINO
❑ NA
❑ NE
12128104

J
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: C .
Farm Name:
County:
er Email:
Owner Name: Al[ —3;F;,ern S .�+C + Phone:
Nailing Address:
Physical Address: )�
Facility Contact: Wig, �p�t7�Ra. Title: Phone No:
Onsite Representative:
Certified Operator:
Region:
Integrator: Q
Operator Certification Number: `�;11
Back-up Operator: Sack -up Certification Number:
Location of Farm: Latitude: EJ e ❑ ' ❑ Longitude: ❑ ° ❑ ' ❑ "
-Y _
- .:.
Design CurrentDesign,
_ _ _.. -..:. -
Current
_ .._
Design
Current
Swine __
Capacity Popu� lemon
WetRoultryE yCapac ry Population
❑ La er
Cattle Capacity
❑Dai Cow
Pouul
❑ Wean to Finish
Wean to Feeder
24,W
DD
-Layer
❑ DairyCalf
❑ Feeder to Finish
DairyHeifer
❑ Farrow to Wean
Dry Poultry
❑ D Cow
E . ❑ Farrow to Feeder
_.m
'�
❑ Non -Dairy
r. ❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pul lets
❑ Turkeys
❑ Beef Brood Co
-
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
SNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
ONA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
V![NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
P NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
yyNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
PNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: 6q I 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 F NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes PjNo ❑ NA El NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes W No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes PNo ❑ 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 JpNo ❑ NA ❑ NE
maintenance/improvement?
IL Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Iq No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) (.QQS-tVL SQrril &4& & a % N641 ) . _.5m a (f V
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
TNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
q9 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Y No
❑ NA
❑ NE
Reviewer/Inspector Name amm a Phone: �JrfJ
Reviewer/Inspector Signature: Date: g 2 O

Facility Number: — Date of Inspection
Required Records & Documents
19_ Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box_
❑ WUP El Checklists ❑Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes -] No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
®No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P9 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
C2 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
JKI No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
tl No
❑ NA
❑ NE
29_
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Q 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
V 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
PNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
U,No
❑ NA
❑ NE
Additional Comments and/or Drawings _..
Page 3 of 3 12128104

i1 Division of Water Quality (� Y
1110 Facility Number Q Division of Soil and Water Conservation �✓
0 Other Agency C6
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit V Routine 0 Compfaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: L1� County: dodo K Region:
Farm Name: 1 Owner Email:
Owner Name: Q 41�yO. N�a Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: W
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
TitleKy- -� CV. W Phone No• — ` 'T
Integrator: r
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 = ' =SA Longitude: 0 ° = 6 0 6f
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (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 'pkNo ❑ NA ❑ NE
❑ Yes
❑ No
fA
ElNE
ElYes
No
El9N
A
❑ NE
❑ Yes
❑ No
TPINA
❑ NE
❑ Yes
P*o
❑ NA
❑ NE
❑ Yes
F No
❑ NA
❑ NE
12128104
Continued

Facility Numbe Date of Inspection
-Waste Collection & Treatment
4., Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
a. If yes.. is waste level into the structural freeboard? ❑ Yes ❑ No CnNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes [ rNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes �?No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes PNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes �MNo ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes"'�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus [:]Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind El Application Outside of Area
12. Crop type(s) . L. Y MJa_ �J M_ � i Vl -S
13. Soil type(s)
14. Do the receiving crops differ from those desibmated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
[I 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
>i No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
h No
❑ NA
❑ NE
IComments (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):
AMTJ i� - 1
12128104 Continued

Facility Number: OT Date of Inspection
Required Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
P No
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
;R)No
❑ NA
❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps [I Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[,%No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections ❑
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
I sNa
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
ONA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
),No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�lVo
1V
El NA
❑.NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
VO NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
t�)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
JP4No
❑ 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
1� No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
— P t"I.- aA k � M- a &fAQjte.
St, q Ste. %
Vkd P
12128104

Facility No. Ti a In� Time Ou# Date
Farm Name t ` LX_ Integrator
Owner Site Rep
Operator No.
Back-up No.
COC Circle:QGener�oor NPDES
Design
Current
Design
Current
We
Farrow — Feed
Wean — Finish
Farrow — Finish
Feed, Finish
Gilts / Boars
Farrow —Wean
Others
E� gn
�7111�L3e Jl�r-V Gy
Crop ie
Rain Gauge
Soil Test
Weekly Freeboard
Spray/Freeboard Drop
Weather Codes
PLAT ~�
Daily Rainfall
120 min Inspections
Observed
Calibration!GPM
Waste Tran ers
Rain Brea cer
Wettable Acres
1-in Inspections
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)
Z-O
O ( _0l
Pull/Field Soil Crop Pan Window
Z
�

