090151_INSPECTIONS_20171231

(Type of Visit: &Uo Hance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Arrival Time:
Departure Time: County: @ aL j e
Region:jT
Farm Name: rtr
+ i
Owner Email:
Owner Name: �J`iCSf—
nytWtS `.LC-
Phone:
Mailing Address:
Physical Address:
Facility Contact: '"+t5
'G` V-1V 1G/Z Title:
Phone:
Onsite Representative:
Q
Integrator: lq, (3-S
Certified Operator: �L
13
Pt - e L
Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
F Desi356urrent
Design
Current
Design Current
Swtne T Ca aPo
P P-
Wet l?onl ti.y
Ca aci
P t3'•
op
Cattle Ca ac Po
P tiY P-
Wean to Finish
La er
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D . P.
Ca aci
Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
t
Turke s
Other z.
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
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 El-Nro— ❑ NA ❑ NE
[:]Yes
[:]No
E] PNX
❑ NE
❑ Yes
[] No
Q"NA
❑ NE
❑ Yes ❑ No
❑ Yes ❑'1To
[:]Yes Lrl "'c
lLJ KA_
❑ NE
❑ NA
[] NE
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

FF-acility Number: jDate of inspection:
f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
o
❑ NA
❑ NE
` a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
7
Observed Freeboard (in): 3.3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes _e'1qo
❑ 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 DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[a -fro-
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q'110
❑ 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
[5,Ko
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[3'qo-
❑ 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): G 13 14 4 cSG 0 G t-Z
13. Soil Type(s): 0 V 0 /IV� A/ o -
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 No ❑ 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?
Reauired Records & Documents
❑ Yes L'i-< ❑ NA ❑ NE
❑ Yes [g-Ko- ❑ NA ❑ NE
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
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
[ "' 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
LDS ""o
❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes gj,,Iqo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

[Facility Number: q - Date of Inspection: T
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
aeo ❑ NA
❑ NE
the appfopriate 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
[KO"' ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
04< ❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[f'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 g2 'qo ❑ 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
❑,Pik
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
to
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[2[4 °
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[]'No
❑ NA
❑ NE
Comments (refer to gnestao ) tEziftiq Ifplain anySYES answers"'and/or any,addxtianai r eni:labons or>any other comm!en� '-
Use drsvrnl!gs of facility�tabetterenislain situahonst(useFaddihonal pagesasecessary,); -
r 7p, SE7
CIA `T(0 -3 os�-( � 9
Reviewer/lnspector Name: " L_
Reviewer/Inspector Signature:
Page 3 of 3
Phone: V OM31233y
Date: " '-4 0
2/4/20 S

Ii ype of visit. d 4ompnance inspection U operation Review U Ntructure Evaluation U I ecnnicai assistance
Reason for Visit: G'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: �(']1 Arrival Time: �oI Y v r Departure Time: County:
Farm Name: f ``i'��,� J S �-t Owner Email:
Owner Name: �l'�ti��GyIS Phone:
-r—
Mailing Address:
Physical Address:
j4 e Region:F_
I?
`
Facility Contact: (
`' rtt
1Jc, cA[d1Q, Title:
Phone:
Representative:
,!
Onsite
Integrator:
Certified Operator:
-,-j
��` r� ��
Certification Number:
Back-up Operator: `�`eV`v�
PJ {
Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Cnrrent
ine Capacity Pnp.
to Finish
7We
Wet Ponitry
La er
Capacity
Pop.
Cattle Caacian
Dai Cow
an to Feeder
der to Finish pt?
Non -La er
Dai Calf
DairyHeifer
Farrow to Wean
Design
Current `
D Cow
Farrow to Feeder
Farrow to Finish
©, 1?oult .
La ers
Ca ae"
P,o .'
Non-Dairy
Beef Stocker
Gilts
Boars
Non -La ers
Pullets
Beef Feeder
Beef Brood Cow
Turkeys
Qtber
Other
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes -8''K6-- ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
V
❑ No
��e
E37bl ��
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWR)
❑ Yes
0 No
L]-NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
[] No
O A
❑ NE
2. Is there evidence of a past discharge from any pan of the operation?
❑ Yes
❑-No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Fa " Number: - 5 (I Date of inspection:
/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
.[� Nn ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
El -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
�o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.) '
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
10
❑ 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
u 'VU
❑ 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
[3-lqo-
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
e'fio
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ll o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,Ln, 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): _ _ — trJ s G o C 606
13. Soil Type(s): o
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑`moo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E] too ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [3'9o_ ❑ 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?
_Renuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
[:]Yes LJ-No ❑ NA ❑ NE
❑ Yes [ ,N ❑ NA 0 NE
[—]Yes JaND ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E1Qo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [:J-,No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EE'No ❑ NA ❑ NE
Page 2 of 3 214.12015 Continued

