090073_INSPECTIONS_20171231

Type of Visit 4*150-mpliance 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: I .`"p 1 Arrival Time: ; Departure Time: . County: Region: !_-_-K D
Farm Name: i�lr�<c�l. Sea, S,� r �6 c P>� Owner Email:
Owner Name: 3F�,' Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:.
Certified Operator: - - S�- - --
Back-up Operator:
Phone No:
Integrator: /irl�✓O -
Operator Certification Number: S
Back-up Certification Number:
Location of Farm: Latitude: 0 o [=] ' [:::] « Longitude: =' ='
= "
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 ves, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (Ifyes, 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?
Page I of 3
❑ Yes 14 No ❑ NA ❑ NE
❑ Yes
Dcsign Current Design Current
ItPoultry
Design Current
❑ NE
Swine
Capacity Population Capacity Population
Cattle Capacity Population
❑ NE
❑ Wean to Finish
El No
❑ La er
0 N
❑ Dairy Cow
14No
Wean to Feeder
a
❑Non -La er
t4 No
❑ Dai Calf
❑ NE
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultryy
❑ Dry Cow
❑ Farrow to Feeder"
El Non -Dairy
❑ Farrow to Finish
E] Layers
ElBeef Stocker
❑ Gilts
Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co w
- - -
-; ❑ Tur
. ke s
Other
❑ Turkey Pouets
❑ Other
❑Other
Number of Structures:
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 ves, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (Ifyes, 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?
Page I of 3
❑ Yes 14 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
El No
El NA
0 N
❑Yes
14No
0 N
El NE
❑ Yes
t4 No
❑ NA
❑ NE
12/28/04 Continued �

Facility Number: — Date of Inspection
Soil type(s) r'� �j A Z
Waste Collection & 'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
;&No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: /�iau 'Si: Gcpl
❑ NA
❑ NE
Spillway?:
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
Designed Freeboard (in): _ %
❑ NA
❑ NE
Observed Freeboard (in): 2_ 7
Does the facility lack adequate acreage for land application?
❑ Yes
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.)
Is there a lack of properly operating waste application equipment?
❑ Yes
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
SNo ❑ 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
9 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
RNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
0- Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
RNo ❑ NA ❑ NE
mai ntenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
E4 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 ❑ Application Outside of Area
%Drift
12. Crop type(s)4C rt W/tr�a� S�i*�s
13.
Comments {refer to question #): Explain any YES
Soil type(s) r'� �j A Z
14_
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
f0 No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
JR No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
R_No
❑ NA
❑ NE
answers any recommendations or`any otf(er comm_ ents °
Use drawings. of facility to better explain situatioi s. (use_additional pages as necessary)
e r re^ S �a • �� pc+•a % %
�O�/l7t•�5�73�G?`'u'---
�`� �v a5urkle APO 17
Reviewer/Inspector Name% s rte— ";� Phone:
7.
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128/04 Continued

Facility Number: g — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes JgNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes 91 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists
❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. El-yes ❑ No ❑ NA ❑ NE
Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield )ZI.i20 Minute Inspections ❑ Monthly and 1" Rain Inspections O Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
JR No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
0 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
R No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
WYes
❑ 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
RNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
9No
❑ 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
Q 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
allo
❑ 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
CKNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�&No
❑ NA
❑ NE
Page 3 of 3 12/28/04

IType of Visit &CComnliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:/+® Arrival Time: �' c3� Departure Time: ,�/ County: I -n- Region:
Farm Name- t �ffreen.. 3,—,x _ �S% r` _�� Or�,� Owner Email:
Owner Name: W /I D uJ4rd I -t. Phone:
Mailing Address:
Physical Address: ii ,,
Facility Contact: a W n We i4pt'd trj. Title:
Onsite Representative: Cf 14
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certifica on Number: /T 76
Back-up Certification Number:
Latitude: = 0i 0 " Longitude: = ° = = u
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
IQ No
❑ NA
❑ NE
Design Current
Design Current
Design Carrent
Swine Capacity Population
Wet Poaltry Capacity Population
Cattle Capacity Population
❑ No
❑ Wean to Finish I I i
❑ Layer I
Dairy Cow
® Wean to Feeder &-foo 1 1
10 Non -Layer I
Dairy Calf
❑ Feeder to Finish I
c. What is the estimated volume that reached waters of the State (gallons)?
Dairy Heifer
❑ Farrow to Wean
Dry Po�Itry
❑ Dry Cow
❑ Farrow to Feeder
❑ yes
El Non -Dairy
❑ Farrow to Finish
Layers
El La
Beef Stockei
❑ Gilts
❑Non -Layers
❑ Beef Feeder
El Boars
❑ Pullets
❑ Beef Brood Cowl I
JM No
❑ Turkeys
❑ NE
Other
❑ OtherI
❑ Turkey Poults
JE1 Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
IQ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ 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? ([f yes, notify DWQ)
❑ yes
❑ No
❑ NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
fX No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
JM No
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility Number: Date of Inspection I v�
be-av- Or-rg__ 4.�70va- �
' Waste Collection & Treatment
Fix 4-s 4s141 -5P.
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
XNo
❑ 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: cy (03 621iv
Spillway?:
Designed Freeboard (in): f
Observed Freeboard (in): - 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
,No
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
JZ 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?
SO Yes
❑ No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
� No
❑ NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
,9 No
❑ NA ❑ NE
maintenance or improvement?
Waste Apn6cation
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
6? No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
0 N
❑ 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) , ",I I eV tt 1W
13. Soil type(s) C-Z12A I IC—D 15M
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
JKNo
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
be-av- Or-rg__ 4.�70va- �
Fix 4-s 4s141 -5P.
Reviewer/Inspector Name s Phone:
Reviewer/Inspector Signature: Date:
12128/04 Continued

