090099_INSPECTIONS_20171231

Type of Visit Oi-C—ompliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit 0-90"utlne 0 Complaint 0 Follow up 0 Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: LsLLJ Arrival Time: as Departure Time: County: Region:
Farm Name:�?��'Y .5 � 111A PS Owner Email:
Owner Name: ,!� T r Y _ _ �! ) I K S Phone:
Mailing Address:
Physical Address:
Facility Contact: J Title:
Onsite Representative: / 1
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 n=I =" Longitude: 0 e 0 I= L
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Desigp _ Current
Design Current
Design Current
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
Swine
Ca pLeityopulation
Wet Poultry Capacity Population
Cattle Capacity Population
a. Was the conveyance man-made?
❑ Wean to Finish
❑ No
❑ Layer
❑ NE
❑ Dairy Cow
❑ Yes
❑ Wean to Feeder
❑ NA
❑ Non -Layer
I
Dairy Calf
Feeder to Finish
&00
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
Dairy Heifer
❑ Farrow to Wean
❑ NA
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
JZ No
❑ NA
ElNon-Dairy
El Farrow to Finish
❑ Yes
❑ Layers
El Beef Stocker
El Gilts
other than from a discharge?
❑ Non-ers
❑ Beef Feeder
El Boars
❑Pullets
❑ Beef Brood Co
Continued
❑ Turke s
OtherTow
❑ Other
❑ Turke Poults
El Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
XNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
JZ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[RNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

Facility Number: — Date of Inspection
' Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes KNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Identifier:
r bow area
Spillway?:
r
Reviewer/Inspector Name
Designed Freeboard (in):
Phone: 970 .5-33
Reviewer/InspectorSignature:
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
Elr�rN
Yes
�o
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not property addressed and/or managed
❑ Yes
MNo
❑ 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?
)ayes
50T o
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
R No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
Elyes.
O No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
J -No
❑ NA ❑ NE
maintenance/improvement?
. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
9No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload [:1 Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10%or ]0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window (:]Evidence of Wind Drift ❑ Application Outside of
Area
12. Crop type(s)
--
13. Soil type(s) A �e
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
EN No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
KNo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detennination ?
❑ Yes
2[ No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
V No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other eommn its
Use drawings of facility to better explain situations. (use additionalvages asmecessary):
r bow area
AL
r
Reviewer/Inspector Name
p -Y
Phone: 970 .5-33
Reviewer/InspectorSignature:
Date:
Page 2 of 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 ER No ❑ NA ❑ NE
the appropriate box. ❑ WCP ❑ Checklists
❑ Design El maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes El No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ["f No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
10 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
CgNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
19 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[0 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
10 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
JRNo
❑ 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
CgNo
❑ 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
[Z No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[9No
❑ NA
❑ NE
Page 3 of 3 12/28/04

Division of Water Quality
FFaciliq Number 0 Division of Soil and Water Conservation
( 0 Other Agency �o'�—�
Type of Visit &6ornpliance 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: ta- f—D Arrival Time: D i7 Departure Time: .�'�-D County:
Farm Name: 74 n"y la Owner Email:
Owner Name: _ ZZ '� l 1.1T Phone: _
Mailing Address:
J'1L_ Region:
Physical Address:
Facility Contact: ArKe )IRJ94 Title: Phone No:
Onsite Representative: Ka A f integrator:
Certified Operator:.___— �5'jl f 5 % ,)JW%2 4 Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
S%inc
Latitude: =0 =L = Longitude: = ° = j
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ La er
❑ Wean to Feeder ❑ Non—Layer
® Feeder to Finish G 4 i7D
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other _...
Dry Poultry
❑
Layers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: t] Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
[I Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: EF—I;
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 P No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes ® No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12/28/04 Continued

Facility Number:— Date of Inspection
❑ No
❑ NA
❑ NE
Waste Collection & Treatment
® No
❑ NA
❑ NE
' 4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes W No
❑ NA
❑ NE
a_ If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 0
Observed Freeboard (in): 37
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes (A 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 [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 �❑ N�oo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?Yes i� 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 M No ❑ NA ❑ NE
maintenance or improvement?
Waste ADolication
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 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 Drifl ❑ Application Outside of Area
12. Crop type(s)rCJr1t�
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes R No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes IN 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 Iand application? ❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
[,No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
AL
r a /
JJ
116we- d/ �e 40'��� d.9 W'; S lc r VO tlN
Reviewer/inspector Name Phone: *70- f3J�73 3 CK -2
Reviewer/Inspector Signature: Date: /,— L;��D2
11/18/04 Continued