Type of Visit &ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: j��`% d Arrival Time:1 Departure Time: ..3 D County: _=a= Region:'
Farm Name: VDK-r; GM Owner Email:
Owner Name: %3r�c�s �r- y Phone:
Mailing Address:
Physical Address:
Facility Contact: ! Title:
Onsite Representative:
Certified Operator: Sr'�
Back-up Operator:
Phone No:
Integrator: lz;l
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [= e = = Longitude: 0 ° [= d = fl
Design Current
Design
Current
Design Current
Swine
Capacity Populatlon
Wet Poultry Capacity
Population
Cattle Capacity Population
❑ Wean to Finish
10 Layer
❑ Dai Cow
to Feeder
0D
❑ Non -Layer
❑ Dairy Calf
FWean
Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
ElFarrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gibs
ElNon-Layers
❑ Beef Feeder
❑ Boars I
❑ Pullets
Beef Brood Co
❑ Turkeys
OtberTurkeyPoults
❑ Other
❑ Other I
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
PINo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
K] No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
t4 No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d- Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
PNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[&No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
ON
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: — Date of inspection ri
Waste Collection & Treatment
i —
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 [RNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes t3 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 10 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? LU Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 5a 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 JRNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ®.No ❑ NA [:1 NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Ycs 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] O lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) C3r04.1, f� • /5 � Caro
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?
jZYes
19
❑ 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
JZLNo
❑ NA
❑ NE
Comments (refer. to question ft Explain any YES;answers and/or. any recommendations or any other comments
Use drawings`of facility.to' better explain situations {useaddittanal pages as necessary)-� c z
��.
Reviewer/Inspector Name �r'v Phone:
Reviewer/Inspector Signature: Date: O w
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection
.i
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 appropriate box. ❑ WUP ❑ Checklists ❑ D❑ esi Ma s gn p ❑Oh ter
21. Does record keeping need improvement? If yes, check the appropriate box below. PYes 19No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections IM Monthly and 1" Rain Inspections ❑ Weather Code
❑ Yes ®,No ❑ NA ❑ NE
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
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes RNo ❑ NA ❑ NE
❑ Yes
E4 No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
O No
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
❑ Yes
10 No
❑ NA
❑ NE
❑ Yes [K No ❑ NA ❑ NE
❑ Yes O No ❑ NA ❑ NE
❑ Yes 10 No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
fO No
❑ NA
❑ NE
❑ Yes
D4 No
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit 0<&mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
�'/ r
Date of Visit: Arrival Time: Departure Time: e Q County: Region: n�
v
Farm Name:yQ Ala .✓`61°t Y 1 Owner Email:
Owner Name:rQ.S1 �r Phone:
u L 9✓s
Mailing Address: /t-&- z Od &o Fk,,+n � f�,o��
Physical Address:._ v 6-3
Facility Contact: -e_ _ Title: Phone No:
Onsite Representative: Integrator:
Certified Operator: r''sw ­e_ ._
Back-up Operator:
Location of Farm:
Swine
Operator Certification lumber: /tw4iz7;2_
Back-up Certification Number:
Latitude: = o = ` =" Longitude: = ° 0 = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
ElLayer (p O� ❑ Non -Layer
❑ Wean to Finish
Wean to Feeder
IA
El Feeder to Finish
El Farrow to Wean
El Farrow to Feeder
El Farrow to Finish
El Gifts
❑ Boars
Other
❑ Other - -
Dry Poultry
❑ La ers
ElNon-Layers
El Pullets
❑ Turkeys
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ DairyCow
❑ DairyCalf
❑ Dai Heifer
El Dry Cow
ElNan-Dai
El Beef Stocker
i
El Beef Feeder
El Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: 7
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 RNo ❑ NA ❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
qNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
14 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of inspection —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I
Identifier:
Structure 2 Structure 3 Structure 4
❑ Yes fiQNo ❑ NA ❑ NE
❑ Yes Umo ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): O_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes allo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes P.No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ® Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes M 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 � No El NA El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Z 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)!CtZ1s,��LT'`SlrJyt t�,2r: �—
13.
Soil type(s) CLv ,,t- y
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
R[No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
PrYes
@tNo ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
MNo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
91 No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
0 No
❑ NA
❑ NE
7 ovw--
Reviewer/Inspector Name `g Phone: y ls�l
Reviewer/inspector Signature: Date: // i D.
12128104 Continued

Facility Number:,V 9—(r Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ®.No ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes KNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Desig
n ❑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 I " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
IN No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[X NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
' No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
&�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[RNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
DINo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
O 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
VNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
0� No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[X�No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
LgNo
❑ NA
❑ NE
/. lva5tr �� ��� �v��� .7 D 4�' _
12128104

sa' = s`���+.
✓'F_ --•i F."` �.fi�a7lSYaawa�J't` xc -
r^ cg ^ +. '��1it, r, .z °p��`•S 'eE- � Sa
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit • Routine O Complaint O Follow up O Emergency Notification O Other 0 Denied Access
Facility Number (p Date of Visit: i la 0 Time: I T 3 a
. O Not Operational C Below Threshold
JILPermitted MCertified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: OT-tc LG N County: .... F�6� q
Owner Name: �, , `2 'Phone No: �/� " 5ev ` SS
Nfading Aiddress: _38 -Tv cue V Qd� tC a.��n. - * --- ------ da k 0_- hf-c—� ; �0,I`t
FP-Mty Contact: .....__E-.t. _ _.___ Title: . _ _. _ Ph,�o`ne No: p
Onsite Representative: Integrator. _ /�1,� ut:a "&tsrnl?s
Certified Operator: Operator Certification Number. (� 2-4T
Location of Farm:
L
59 Swine ❑ Poultry ❑ Cattle ❑ Norse Latitude • 64 Longitude • &
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 9No
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 VNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes KNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes TWO
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ___� _- • _ _ _ _ _ _
Freeboard (inches):
12112103 Continued

Facility Number: -j - & e � I Date of Inspection
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 0No
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 maintenance/improvement? ❑ Yes XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑Yes RNo
elevation markings?
Waste _Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes Wo
11. Is there evidence of over application? if yes, check the appropriate box below. ❑ Yes ;9No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type ��` r i`rrK�a�6t_ �k� . 5 VKOJA_ A MAA,
13. Do the receiving crops differ with those designated in the Certii
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?
Animal Waste Management Plan (CAWMP)? ❑ Yes
M No
❑ Yes
PANo
❑ Yes
19 No
❑ Yes
6No
15. Does the receiving crop need improvement? ❑ Yes KNo
16. Is there a lack of adequate waste application equipment? ❑ Yes KNo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes C&No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? if yes, contact a regional ❑ Yes MVo
Air Quality representative immediately.

FacW7 Number: q — & �( Date of Inspection E�
i
Repaired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ;KNo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes Wo
23. Does record keeping need improvement? If yes, check the appropriate box below. X Yes ❑ No
X Waste Applicadow"" ❑ Freeboa" Waste Analysib"*'❑ Soil Samplinj-"
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
JO No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
5ZNo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(iet discharge, freeboard problems, over application)
,4
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
[:]Yes
CANo
28. Does facility require a follow-up visit by same agency?
❑ Yes
25NO
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Eff No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, slip questions 31-35)
❑ Yes
9,No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a ruin gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfapolt Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
© No violations or deficiencies were noted during this visit. You wiR receive no further correspondence about
this visit.
ta,Ae_ sus • ✓-�3/,o K
I/t,lo-q
Z3 . arc ; s `��'p oF-tU__e_e we.e-ire �na� Go,►•e�. 61 d.
A-,v l.t S i s . Pt a oLs 4& (a� wa s(-e- s � acf d - -� •�-� �r
Crsve� ` K.a_ Q,.4' re- I eft-r- , : t-r1-r4,
u,> t„c a , Vc„Jln to . c4s�e- a_ a (s .
12112103

0
�- �.y-r'�. ;'-�w"��c? >°��"'�.i��' r. .r-L/�V�Cri �I7Ly_s"`i i�_ed.. r�s�.r--,-.xr�.. 1�'� .i: - �r^"�'•.._z3"`� -_�'S- cs-� r� � Y
Type of Visit O Compliance Inspection O Operation Review ®Magoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Faciliry lumber �
Date of Visit: - Time:
--• •—•10 not Operational 0 Below Threshold
O Permitted [3 Certified M Conditio all Certified Q Registered Date Last Operated or Above Threshold:
Farm Name: • County: �.
Owner Name: Phone No:
Mailing Address:
Facilit-3. Contact:
Onsite Representative:
Certified Operator:
Location of Farm:
Title:
Phone No:
Integrator:
Operator Certification Dumber:
21wine ❑ Poultry ❑ Cattle ❑ Horse Latitude C70 ° " Longitude • �•
Design Current
Design Current Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle Capacity Population
❑ Wean to Feeder
Laver
DairyElFeeder
to Finish
❑ Non -Laver
FEI Non -Dairy
❑ Farrow to Wean
El Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
Number of Lagoons I FrZU2- ILJ Subsurface Drains Present JJLJ Lagoon Area JL Spray Field Area
Holding Ponds / Solid Traps No Liquid Waste Management System
Discharbes 8 Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State? (If yes.. notify DWQ)
c. If discharge is observed. what is the estimated flow in eal/min?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the eaters of the State other than from a discharge?
Waste Collection 8• Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure ? Structure 3 Structure 4 Structure
Identifier:
Freeboard (inches):
05103101
❑ Yes ❑ No
❑Yes El No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
Structure 6
Continued