1
t
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
❑ Yes Rj No ❑ NA ❑ NE
❑ Yes P.No ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ❑ No ❑ NA ❑ NE
® Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
24. 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
IgNo
❑ NA
EINE
❑Yes
®No
El NA
El NE
VN
El No
El NA
El NE
❑ Yes
[5 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
EffNo
❑ NA
❑ NE
❑ Yes A No ❑ NA ❑ NE
❑ Yes 14 No ❑ NA ❑ NE
❑ Yes 5a No ❑ NA ❑ NE
❑ Yes 04 No ❑ NA ❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
J& No
❑ NA
❑ NE
Additional Comments and/or Drawings:
1212xIi9d
1212xIi9d

n of Water Quality
ji acity Number7j Division of Soil and Water Conservation
- — Q Other Agency
Type of Visit (6<6`inpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:/?� Arrival Time: �� Departure Time: �(�d County: 'L Region: /ZQ
Farm Name: 67rznew. r S': r _ ��G� Owner Email:
Owner Name: ft �� _ Phone:
Mailing Address:
Physical Address:
Facility Contact:/�% .vi/d Title: Phone No:
Onsite Representative:_ Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o =' = " Longitude: = ° =' = "
Design Current
[:]Yes
Design Current
Design Current
Swine Capacity Population
Wet Poultry
Capacity Papulation
Cattle Capacity Population
❑ Wean to Finish
❑ La er
a. Was the conveyance man-made'?
❑ Dairy Cow
Wean to Feeder
❑ Non -La
-Layer
El NE
Dairy Calf
Feeder to Finish
RNo
��„�wa�..
❑ Dairy Heifer
❑ Farrow to WeanDry
Poultry
ElD Cow
❑ Farrow to Feeder
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
' "'`'' ”
❑ Non -Dairy
❑ Farrow to FinishLaers
❑ NE
2. Is there evidence of a past discharge from any part of the operation`?
❑ Beef Stocker
❑ Gilts
❑ NA
EINE
El Beef Feeder
❑ Boars
Wo
El NA
ElBeef Brood Co
other than from a discharge?
❑Turke s
Other
El Turkey Pouits
12/28/04
Continued
❑ Other
ltumber of 5tretctures:
'ems _;- .:..
Discharees & Stream Impacts
❑
❑ Non -La ers
❑ Pullets
❑ Other
1. Is any discharge observed from any part of the operation?
[:]Yes
WNo
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made'?
❑ Yes
P No
El NA
El NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
RNo
El 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)
E] yes
P No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation`?
❑ Yes
JQ No
❑ NA
EINE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
C] Yes
Wo
El NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: g -Z 3 Date of Inspection %
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ud No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes JKNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: -- _ .5 i 1' & ,C
Spillway?:
Designed Freeboard (in): 9 /g
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes P9 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 KNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? CjYes ❑ No ❑ NA EINE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes UNo ❑ 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 C No ❑ NA ❑ NE
maintenance or improvement?
Waste APRlicHtiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes J& No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes D�lNo ❑ 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) d- ;
13. Soil type(s) t9k
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [8LNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes RNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 2L No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes �4 No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes allo ❑ NA ❑ NE
Reviewerfins ector Name Y
p �, ws/Y�/�� `fit --ice Phone: .33 —3332
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/04 Continued

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 ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RNo ❑ 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
P1 No
❑ NA
❑ NE
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
J4 No
❑ NA
EINE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,Q No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
54 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
E9 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
)ZNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
BNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document❑yes
� No
❑ NA
❑ 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
9 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
E9 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
IQNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
DC -No
❑ NA
❑ NE
Additional`Comments and/or Drawings:. x s.
•
Page 3 of 3 11/18104

{,
Type of Visit EM-ompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: �Gcr�r� Region:
Farm Name: �/`>r c�� s; r �-� � -:a-r-- Owner Email:
Owner Name: U)aL-Phone: O— J�
Mailing Address: r' �'s-a r La n_d H L
Physical Address: C—e r-,- _7K.W
Facility Contact:
Onsite Representative: 15',AJ1?2`_
Certified Operator: -I �4_t77 e
Back-up Operator:
Title:
Phone No:
Integrator:
Operator Certification umber:
Back-up Certification Number:
Location of Farm: Latitude: = = = e Longitude: = ° = I = u
Design Current Design Current Design Current:° s
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑ Wean to Finish
10"Wean to Feeder Op
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other - _-
❑ Layer
❑ Non -La et
Dry Poultry:
❑ Layers
❑ Non -Layers
❑ Pullets
❑Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ElStructure ElApplication Field ElOther
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (I f yes, notify DWQ)
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
E]Dry Cow
❑
Non-DaiLy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl I
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
[10 No
❑ NA
❑ NE
❑ Yes
[XNo
❑ NA
❑ NE
❑ Yes
C4 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
KNo
❑ Yes DkNo ❑ NA ❑ NE
❑ Yes ;K No ❑ NA ❑ NE
12/28/04 Continued