Facility Number. — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EO 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 ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes DINo ❑ 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 5INo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EK No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
f4 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
J2 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[)jNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
&No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
(K 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
[51 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
Ed 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
EINE
33. Does facility require a follow-up visit by same agency?
❑ Yes
5U -No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12/28/04

Type of Visit —0 Compliance Inspection O Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit autine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: fl.3a-O(a Arrival Time: Departure Time: d O County: s. -t_ Region:
Farm Name: -X0 -5Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: 5a /y, ` t L3 i % ���� Title:
Onsite Representative: a ` ....
Certified Operator:
Back-up Operator:
Phone No:
Integrator:�� d
Operator Certification Number: T �-3-
Back-up Certification Number:
Location of Farm: Latitude: = =s 0 Longitude: = ° E--] ` ="
Design Current
❑ Yes
Design C>urrent
Design C•arrent
Swine Capacity Population
Wet Poultry
Capacity Population
e
Cattle Cpatat
acity Poguion
❑ Wean to Finish
❑ Wean to Feeder
❑ La er
❑ Non -La er
❑ Yes
[I Dairy Cow
❑ Dairy Calf
❑ NA
® Feeder to Finish 0
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
'T
❑ Dry Cow
❑ Farrow to Feeder
E] Non -Dairy
El Farrow to Finish
❑ Layers
❑ NA
❑ Beef Stocker
Gilts
❑ Non -Layers
Q[ No
El Beef Feeder
PBoars
❑ pullets
❑ Yes
❑ Beef Brood Co
❑ NA
❑ Turkeys
other than from a discharge?
Other
❑ Turkey Poults
Page l of 3
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
P§ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[K No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
RNo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
KNo
❑ NA
EINE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Q[ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
PZ No
❑ NA
❑ NE
other than from a discharge?
Page l of 3
12128/04
Continued

Facility Number: — Date of Inspection 1 Pr�
PjNo
[:INA
❑ NE
[-]Yes
Waste Collection & Treatment
[:INA
❑ NE
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ta No
❑ NA
[:1 NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
3 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
CK 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
[a 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?
lyes
[9No
❑ NA
❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
t@ No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
0 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
10 No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ONo ❑ 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 [3Evidence of Wind Drift [I Application Outside of Area
..L���
12. Crop type(s) yn f1 / .ty �lAs'� Z //9 ✓z'rS �Yd�
13. Soil type(s) ,-- Aj
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes KNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 19 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes a No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PjNo
[:INA
❑ NE
[-]Yes
�R No
[:INA
❑ NE
Comments (refer to quesi on #): 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)-
._.'
ecessary}
_ .W— . _ I IF
3��
Reviewer/Inspector Name I G' v—f Phone: 517 —y33-33 3
Reviewer/Inspector Signature: Date: j� �fl C7 iQ
Page 2 of 3 12128/04 Continued

Facility Number:g 9 Date of Inspection �� a
F
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes BNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes F�![No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 99 Yes ❑ No ❑ NA ❑ NE
❑ Waste Application 10 Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
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?
2T 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
K No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
D9 No
❑ NA
❑ NE
❑ Yes
E, No
❑ NA
❑ NE
❑ Yes
El No
❑ NA
❑ NE
❑ Yes
CgNo
❑ NA
❑ NE
[]Yes ENNo ❑NA EINE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes jo No ❑ NA EINE
❑Yes 4 N [:1 NA [I NE
❑ Yes 54 No ❑ NA EINE
❑ Yes JZNo [--INA ❑NE
Additional Comments and/or Drawings:
1. wee k r rre-r1ay. e2) /" k 67 /4
,Sf3mi. k/rt lea wI r—rz-� /V S's 04,/- Ac -v- - ks t—vl 'WA,
Page 3 of 3 12/28/04