Fac' ty Number: —
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuetures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Apnlication
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application?„ ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
13. Do the receiving crops differ with ose designated in the Certified Animal Waste Management Plan (CAWMP)?
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?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes Prvo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes P7vo
❑ Yes R?fo
❑ Yes 2vo
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
❑ Yes ❑ No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
[] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
,jet
Consments refer to questiaa'Ezplatn aty YES ans Hers andfor'any recommeadations ar any4other comments.
Use drawn .- _.
„gs of faciltty to better expla�©�sttuatrons� (use additional pages as gecessary): El Field Copy El Final Notes
1
Reviewer/lnspector Name 1 - i = z
Reviewer/Inspector Signature: Date:
OSIO3101 Continued

�V
II" G-�L'v�`,da-wt"`_ .l.:t.r"`�'•.s. _ `� �'.4"�C..f sue,. t.�r"Ce' r. n.rl4ll��<+a�,,.�¢?e•�r'F, - f . 't. _ � . -. '3.�, ..a.:7� _ f - , _ � � :#� .`. _. - s.a . .s.. -' .. -� _ �-�
Type of Visit 0 Compliance Inspection O Operation review Q Lagoon Evaluation
Reason for Visit ®Routine C)Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Date of Visit: Time:
Facility lumber b
,. Not O erational Beiow• Threshold
® Permitted ® Certified 0 Conditionally Certified j] Reggistered Date Last Operated or Above Threshold:
Farm Name: 0 ri C, (e— AJ urr Count.•: L? C&CI — n
Owner Name: 91. Phone No:
Mailin= address: 1 < _1,4 t a-_ C1 i ['_ AL C , �ZV.jgt
Faciliry Contact: g6, a aPf-_dTitle: Phone No:
Onsite Representative: Integrator: M
Certified Operator: r' Operator Certification Number: j L 17
Location of Farm-
6 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ` ` Longitude ' 1
Design Current Design Current Design Current
Swine Ca adty Population Poultry Ca acitY Po uhttion Cattle Ca acitv Population
®Wean to Feeder 1 6-04 ❑ Laver I 1 ❑ Dairy
❑ Feeder to Finish ❑ Non -Laver 1 10 Non-Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons
Holding Ponds / Solid Traps
Discharges & Stream Impacts
I _ Is any discharge observed from any part of the operation?
Subsurface Drains Present
Discharge oricinated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, noti-f DWQ)
c. If discharge is obsm-ed, what is the estimated flow in tral/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
Area Ju S `rati• Field Area I
3. Were there ant- adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Wa a Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure
Identifier:
Freeboard (inches):
05103101
❑ Yes [;a No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes M No
❑ Yes Q No
❑ Yes ® No
Structure 6
Continued

Facility Number: — 1,4 Date of Inspection c
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
b. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes [I No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes N No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes r3 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Ammlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes N No
12. Crop type Re_rrr, Ld,- J- Srn. ls-r 6". 5's
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
[5@ No
14, a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
Ed No
16. Is there a lack of adequate waste application equipment?
❑ Ycs
U(No
Reuuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[�No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
[�LNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
RNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
ff No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ®No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes [W No
24. Does facility require a follow-up visit by same agency? ❑ Yes O No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
' �1s.9a,�nH�� � � 1.�.s �' := a . _ . ��'s � � iiu � ►..ri.� � .a�Sr �_ *
G�o�bmm�e fer to;questton#/} Ezplatritt�an ,. Y ;answers and/or an} recomme arionsror�any other=commentsz
,UseldraRrngs afRfacilrty tosb'etter explam�situattods.�(use addrtiotiiil pages';as necessary) El Field Copy ❑Final Notes
yyy�
3'r:..
- l e_je tj� tz,3 1, j JoD d j ,
Reviewer/Inspector Name I
Reviewer/Inspector Signature:
Date: ! 2 La
05103101 Continued

Facility INurnber: Oq — Date of Inspection r�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or Iagoon fail to discharge at/or bclou-
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on ncivhborina vegetation, asphalt.
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. %Vere any major maintenance problems with the ventilation fants) noted? (i.e. broken fan belts. missing or
or broken fan blade(s). inoperable shutters_ etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submersed fill pipe or a permanentltemporary cover?
Additional
❑ Yes ❑ No
❑ Yes [0 No
❑Yes ®No
❑ 1'es No
❑ Yes ED No
❑ )-es [allo
❑ Yes ❑ No
03103101

IType of Visit ACompliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit QAoutine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other 0 Denied Access
�Facility Number 2N7 - Date of Visir
XPermitted 13 Certiryd E3 C ditionally Certified [3 Registered
Farm Name: 7 ........
Owner Name:
MailingAddress: ................................................................................................................. . ...
3�hft--
0 =Not rational 0 Below Threshold
Date Last Operated bo Tbreshold: ...... -- -- --
County: ...7-1 --------------- ----------------
Phone No:
Facility Contact. ............................... Title- Phone No: ............................. ........
Onsite Representative: Integrator
Certified operator-.Vit-#/—.-...--. .... ...... Operator Certification Number:..... ..... .
Location of Farm:
AL
qr
0 Swine 0 Poultry 0 Cattle 0 Horse Latitude Longitude
Number of Lagoons .... ......
Subsurface Drains Present FO Lagoon Area JEJ Spray Field Area
Hid Ponds "-/'Solid iravd"�
I Waste Management S�
0No U uid
.dhgSystem
Discharges A Stream ImBacts
I - Is any discharge observed from any pan of the operation.? ❑ Yes No
Discharge originated at: C1 Lagoon [] Spray Field [I Other
a. If discharge is observed, was the conveyance man-made? 0 Yes, No
b. If discharge is observed, did it reach Water of the State? (ffves no* DWQ) ❑ Yes 0
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 0
2. Is there evidence of past discharge from any part of the operation? E] Yes 0
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? 0 Yes �No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less thanadequate? [I Spillway ❑ Yes 0!*i�
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ........................... .......................... .......................... ........................... .......................... ...........................
Freeboard(inches): ....... 30 ............ ........................... .......... ............... ........... .............. .................................. ..........................
........... ... . ... . ...... I ...... ......................... —.1—......-....._...........................I ..... . ................