Facility Number Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes WNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes vii No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design El 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 E4 120 Minute Inspections ❑ Monthly and l " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
EA No
❑l NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Yes
❑ No
ETNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?Yes
10
t
❑ NA
El
25.
Did the facility fail to conduct a sludge survey as required by the permit?
19 Yes
®
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
W No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
4KYes
K[No
ER NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
{ No
❑ NA
❑ NE
24.
Did the facility fail to property 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
RNo
❑ 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
X 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
R No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
K No
❑ NA
❑ NE
Addi#idAal�Co�meiets.aod/ar'Drax�ings �
; � �a;� '� ;3,�: , �"'
/& +-D G"t e --f' 74e j U-," 7k
1 9V M, n . /7j" rq
�.-.--
12/28/04

a •
❑ Yes .
Facility Number: — Date of Inspection I v:12—
❑ NA
Waste Collection & Treatment
15. Does the receiving crop and/or land application site need improvement?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes 'O No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: (i 3
❑ NA
Spillway?:
17. Does the facility lack adequate acreage for land application?
Designed freeboard (in):
0 No
Observed Freeboard (in):
❑ NE
18. Is there a lack of properly operating waste application equipment?
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes t4 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
❑ NE
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes 14 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 J0 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 j] Yes [A No ❑ NA ❑ NE
maintenance or improvement?
Waste Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy'Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes .
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
19 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑
Yes
59 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
10 P--+- PO - G3 wvc� en- Lary-
Reviewer/Inspector
aryReviewer/Inspector Name : ±1; * Phone:
�'' 6( +may. �r::, .
Reviewer/Inspector Signature: Date:
12/28/04 Continued

ITYpe of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
'Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: / 'oma Time: ; o
O Not Operational Q Below Threshold
M-fermitted M -Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: - Getz .. S. %G _Ge d ry _ . W County- 094,1,eQ
Owner Name: •••1y� cnt y�•o,Tr. ` Phone No: 9/0 Y835
MailingAddress: _L'-57 ��.'c.�� .. /Qgr�r _ ��0V$y
Facility Contact: Title: _ Phone No: 2 1 Q 27
Onsite Representative: -624&e— ?!/ 54r.,rat, Integrator.
Certified Operator. _�--.: a -H-aum=z Operator Certification Number:
Location of Farm:
M -a ravine E3 Poultry E3 Cattle [3 Morse
Latitude Longitude
�' �u Longitude �• �' �u
Discharees & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes P440-
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a_ if discharge is observed, was the conveyance man-made'? ❑ Yes 0 -Ko-
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes g0o
c. If discharge is observed, what is the estimated flow in gaLlmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 0•o
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Bo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 01fo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes 00o -
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structum G
Identifier: ....._._.L
Freeboard (inches): 33 A,3 ir"
12/12/03 Continued

Facility Number: 17 — ? 3
Date of Inspection U'
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 maintenanmrimprovement?
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 maintenancehmprovement?
❑ Yes �o
❑ Yes
❑ Yes pll o
❑ Yes 21 o
❑ Yes 2'1 o
❑ Yes BoriO
1 l _ Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes [3'No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
}��,p fin( 37s/ fC'a , `1120 W0 's° so
12_ Crop type Ll.II". J. / wgdE -- SwvhP�aw hl.'Ilei� Smolt �ro,.,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes EPro
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [. }Ko
❑ Yes [-}bio
❑ Yes ❑ No
❑ Yes SF14o
❑ Yes [bio
❑ Yes []-No
r ,tea �'a-'Y--""` �
Commits (,�fer► nr _ �: aa�scr.
�
�ield Copy ❑ Final Notes K .
1/
Pl�asG G�ecl( {�(/rTh TGe�h;��! SP<<, sc�4r�f Tµe J✓ /'a��s an � YL strTrr"
�r►; Ile f.
TWO SM f d rlu S d 7� ei A �.r � low 14,
,�
Q / 6�, ! c Sd4J 9/oJS Sae&l fo eS �
s4j e- d ver
J
40 �.[ ✓tom erps,`�
Wr
Reviewer/Laspecctor Name % W `R `
"AA, � .
Reviewer/inspector Signature: Date: - n
12/12103 Condmmd

FaMt Number: q -- •j3 Date of Inspection -a
Repaired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes lido
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
{ieJ c}terk}ists, d%iga,s, etc.)
❑ Yes &N-0-
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes ®-Zd'
❑ wutc A.ppUeation ❑fTmtWU ❑ ste�ysis ❑ Soil Sampling
L
24. facility not in compliance wi}1r any applicable aback criteria in effect at the time of design?
is
❑ Yes r�No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes Si'iro
26. Fail to notify regional DWQ of emergency siUNWons as required by General Permit?
OeJ discharge, freeboard problems, over application)
❑ Yes GINO
27. Did Reviewer/Inspector fail to discuss reviewlinspection with on-site representative?
❑ Yes ©-No
28. Does facility require a follow-up visit by same agency?
❑ Yes Q.#w
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes [}44v—
NPDES Permitted Fac7itiess
34. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes awo
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 rain 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 ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
No violations or deficiencies were noted daring this visit. You will receive no farther correspondence about this visit.
Caaadlor ��- = �y - _
Ed
12112103