r'
(Z \\h{ s Y, b Vic. c I 34,7
Question Areas:
Disc hrge & Stream Impacts Waste Col, Slor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Bary D Billups Operator Certification Number: 17943
Secondary OIC(s):
Onsite Representadvels): Name Title Phone
24 hour contact name Kathy Barker Phone:
On-site representative Kathy Barker Phone
Primary inspector. Bill Dunlap Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Calibration Sept 15 Sludge Survey 12-18-2017 0-4.3, P-3.8 44%
page: 1
Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
090099
Facility Status: Active
permit: AWS090099
Denied Acoess
Inpsectlon Type:
Compliance Inspection
Inactive Or Closed Date:
reason for Visit
Routine
County:
Bladen Region:
Fayetteville
Date of Visit;
10/17/2017 Entry Time: 09:15 am Exit Time: 10:00 am Incident S
Farm Name:
Bary Billups
Owner Email:
Owner.
Bary D Billups
Phone:
910-862-4502
Mailing Address:
928 Culbreth Smith Rd
Elizabethtown NC 28337
Physical Address:
415 Culbreth-Smith Rd
Elizabethtown NC 28337
Facility Status:
Compliant ❑
Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34'45'51" Longitude:
78° 352W
SR 1507
Question Areas:
Disc hrge & Stream Impacts Waste Col, Slor, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Bary D Billups Operator Certification Number: 17943
Secondary OIC(s):
Onsite Representadvels): Name Title Phone
24 hour contact name Kathy Barker Phone:
On-site representative Kathy Barker Phone
Primary inspector. Bill Dunlap Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Calibration Sept 15 Sludge Survey 12-18-2017 0-4.3, P-3.8 44%
page: 1

r
Permit: AWS090099 Owner - Facility : BarryD Billups Facility Number. 090099
Inspection Date: 10/17/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 1,600 1,600
Total Design Capacity: 1,600
Total SSLW: 216,000
Waste Structures
DWgnated Observed
Type Identifier Closed Date Stan Data Freeboard Freeboard
Lagoon 09-99-1 20.00 29.00
page: 2

dr -
Permit: AWS090099 Owner - Facility: Barry D Billups Facility Number. 090099
Inspection Date. 10/17/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
[]
(]
Discharge originated at:
0
If yes, is waste level into structural freeboard?
❑
Structure
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
Application Field
❑
trees, severe erosion, seepage, etc.)?
❑
Other
❑
6. Are there structures on-site that are not properly addressed and/or managed through a
❑
a. Was conveyance man-made?
❑
[]
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
M ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
0 ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■ ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yea
No Na No
❑ ❑ ❑
4. Is storage capacity less than adequate?
❑
■ ❑
0
If yes, is waste level into structural freeboard?
❑
Excessive Ponding?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
❑
PAN?
❑
6. Are there structures on-site that are not properly addressed and/or managed through a
❑
01111
❑
waste management or closure pian?
❑
Outside of acceptable crop window?
❑
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
E ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
E ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance altematives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

r
Permit: AWS090099 Owner - Facility : BarryD Billups Facility Number. 090099
Inspection Date: 10/17/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application vee No Na No
Crop Type 1 coastal Bermuda Grass
(Hay, Pasture)
Crop Type 2 Coastal Bermuda Grass wt
Rye Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1 Kenansville
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E ❑ ❑
15. Does the receiving crop andlor land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure andlor operate per the irrigation design or wettable acre
❑
E ❑
❑
determination?
Design?
❑
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
❑
❑
Records and Documents
Yen No No Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
E ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090099 Owner - Facility : BarryD Billups Facility Number. 090099
Inspection Date: 10/17/17 inpsecction Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na Ne
Stocking?
❑
0 ❑
❑
Crop yields?
❑
120 Minute inspections?
❑
N ❑
❑
Monthly and 1" Rainfall inspections
❑
Sludge Survey
❑
0 ❑
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
23. If selected, did the facility tail to install and maintain a rainbreaker on irrigation equipment
❑
N ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
E ❑
❑
appropriate box(es) below:
❑
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
E ❑
❑
Non-compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
❑
0 ❑
❑
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑
❑
27. Did the facility faihto secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
N ❑
❑
contact a regional Air Quality representative immediately.
30_ Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e_, discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
E ❑
❑
CAWMP?
33. Did the Reviewerllnspector fail to discuss reviewtinspection with on-site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
D
0 ❑
❑
page: 5

Rr 1_�r
Type of Visit: O -Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: eRoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time Departure Time: E County: Region:i
Farm Name: �� �kelac Owner Email:
Owner Name: z r^' fS t f w_C Phone:
Mailing Address:
Physical Address:
Facility Contact: K_ �tl y (�j �.cd` Title: Phone:
Onsite Representative: tr Integrator:
Certified Operator: VjR LL.�r' 6, Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design CurrentI
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish
Layer
airy Cow
Wean to Feeder
Non -La er
airy Calf
Feeder to Finish
airy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D Point ,
CaFaci
P,o .
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [C]. ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No Q'1s1A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No EJ -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 ErKA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [;J►No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [] Yes [;j.No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/412011 Continued