ItaqUily Number: - 01 Date of Ins tion:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [J t ❑ NA ❑ NE
.'
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E3-?-�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 first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [5-No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? 0 Yes [J� ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes [3-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 E]-Ntr ❑ 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 Isivo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
F�No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
E]�`No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[a/No
❑ NA
❑ NE
V4,
(U- C(� 'g-t r e' :15
cep lo-
Reviewer/Inspector Name: I Phone:_*-
qSy3W
Reviewer/Inspector Signature: Date:
Page 3 of 3 214120

l s �-« �
Structure Evaluation Inspection
Facility Number: -- •1 51 Date: ' 6 Fe-c
Time in: /0 8 S Time out: /J/; l O •
Farm Name: k`e,f
�''(' Farm 911 address:
Owner Name: f(t`ti-}` -reorI tJ
Facility Contact: •I'4tikQ,c--��v►
Onsite Representative: Integrator' WE
Certified Operator: KrAiA, �y���s Cert. Number
Is storage capacity less than adequate? Yes ' No
If yes is waste level into the structural freeboard? Yes No
Structure: 1 2 3 4 .5 6
Identifier:
Spillway?
Designed Freeboard (in.):
Observed Freeboard (in.): id)`-
Are there any immediate threats to the integrity of any of the structures
observed? Yes No
Do any structures lack adequate markers as required by the permit? Yes . No e,/
Does any part of the waste management system need repair Yes No
Condition of field's 6001 P IA.)r/f
Condition of receiving crop . C 00,2 S la,
Y
Comments: keto I flkcv c K

A6
Type of Visit: QCompliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Glioutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Timellbor I County: Region ..—F /40
Farm Name: Owner Email:
Owner Name: t'i c LPhone:
Mailing Address:
Physical Address:
Facility Contact: Vat y ed' Title: Phone:
Onsite Representative: << Integrator:�`S
Certified Operator: p �d�•Q Certification Number:/
v
Sack -up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Wt e- — 0JS
Design Current
EEO
Swine Capacity Pop.
Wean to Finish
oul
Wet Ptry
ILayer
Design
Capacity
I I
-ur
Pap.
I
Mill Design
Cattle Capacity
jDairy_Cow
Current
Pop.
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
1l . l',oult ,
Layers
Ca aci
to
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
113eef Feeder
Boars
Pullets
I Beef Brood Cow
Othe
Other
Turke s
I ITurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes D'go_ ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No dNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
[] No
dNA
❑ 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
J2(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
[�o
❑ NA
❑ NE
of the State other than from a discharge?
Page l of 3 21412014 Continued

1♦aciii Number: - S Date of Inspection:
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 [:]No �A ❑ 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 LOTIZ ❑ 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
DNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
[:]Yes
[ No
[DNA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
to
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
VO
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
dNo
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes CIONo ❑ 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): a... a . "v `-
13_ Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application'?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
M4
❑ NA
❑ NE
D Yes
®'No
❑ NA
❑ NE
❑ Yes
[ f ^No
❑ NA
❑ NE
❑ Yes ["'No ❑ NA ❑ NE
❑Yes E3 o ❑NA ❑NE
❑ Yes [?'Po ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
❑ WUP ❑Checklists [:]Design [:]Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes []rNo
❑ 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 9 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
[:3 NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Factlity l urnber: _ �T� Date of Inspection:_
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes []]�<o❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q Ko ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 2"No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes O o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �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 [` o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes ❑-No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? if yes, check the appropriate box below.
❑ Yes
FJTlo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
M<es
❑ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[ANo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
EJ-Dilo
❑ NA
❑ NE
Comments (refer to question #) Explain any -YES aiiswers.,and/or any additional recommendations or any other comments
Use drawings of facility to Better: explain pages as -necessary).
7V4-a
�32- N�y�t F.,te,6ua,4 o&e 4v e"<t bC74 (`?"Sz.h
Reviewer/Inspector Name:
c:, Phone:
Reviewer/Inspector Signature
Page 3 of 3

Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number: 090151 Facility Status: Active
Permit: AWS090151
❑ Denied Access
Inppection Type: Compliance Inspection
Inactive Or Closed Dale:
Reason for Visit: Routine County:
Bladen Region:
Fayetteville
Date of Visit: 09/17/2015 Entry Time: 02:00 pm Exit Time: 3:00 pm Incident it
Farm Name: J. B. Priest Farm 1
Owner Email:
Owner: Priest Farms LLC
Phone:
910-645-6697
Mailing Address: 155 Robbins Rd
Council NC 28434
Physical Address: 3917 White Plains Church Rd
Council NC 28434
Facility Status: 0Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farts: Latitude:
34° 29' 49" Longitude:
78" 31' 41"
NC 87 S. tum right at Monroe onto SR 1704 (Airport Rd) go 1.1 miles and turn left onto SR 1713 (White Plains Ch Rd) go thru
Lisbon on 1713 for about 1.5 miles to farm on left. TT=1 hr. 8 min TD=57 miles.
Question Areas:
Dischrge & Stream impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: James B Priest
Operator Certification Number.
16965
Secondary OIC(s):
On -Site Representative(s): 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 September 14
Sludge Survey Sept 14 0-3.7, P-3.4 49%
page: 1