Type of Visit: (DoCompliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance I
Reason for Visit: outine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time:County: I Region:
Farm Name: _ Ow`nerrEEm-ia-ill:
Owner Name: 0",..c Phone:
Mailing Address:
Physical Address:
Facility Contact: a S� Title: Phone:
Onsite Representative:
Certified Operator: V 1,
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number: !/ q s:
Certification Number:
Longitude:
Finish
Wean to Feeder
Designl Currents
Myer
Non -La er
Sity-
aPoCattle CityapacPop.
Dairy Cow
I Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
a. Was the conveyance man-made?
=
Design Current D Cow
Farrow to Feeder
❑ NE
D a Poul
Ca aci ! P. Non -Dairy
"
Farrow to Finish
[�15A
11-avers
e Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
❑ Yes
Pullets
.y Beef Brood Cow
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
Turkeys
C3 No
Other
t "=
Turk e Poults
❑ Yes
Other
❑ NA
Other
of the State other than from a discharge?
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[;L>kr_❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
0 Yes
❑ No
❑-ItA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[�15A
❑ 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
0"NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
C3 No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
EfrNo
❑ NA
❑ NE
of the State other than from a discharge?
—� Page 1 of 3 21412011 Continued
h1\

Facili Number: - Date of Inspection:
�
❑'Ro
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Waste Collection & Treatment
[TNo
❑ NA ❑ NE
the appropriate box.
4.-Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
NA
❑ NE
a. if yes, is waste level into the structural freeboard?
[:]Yes
❑No
Ca FSA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ Weather Code
Identifier: G's S &ey
22. Did the facility fail to install and maintain a rain gauge?
[:]Yes
dNo
❑ NA ❑ NE
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): b
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Lg-Nb
❑ 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
© o
❑ 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
[5'�o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0'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
F.Pdo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 -Ko- ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift p Application Outside of Approved Area
12. Crop Type(s): �j O✓ �{� S G ri Gi�]3
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ro[-]NA [-]NE
15. Does the receiving crop and/or land application site need improvement? E -]Yes ❑ NA ❑ NE
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?
Reuuired Records & Documents
❑ Yes [�ff_No ❑ NA ❑ NE
❑ Yes D—No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
19. Did the facility faii to have the Certificate of Coverage & Permit readily available?
[:]Yes
❑'Ro
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
[TNo
❑ 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
[fNo
❑ 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
dNo
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes D No 0 NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Faci6 Number: jDate of Inspection:b MiA,
tv
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25'. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspcctor fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Stu- C(�C>t
Gst-q
0
[Ej i ❑NA ❑NE
[-Na-- ❑ NA ❑ NE
❑ Yes [ 37 ❑ NA ❑ NE
❑ Yes [D-95 ❑ NA ❑ NE
[—]Yes Q -N -o ❑ NA ❑ NE
[:]Yes []-Nm ❑ NA ❑ NE
❑ Yes [3-N-6— ❑ NA ❑ NE
❑ Yes [3 -Nn ❑ NA ❑ NE
❑ Yes
E3 -No
❑ NA
❑ NE
❑ Yes
[3-110
❑ NA
❑ NE
❑ Yes
�o
❑ NA
❑ NE
{� I
Reviewer/Inspector Name: Phone: J T
Reviewer/Inspector Signature: �� '� �'Lr i} Date: !r
Page 3 of 3 2/4/2014

Type of Visit:=OU'Zine
ce Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival) Time: LLQ Departure Time: County: Region: � Q
Farm Name:/ -
Owner Name: CtJa
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: �X Ac(1 �r _ Title: b1C.X-4'r--_
Onsite Representative:_ /
Certified Operator: _�(f �r�_ % ',r �q
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Wto Finish
77eWFijy
Current
i__
pultry
La er
Design
Opacity
Current
Pop.'
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to Feeder
a
Non -La er
Dai Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Design
Curent
Cow
Farrow to Feeder
D , P,oul
'Ca acity
Po" �`
Non -Da'
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -1 a ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
all
Turkeys
Other
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:
[:]Yes 7 No ❑ NA ❑ NE
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 E, No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes Co No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 214/2011 Continued

Facie Number: -7.3 1 1 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �allo ❑ 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: /�,-r+- /s; l�i�A
Spillway?: q
Designed Freeboard (in):
Observed Freeboard (in): ��_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
[:]Yes
D4 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 46 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
1Z No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
3
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window / ❑ Evidence of Wind Drift ❑ Application Outside of Approved/Area
12. Crop Type(s): l/1 Gv�v / S �r R ✓ /t
13. Soil Type(s): �¢� / LQ / -5 7f--
14.
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E. No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �A No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes K-11 No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes E, No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes (g 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 g, 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 E�jNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes 0 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