Facility Number: - Date of Ins eetion:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? sE]NA ❑ NE
a. If yes, is waste level into the structural freeboard? Yes S ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 • Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? Yes E�,lo ❑ 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
EB No
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
Cg -Vo
❑ NA
❑ NE
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
B -No
❑ 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)
❑ NE
the appropriate box.
9. Does any part of the waste management system other than the waste structures require
[:]Yes
t3'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ff No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [-]Yes C;�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): (,ID
13. Soil Type(s): -e_ &ani �Cqe- -
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E2 -Po ❑ 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 [D -No ❑ NA ❑ NE
acres determination?
l7. Does the facility lack adequate acreage for land application?
[:]Yes
U�4o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Cg -Vo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[Ido
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[�Ko
❑ 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 E2"No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:]Yes [ZrNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes dNo ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Candnued

Faciti Number: ki- Date of Ins ection:
24, Didrthe facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑i -No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check [] Yes [-lo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes Q'No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [R'0&o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? if yes, check the appropriate box below,
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33_ Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑Yes [J]No E] NA F] NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes ['*No ❑ NA ❑ NE
❑ Yes [%f No ❑ NA (] NE
❑ Yes ['No
❑ Yes C No
❑ Yes [2"No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Eomments.(refer to question #() Explainany YES answers and/or any additional recommendations or any other comments
Use drawings offacilityto better explain situations (use additional pages as necessary):
Ck'QC OCT
Syf 15 a 8' P-. 6.7
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
ff
Phone: 43 3" 3 3 3
Date: V, 1
2/4/2071

Type of Visit:C�ommpliance Inspection Operation Review O Structure Evaluation O Technical Assistance
C1
Reason for Visit: Koutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: t Arrival Time: 00 Departure Time: I 7 County: s Region90:
Farm Name: cf-9y y Q j=7`-Xc; �,rc.. Owner Email:
Owner Name: �3At S Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: l K Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
... .Design Current
Design
Current
!&esiznj Current
Swine Capacity Pap.
Wet Poultry
Capacity
Eop.
Cattle Capacity Pop.
Wean to Finish I
11-ayer
Dairy Cow
Wean to Feeder I
iNon-Layer
I
Dairy Calf
Feeder to Finish 0
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D . P,ou1
Ca .aci
P,o _.
Non -Dai
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
Gilts Non -Layers
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Cq-W ❑ NA ❑ NE
[:]Yes ❑No
[:]Yes ❑No
[7r—NA ❑ NE
E A ❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWR) ❑ Yes ❑ No QNA ❑ NE
z. Is there evidence of a past discharge from any part of the operation? [:]Yes [i]' -No ❑ NA ONE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes e No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/412014 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Cp.?4V— ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [f r A ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a -lo
❑ Yes
[]�<o
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Eno
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑WUP ❑Checklists ❑ Design ❑ Maps E31 -ease Agreements
❑Other:
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[�J`&o
❑ NA
❑ NE
waste management or closure plan?
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
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
dNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[3lo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
D Yes
�o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes �10 ❑ 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):.�J'Vi/lc.+-e��
r1 j
13. Soil Type(s): YS4,A h, ! P
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [ o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [3 -?ft ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes [ o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [3No ❑ NA ❑ NE
❑ Yes [Z"No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[]�<o
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
[2,fgo
❑ NA ❑ NE
the appropriate box,
❑WUP ❑Checklists ❑ Design ❑ Maps E31 -ease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
[:]Yes
[7f No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis D Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[ff No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbrcakers on irrigation equipment? [:]Yes [%INo ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Pkeflity dumber: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ ].No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑'go ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes D -Ko ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [2,No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[3-o
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[3,wo
❑ 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
[3'go
❑ 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
C3<o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[aw!Ro
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[r No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[21 o
❑ NA
❑ NE
Reviewer/Inspector Signature: LV --b ""m Date: ,? Dpe-
Page 3 of 3 2/4/2014

(3104' s q 13�
Type of Visit: (3rUom cc Inspection O Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Q outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:
Farm Name:
Arrival Time: L�� Departure Time: County: aL.Qt^ Region:
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator: L
Certified Operator: �qrL_� .. Certification Number: l�
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
*-So s -y jttf,ae has„
Discharges and Stream Impact
Design Current
Design
Current
Design Cnrrent
Swine
Capacity Pop.
Wet Poultry
CapacityCattle
Discharge originated at: p Structure ❑ Application Field ❑ Other:
Capacity Pop.
Wean to Finish
M inyer
on -Layer
a. Was the conveyance man-made?
❑ Yes
Dairy Cow
Dairy Calf
Wean to Feeder
Feeder to Finish
VV
❑ Yes
❑ No
EIGA
Dairy Heifer
c. What is the estimated volume that reached waters of the State (gallons)?
Farrow to Wean
Design
Cnrrent
Pry Cow
❑ No
Farrow to Feeder
❑ NE
D , P,oui
Layers
Ca aci
P,o P.
Non -Dairy
Beef Stocker
0 NE
Farrow to Finish
❑ Yes
Gilts
❑ NA
Non -Layers
Pullets
of the State other than from a discharge?
IM
Beef Feeder
113eef Brood Cow
Boars
_ -
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Impact
1. Is any discharge observed from any part of the operation?
❑ Yes
❑'NO
❑ NA
❑ NE
Discharge originated at: p Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[3'RA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
EIGA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
[Z"NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[al o
❑ NA
0 NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 214/2014 Continued