Facility Number Date of Inspection �s
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7_ Do any of the structures need maintenancPlimprovement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application'., - ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type k a 14, 42,,kLl1el� F�"
13. Do the receiving crops differ with those desi at in the Certified Animal Waste Management Plan (CAWMP)?
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?
RMired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes +o
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes If
No
❑ Yes o
❑ Yes o
❑ Yes 14 No
❑ Yes PNo
❑ Yes PdNo
❑ Yes No
❑ Yes No
❑ Yes Wo
❑ Yes [klNo
❑ Yes %No
❑ Yes t?No
❑ Yes XNo
❑ Yes &o
© No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
❑Field Copy ❑ Final _Notes
to n eval`� e u/� w��
Ste. ra;� is, re o
5 �
I 1
�f k�.4da4 5'.�� 'lam
StazJ
Reviewer/Inspector NameEw r041=��
Pate-P
Reviewer/Inspector Signature:
05103101 V Continued

Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: ls' d% Time: : "vT
Facility Number O G
0 Not Operational 0 Below Threshold
Permitted .E Certified © Con
di
tionally Certified [3 Registered Date Last Operated or Above Threshold: .............
Farm Name: ,Ci� , !!I ...... County: i444r_ j....................I....
.... ............................
OwnerName:............... Phone No: ...1.!/O -.rl�..Y...................... ................................................................. ..... ......................
Facility Contact: .............4 Title: .... Phone No:.................. .................................
Mailing Address:........t....trrL!..f%.....�,r........1��*�'��/ .....1� .. j,�L �... r�,Q...tii�.�
Onsite Representative:........... ...../ Integrator: 7 . ... .....................
Certified Operator: ................. �.. .,.. �`1+ . ............................
Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 46 Longitude • 4 «
Design Current
CanacitV Pooufation
Wean to Feeder
4
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population Cattle
❑ Layer ID Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number"of Lagodfis - ❑ Subsurface Drains Present ❑Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid -Traps 10 No Liquid Waste Management System - ={
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation? ❑ Yes KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made`? ❑ Yes XNo
h. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes J'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 PINo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes xNo
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 kNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
identifier:
.Z S..
Freeboard (inches):
5100 Continued on back

Facility Number: 0,4 — Date of Inspection I- Printed on: 1/9/2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes XNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes )K No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes XNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes XNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes fiqNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes allo
12. Crop type
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ANo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes KNo
b) Does the facility need a wettable acre determination? ❑ Yes R No
c) This facility is pended for a wettable acre determination? ❑ Yes P No
15. Does the receiving crop need improvement? j'Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ,g No
Required Records & Documents
17. Fail to have Certificate of Coverage & GeneraI Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, det�m wrtc.) ✓ L_
19. Does record keeping nee eb improvement? (ie/ irrigation, freoard waste analysis soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21 _ Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0; viQla�iQnjs;off defciencies vre pQted daring phis;visa; Yo> wig �eeiye lao fuser
• eotrrespondence. about this visit. ..............................
... .
�9/%f!e �/ /1t�r/✓ ta~//'� ��iirR.� O � LJ�� .�R�� sS7�C- � fi.F.A.lf �C,
fs ZZ4 cis Aeor ?t /k
❑ Yes ,nt No
❑ Yes JR[No
)a Yes ❑ No
❑ Yes Cij�No
❑ Yes kNo
❑ Yes No
❑ Yes )JUNo
❑ Yes ANo
❑ Yes MNo
46
Reviewer/Inspector Name f7. r *
Reviewer/Inspector Signature: ,.,ice, Date: 3 /�
5100

I Facility Number: 6o 3 — Date of Inspection /1` d Printed on: 1/9/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below $QYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 127No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes Myo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes [XNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes EkNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes �3 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? AQ Yes ❑ No
AdditioaW onumentson or: rewurgs: _ - j3
AL
5100

E3 Division of Soil and Water Conserratiori - operation:Review
'..0 Division of Soil and.Water Gpnservat�on = Cotnpliatace'Inspection
rr—YA L
{� Division of Water" Compliance Inspectiop R�
`� Wiz...-... Other Agency Operation Itevte►s _ >`
10 Routine 0 Complaint 0 Follow -up -of DWQ inspection 0 Fopilow-np of DS�VC review 0 Other
E-_-- Facility Number O — � � Date ofInspection 2
.._. ,, „,,-,„ �,, I Time of Inspeclion 3' 2=t hr. (hh:mm)
E] Permitted ®Certified ❑ Conditionally Certified © Registered JE3 Not O erationa]�7Date Last Operated:
Farm Name: ...�. . s •� 7 Cuunt�'= ...-...!���f�....... .................. .... ...................
t/ .................... •----
Owner Name:.............%.�...,.K.....� � ,�/0 s d
I•-.............. ............................... .............................. Phone .- .f .................-............
Facility Contact: ......x? 77.......................... Title: ------
...---.............................. .......... .............. Phone No. ...................................................
MailingAddress: ........5!..... ................... .............
Onsite Representative:............� .................................................. Integrator:.. r�'�...�F� . ........................
Certified Operator: / f� �� Operator Certification Number:
p .. %.. (... p .........................
Location of Farm:
------------
............................... .............................................................................................. I ........ ............ ........•...--.......................................---..--.--•--......................
......................................................................................................................................................................................................................................................................
Latitude Longitude
Design Current = :r. Design . Ciirrent' Design Current
Swine Ca achy Population Poultry<,'.-�.- = . Capacity .. Population Cattle Capacity Population
"Wean to Feed 262V ❑Layer ❑ Dairy
❑ Feeder -to Finish ❑Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total.Design Ca0adty -
❑:
Gilts
❑ Boars T ' al SSLW
Lagoons ,Number. of Lagoons ❑ Subsurface Drains Present ©LaKuon area ❑ Spray Field Area
�:.
Holding.Pon4i / Solid Traps i ❑ No Liquid �i'aste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made:'
h. If discharge is observed. did it reach Water of the State? (If yes, nutiry DWQ)
c. if discharge is observed. what is the estirtmated flow in gallmin?
d. Dues discharge bypass a la4goon system'? tiIf yes, no€iN DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structur 5
Identifier:
❑ Yes W'No
❑ Yes Q No
El Yes ANo
❑ Yes PkNo
❑ Yes RNo
❑ Yes 9No
❑ Yes PNo
Structure 6
Freeboard(inches): ................. .............................. .......................... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion.
seepage, etc.)
3/2 3/99
❑ Yes J;KNo
Continued on back