'IFacitity Number: 2 - Z5 1 1 Date of Inspection: X—.3-1-3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No
• 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �&No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey E] 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 gS-No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes r%2 No
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?
❑ NA ❑ NE
F] NA E] NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes FO No F] NA E] NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes MNo ❑ NA ❑ NE
[:]Yes �No
❑ Yes Q. No
❑ Yes Cj?[No
❑ NA ❑ NE
[DNA ❑NE
E] NA ❑ NE
Conments'(referto question #):`Eaplain'.any YES answers and/or any additional recommendations or any outer comments SLK.
Use.drawings-of facility to better explain situations (use additional pages as necessary).
�vtUL i,U 1)r , Q.w L�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: jl4--4/M—T3ao
Date: '0113
214/2011

a 1 V%'(s
Tpe of Visit: 9,Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit/: Q6outine O Complaint O Follow-up O Referral O Emergency Q Other O Denied Access
Date of Visit: 'Arrival Time: Departure Time: County: �2�t,�— Regi
k-. T2 D
IF
Farm Name: Owner Email:
Owner Name: 71 Q A) fr �-{� Phone:
Mailing Address:
Physical Address:
Facility Contact: C4'k'._A� f Title: Phone:
Onsite Representative: ^�pc�`� Integrator:
Certified Operator: tk),}p�-� Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
i a M��, "Design Current
'! Design
Current
Design Curren#
ei
Swine -.Capacity Pop.
w
Wet Poultry- Capacity
Pop.
Cattle C►apacity Pop.
_.
Wean to Finish I
La er
Da Caw
Wean to Feeder D
on -Layer
Da' Calf
Feeder to Finish
r `"
Da' Heifer
Farrow to Weans
Current
D Cow
Farrow to Feeder
- k.A'-dt f 3ni''f'o-5•
D , P,oul F Ca act
Non-Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef $rood Cow
,,. ..
Turkeys
O#ber A F
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 [ ZPK- ❑ NA ❑ NE
❑ Yes ❑ No Q3 TSA ❑ NE
❑ Yes ❑ No � ❑ NE
❑ Yes
❑ No
❑ Yes
4 IV r
E:g�/
❑ Yes
❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 2/412011 Continued

[Facility Number: - Date of ins ection
WAste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [4 -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):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes RZ�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 [a_tLo- ❑ 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 []-Ne ❑ NA ❑ NE
8. 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 ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes [�'�Io ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes [Hjl�0 ❑ 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): [ G 6
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Z.Ko
❑ Yes
Elvv-
❑ Yes
[2,No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes [j >o ❑ NA ❑ NE
❑Yes M'Ko ❑NA ❑NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [?No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes ❑ 1s cL ❑ 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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [] Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
Ei/
Q Na
❑ NA ❑ NE
T/ ❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

FacHi Number: - Date of Ins ectio jk
24. Did the facility fail to c librate waste application equipment as required by the permit? ❑ Yes [�Wo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [3,,Wo
' 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 [.'fio
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [;Ko
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [�o
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
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 E?<o
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 []2"N'o
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA FINE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ YesIo C] NA E] NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? E] Yes F(No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [7f No [DNA ❑ 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). x
sl�ye Px+
Reviewer/Inspector Name: �j I
Reviewer/Inspector Signature:
Page 3 of 3
e:
Date:
2/4/Zoff

6
Itype of visit: w c:ompttance inspectton V vperanon tceview V structure Evaluation U l ecnnical Assistance
Reason for Visit: 124 utine O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: l0.` DD Departure Time: , p} County:` Region: /4�0
Farm Name: G/'-ne1 c a � �� r l'r d Owner Email:
Owner Name: �(%� �OCIJGtra� Phone:
Mailing Address:
Physical Address:
Facility Contact: ts'040a-r Title: Phone:
Onsite Representative: Integrator: IXV44 /4i�
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharees and Stream Impacts
I _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes F[ No ❑ NA ❑ NE
❑Yes ❑No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [3 Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes allo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [] Yes ® No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued
Design Current
'D'esign
Current
Design Current
Swine ` „{ Capacity Pop.
Wet Poultry
-,
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder p a
Non -La er
Da' Calf
Feeder to Finish
-
Da' Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
�D . Poul
,Ca aei
P,o ,.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Lavers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turke Poults
Other
Other
Discharees and Stream Impacts
I _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes F[ No ❑ NA ❑ NE
❑Yes ❑No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [3 Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes allo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [] Yes ® No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
_0 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ® No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: at -r --r_ Spic..
Spillway?:
Designed Freeboard (in).-
in):Observed
ObservedFreeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes ® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ® 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 C:] Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [5 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes V1 No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Window ❑ Evidence of Wind Drift Application Outside of Approved Area
/Crop
//❑
12. Crop Type(s): i clla �yri�l'Y�l ZQ/�►'l ILUh�c'/ .15 14 /wt�4-fAlu/ ( Yc+ ..
/�r
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes '® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes O 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?
❑ Yes to No ❑ NA ❑ NE
❑ Yes [Z No [DNA ❑ NE
Required Records & Documents
19_ Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists [—]Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [K 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 [3 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 5D No
[] NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
[]NA ❑NE
Page 2 of 3 2/4/2011 Continued

• Facility Number: -7, Date of Inspection. d�
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes ® No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a FOA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit'? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
33. Did the Reviewer/lnspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[:]Yes allo ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes M No ❑ NA []NE
❑ Yes [X No ❑ NA ❑ NE
❑ Yes N No
❑ Yes fZ No
❑ Yes jg No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
4 #) :,Explain y y essary)...
Comments refer to question #.:,Ex lain an YES answers _and/or any additional recommendations or any other commen
Use drawings of facility to better•explatn situations (use idditiooal pales as nee'-' w , _:, 4?
f%i� Cjji D "`� �! C,t'a� J�� a dVR�f� n�t��j / �/ 6� c+��+ Q i Sip `� �S06
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
u
Phone: 33 DO
Date: 31x
214/2011