Permit: AWS090151 Owner - Facility : Priest Farms LLC Facility Number: 090151
Inspection Date: 09/17/15 Inpsection Type: Compliance inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 4,696 2,000
Total Design Capacity: 4,896
Total SSLW: 660,960
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon
1
Lagoon
FARM 1
Lagoon
LAG 1
19.00
27.00
page: 2

Permit: AWS090151 Owner - Facility : Priest Farms LLC Facility Number: 090151
Inspection Date: 09/17/15 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?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
M ❑
❑
b. Did 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?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes No Na No
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led large
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
11011
❑
waste management or closure plan?
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
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M ❑
❑
maintenance or improvement?
Waste Application
Yes No Na Re
10. Are there any required buffers, setbacks, or compliance alternatives 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

• Permit: AWS090151 Owner - Facility : Priest Farms LLC Facility Number: 090151
Inspection Date: 09/17/15 Inppection Type: Compliance Inspection Reason for Visit: Routine .
Waste Al2plication Yes No Na No
Crop Type 1 Com, Wheat, Soybeans
Crop Type 2 Coastal Bermuda Grass
(Hay, Pasture)
Crop Type 3 Coastal Bermuda Grass w!
Rye overseed
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Dunbar fine sandy loam
Soil Type 2
Norfolk
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
❑
❑
❑
Management Plan(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 acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
E ❑
❑
Records and Documents
Yea
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
N ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other"?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

Permit: AWS090151 Owner - Facility : Priest Fauns LLC Facility Number. 090151
Inspection Date: 09/17/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yea
No Na Me
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
25. Is the facility out of oompliance with permit conditions related to sludge? If yes, check 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?
❑
N ❑
❑
27_ Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes No Na Ne
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,
❑
E ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
E ❑
❑
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 Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
M ❑
❑
page: 5

Type of Visit: &Co—mpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: QMoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: "7 Departure Time: County-, !!'��
Farm Name: ��/'<<�t�c/`t�f '[� Owner Email:
t� Owner Name: ( �t(' I Phone:
Mailing Address:
Physical Address:
Facility Contact: 1�4Y�� Title: Phone:
Onsite Representative: t integrator: o K
Certified Operator: Certification Number:
t
Back-up Operator: � SS � �C`ht � _ _ Certification Number:
Location of Farm: a. Latitude: Longitude:
Wean to Finish
I JLa er
Dairy Cow
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Non -Layer
Dairy Calf
Dairy Heifer
Current Dry Cow
Pao :' _ Non -Dairy
Mire,
911 .1
Design
D P,oultr. Ca aci
ILayers
Beef Stocker
Beef Feeder
Gilts
Boars
Non -La ers
I Pullets
Beef Brood Cow
Poults
Other
Discharims and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 3 0 ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No [3-NA' ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No [�t ONE
c. What is the estimated volume that reached waters of the Mate (gallons)?
d. Does the discharge bypass the waste management system?'(If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[—]Yes ❑ No
❑ Yes "E3<0o
❑ Yes ElNo
['NA
❑ NE
❑ NA
[] NE
❑ NA
❑ NE
Page I of 3 21412011 Continued k

Facili Number: - Date of Ins ection:
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 ❑ No [2-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 Ej1q6--❑ 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 ❑-K-5 ❑ 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 lro ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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 [ Iq—oo ❑ 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 E'No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
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
❑-i-o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[3'1 o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
D-g
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑'qo-
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E5`N_o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
E 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 ❑ 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 KNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes FJ'No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Faeili Number: IDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes LS 11O ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes lamKb- ❑ 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 [gam ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes a"o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes �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
To
❑ 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
D 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
dN o
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
El Yes
VNo
❑ NA
❑ NE
ditional recommendations or an other comments:
- - Y
draw
as necessa
Use drawings of facility to better explain situations s (use additional pages "T ry)::
p
Reviewertinspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Tto-
4�TFJI
Date:
4/ to]