Facility Number: — 4 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
'immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12- Crop type
41
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
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?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ic/ irrigation, freeboard, ,%ste analysis & soil sample reports)
20- Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
�; �Va-violatidtis'ol deficiencies were noted• During #his.visit' • Y:ou wlli•tee0W6 titi furthgr .: .
correspondence.a�otit ths :::
i'
'Explain:any YE'
etter.:explain situation
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
❑ Yes No
XyesAMC—
C❑lYes `® No
❑ Yes KNo
❑ Yes RNo
❑ Yes RrNo
❑ Yes ,M No
❑ Yes KNo
❑ Yes )![ No
❑ Yes JR'No
❑ Yes No
❑ Yes No
❑ Yes ANo
❑ Yes P'No
to Yes d No
❑ Yes )KNo
❑ Yes kNo
❑ Yes RNo
❑ Yes k'No
❑ Yes O No
❑ Yes $tNo
A6

■ 1
Facility Number: O — fate ofinspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Rryes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? []Yes CkNo
28. 1s there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes XNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 4N No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes )Q No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes XNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
3/23/99

r. 0 Division of Soil and Water Conservation Operation Review
© Division of Soil and Water Conser+vabon �Cornpllance Lis ee#on_
19bivision of Water.Quahty Compliance %nspeet bn �
110ther Agency Opera#ion Review " -
10 Routine O Complaint O Follow-up of DWQ inspection Q Follow-" of DSWC review O Other
Facility Number a p Date of Inspection - - p
Time of Inspection /> ' -1D 124 hr. (hh:mm)
© Permitted 0 Certified © Conditionally Certified [3Registered 13 Not Operational Date Last Operated:
Farm Name: ...' o./ /..1C..G4r�R1 ....---•• County:....._r.�............................................... .......................
----._ /.................... ...... ......................
Owner Name :...... .... 4... ... y.. ........ --_. ................ Phone No: 9/O p ' :S yy6
....... /....._.. r �.....P ... �.......................................
Facility Contact:.........�.f5/........................ Title:..... Phone No: ......
Mailing Address: 38 < .lY'�'/�'�'`L.._��?'.... .f"�'"`-'.... � ....... a'..................../ ......................... /,-.....................
............ % ......... ..... ............ ..e.,4.�,....
Onsite Representative:.../ e!��r......... /...................... Intel;rator,. _,,zW``..��.... � ^`...�...................
..
Certified Operator:..,,,,,.. 10A ............ ......... , ,,gip 1 Operator Certification Number:.../ 7 ,,
Location of Farm:
Latitude 0 ' Longitude • ' 64
Design
Current" _ _.`Design
Current Design Current
C.
�"
Swine ..__ ._. '' .. :Ca acity
__
Poult
Population': Iy ..._ .Capacity
:;:
Cattle
:Po iilatiojm Capacity Population
Wean to Feeder 21L60
z4-AT ❑VLayer
❑ Dairy -
❑ Feeder to Finish
❑ Non -Layer
' ❑ Non -Dairy
❑ Farrow to Wean
•;. ❑
Farrow to Feeder
Other
., • . ' .'
❑ Farrow to Finish
�'otal Design Capacity.
- ❑Gilts,_
• , ...
❑Boars
_ _
= Total SSLW
Number of Lagoons-•
/ . ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Ares
_Holden Ponds / Solid Tra s
g° p
�: ❑ No Liquid Waste Management System
_
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
DischarGe originated at: ❑ Lagoon ❑ Spray Field ❑Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes KNo
c. If discharge is observed. what is the estimated flow in gal/min?
d. Dices discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes XNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes )j4 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 19 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ,RNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
2 5` "
Freeboard(inches): ........... .... ................................ .......... I........................ ......... --....... I................ ......... I.........................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
3/23/99 Continued on back

Facili[y Number: Q 9 — `3 Date (if' Inspection G .�-
6. Arc there structures on -site which are not property addressed and/or managed through a waste management or
closure plan?
❑ Yes
5d No
(If any of questions 45 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?
Xyes
❑ No
8. Does any part of the waste management system other than waste structures require maintenarice/improvement?
❑ Yes
NrNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
{ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
1. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
No
c
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
o
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
zo
b) Does the facility need a wettable acre determination?
❑ Yes
P No
c) This facility is pended for a wettable acre determination?
^Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
XNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
)kNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(icl WUP, checklists, design, maps, etc.)
❑ Yes ANo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
)iNo
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes)No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
tg:No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
❑ Yes
N No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
[:]Yes
JJ No
24- Does facility require a follow-up visit by same agency?
❑ Yes
i&No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
PKNo
.: Nb •violafiQnis:ot- deficiencies were nofea• during this visit' - You will reeeiye ilio fufrt r - . - . -
corres ondeirceabani>kthisvisit.:::::..'.'.".......'-'-'• •"• •'•'- - -'-'-'•'•"•'-'•'-'•'-
_
Reviewer/Inspector Name ,,77 // �` se
/C a b.�R r. e F
Reviewer/Inspector Signature:
Date: 7 —
3/23/99

Facility Number: Qp - Datc of luspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below XYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes P�No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes XNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes XNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
3/23/99

O Division of Soil and Water Conservation [3Other Agency
Division of Water Quality
0 Routine 0 Complaint 0 Follow-up of DIVQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number C7
Time of Inspection 'dCl 24 hr. (hh:mm)
0 Registered ®Certified [3 Applied for Permit ❑ Permitted Q Not Operational Date Last Operated:...,....•
Farm Name: ............�v '! ...N County:........ ��J..........._........I....... ....... I...............
Owner Name: !� f}7� ...... � PhoneNo: .......................................................................................
............... ...........................
Facility Contact: ...... Title: ..... Phone No: ..........
iathngAddress.................7p-.............. ...�-... �i ........ . - ! ..... yr... ..... f................................... ..........................
Onsite Representative:.....,.. .... .. Integrator:.- ......................
Certified Operator,....... ..... xTk� L....................................................... Operator Certification Number. ..... .% x.2.z ........
Location of Farm: /
Latitude • ' 0G6 Longitude • 06 "
Destgt ,' r `.. _"Current ..Current"
rrenDsign
'Capacity Po uln ,CaClatin..Pouli�". atiouPacityPo uoa
O-Wean to Feeder
Zjdb
7
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
General
1.
Are there any buffers that need maintenancelimprovement?
❑ Yes
IkNo
2.
Is any discharge observed from any'part of the operation?
❑ Yes
Wo
Discharge originated at: ❑ Lagoon' ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
WO
b. If discharge is observed, did it reach Surface Water? (if yes. notif)v DWQ)
❑ Yes
XNo
c. If discharge is observed, what'is the estimated flow in gal/inin?
d. Does discharge bypass a lagoon system! (If yes, notify DWQ)
❑ Yes
E No
3.
Is there evidence of past discharge from any part of the operation?
❑ Yes
Nt No
1
4.
Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
UNo
t
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
RNo
maintenance/improvement?
6.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7/25/97
Continued on back