f
Facility' Numbeir
❑ No
❑ NA
%
❑ Yes
❑ No
❑ NA
❑ NE
Type of Visit 9rfmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit �utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Dale of Visit:/� Arrival Time: .� Departure rune: : jJ(� County: `�� Region: /�O
Farm flame: LTI'r'�/C .Sri � �3i r 1sr!1,24u= Owner Email:
Owner Name: �/ziJ![l� O Phone:
Mailing Address:
Physical Address:' ' `—
Facility Contact: /2kdk2,9 ffY>l1/�z'/i f Title: Phone No:
Onsite Representative: 5 Integrator:
Certified Operator: �ldne_ Operator Certification Number:
Back-up Operator: Back-up Certification dumber:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Other
❑ Other
Latitude: ❑O =1 =U Longitude- ❑9 u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
Dry Poultry
Pullets
Other
Discharges & Stream lm� pacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non-Daizy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood CoYA
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gailons)?
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 [3No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
;.No
❑ NA
❑ NE'
El Yes
1)5�
0 N
❑NE
12/28/04 Continued

' Facility Number: — 231 Date of Inspection
1. 0�14_6!50%
Waste Collection & Treatment
14. Do the receiving crops differ from those designated in the CAWMP?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
®,ND ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Stnicture 4
Structure
5 Structure 6
Identifier:
allo
❑ NA
Spillway?:
17. Does the facility lack adequate acreage for land application?
❑ Yes
Designed Freeboard (in):
❑ NA
❑ NE
Observed Freeboard (in); 7
❑ Yes
ERNo
❑ NA
❑ NE
5. Are there any immediate threats to tate integrity of any of the structures observed?
❑ Yes
V?!LNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
b. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
R 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?
Z� Yes
❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑Yes
KNo El NA El 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
N -No ❑ NA Cl 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
2 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
13. Soil type(s) t94W_ 1/CO S'7-
1. 0�14_6!50%
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
MNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
9 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination' ❑ Yes
allo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
9No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ERNo
❑ NA
❑ NE
Comments (refer to question #f): 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):
1. 0�14_6!50%
Reviewer/Inspector Name (TIx �j---- Phone:
Reviewer/Inspector Signature: Date:
12128/04 Continued

Facility Number: — 3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Q�No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 10 No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
2 1. Does record keeping need improvement? If yes, check the appropriate box below. B Yes JVNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ® Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
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
[0 No
❑ NA
❑ NE
❑ Yes
ER No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
91 No
❑ NA
❑ NE
❑ Yes
ENo
❑ NA
❑ NE
❑ Yes Jallo ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
[--]Yes
®No
❑ NA
❑ NE
❑ Yes
14 No
❑ NA
❑ NE
❑ Yes
[K No
❑ NA
❑ NE
Ad boreal Comments aadlorDrawings:
12/28/04
12/28/04

Division of Water Quality
r�
Facility Number�� 0 Division of Soil and Water Conservation
=___21
--- ... 0 Other Agency
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: Arrival Time: -;3 ,� Departure Time: Jr: �C County: Region:
Farm Name: [��rCQ�yl , Szn:f S, r Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: J
Facility Contact: d /J Title:
Onsite Representative: ✓��"��
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
Phone No:
Integrator:
Operator Certifica •on Number:
Back-up Certification Number:
Latitude: = o =I ="
Longitude: = ° = =
Design Current Design Current
Capacity .Population Wet Poultry Capacity Population
EEIILayer���
I, JE1 Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made`?
Design Current'
Cattle Capacity Papulation
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
E]Dry Cow
❑ Non-Dairyj
❑ Beef Stocker t
❑ Beef Feeder
❑ Beef Brood Co 1.,
Number of Structures: ©`
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any pan of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes &No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
V,No
❑ NA
❑ NE
❑ Yes
�!No
❑ NA
❑ NE
12/28/04 Continued

I
+ Facility Number: — Date of Inspection -=f
❑ Yes
Waste Collection & Treatment
❑ NA ❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes [SNo ❑ 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: l ez='Sr
❑ NA ❑ NE
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):+
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes Z No ❑ NA EINE
(ie/ large trees, severe erosion, seepage, etc.)
S No
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes U1 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?
RYes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
J@ No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
Reviewer/) nspector Name Phone:
9. Does any part of the waste management system other than the waste structures require
❑ Yes
14 No
❑ NA ❑ NE
maintenance or improvement?
Waste Avolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
S No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
allo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑/Evidence of Wind Drift ❑/ Application
Outside of Area
12. Crop type(s) i`rn�blit ��d / eDr� �lf/lt-/S'�l
13. Soil type(s) 6:id Z
T_
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
allo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
J@No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
allo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
3 -No
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
( ► tF-ucP 6w7—WDrk 1
(5f
w
Reviewer/) nspector Name Phone:
Reviewer/Inspector Signature: Date:
12128/04 Continued

Facility Number: — Date of Inspection 3 -
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropirate box. ❑ WUp [l Checklists
❑ Design El Maps El 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 ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes J4 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
29 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
N No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Callo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
J9 No
❑ NA
EINE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
JZNo
❑ 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
25No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
®,No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[5ZNo
❑ NA
❑ NE
Add�tio aI�C mrnepts }aridlor�Drawmgs. �K� , - > �.. '"�^ f
Page 3 of 3 12/28/04
Page 3 of 3 12/28/04