B f WS- 17 /q 170
Type of Visit: WCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: (2�<o`utine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ( Departure Time: County QL� Region
Farm Name: T" ri �� e: ! Owner Email:
Owner Name: ]2 1 F, Phone:
Mailing Address:
Physical Address:
Facility Contact:
Iaf �� -C-w Title: Phone:
Onsite Representative: Integrator: M
Certified Operator: I- ��� a c, Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
" Design CurrentmEE_ill`
Design Current Design Current
Swine Capacity Pop.
Wet PouftryTCapacity Pop. Cattle Capacity Pop.
Wean to Finish
La er DairyCow
Wean to Feeder
'
Non -La er DairyCalf
DairyHeifer
Feeder to Finish
Farrow to Wean
Farrow to Feeder
;J Design Current D Cow
D , P�oul'° " Ca acit P,o Non -Dairy
Farrow to Finish
La ers Beef Stocker
Gilts
I
ers Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other MIMI
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[JNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
0 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
[ �o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 21412011 Continued

f
Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
aN"-
❑ 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
0<0
❑ 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
❑ 11<oo
❑ 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
gj-N—o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E;,W
❑ 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'N0
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Q'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [2-lQ'o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): r j�J U*li3 $OV151 IS e/yt�
13. Soil Type(s):
r
14. Do the receiving crops differ from those designated in the CAWMP?
15_ Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ENo
❑ 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 E?rNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E jNo
❑ Yes Uw.a ❑ NA ❑ NE
❑ Yes Q'"o ❑ NA ❑ NE
[] Yes
[�b
❑ NA
❑ NE
❑ Yes
L.Q "o
❑ NA
❑ NE
❑ Yes
[ o
❑ NA
❑ NE
[D Yes E]No ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fatili Number:" jDate of Inspection z'oY
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0,14o ❑ NA
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes M<o ❑ NA
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:
❑ NE
❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes �iQo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
,,�
L.ZKo
❑ 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
[ONo
❑ 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
Ca o
❑ 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
[3'�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
[3/No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[O�4o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�o
❑ NA
❑ NE
Comments refer to question # Explain -any YES answers and/ or any additional recommendations orany other comments "-
Use drawings of facility to better`exlatn situahons(use addttio
g tY P naI pages as necessary)
- - -
__�
C11CV( 44 ICA
Reviewer/Inspector Name:
4' -e&AstL,­ �), 3{ Z°!L(
`1kAI ju
Reviewer/Inspector Signature: Date:
Page 3 of 3
21412011

E
1
on LUAW.ater Quality s'
Facility Number ®- /�� � Division of Soil aad Water Eonservation � —� f �--
�+ Other Agency
Type of Visit: Q'Compliance Inspection r50peration Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: �utine O Complaint O Follow-up 0 Referral O Emergency O Other 0 Denied Access
Date of Visit: p— / Arrival Time: : 3 D Departure Time: ' y— County: ,. Region:
Farm Name: f r- 1 Owner Email:
Owner Name: „ „ CI '3 _Tr , '=S7__ Phone:
Mailing Address:
Physical Address:
Facility Contact: r-� Title: �' J�z•�. Phone:
Onsite Representative: 7t- r t 5 Integrator: 6P_fu r
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Gurreot` g'
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
C►►attic Capacity Pop.
Wean to Finish
La er
Daig Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . Pzoult .
C_a aci
P.o
Non -Dairy
Farrow to Finish
ILayers
I
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
-
Turkeys
O#her
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 K_No ❑ NA ONE
❑ Yes
[:)No
❑ NA
❑ NE
❑ Yes
❑ No
[:]NA
❑ NE
[:]Yes [:]No
❑ Yes 2 No
❑ Yes EINo
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Page I of 3 21412011 Continued

' Facility Number: jDate of inspection:
Waste Collection & Treatment
4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 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
® 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
[RNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the pen -nit?
❑ Yes
MNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
®No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[g No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes PINo ❑ 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 Types) J�"i�f �/ fi cic��iGr— Z-S.�_
13. Soil Type(s): r`
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [gNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [SNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes Z 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 RX No ❑ NA ❑ NE
❑Yes ®No ❑NA ❑NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ® No ❑ NA D NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes allo ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [A No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [&No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
D NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fili umber: - Date of Inspection:�-
r-
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 0 No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [Z No
[] NA ❑ NE
[DNA ❑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
0 No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Yes
LZX No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
[gNo
❑ 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
[S No
❑ NA
❑ NE
Comments (refer l gocstton ## Explain any YES answers and/or any additional ommendations or•any„other comments.
g h . yn �. Y
Use drawin s:of.facili. to better,ex lain situatinons use additional; a 4 sVas necessa ;,
2.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

F1
Type of Visit: jOrCornpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: &, outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: / e"7 Departure Time: County:
Farm Name: �g� /CQ /�f Owner Email:
Owner Name: J� . �. �%' j rs Phone:
Mailing Address:
Physical Address:
Region: La
Facility Contact: �ct✓/Crr Title: Phone:
Onsite Representative: x f� ,.r - /''��Sr Integrator: rnLr✓p
Certified Operator: Fr <:g T` Certification Number: �v
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
IN V
Design Current ,Design Current
Swine Capacity P. Wet Poultry Capacity Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Dairy Calf
Dairy Heifer
Wean to Feeder
on -Layer
Feeder to Finish
a
- r .. _
'"�''� �-a- ` °`
. i;Design Current
D , PoulCa a�ity Pao
Farrow to Wean
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
ILa
era
Beef Stocker
Gilts
Non -La era
Beef Feeder
Boars
Pullets
I
113cef Brood Cow
Other
Turkeys
Turkey Poults
Other I f
Other
Discharges and Stream Impacts
1. Is any discharge observed from any pan 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 R No ❑ NA ❑ NE
0 Yes [:]No
[—]Yes [:]No
❑ Yes ❑ No
❑ Yes allo
❑ Yes R1 No
❑NA []NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