Facility Number: — 6
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1
Identifier:
Freeboard (ft): ......... .............
Structure 2 Structure 3
10. is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers'?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
❑ Yes ArNo
XYes ❑ No
Structure 5 Structure 6
15. P type .e 1....................................:......................................................................I...............
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified gr Permitted Facilities Only
23. Does the facility fait to have a copy of the Animal Waste :Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit'?
13 No.violations or deficiencies were noted- during' this visit..You.W'ill receive no further
correspotidence about this:visit:
E) Yes M No
❑ Yes OrNo
❑ Yes WNo
❑ Yes M No
❑ Yes KNo
................................
❑ Yes
❑ Yes NINO
❑ Yes R, =o
❑ Yes CR ,NO
Cl Yes k N o
❑ Yes PTNo
XYcs ❑ No
❑ Yes Rd No
❑ Yes WNo
❑ Yes JW No
Cumiiients°(i"efei,to,guestion #) ;Explain any I'ES ans vers'and/or any reconimen&ttons or any i:6- cei<nment's
Use drawings of facility to be tter'explatn`situatinns (use additional pages as:nece5sary
z. 6�_,
7125/97

t � 5
r*
CA n i M'ad n d I o t Upei-ation Review .
c
®DWQ, Animal Feedlot Operatlon S><ie Inspection
8 Routine O Complaint O Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Date of Inspection a
Facility Number
Time of Inspection 0 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status, W Regtstered ❑ Applied for Permit (ex:1.25 for I hr 15 miu)) Spent on Review U
❑ Certified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:... _ .._ .. ..........._ _....� .... ..... ... ...
Farm Name: T ��iclC �1� County:.��!J . - _ .. ......_ . .... .
Land Owner Name: Phone No:
Facility Conctact:------ .,_..•. Title: Phone No:..
... l
Mailing Address:. ..�...0..���`'� �o6 /j f .. .... ......._... .. _....r.. ......
Onsite Representative . _..... Integrator• �^
Certified Operator: _.. _,-.,.� ......... ._... _.. Operator Certification Number:
Location of Farm:
Latitude �� �f o K Longitude ' 4
Type of Operation and Design Capacity
SWv IIixCxi axs- i. > CDe„5rgn ,Clt- ` ue " Drep' e�Slgn-. k--9D"`•eSi En�
Poui a tiy' Ca le:CSlDar Pc aCunzrlra,e
#nt`oPt
wn�a..
:
91 Wean to Feeder 2(d ❑ Layer ,:.a` ❑ D
K
❑ Feeder to Finish "❑ Non -La er ❑ Non -Da'
rae as
Farrow to Wean
,.,
Farrow to Feeder Total DestgngGapacfy
ID Farrow to Finish
❑Other H. 3Torai
ux.. ".x;,�"r.
- «
k��,z»'.',
Number of Lagoons, Holdmg�Ponds ❑Subsurface Drains Present
§ ❑ Lagoon Area `h ❑Spray Field Area
Genr,rai
1. Are there any buffers that need maintenance/improvement? ❑ Yes kNo
2. Is any discharge observed from any part of the operation? ❑ Yes JKNo
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes k No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes KNo
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
3. Is there evidence of past discharge from any part of the operation? ❑ Yes No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes lPo
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes VNo
4/30/97 maintenance/improvement? Continued on back

Facility Number:..,4�.j`.._
6. is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes J4 No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes )�(No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes N No
Structures lagoons and/or -Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes O'No
Freeboard (ft): Struc 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste A Ii ati n
14. Is there physical evidence of aver application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
IS. Crop type .... ............... ....— .. ....
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes )q No
❑ Yes *No
.kYes ❑ No
❑ Yes [-No
❑ Yes KNo
❑ Yes IV No
❑ Yes )q No
KYes []'No
❑ Yes ONO
❑ Yes N No
❑ Yes tQ No
[:]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Comments {refer to queshoti #) Explarn any YES answers arid/oi any recommendations or any. otherm coments" `
Use drawings of facility to Wetter explain situations: •(use addihonaLpages as necessary) - -
iZ_� � � o� �� �^�' S•�iE- �.E.f /u /llaGriri .¢� srn.�l�E 4
��
Reviewer/Inspector Name VMW
� T
a r• a mac-+- �$__, '•Wy`iye16�.Y��
Reviewer/Inspector Signature: � Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

State of North Carolina
Department of Environment,
Health and Natural Resources •
Fayetteville Regional Office
Janes B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
June 3, 1997
Mr. Ray Beasley
P.O. Box 31
Elizabethtown, NC 28337
SUBJECT: Operation Review Corrective Action Recommendation
Yorick Nursery Facility No. 09-64
Turkey Oak Nursery Facility No. 09-63
Bladen County
Dear Mr. Beasley,
On June 2, an Operation Review was conducted of the above listed farms. This Review, undertaken in
accordance with G.S. 143-215.10D, is one of two visits scheduled for all registered livestock operations during the 1997
calendar year. The Division of Water Quality will conduct a second site inspection.
During the Review, it was determined that waste was not being discharged to the waters of the State, and the
animal waste collection, treatment, storage and disposal systems were operated under the responsible charge of a
certified operator. However, the following management deficiencies were discovered and noted for corrective action:
All farms. Cut down pope berry bushes on inside slopes of lagoon. May need to use herbicides
to control vegetation on steep slopes of lagoon.
2. Yorick Nursery. Trees and roots on slopes of lagoon need to be removed. Contact your
technical specialist about this.
These management deficiencies need to be addressed and corrected. You are encouraged to contact your certified
technical specialist if additional assistance is needed. The following reviews and inspections will re-examined these
deficiencies to determine if corrective actions were implemented.
Wachovia Building, Smite 714. Fayetteville Na . FAX [phone]
North cnrolinn 28301-5043 V14i C An Fqual opportunity AffirmntivP Action Fmployer
Voice 910 -186 1541 5WI. recycled/10% post consumer paper

In order for your facility to remain in compliance with environmental regulations, animal waste cannot be
discharged into the waters of the State, and the animal waste collection, treatment, storage and disposal systems must be
properly maintained_ nd operated under the responsible charge of a certified operator.
Please remember that if you do not have a certified animal waste management plan, you are required to do so by
the end of this year. The plan must be certified by either a designated technical specialist or a professional engineer. For
additional assistance with the plan, please contact your local Soil and Water Conservation District Office or local
Cooperative Extension Service Office.
The Division of Soil and Water Conservation appreciates your cooperation with this Operation Review. Please do
not hesitate to call me at 910-486-1541 ext. 224 if you have any questions, concerns or need additional information.
Sincerely,
Audrey D. Oxendine
Environmental Engineer I
cc: Sam Warren - Bladen Co. NRCS
Ed Buchan - FRO DWO Environmental Engineer
Murphy Family Farms
DSWC Regional Files

