090198_INSPECTIONS_20171231

,(3 Division of Soil and Water Conservation [3 Other Agency��
O.Division of Water Quality
IGIRoutine Complaint O Follow-up of DWQ inspection O Follow-up of DSW C review O Other
Date of Inspection
Facility Number o
Time of Inspection Z: � 24 hr. (hh:mm)
© Registered p Certified 0 Applied for Periniitt ®Permitted 113 Not Operational] Date Last Operated:..
Farm Name:,✓,./ S !`�r5-=.•`� ..................... County:............ ....................---.............
Owner Name:........l�-nPlt�......... Phone No' : � �/��...r� fit... �1. ......................
Facility Contact: 1 f..... Title : ..................... .....................�.~..7...r .....
Mailing Address: ........ r.�'... .......
Onsite Representative:....., �
Certified Operator:..-... t�' r... lac.r�.....................................
Location of Farm:
....... Phone No: ...........................
.f....�....... ...--- ........... ............. .......•.........
Integrator:.... G--.."7..........................................
Operator Certification Number ,--.z.�.y!�
.....................
Latitude • = ` = « Longitude ' 0' «
Design Currents
� Design Current Design Current
Svrxixe A Capacity< PopulationPoixltry
,,
Capacity Population Cattle. Population '
Y.
�kCapacity; n
"
Wean to F
❑ Feeder
'fi
Feeder to Finish
_
V: ..� .,.: s 3 ,
❑ Other
® Farrow to Wean
`iGZ
a.fi
Farrow to Feeder
r'
a �Tota1 Design Capacity as K:z
t� f x
Farrow to Finish
❑ Gilts
/Zz
✓
❑Boars
otaISSLW
k'# 4
wR¢e
umber of�Lagoans !Holding Ponds ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
❑ No Liquid Waste Management System z.
6
❑ LayerDairy
❑ Non -Layer
� •� ❑Non -Dairy
Genera
1. Are there any buffers that need maintenancelimprovement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge. is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (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)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
1� 7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes CkNo
❑ Yes 91 No
f
❑ Yes
No
❑ Yes
Wo
II
N�
❑ Yes
FZNo
❑ Yes
gNo
❑ Yes
KNo
❑ Yes
wo
❑ Yes VNo
❑ Yes V No
Continued on back

� F
i Facility Number:0,9
1 8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (l.agoons.Ilolding ,Ponds, Flush Pits, etc.)
9. is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (ft): .............4+: A .. .......,...........:.........
10. Is seepage observed from any of the structures?
11. is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
l5. Crop type
..........,,if.r.....,.E......................................................................
❑ Yes ANo
❑ Yes 0 No
Structure 5 Structure 6
........................................................................
❑ Yes �?' No
❑ Yes MO
❑ Yes JX No
❑ Yes KNo
❑ Yes Wo
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities On[X
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0: No.vitilatioitsor deficiencies.were-noted during this:visit.-.You.will receive no,fliriher,::
O&espatidenee about this:visit:
XYes ❑ No
❑ Yes *0
Yes ❑ No
KYes ❑ No
R Yes ❑ No
❑ Yes tUNo
❑ Yes fWo
❑ Yes ,(No
Xes tr
❑ Yes R No
r
Gas!-���✓ d� /�'.��-- Gi.Q-S � ���,¢S � /f� �d� /�
Reviewer/Inspector Name
7125/97
Reviewer/Inspector Signature:
Date:

D. Division of Soil anj
© Division of Soil at;ii
.Agency
IQ Routine Q Complaint 0 Fallow -up of DWg infection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection
Time of Inspection F�l 24 hr. (hh:mm)
E3 Permitted © Certified [] Conditionally Certified E3 Registered 0 Not O erational Date Last Operated:
Farm Name: ....... Y_.t.'f10J.-CIR........ i.... ... County:.........�.............................
Owner Name:........................................... C .� L,�,,, ..... Phone No. 22" - Z 1 t i
..... 1-. ...............-._.-. .. ....... ~..... ....... -.......................................................................................
Facility Contact: ...... W.C.tJ.4�...... / E 1f . 1 _.. Title: .... L Gi ���.�il.I............. Phone\io:...................-._..............
'flailing Address: ...... PQ...&.. C.......� 5............................................................................j�'�?5�...�.LCL..._.l.................... rr....7........../..../...........
Onsite Representative: ... N t! „), (,trvl Integrator:
Certified Operator:...... �. ....,I,JGi E.._. 1. ...................... Operator Certification Number:..........................................
Location of Farm:
.................................................. .......................................................................................................................................... .........................................................................
Latitude 0 ' - Longitude C�• 6 44
Design Current ,; ... Design Current Design .Current `;
<Swine :Capacity Population ,Poultry Capacity;:,Population Cable Capacity . Population
Wean to Feeder
p
Feeder to Finish
2
Farrow to Wean
(� Z
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts t ,
❑ Boars
fl Non-
- M Non-Dai
❑ Other
Total Design Capacity
- = _ Total SSLW
111'nmber of Lagoons '�� ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holdm ` Ponds /Solid Traps ❑ No Liquid Waste Management System-=
59- _ ._. p
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes *No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes [ No
b. If discharge is observed, did it reach Water of the State? (If ycs, notify DWQ) ❑ Yes ' 1 No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon s Stott? 1C es, notify DW ❑ Yes �No
g ) P� g Y• { yes, ) Q)
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [KNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 9No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: /i 1!
Freeboard(inches): i1...............................................................................................I..........---................................
.......... . .....I......... ..................t .............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] Yes J� No
seepage, etc.) Y �-'
3/23/99 Continued on hack

Facility Number: L0— Date of laspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑Yes
f�No
(If any of questions 4-6 was answered yes, and the situation poses an
Y
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
XNo
8- Does any part of the waste management system other than waste structures require main tenatice/improvement?
❑ Yes
ONO
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
ANo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
)rNo
11. Is there evidence of over application? ❑ Excessiv Ponding ❑ PAN
❑ Yes
KNO
\\
12_ Crop type &C-144U.4 a—
13. Do the receiving crops differ with those designate to the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
f No
\
�WNO
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
;A(No
16. Is there a lack of adequate waste application equipment?
❑ Yes
Po
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? [:]Yes KNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes 4
No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes �No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? El Yes � `NO
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes RNO
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes VNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes j�rNNo
24. Does facility require a follow-up visit by same agency? ❑ Yes A No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes � No
Q.violaiicjris oe d�#ieiencies mere poled dewing {his,visit' - Yoti will-f&0*0 titi rurthgr \\
:' corres oridenke* A6i f this visit.: .. .... . .
Comments'(refer to'question #). Explam-any YES answers and/or any recommendaitons or any other coiiutments:
Ilse drawuigs of facihtyV to betterexplatn;situatians (use additional gages as -necessary) = -
7A S
i s � n e� 5 7�
� 12 o
i ��' � �i`a -- � C, 5 ,bee t �>o
��r�e
AL
Ave
w a � �/44,7'-ed
/ .ti �'�. �l
d->C ) � 9 ' a . LJ h 4 s
ca.�
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: 3-
3/23/99

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

10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DS_WC review 00ther
Facility Number Date of Inspection a -
Time of Inspection 24 hr. (hh.mm)
Kpernijttedfi Certified [3 Conditionally Certified 0 Registered 0 Not O erational Date Last Operated: ..........................
Farm Name: ...............?.n,11 AC t+ec31.J "v1. County:............1.�lOi.'�n1.............�................-.....
.............................................. .`............. ..--....................
Owner Name; ,,,,,,,,,,,,,,,, �- Phone No: .......:��..................c......I—..--. ...............................
Facility Contact: ....................... .. Title: Phone No:
Mailing Address: ............. >�`.. L ........
y1...............A.:�.......-........�-:.................. f... N a
Onsite Representative:..... ......L1...`. 4e `.� G�/'Yt ................... Integrator: ....�.`.�...... �!�`} ..'...".r'%'L�
ii "'....�.. .. .✓✓J
Certified Operator: .....
rL _ ...... Operator Certification Number:,,.,,,,,,,,
........ K. ..................
Location of Farm:
........................................... ........................................ ................ ............................ ........... ........ ........................................................... .................... ..........................................
Latitude 0 • 6 64 Longitude 0 • 9 C�G1
Discharges & Stream Impacts
Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If ycs, 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 8 Treatment
4. Is storage capacity (freeboard plus storm storage) Icss than adequate? ❑ Spillway
Structure
Identifier: I /
Freeboard (inches): .......................
Structure 2 Structure 3 Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed? / (ie/ trees, severe erosion,
3/23/99 A4� = fe i c1i5T:J- wee5 �0 C/�wl fire seepage, etc.)
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes /No
StructkN
l
❑
'ontiAued on back