1 lis l J -5, L'&L r
ivision of Water Resources
Facility Number-.� © Division of Soil and Q
ater Conservation
� Other Agency
Type of Visit:rRoutine
fiance Inspection Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: Q Complaint 0 Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: . „c- Arrival Time: ;3 S Departure Time: County:
Farm Name: GrIe e VISCI �sI U Owner Email:
Owner Name: A. 5111 _a 0q S ®r1 Phone:
Mailing Address:
Physical Address: fL_�
Facility Contact: (�cc. lS' �6t.-�A j( Title: Phone:
Onsite Representative: It Integrator: 0495
Certified Operator: 1 v C, 6 G4%J 61. Sic 4L
Back-up Operator:
Location of Farm:
Latitude:
Region: L�
Certification Number: T7 6 H. s
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
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 [D NV- ❑ NA ❑ NE
[:]Yes ❑ No [4 -NA ❑ NE
❑ Yes ❑ No [3 -NW- ❑ NE
❑ Yes
Desighp Current
❑-'gA-
DesIn
Current
Design Current
Swine
Capacity. Pop.
Wet Poultry
ity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
at Cow
W can to Feeder
• .1-03 la i
Non -La er
at Calf
Feeder to Finish
.,,
.:. _:........
Da Heifer
D Cow
Non -Dairy
Farrow to Wean
Farrow to Feeder
Design C urrent
D , P.oul Ca aci P.o P.
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
Gilts Non -Layers
Boars
Pullets
Beef Brood Cow
Turkeys
Other
;.
Turkey Poults
i
Other
I 10ther
I
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 [D NV- ❑ NA ❑ NE
[:]Yes ❑ No [4 -NA ❑ NE
❑ Yes ❑ No [3 -NW- ❑ NE
❑ Yes
[:]No
❑-'gA-
❑ NE
❑ Yes
[D -NU
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 21412015 Continued

Facili Number: C1 - % Date of Ins ection: 1,3 amu. vL -
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ ""' ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes D No Q -N [] NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: , &—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3-5 9
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yeso ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) �-
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes [J No ❑ NA ❑ NE
waste management or closure plan?
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 []I-""
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes [2,le
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
Required Records & Documents
9. Does any part of the waste management system other than the waste structures require
❑ Yes o
❑ NA
❑ NE
maintenance or improvement?
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Waste Application
[n—No
[DNA
❑ NE
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes[i,�Vo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes �'i o
❑ NA
❑ NE
❑ Excessive Ponding D 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
/_'x
12. Crop Type(s): C� (y �?1 ���- to M t �[ �� % zs G4. --e-
-e13.
13.Soil Type(s): Ev 24— (rj0
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes o
❑ NA
❑ NE
(I"I. Does the receiving crop and/or land application site need improvement?
es �'1��
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
Q Yes [fjNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
[:INA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
rf-Mo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
EfN o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[n—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 [dv
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall E] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [-No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [�-l�o
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 214/2015 Continued

F_acitity Number: ff_- 77�7 jDate of inspection: -3� 2& /
. 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [E4--N-o_ ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E I'�o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of fust survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes O -No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑-N-o- ❑ NA ❑ NE
Other Issues
28. Did the facility fail to property 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/Mspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
E
re
❑ Yes [Zl-1V o ❑ NA ❑ NE
❑ Yes [9 -'go ❑ NA ❑ NE
❑ Yes [;LNo ❑ NA ❑ NE
❑ Yes [!3'5_o 0 NA ❑ NE
❑ Yes GDN6' ❑ NA ❑ NE
❑ Yes [aA6— ❑ NA ❑ NE
❑ Yes 1� o ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone: r 3 33
Date: &,,A&
21412015

DEvision of Water Resources
Facility Nu!ffierrC _® Division of�Soil and Water Consena6on
N
®Other Ageney
Type of visit: (D -Compliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: (DrUoutine O Complaint Q Follow-up O Referral Q Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: I I,' yd Departure Time: ` County:�•�
Farm Name: ell, e_e%_� SC& z-7 &N 6*e'i2:4 .i- Owner Email:
Owner Name: L& "` 'i V kU t.*�_ Phone:
Mailing Address:
Physical Address:
Region: j
Facility Contact: G'�tA_a ( S (� tz,^Wl`l(, Title: Phone:
Onsite Representative: V Integrator: i4(q— S
Certified Operator: 1C�r �y� rzll ' S�-<-�'1 Certification Number: L �lpi�
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
__., . _...
:..,: ,, .,- ........
a "' 'fit:; '"•1�
Design Current
Design
Current r Design Current
Swine
Capacity Pap. Wet Poultry
Capacity
Pop Cattle Capacity Pop.
Wean to Finish
n° Layer
Dai Cow
Wean to Feeder
v 9„ Non -Layer
Dai Calf
__ _
FeedeFeeder to Finish
r
'' µ''
Dai Heifer
Farrow to Wean
Design
Current _ = D Cow
t.-
Farrow to Feeder
,? _ D , Poult
Ca act
Po -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Caw
Turke s
Other
TurkeyPoults
Other
Other
Discharzes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes Ef No ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No [�A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) [:]Yes ❑ No Q�A ❑ NE
c- What is the estimated volume that reached waters of the State (gallons)?
J
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes [:]No 23'NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes E ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes ❑No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2015 Continued