1
❑ MVQ _animal Feedlot Operation Site Inspectiori
We-t to Fctczr j --
Feuer to Finish
Farra- to Wcan
Farrow to Fo- ,7 I I
IF-1 Fg,:c:v :o
O Routine O C grimlaint Q Forlo«-uu of I %VO imucclan Q Wamuu of DS IC rcvics�: Q Uthcr
—� Date of Inspection -
FaMtz Number
Time of Inspection !. Use =' hr. dine
F3M1 St nt;:..---___- � _ f-�L Tour Tune (in hours) Spcnt onRevie•,s-
nr Insueccintt includes t,-^.-Pl _rns3 proccain>>
Farrar Am,
(Mailing Address:
Onsite Represenrzdve:
Certified Operator:
Location of Farrrt:
Wel,
P h o n e No:-----
- I
Integrator:. --
Operator Certification Number:
I
Latitude Longitude E C, F �
Q' of Operationai _ Date Last Operzted:
Type of Operation and Desigga Cnpac-(v
Swine
'-.. iYistiiije - :.._ Pourtry tinmbet `..." ..": C—,cde _ "wYttmbe^
Cr L zvc I -'�Q Darn
jp Non-Lzver I _ - Li lea: I �`its:
--_
Cut
::::;.-•:;Yutnbez aCFa>; nns.f ga3�in�-Poi - E1 Suh5uriace Drains Present
r ";w - - Spray Fiefd:�rea
�. -
_
Ge*Ze--I
the-e MY bUfft-7S tbat ie-d rnaintenanCt!LMprave:::c-:t? -{es V—�o
Z- Is InY discharge cbse - -ed Porn an,.- ', of the nee soon C Yes �j i :o
x !� ' ,a
= If Qi5C:33C?'_ IS QQSe:"%�2^ '.'.•':�S ;�e can �'C:'ar1Ce^:;a.[1-�?IICe 7 ��r--;;l �/y-;I ��
i F,�..'$� `we 1 cbs=: e,^_- ld A r..._.... �r1 C:aC� .: ;yt�`? (Ir ::!,'.. �Gtl�"" I�.�V �j I! Ye �y� A
!; 1swagv IS able`"��el hat A :.�re'_,il[Ti::_:d :!ow ITS�'•'
3. Is IheM Ovid & of oast dkC:Zrvr fiUrr ariv p1r* of :he cpe^ticn % [ } cs (K' o
•t .:5 al^' "r�-e i�:.:-zcs to the •.vate.5 or r[te fit,-.ce nrrmer ebznarrr a 'r-_-s LYQ
(�`io
= p2s or to , cs,e rn2naec:re7r s:sre:,r (rather Onn iaeconsihorezing ponds) re3uirc [ 10 No
Continued on ACC."

7. Did chz t'acaioi Fail to have a r_:,hied operator in responsible came (if inspection after f1119 7)?
S. :ire there laeoons or scontee ponds on site which ne-d co be prooeriv closed?
titruct_ures _f l,ar7oons and/or Holding Pondsl
9. Is struccuml freeboard less than adequate'
Frccboard (!t): Laeoon I L neon ?
10_ Is se -page observed from arty of the structiues?
11. Is erosion, or any other threats to the intcznty of any of the stt-u=res obse:-: ed?
12_ Do any of the srruc:ures need maintenanccAnpro vemcnt?
(If any of questions 9-12 was answered ves, and the situation noses an
iinmedi ite public health or environmental threat, notify DWQ)
La —awn 3
13. Do any of the strucwr,-s lack adquate markers to ident s-X--, and s.op pumptncz levels?
WasteAi3olicatiori
Ea. Is there p�rysic +l c.ideace of over appiic *lien?
(If in excess of GRIP, or runatt Snie:-ing '•s•uters of the State, eot7fy D WQ)
E 5. Crop type
lb. Do the active Cops dig:c:.vital those dcsi¢matediu the Animal as.e lAanagcment Nman*
17. Does the f3ClttCr' :l�'fe 3 l2C:i OC �Ci[I[I2te 3C ��.Y� toC fand?apltCOn?
E S. Does the cover crop need improvement?
19. Is.there a lack of available irrigation cquiorr =0
F6i- eieii�ed Facilities Or11V
26. Dbes the facility fail to have a copy of the Anira..l W=e Mar-FmcwC Ptm Mdiiv available?
2 E- Does. the. fanility fail to comeiv wick the .A- irnzE ` zs-.e-M-na-tmeat Plan in any way?
22. Does rrcordkeepingne-d improvement?
=i. Doesfacility require a foilosv-,in visit: by same ag=-cy?
24. Did Revte :veaT.pspector fail to dLwu-- revieNrmspc-=an with oww= ar dpe ator in caarge?
C "'es A t to
La,2oou :'
Y ts %,NO
C = 6Na
Yes 0 No
Cl Yes K O
0 Yes Plao
El Yes
Q Yes Q No
C Yes C Vo
Q Y�ts C `lo
Yes C i`+o
"ees D L40
(�otrtitte (re!~c�t�.qucmorzr : EtplantaCty-�YiS 'j= es azsdlar y::re-atnriicadaisot ac atl CCi=c_t
Usc:drdwirigs�roc:�.sii`r�to�bc��'plan'�siCtz��on�[ttscsddicioCrarna¢~s�:nett �.,M�-��'�_�--�'_... -..-. ..
�-� (due ¢ •�rn��. �'r,,�{� �'�.�- �-�-� �. y�c.�,�-��
Revie.rerrTnspectnr
Reviwer:Tnspector Sicnarure: J j�
Dare:
—2-
CC. DiriS:rlr•. r7j t�:elr. 1',.;ft.. 'r-. rJrl::j:.- .){,.:uri. � 1CIfr- _r_._p,;��.^•f L'r.[.