' Fagiti`Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No 0 NA ❑ NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): / �` _
Observed Freeboard (in): .33
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., 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 KNo ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ®No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes O No ❑ NA ONE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes q No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes J4 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �jNo
❑ 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_fiv��s-
13. Soil Type(s): jV z
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [q No ❑ NA ❑ NE
❑ Yes ET No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
P No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[4 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
4Z No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
0 Weather Code
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

FaciuNumber: - Date of Inspection: G � —
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EK No ❑ NA ❑ NE
25. Is the facility out of compliance with permii conditions related to sludge? If yes, check ❑ Yes [ 'No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
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/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 EpNo ❑NA ❑NE
❑ Yes 54 No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes &No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes R� No ❑ NA ❑ NE
❑ Yes
f4 No
[-]Yes
No
❑ Yes
No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any_YES answers and/or any additional recommendations or.any other comments:'r1 r.'.
Use drawines of facility to better -explain situations (use additional pages as necessary). = zr
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �% 1ZEJ_TDCD
Date: OL,
21412011

g-/r-Zn/o
Type of Visit (3rVompliance Inspection U Operation Review Q Structure Evaluation U Technical Assistance
Reason for Visit outine 0 complaint 0 Follow up- 0 Referral 0 Emergency 0 Other ❑Denied Access
Date of Visit: -Z --/p Arrival Time: /Z' Departure Time: County: �4 a Region:
Farm Name: �'. ter; eS 'or — _ r/ Owner Email:
Owner Name: 41 : Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: �94-fNc� Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = 0 = & =" Longitude: = o = I = W
urrent Design
Design Onrren# Desig15l
Current
Swine
Oapacity Population Wet Poultry Capacpulation Cattle Capacity
Population
❑ Wean to Finish
Layer
❑Dairy
Cow
❑
❑ Non -La er airy Calf
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El 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 No ❑ NA ❑ NE
❑Yes
[I No
❑NE
❑ Yes
❑ No
�D,NA
NA
❑ NE
L7 NA
❑ NE
❑ Yes
❑ No
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes B No ❑ NA ❑ NE
Page I of 3 12/28/04 Continued

F9cility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA
El NE
a. If yes, is waste level into the structural freeboard?
❑Yes
B
L7No ❑ 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
No ❑ NA
❑ NE
(ief large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
L-'1"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 214o ❑ 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 a<0 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10, Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 3 No ❑ NA ❑ NE
maintenance/improvement? 11, Is there evidence of incorrect application? If yes, check the appropriate box below. ElYes 2<01 ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acccptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
/
12. Crop type(s) X!/ulce/4- e/axa tirL /�4 G/��.-.s:.✓ �O, 5.� N-i.J�a - .�.
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Lam], NNo ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
El Yes
E]'< ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
Er"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?
El Yes
,_.,,
9<0 t❑ NA
❑ NE
h-
r { question ) p ans��ers and/or any`reco m ndations ormany other cornments
Use drawings of facility better explain situation (use additional pages as necessary)
46
h' P ,
Reviewer/inspector Name Phone:
Reviewer/Inspector Signature:te�lDate: 7-ZG -ZGYQ
12128104 Continued

Eorwity Number: 0 -1-51-1 Date of Inspection
Re uired Records & Documents �,/
. 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes L1 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [2< ❑ 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.
❑ Yes
3<
❑ 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
9<o
❑ 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
L �N�❑
NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
DIX10
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ErNo ❑ NA
❑ NE'
29_ Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ErNo ❑ 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
�,
E7 o ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
ElYes
9<o ❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
,.,
Lf'No ❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA
❑ NE
Page 3 of 3 12128104

� s /0 -0 9 - zo 0 R
ion of Water Quality
Laciii—
ty NumberME
, j Q Division of Soil and Water Conservation
.--- - - -- 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 Q Other ❑ Denied Access
Date of Visit: ti `Arrival Time: ; d0 Departure Time: ; OD County: $���/d.✓ Region: _1g�_A X5
Farm Name: -7, -0, l' C'_1 es � � r� � _ Owner Email:
Owner Name: ti . g . f't/'���.5 t" Phone:
Mailing Address:
Physical Address:
Facility Contact: Ka c, N5 4 Title: 7 -e&; S7pe- C Phone No:
Onsite Representative: %�� �us�N Pry 4s f integrator: /y1urut X.I-d-1,JAl
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: L] 0 ET
1:1 Longitude: 00 [� s = {6
Swine
_Wean to finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
�: ❑ Non-Layet
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 Population.;;°
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ffNo ❑ NA ❑ NE
-'A
❑ Yes
allo
EN
❑ NE
❑ Yes
❑ No
R<A
❑ NE
L7NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ NA
❑ NE
Yes
[IL�1
�P�
No
❑ NA
❑ NE
12128104 Continued