Facili Number: ZI - Date of inspection;
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ ?1qo ❑ NA
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 1_J 1"A
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
❑ NE
❑ NE
Observed Freeboard (in): -d--F-
[1] No
❑ NA
❑ NE
[:]Yes
[:3
5. Are there any immediate threats to the integrity of any of the structures observed?
[] Yes
6
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ NE
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
No
[] NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
D" o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Io
❑ 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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
❑ Yes < ❑ NA ❑ NE
❑ Yes Llr""O ❑ NA ❑ NE
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [].l4o❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs. ❑ Total Phosphorus [] Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Win w ❑ Evidenc of Wind Drift [] Application Outside of Approved Area
12, Crop Type(s): V- i � � Cyr
13. Soil Type(s):
K,- /f G wf v cit
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?
IT Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Nt�
❑ NE J
❑ Yes
[1] No
❑ NA
❑ NE
[:]Yes
[:3
[] N
❑ NA
[DNE
Yes
No
❑ NA
❑ NE
[:)Yes
dNo
[DNA
❑ NE
[:]Yes
[ (No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Ulo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Eg iso ❑ 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 [J No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [-]Yes &No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes Ea�No
❑ NA ❑ NE
C] Weather Code
[::]Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Facdi .Number: - Date of Inspection: a
2J. -Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Io
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
0,No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
[e,110
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
[ -No
f
❑ 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 [D -No ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
❑ Yes Ef]"No ❑ NA ❑ NE
❑ Yes CNo ❑ NA ❑ NE
[]Yes [ErNo
❑ Yes 0 No
[::]Yes O'No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question,#)Explainany YES%answers and/or any additional recommendations or.any atker,c�om menu.
Use drawings of facility to better explain situations (use additional. pages as necessary)
V0 0
WIC Sttu-vl�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 4 9 J
Date: d V l
2/4/2014

M,'. J..�t
Type of Visit: Q Compliance Inspection Q Operation. Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: ,QRoutine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access
ILL
Date of Visit: Arrival Time:�Departure Time: County: Region
c
Farm Name: dk [ , Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: A le
� j
Title: f �SL� Phone:
r 4 /y
Onsite Representative: K Integrator:
Certified Operator: , IMl Certification Number: Zf t3
Back-up Operator:
Certification Number:
Location of Farm: ` Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
io
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
4[�J3QA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[—]No
[RTA
❑ 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
lJD-NA— ❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

,I
Facili Number: - Date of Ins ection:
Waste Collection & reatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Identifier:
®.Na ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E&NT ❑ 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 C2Xo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
[—]Yes [Z o
❑ 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)
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
9. Does any part of the waste management system other than the waste structures
require ❑ Yes [Lpfo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
��
❑ Yes Cg o
❑ NA
❑ NE
maintenance or improvement?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[3,14
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes LlljK'b
❑ 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
g
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
12. Crop Type(s): e_/ l� !
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[B/No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ [ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ZKo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[9 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[3,14
❑ NA
❑ NE
Required Records & Documents
No
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
g
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[J o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other: /
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes ELJ"'o ❑ 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 [ 'No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes FSBio ❑ NA ❑ NE
Page 2 of 3 2.1412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [5No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [j1Go
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ENo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes O�No
❑NA ONE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
Q�Qo
❑ 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
E� leo
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
34. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[�rNo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[(No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[]JAo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[BNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Vo
❑ NA ❑ NE
Comments (refer, t&question- Explain. any.YES: answers and/or -any additional recorrtmendat#ons or any other' dm—menfs.
Use draivinasbifacility to better explain situations`{use additioz<al:pat"es as necessary). ,;
w
GA4'4 oc, (IZ.
i3 f� �N
Reviewer/Inspector Name:
Phone V, Q -3
Reviewer/Inspector Signature: Date:
Page 3 of 3
214/2011

Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit:0-9-0-u--tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: J d Departure Time: /s County: ,8•.a Region:
Farm Name: Q'er ( 5
OwnerName: rr rK L� ) 1A -PS
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: zz'2/` k
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Title: �c s� Phone:
��-
Latitude:
Integrator:
Certification Number:
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 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 RNo ❑ NA ❑ NE
❑ Yes ❑ No
[:]Yes ❑No
❑ Yes
Design
Currents
Design
Current
Design Cnrrent
MEN
Capacity
Pap „
Wet.P,oul_try
Capacity
Pap.
-' Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
I iNon-Layer
I
Dairy Calf
Feeder to Finish
20 D
Daig Heifer
Farrow to Wean
'
Design
Current _
DIX Cow
Farrow to Feeder
D P,oti1 6
Ca aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
'" Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
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 RNo ❑ NA ❑ NE
❑ Yes ❑ No
[:]Yes ❑No
❑ Yes
❑ No
[:]Yes
EZ No
[:]Yes
QNo
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 214/1011 Continued

• Facility Number: jDate of Inspection:
❑ Yes
®No
❑ NA
❑ NE
Waste Collection & Treatment
0 Yes
® No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
E�jNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
the appropriate box.
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(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
Eg 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
❑ Yes
[S No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
M No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Cj�-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 1Window ❑ Evidence of Wind Drift E] Application Outside of Approved Area
12. Crop Type(s) rf'1vt.Ylo'� tL
13. Soil Type(s):
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 allo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable []Yes 0 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
®No
❑ NA
❑ NE
18. Is there a lack of property operating waste application equipment?
0 Yes
® No
❑ NA
❑ NE
Required Records Documents
_&
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® 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 S No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes allo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
[:INA ❑ NE
Page 2 of 3 1/4/1011 Continued

Facility Number: - I Date of Inspection: _4_ _,2o1
❑ Yes
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[.No ❑ NA ❑ NE
25_ Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[allo ❑ NA ❑ NE
the appropriate box(es) below.
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge
levels
❑ NA
❑ Non-compliant sludge levels in any lagoon
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
List structure(s) and date of first survey indicating non-compliance:
❑ NA
❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
[allo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[R No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
® No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30_ Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
0 No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
® No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
ELNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. t
Use drawings of facility to better explain situations (use additional pages as neemdr.
G j nur� Wig"A
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: Date: /7—
Page
Page 3 of 3 2/4/2011

Date of Visit: - j Arrival Time: Departure Time: County: Region: �j�
Farm Name: i flike.S
Owner Name: j2, Ld l S
Mailing Address:
Owner Email:
Phone:
Physical Address:
Facility Contact: 7?�ar Ik r>r-- Title: Phone:
Onsite Representative: Integrator: AZyr,14 25AD, ,
Certified Operator: r i [ Certification Number: 17:z4-3
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Design Current
Capacity Pop.
V4'et Poultry
Layer
Non -Layer
D , Poult ,
Design Current
Capacity Pop.
"
Design Current
Ca' :acr Po . _
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
—DairyHeifer
Dry Cow
Non -Dairy
Farrow to Finish
Layers
'°
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
tt
?P11
Turkeys
Turkey Poults
_
Other Other
Discharges and Stream Imnacts
1. Is any discharge observed from any part of the operation? ❑ Yes C�L No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ®, No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 15a No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facitity Number: - Date of inspection: S
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
Identifier:
Spillway?: _
Designed Freeboard (in): T�
Observed Freeboard (in): _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5 Structure 6
❑ Yes [g No ❑ NA ❑ NE
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
CE .No
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
(Z No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
c 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)
the appropriate box.
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[&No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes E[No [DNA ❑ 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) [D Evidence of Wind Drift [:]Application Outside of Approved Area
12. Crop Type(s): �,
13. Soil Type(s): ,jr-"f
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ®.No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 0 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
(Z No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[S No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
O 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 M No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes R 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- /�—
• 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 POA for sludge levels
Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [] Yes No
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
E] Yes ® No
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 Co 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 ® No
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes ® No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[] Yes ® No
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with an on-site representative?
❑ Yes [g No
34. Does the facility require a follow-up visit by the same agency?
E] Yes ® No
�NA []NE
[] NA NE
[]NA NE
[] NA NE
NA [] NE
NA E] NE
NA ❑ NE
[] NA ❑ NE
E]NA []NE
[] NA E] NE
NA [:] NE
Comments (refer to question: ft Explain any YES answers and/or any additional recommendations or anyothe�camments
Use drawings of facility to. better explain situations (use additional.pa es as necessary).
�•C %��� G��� tel• ��s.
w
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:lQ ��3-3300
Date:
2/4/1011