Site Requires Immediate Attention:
Facility No. 0 -la
DIVISION OR -ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOTOPER:ATTONS SITE VISrmnoN RECORD
-Farm N:
Mailing
County: 4s�cd
Integrator.
On Site Representative z
Physical Addmss/Location:
DATE: , 1995
�-'Tuzic: � � � 1�• i
Phone:— (5 to )_. 284 - P u ? —,Phone: _ i n3 .245 -a i jL..—_.
Type of Operation: - Swine x Poultry Cattle
Design Capacity: at..,bc- Number, of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude• Longitude:
Circle Yes or No .
Does the Animal Waste Lagoon have sufficient freeboard, of I Foot + year: 24 hour storm event
(approximately 1 Foot + 7 inches) Yes 'or No Actual Freeboard:-aFt. �`.alnches
Was any seepage observed from the lagoon(s)? Yes'or No Was any erosion observed? Yes or No (Seepage Was
Is adequate land available for spray? .'Yes or No ..Is the cover crop adequate?' Yes or No Not Evaluated
Crop(s) being utilized; 5 ra Field'+or;'covezkcro ' was not evaluated
Does the facility meet SCS minimum setback -criteria?. 200 Feet from'Dwellings? Yes or No
.100 Feet from Wells? Yes or No
*Is the animal waste stockpiled within IMFeei of USGS Blue -Line .Stream? Yes or No*
* Is animal waste land applied or spray irrigated' within 25 Feet of a USGS Map Blue Line: Yes or No
Is animal waste discharged into water of the state by man-made ditch; flushing system, or-0ther
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste. management records (volumes of manure, land applied,
spray irrigated on specific acreage wiih`cover Crop)?. Yes or No(Waste management records were not
Additional Comments:
This was a v more' orou ns action will be- cj2_nducted in the— f uture.
Please contacV.-DEM should any 'condition- arise that pose6'.a danger to surface waters.
* This farm was not located onn-a USGS TOPO map to determine YBlue Line" status.
A )P&ES 16 . Mne_] ] nee v% An m -- AlYa 11 -l-rr-pS Z ­P " .-n 4.-. .,. k..
1ieeJL ILI, I h I -I,. I T -w 'Z.-A,�­ e-w1 . ti A`- -it:v1Q 1,
If you have questions cone
this report
dd-not hesitate to•.contact the inspector
at [phone]. Please contact. the, inspector if the above information is incorrect.
J
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Rrquim Immediate Attention:
Facility No.
DMSION OF ENVIRONMENTAL MANAGEMENT
ANUAAL FEEDLOT OPOUTIONS SITE VISITATION RECORD
DATE: �e� 1995 -
►S 9
-Farm Nj
Nailing
County: ti��-
Integmtor. M-rD64 �-ae ., Phmu:—C4toL_ 281-1 ,21[ t
On Site Representative: Phone:
Physical Address/Location: _ r _
Type of Operation: Swine g Poultry _ Cattle
Design Capacity: at-e s Number of Animals on Site: ram(.^
DEM Certification Number. ACE_ DEM Certification Number: ACNEW
Latitude: • Longitude: • ;w„_'
Circle Yes or No .
Does the Animal Waste Lagoon have sufficient freeboard. of I Foot !+6year 24 hour storm event
(approximately I Foot + 7 inches) - Yes or No Actual Freeboard:L �-.LjIncbes
Was any seepage observed from the lagoons)? Yes or No Was any erosion observed? Yes or No (Seepage was
Is adequate Iand available for spray? Yes or No Is the cover crop adequate?' Yes or No Not Evaluates
Crop(s) being utilized:_ (Spray Field' or"'cover crop' was not evaluated)
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
* Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No*
* Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No
Is animal waste discharged into water of the state by man-made ditch, flushing system, orbther. .
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No(Waste management records were not
Additional Comments:— r►iewed� - _
This was a very brief, inspection,- a more tborou6-it@oection will be conduQted in the future.
Please contactoEH should an 'condition-- arise that posei a danger to surface waters.
* This farm was not located on a USGS TOPO map to determine VBlue Line" status*
L
g1 l C •t.� :O 10 .1Ct- i.Ae fi _ 4h1_-tln&s.A i Wk_
If you have questions concefting this report please do -not hetitats tor --contact the ins ec
at [phone]. please contact the inspector• if the'above information is incorrect.
J
Inspecwr Name Signature
cc: Facility Assessment Unit- Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No. 0 -
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANMIAL FEEDLOT OPERATIONS STTE VISITATION RECORD
DATE: L 9 , 1995
T"unc� 15'51
•Farm Ni
Mailing
County:
Integrator: M,,r&4 .:, Phone:-- , (�jto) M1 % a 111
On Site Represenitati've: Phone: lg i m) 27. 5 a I I 1
Physical Address/Location:_J'
Type of Operation: Swint _x_ Poultry ,_,i; . Cattle
Design Capacity: Number of Animals on Site: C-Atag-so rser�
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude• Longitude:
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard. of 1 Foot + year. 24 hour storm event
(approximately I Foot + 7 inches) - Yes or No Actual Freeboard: Ft. ,Inches
Was any seepage observed from the l_agoon(s)? Yes or No Was any erosion observed? Yes or No (Seepage Was
Is adequate land available for spray? Yes or No Is the cover crop adequate?' Yes or No Not Evaluated
Crop(s) being utilized:_ (Spray Field' or cover- crap was not evaluated)
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
* Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
* Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map BIue Line: Yes or No
Is animal waste discharged into water of the state by man-made ditch, flushing system, ofbther
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste nnanagement records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No(waste management records were not
Additional Comments:_ reviewed)
vthorough ns ection will be-rgnducted ure.
Please contacV.DEK should an 'condition-- arise that poses a danger to surface waters.
* This farm was not located on a USGS TOPO map to determine Mue Line" status.
, _ -3t 1114 11
If you have suestions conceiNhing this report please do -not hesitate ta-.contact the ins actor
at [phone]. Please contact the inspector'if the -above information is incorrect.
J �W
Inspector Name 'Signature
cc: Facility Assessment Unit �;� '�-. Use'Attachments if Needed.

Farm Ni
Vailing
County*
Integrator:
On Site R4
Physical A
Site Requires Immediate Attention:
Facility No. 0
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANWAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE; , 1995
Tina:
Phone:4 do ) M - 2112
—Phone: 61n) , 75 -A rR 1
Type of Operation: Swine g Poultry ,__,- . Cattle
Design Capacity: 26a40 _ Number of Animals on Site: att�o urser•�
DEM Certification Number. ACE DEM Certification Number: ACNEW
Latitude: • « Longitude: • • r
Circle Yes or No,
Does the Animal Waste Lagoon have sufficient freeboard. of I Foot + year 24 hour storm event
(approximately I Foot + 7 inches) Yes or No . Actual Freeboard:�FL_ ;-aInches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No (Seepage was
Is adequate land available for spray?' Yes or No Is the cover crop adequate?' Yes or No Not Evaluates
Czop(s) being utilized; (spray Field' or cover crop. was not evaluated
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
* Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No*
* Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No
Is animal waste discharged into water of the state by man-made ditch, flushing system, orbther
similar man-made devices? Yes or No If Yes, Phase Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No(waste management records were not
Additional Comments: _,. _ reviewed) _
This was a very brief�Inga ntorl thorough insuection will be conducted in the f iture.
Please contactzDEM should any'condition--arise that poses a danger to surface waters.
* This farm was not located on a USGS TOPO map to determine Mue Line" status.
01 e4 S _4o lower Y.er., 1=retlnsc rLA 1 "
If you have questions conceding this report please do -not hesitate ta,.contact the inspector
at [phone]. please contact the inspector, if the-above'information is incorrect.
Inspector Name iSignature
rc: Facility Assessment Unit - �` ; 5 . Use Attachments if Needed.