flacilitj Number: Qg— /5/ Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): % y
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ yes
Ej o ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
ETNo ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes <oIs ❑ NA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 8< ❑ 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 BoKo ❑ NA ❑ NE
maintenance or improvement?
Waste Aaulication /
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes D 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 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drilfl ❑ Application OutsideofArea
12.
/
Crop type(s) f� 6i+1 wdtl �N^`c [ [ rn, �nJ 0, S •J SD 41WV "I' Coe*
13.
Soil type(s) A ht- /1VV' -
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
B<o ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
L -<oo El NA
El NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
,
!�<oo El NA
El NE
El17. Does the facility lack adequate acreage for land application? Yes
NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? El Yes
no�
LI NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ) ` Phone: 7aE
Reviewer/Inspector Signature: Date: e —2& —2—oo /
111,151U4 conttnuea

r.- -zo -?5� q
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 ETIN. ❑ NA ❑ NE
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑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
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain InspectionsEl Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
DlNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E N/o
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ NA
[INE
25. Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
�B<oo
Ko
El NA
El NE
26. Did the facility fail to have an actively certified operator in charge?
ElLYes
,L'
<
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ErNo
❑ NA
❑ NE
Other Issues
2& Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El yes
�
o�❑
NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
,B
B<0
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 L Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
aN.
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El[ Yes
No
[I-
El NA
❑ NE
33. Does facility require a follow-up visit by same agency?
El Yes
,
E No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

_13-T114S
151
Type of Visit {)-6ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint Q Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: C-�
Farm Name:
Owner Name: _ •S j la ! 1� 5
Mailing Address:
� 3t7 County: *e_`-9c1c v Region:
Owner Email:
Phone:
Physical Address:
Q , 9/�
Facility Contact: �1 ,e�11 G! A.N Title: /eU. � Phone No:
Onsite Representative: /\ � Integrator: I / � ��_
Certified Operator: J at~..�s a • Pi�,i<s� Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [= o ❑ r [�dl Longitude: 0 ° ❑' =
Design
Current Design. Cnerent Design Current
Vt'et Paultr�} CapacityPopulation Cattle Capacity Populati
RtapacityAVpulation
n to Finish
❑ La er
❑ Dai Cow
II
to Feeder
❑ Non -La er
❑ Dai Calf
krean
er to Finish
= ❑ Dairy Heifer
r ..
El Farrow to Wean
Dry Poul#ry d ° fir' ❑ DryCow
y
❑ Farrow to Feeder'"
El Non -Dairy
El Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Bcef Feeder
❑ Boars
❑ Pullets
❑ Turkeys ElBeef Brood Cowl
a ' -!td .
❑ Turkey Poults
Other
❑ Otherw
❑ Other �Number;of�Structures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
IyNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[yNo •
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
qNo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (Ifyes, 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 adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
( No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: D
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 719
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?
i
❑ Yes [ No ❑ NA ❑ NE
[I Yes [ No ❑NA ❑NE
Structure 5 Structure 6
❑ Yes
q No
❑ NA
❑ NE
❑ Yes
[I No
❑ NA
❑ NE
If any of questions 4-6 were answered ves, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement'? ❑ Yes 0 No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes qNo ❑ 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 (DNA ❑ NE
maintenance or improvement? /
Waste Application
10, Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes V No
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop
//Window
` ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �L�,"1! dA _ L 17-7 F pit�7�/�'� .....� _. �i�(tl� � �✓ L� -S ), S,1 i✓. G
El NA ❑NE
54
13.
Z
Soil type(s) ��� + Na
—
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[2fNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
EYNo
❑ NA
❑ NE
16,
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[7 No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
WNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
�R No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recoinmendations.or any other comments.
Use drawings of facility to better explain situations. (use' additional pages as` necessary).:
i
7
Reviewer/Inspector Name �� S Phone: V40, P3.33.3 O
ReviewerAnspector Signature: Date: —,a 7-00
Page 2 of 3 12128104 Continued

;4
Facility Number: O q -/5/ Date of Inspection D D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (;M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? if yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design
g El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ElYes LM 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
1
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?
[I Yes
[�No
❑NA
El NE
❑ Yes
[4fNo
❑ NA
❑ NE
❑ Yes
JNo
❑ NA
❑ NE
❑ Yes
1� No
❑ NA
❑ NE
❑ Yes
1� No
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes
[O No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
F] No
❑ NA
❑ NE
Page 3 of 3 12128104