4-12.010 -re
Type of Visit Grotornpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Ce outine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: / lb Arrival Time: Departure Time: �,County: !! Qo Region:
Farm Name: Cal &Af..ZS Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: 46Title: Phone No:
Onsite Representative: J&Aqr &'rf Integrator:
Certified Operator: &M, B/ ,DS Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o =' = « Longitude: 0 ° =
Design Current
Swine Capacity Population►'et
Design C►urrent
Poultry Capacity Population
Design •urren#
Cattle Capacity Population
❑ Wean to Finish
10 Layer
❑Dairy Cow
❑ Wean to Feeder
JE3 Non -Layer I
airy Calf
50 Feeder to Finish 114oCO I lle490
Dairy Heifer
❑ Farrow to Wean
Dry Poultry
E]Dry Cow
❑ Farrow to Feeder
El Yes
❑ Nan -Dai
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Cowl
ElTurkeys
Other
❑ Other JiLaOther
❑ Turke Poults
I
umber 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 yes, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes R No ❑ NA ❑ NE
❑ Yes
❑ No
M -NA
❑ NE
❑ Yes
❑ No
[�MA
❑ NE
0'<A.
El NE
❑ Yes
NNo
El Yes
�❑
ET,IN��o
El NA
[:1 NE
[:]Yes
P4
❑ NA
❑ NE
Page I of 3 11/18104 Continued

Facility umber: 0 — Date of Inspection
Waste Collection & Treatment ��//
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes [9 o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 2<o ❑ NA ❑ NE
Strucuire 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: D
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
®No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc_)
6. Are there structures on-site which are not properly addressed and/or managed El Yes
//
2 *NNo
❑ NA ❑ NE
through a waste management or closure plan?
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
[`Io
ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? ElYes
n No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
❑ Yes
R No
4. Does any part of the waste management system other than the waste structures require [] Yes
eNo
❑ NA ❑ NE
maintenance or improvement?
❑ Yes
3_,"NNo
E,_,/
Waste Application
NE
18.
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
2*�o
❑ NA ❑ NE
maintenance/improvement?
❑ NE
11. Is there evidence of incorrect application? If yes, check.the appropriate box below_ ❑ Yes
EXo
❑ 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) 4h9rMUrJ4 — / .D. 6- o
13.
Soil type{s} — —
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
20&o
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
R No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
3_,"NNo
E,_,/
[I NA
NE
18.
Is there a lack of properly operating waste application equipment?
El Yes
LYNo
❑ NA
❑ NE
AA,44- c.s��y,.s ",-_cdc —Ta �e- mom- 16'�Www
s d t LS Ts 1--A7 s�S
L
Reviewer/Inspector Name Gr Phone: Q 3
Reviewer/Inspector Sign re: Date: O Ile
Page 2 of 3 It 12/28/04 Continued

Facility Number: — Date of Inspection Lmzv
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 2lo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [9<o ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design b 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 ❑ 120 Minute Inspections ❑ Monthly and 1 " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[EXgo
ElNA
ElNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Milo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[No
❑ NA
[I NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
t[]'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
9;?No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Bo&o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
®''lo
❑ 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
2 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
P 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
qo
[INA
[:1NE
33.
Does facility require a follow-up visit by same agency?
ElYes
&No
❑ NA
❑ NE
Page 3 of 3 12128/04

f YAWS '7--0.9-0001
Facility Number
Q"l ivision of Water Quality
0 Division of Soil and Water Conservation
Q Other Agency
Type of Visit
ompliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
Q-RGutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: FT_6_V__1D_q1 Arrival Time: /� � �Is.1 Departure Time: f .' Q County: 1816 G4 Region:
Farm Name: pari" _ �� �$ RAI 1151, Q_ Owner Email:
Owner Name: liirlr��,-��T Phone:
Mailing Address:
Physical Address: !�
Facility Contact:B�I�t'lG� ✓ ^ Title: �- + Phone No:
Onsite Representative: � Bd wKBv- Integrator: /���[�' � Cz✓i✓
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: ' Latitude: = =4
=is Longitude: 0 0 = f = "
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish i
❑ can to Feeder
[ErFeeder to Finish /,7 DD
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑
Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Cu
Cattle Capacity P6 —
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: / s
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ETNo ❑ NA ❑ NE
❑ Yes
❑ No
0' -NA
❑ NE
❑ Yes
❑ No
ENA
❑ NE
�A
❑ NE
❑ Yes
❑ No
❑ Yes
❑'llo
❑ NA
❑ NE
❑ Yes
ETNo
❑ NA
❑ NE
12/28/04 Continued