[Facility Number: J - Date of Ins ection:
❑ Yes
Io
❑ NA
Waste ColleOibn & Treatment
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[3 -No
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[ge��No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes E'❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: ,JrtL. �.y4%e�.L
17. Does the facility lack adequate acreage for land application?
❑ Yes
Spillway?:
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
Designed Freeboard (in):
F:�No
❑ NA
❑ NE
Observed Freeboard (in): 4/H_ 3
❑ Yes
[Ej"'No
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes Ca-No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ NE
the appropriate box.
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes ED-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?
ee❑
NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes C2-11;to`
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Docs any part of the waste management system other than the waste structures require ❑ Yes ❑-Pro— ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA 0 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 p Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
c
12. Crop Type(s):
13. Soil Type(s): L4, �s 64
b[�
14. Do the receiving crops differ from those designatedtn the CAWMP?
❑ Yes
Io
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[3 -No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
bKo
❑ 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
F:�No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[Ej"'No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ENo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [] Design ❑ Maps [:1 Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes [3*No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes C:.No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/412015 Continued

Facilitv Number: - `i Date of Inspection:
24. Did the'f`aci1ity fail to calibrate waste application equipment as required by the permit? l
❑ Yes
LJ go ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[a'1Qo ❑ NA
❑ NE
the appropriate box(es) below.
BNo
❑ NA
❑ NE
❑ 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
[a --two ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
E2 -Ko' ❑ 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 [T No ❑ NA ❑ NE
❑Yes �o ❑NA ❑NE
❑ Yes [✓]No ❑ NA ❑ NE
❑ Yes E] No ❑ NA ❑ NE
❑ Yes
[DNo
❑ NA
❑ NE
❑ Yes
[D] No
❑ NA
❑ NE
❑ Yes
BNo
❑ NA
❑ NE
lComments (refeir to question:#) Explam:any YES answers and/or any additional recommendations or any other. comments•
usedraWings,ii)f facilityto better egplaut situations f use additional pages. as necessary)...
Crt�l� ✓��r�� ��� Ib S�ud,2C�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: to., )
Date: 1 f
21411015

Type of Visit: O Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: t.0 Routine O Complaint 0 Follow-" _ O Referral O Emergency 0 Other O Denied Access J
Date of Visit: 2R Arrival Time: Departure Time: County:�} iQy�P1 Region
Farm Name: &e� S'. VL
Owner Name: a11ft
Mailing Address:
Physical Address:
Facility Contact: C V&1' Title:
Owner Email:
Phone:
Phone:
Onsite Representative: 'Le Integrator:
Certified Operator: 1tc l_c��-..i S�,T{,t Certification Number: ��b 61-0
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
_. -Design Current
❑ Yes
Design
Current
Design Current
Swine Capacity Pop.
a
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
CjNA ❑ NE
�9 .
❑ Yes
[fib
DNA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Wean to Finish
La er
Dairy Cow
Wean to Feeder
er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D P►oul
Ca aci
Pio P.
Non -Dairy
Farrow to Finish Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I jBeef Brood Cow
" <4 Turkeys
Other- .,
Turkey Poults
Other I
Other
Discharges and Stream Imoacts
1. is any discharge observed from any part of the operation? ❑ Yes [ o ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes [:)No [3-114-A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
0 Yes
❑ No
CjNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[fib
DNA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[rNo
❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Number: - Date of Ins ection•
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1!I Iqo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? 0 Yes [:]No [51NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: —"�—
Designed Freeboard (in):
Observed Freeboard (in): eW
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 03'17b ❑ 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 []3"go ❑ 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 0 o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) _V
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 [ fNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [!5No ❑ 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): �' �TW •^�
14. Do the receiving crops differ from those designated in the CA MP?
0 Yes
ffrNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
&I -No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
ka No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
i. leo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
,[JONo
0 NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes eNo
;lo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ 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 Io ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [] Stocking ❑ Crop Yield [:1120 Minute Inspections [:]Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes &f'To ❑ 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 2/4/2014 Continued

lFacitity Niumber: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E Igo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes iso ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of fust survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes E!J�No ❑ NA [] NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes YNo ❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
[—]Yes
[/] No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
dNo
❑ 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
YNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EfNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
[—]Yes
ZNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
[:]Yes
FrNo
❑ 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).
r
tj
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Site Requires immediate Attention:
Facility No.
DIVISION OF EN IRONIME AL MANAGBMENI'
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: g" z '1995
Time:1p� 3G 1.0:W
Farm Name/Owner-
6 ca Z9z7)
01 r
Mailing Addiess: F1--1 Z SAx 13 ', aV&/*No A)0- -CV-441 _
County:— << sL',b gg,,)
Integrator: Phone: Pg9 - ell
On Site Representatives u /IIt� ���d Phone: i/D s�,�-- 46 Z2
Physical Address/Location-
Type of operation
- �v�r�r • � .sr.%_ i.J r: sT o-�--fix CJD = - __,_ - _
Swine 3-C Poultry Cattle
Design Capacity: Do R-40� Number of Animals on Site: ZSSD
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 + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yeso>io Actual Freeboard: ____Ft. Inches
Inches���
Was any seepage observed from the lagoon(s)? Yes 06 Was any erosion observed? Yes o'(J,Lo-r
Is adequate land available for spray? es r No Is the cover crop adequate? es or No
Crop(s) being utilized: rJ 7S
Does the facility meet SCS mini murn setback criteria? 240 Feet from Dwellings or No
100 Feet from Wells? �or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes qtNo
Is animal waste: land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes 00
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o o 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 o(s)
Additional Comments:
E< -c-- tj A V Kgj -T-1
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.