M
z'_A^A -Ld 6 7 k R :7- 2. V- 0 7
l Division of Water Quality
I
=Facilityumber p 9 J 0 Division of Soil and Water Conservation
- - - - 0 Other Agencyt
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ZG D / •1 Arrival Time: 4_( Departure Time: ,ADO County: �lGa�^� Region: 0
Farm Name: `S O 8 • Pr CSl Fu'Aq Owner Email:
Owner Name: T.R. pv_45 � Phone:
Mailing Address:
Physical Address:
Facility Contact: 1Sa44 u b ujgAl Title: Ice— S?GG Phone No:
Onsite Representative: Integrator: e5�j c.J /✓
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: E71 o =' ="
Longitude: = 0 0 [ = „
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
❑ Wean to Finish
❑ Wean to Feeder
14 Feeder to Finish
$DO
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man -trade?
Design Current
Cattle Capacity Population;
❑ Dairy Cow
❑ Dairy —calf
❑ Dairy Heifei
❑ Dty Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes EXNo ❑ NA ❑ NE
❑ Yes [;IrNo ❑ NA
❑ NE
❑ Yes No ❑ NA
❑ NE
❑ Yes [� No ❑ NA
❑ NE
❑ Yes
No ❑ NA
❑ NE
❑ Yes �fNo ❑ NA ❑ NE
12128104 Continued

acithy Number: 0 9 — /SI Date of Inspection DZ
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes oNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes PNo ❑ 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 �VNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes P)No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes PNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ElNA ElNE
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 9NNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ FAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acccptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
cc/_
13. Soil type(s)ALE
If
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �m No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes V 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
11No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
W No
❑ NA
❑ NE
IComments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector dame G,1/t�s Phone: gle, �y53.33oo
Reviewer/Inspector Signature: Date: ��yG�ZB 7
12128104 Continued

i 7
Facility Number: O 9 —/s/ Date or Inspection lv D7
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [19 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VI No ❑ NA ❑ NE
the-appropirate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes M No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ej No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[;R No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
P No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
17No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
tom 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
rU No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

z
Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (DRoutine O Complaint O Fallow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: fa D Arrival Time: 2 ; Departure Time: 3: / County: Jr.>14 dle Al Region:
Farm Name: �� 1�- _ �t' + e S -� r-n t.-M I Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: SS
Facility Contact: A; QQgi, 1!4L :.✓ Title: Phone No:
Onsite Representative: cam. z Y�, �S 19. d ,S� Integrator: akAlg �la?✓i✓
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = , = u Longitude: E__1 ° = u
Desigtt Current Design
Current
Design Crr uent
Swine Capacity Population Wet Poultry Capacity
Population Cattle
Capacity Population
❑ Wean to Finish
❑ La er
El Dairy Cow
El Dairy Calf
El Dairy Heifer
❑ Wean to Feeder
❑Non -La er
Feeder to Finish
roa>."
El Farrow to Wean
�'
Dry P-.odItry
❑ D Cow
ElFarrow to Feeder
- "
❑ Non -Dairy
❑ Narrow to Finish
❑ La ers
❑ Non-ts ers
❑ Beef Stocker
❑Beef Feeder
❑ Beef Brood Co
❑ Gilts
❑ Boars
❑ Pullets
❑ Turkeys
Other ❑ Turkey Puults
❑ Other ❑ Other
I Number of Structures:
I
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
III
❑ 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
93 No
ElNA
ElNE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
E/ No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

{
Faeiility Nu m ber:d
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?
[I NA [I NE
El NA El NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: 1CI�
Designed Freeboard (in): f -!
Observed Freeboard (in): 3 7
❑ Yes [A No
❑ Yes 10 No
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 ONo ❑ 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 [XNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ?No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA ❑ NE
maintenance/improvement? /
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift�1 ❑ Application Outside of Area f
12. Crop type(s) 13«1k, I_ / , (�rvu-� ' __ �.t2/��o.`.tI t"A . S, � 75, u� A..IS A J1 e— T
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
14 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[XNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[�No
❑ NA
❑ NE
Reviewer/Inspector Name — s Phone: (9/0j !9=133 — 33 0 O
Reviewer/Inspector Signature: a'a_s_� Date: O
Page z of j 12128104 Gonhnued

r f
` Facility Number: Date of Inspection
'Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes IyNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El maps El other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Tqo
ElNA
ElNE
ElWaste Application ❑ Weekly Freeboard ElWaste Analysis ElSoil Analysis ElWaste 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
[yNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
PNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
E�No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
PNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
PfNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�gNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes �gNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
V 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
O 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
VNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/lnspector fail to discuss review/inspection with an on -site representative?
❑ Yes
VNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[ WNo
❑ NA
❑ NE
Additional Comments and/or Drawings;
T
Page 3 of 3 12128104