t
Facility ]Number: Q
Date of Inspection:4_ O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 31"
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
❑ Yes 3 o ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 0-14o ❑ NA ❑ NE
❑ Yes L7 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes DIo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ErNZ ❑ 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 0 Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [1'1io ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes. check the appropriate box below. ❑ Yes 3 W"'o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl/ ❑ Application OutsideofArea
12. Crop type(s) 8eAirt„t,,-'Ja.1 f`G ��� �+"Yi �l g''"-ry
13. Soil type(s) <e.A
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes BlNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
E3'NNo
❑ NA
ElNE
El, NNo
❑ NA
❑ NE
oo
❑ NA
❑ NE
,E3
Levo
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name f` e�/� (� Phone: I1/0 - y33.333 S�
Reviewer/Inspector Signature: Date: 6 `O V - ZQO 1
12128104 Continued

i
Facility Number: D 9 — Date of Inspection
Renuired Records & Documents ,,,/
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes L� No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes L] No ❑ NA ❑ NE
the appropirate box. ❑ yip ❑ Checklists
❑ Design El Maps El Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes L7 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfali ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
B No
[INA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
o
El NA
[INE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,9/
L' No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
D<o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
B"NNo
El NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
[__1 Yes
[3/ o
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
D o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
,—,/
L� 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
ElLl 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
C]�No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
QNo
❑ NA
❑ NE
Comments and/or
12/28/04

State of North Carolina
Department of Environment, WMI
J Health and Natural Resources ,! LT.
Fayetteville Regional Office
James B. Hunt, Jr., Governor p E H N F�
Jonathan B. Howes, Secretary
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
Water Quality Section
July 13, 1995
Mr. Jimmy Vinson
Environmental Resource Manager
Brown's of Carolina, Inc.
Post Office Box 487
Warsaw, N.C. 28398
SUBJECT: Compliance Inspection
Barry Billups Swine Farm
NCSR 1507
Bladen County
Dear Mr. Vinson:
On J e 12,E 1995, a cursory inspection of the subject animal operation was performed
by the Fayetteville Regional Office. Please find enclosed a copy of our Compliance Inspection
Report for your information. It is the opinion of this office based on the information provided
by Browns of Carolina, Inc. staff and observations made during the inspection that the facility
is in compliance with 15A NCAC 2H, Part .0217 and the Animal Waste Management is being
properly conducted.
Please provide a copy of this report to the individual farm owner or manger and should
you have any questions regarding this matter, please do not hesitate to contact this office at (9 10)
486-1541.
Sincerely,
JU_
Paul E. Rawls
Environmental Specialist
cc: DEM Compliance Group
Wachovia Building, Suite 714, Fayetteville. North Carolina 28301-5043 Telephone [phone] FAX [phone]
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NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH & NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
Farm Name/Owner
Inspection Date
Farm No.
Browns of Carolina,Inc.
July 12, 1995
N/A
Mailing Address (Farm)
Barry Billups Farm
Rt. 2 Box 63
Elizabethtown, N.C. 28337
Facility Telephone Number
J910) 862-4502
All comments will be discussed in the Comments Section.
SECTION I
Animal Operation type: SWINE
SECTION 11
N Comments
1. Does the number and type of animal meet or
exceed (.0217). criteria? [Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system)]
X
2. Does this facility meet criteria for Animal
Operation REGISTRATION?
X
3. Are animals confined fed or maintained in this
facility for a 12 -month period?
x
4. Does this facility have a CERTIFIED ANIMAL WASTE
MANAGEMENT PLAN?
_X—
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
X _#2_

r
AdMinistrgtion and Programa
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc.
SECTION III
Field Site Management
1. Is animal waste stockpiled or lagoon
construction within 100 ft. of USGS Map
Map Blue Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ft. of a USGS Map
Blue Line Stream?
3. Does the facility have adequate acreage on
which to apply the waste?
4. Does the land application site have cover
crop in accordance with the CERTIFICATION PLAN?
5. Is animal waste discharged into waters of the
state by man-made ditch, flushing system, or
other similar man-made devices?
6. Does the animal waste management at this
farm adhere to Best Management Practices (BMP)
of the approved CFRTIFLCATION?
7. Does animal waste lagoon have sufficient
freeboard? Now much? (Approx. 5 ft.)
8. Is the general condition of this animal facility,
including management and operation, satisfactory?
Y _N Comments
TX,
Y N Comments
_X_
_x_
X
_XT
X
SECTION IV Comments
1. Farm has a certified waste management plan based on comments from Brown's
of Carolina staff.
2. This farm has not yet land applied waste.
3. Current cover crop at time of the inspection had not yet been established.