Type of Visit ® Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit 46 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: � Arrival Time: OQ Departure Time: County: 9 .140i-e.tA Region: Cif
Farm Name: -_ S?� _ ^r�r f= s± &.OaA # Owner Email:
Owner Name: �e_S +-, Tr- . Phone:
Bailing Address: 3 Z Li s 60-, �a tea, c i /�C._ z b Y3 y
Physical Address:
Facility Contact: / Title:: /P►h/one No:
Onsite Representative: ___ & DtJatraLµ / —Z 1_aS'7-AV - Integrator: __� yt Lt fT " - s9CtZ..4/&,
Certified Operator: , ��D� G S" Sr Operator Certification Number: 1`0
-�otw.LS g f r'! �t� Back-up Certification Number: Y Back-up Operator: p Certi
Location of Farm: Latitude: 0 o ❑ ' = u Longitude: = ° Q , [=I u
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish 4 iq
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish -
El Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non-Layet
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 Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: F/ l
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 WNo ❑ NA ❑ NE
❑ Yes
❑ No
KNA
❑ NE
❑ Yes
❑ No
E!VNA
❑ NE
2�NA
❑ NE
❑ Yes
❑ No
❑ Yes
2INo
❑ NA
❑ NE
❑ Yes
[&No
❑ NA
❑ NE
12128104 Continued

Facility Number: - fjr`� Date of Inspection Z
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
Identifier:
Spillway?: +1a
Designed Freeboard (in): 19 r
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes E.No ❑ NA ❑ NE
❑ Yes ❑ No RNA ❑ NE
Structure 5 Structure 6
❑ Yes KNo ❑ NA ❑ NE
❑ Yes [RNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes KNo ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes EkNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [R.No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [ANo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [K No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) ram?rWyda_ - i Co_� e_d Swsa.� �u� •1 - S'C� adC So s► {��+a..tiS,
13. Soil type(s) 1�,V A ) 1f2 6
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Ej 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 UNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes WNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes RNo ❑ NA ❑ NE
ReviewerlInspector Name DM ;- kw Phone:
Reviewer/Inspector Signature: Date: rzLR f o��
12/2R/4Q Continued

>!ac� ilit3t Number: 7 — /s( Date of Inspection
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 ZNo ❑ NA ❑ NE
the appropiate box. ❑ wup ❑ Checklists ❑ Design
g El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes (WNo ❑ 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 [9No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0 No ❑ NA ❑ NE
24.
I9D
Did the facility fail to calibrate waste application equipment as required by the permit? /8 9
❑ Yes
[82qo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit? / 6✓r
❑ Yes
[. No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
(KNo
❑ 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
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
W 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
Wo
❑ 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
gNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
KNo
❑ NA
❑ NE
Addthonal;Co"ents and/ror Drawtngs� • � r °`�"; �`� '° a' ,� � a a
12128104

(Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation I
I Reason for Visit 0 Routine O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time: % 5..
O Not rational Q Below Threshold
® Permitted M Certified Conditionally Certified 0 Registered Date -Last Operated or Above Threshold:
a F v
•
Farm Name: r c'e �- F �a I. N County: 1/� �e•v
Owner Name: e.:.._. P- + f -- • Phone No:
Mailing Address y Co "Av G o' /, - Al e4s y.
Facility Contact:
Title:
Phone No: —21" O V9
Onsite Representative: J. B. _&.1,.. i- Q+ � � ,i integrator. , � _- rn_.r.�. ---
Certified Operator: _ Sx't . s_ Q . _ Qx. s - 7 fi - Operator Certification Number.
Location of Farm. -
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0• �u Longitude �• �Du
Disc es A Stream Impacts
l . Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection A Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Identifier: __W _. .......
Freeboard (inches): aG ry
❑ Yes ❑ No
NI
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [3 No
❑ Yes 6 No
Structure 6
MUM Contbzued

Facility Number: — ,(S/ Date of Inspection /1 /
.5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancerimprovement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste AnRlimtion
10. Are there any buffers that need maintenance improvement? []Yes No
I I - Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes CENo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. `"op rAn .V e- rA-G Z-IOC / vs / l_^P-^, 1.ji e4T. Cn Li JJ
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWPOP)? ❑ Yes (] No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes O No
c)'Ibis facility is pended for a wettable acre determination? ❑ Yes EP No
15. Does the receiving crop need improvement? ❑ Yes q No
16. Is there a lack of adequate waste application equipment? ❑ Yes P No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes qNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 12 No
I9. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Air Quality representative immediately.
10 Field Copy ❑ Final Notes
Reriewer r Name
Reviewer/Inspector Signature: Cam- Date:
12112103 / Continued

Facility Number: 9 - /S/ Date of Inspection y !3
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23_ Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
[I Yes
❑ No
27_ Did Reviewer/Inspector fail to discuss review/iaspection with on -site representative?
❑ Yes
❑ No
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29. Were any additi ;:-A problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
Yes
❑ No
31. if selected, did the facility fail to install, and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
IR No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
IN 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 10 Inspection After I" Rain
❑ 120 Minute inspections ❑ Annual Certification Form
I2/l2/03