-®,Division of Water Quality
Q Division of Soil and' Water Conservation -
O'Other Agency _
of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit, /1 Time: %Cv& Printed on: 7/2112000
d
O Not Operational O Below Threshold
® Permitted ® Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .................
Farm Name-1✓!a"` e��`^—.. County:,tt.��f'N....................... ......................
G............................................................. Q —3z
OwnerName: ...................... ............................................................ Phone No:7�6..1�ia.......... ....... ..... .
Facility Contact:.........�r��l'�......................Title:.....................{......................................... Phone No:...................................................
..
Mailing Address: .........�f2.... 1.. ......��....V. � .����.!{1.�....�s��:CT......................_........ ..........................
...
Onsite Representative: .......�1....A�. ��!1 .......... ....... integrator: --,
p-.......
Certified Operator: ,, ,. ..... Operator Certification Numher:-.......-
Location of Farni:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude C�• �� �== Longitude �• �° 0°
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Po ulation
Wean to Feeder ❑ Layer I 1 ❑ Dairy
Feeder to Finish 10 Non -Layer I A 110 Non -Dairy
Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present j❑ Lagoon Area J❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste ;Management System
DischarZes & Stream Impacts
I. Is any dischargc observed from any part of the operation? ❑ Yes 9No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes XrNo
b- If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes ,® No
c. If dischan,e is observed. what is the eAiinated slow in gal/min?
d. Dees discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes, No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes e® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes X No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ;RNo
Structure I Structure 2 Structure ; Structure 4 Structure 5 Structure 6
Identifier: ........... r31................ ......... .. ..... ..................................... ................-..........................................................................................
ter.... -..
Freeboard (inches):
5100 Continued on back

Facility Number: 4 — Date of Inspection 0 Printed on: 7/21/2000
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
closure plan? ❑ Yes No
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? [:]Yes KkNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes WNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes to
Waste application
10. Are there any buffers that need maintenance/improvement? ❑ Yes t3v0
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes -WNo
12. Crop type
13. Do the receiving crops differ with those designa ed in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes P'No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes F3 No
b) Does the facility need a wettable acre determination? ❑ Yes RNo
c) This facility is pended for a wettable acre determination? ❑ Yes R No
15. Does the receiving crop need improvement'? Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes R No
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available'?
Oc/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
0e/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Tnspector fail to discuss review/inspection with on -site representative'? ❑ Yes (a No
24. Does facility require a follow-up visit by same agency? ❑ Yes X] No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 5d No
din violations;or deficiencies v�ere noted dking 0 s;visit'.- Yoitt wi�l-ree�ive Rio 1Furthetr ; ;
corres ori�eirre. about this visit... .. - . ... ; • .
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
Reviewer/Inspector Signature: xis- ',��A2P41_1Lil! Date: (�// J� vy 5100

Facility Number: Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or 1+iclow Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes IR No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes WLNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ®No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
Additional omments and/orDrawings:
AL
5100

Type of Visit ® Compliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit 8 Routine O Complaint Q Follow up Q Emergency Notification O Other p Denied Access
Uate or Visit: �/ Time:
Facility Number p
Q Not Operational Q Below Threshold
® Permitted M Certified 0 Conditionally Certified Q Registered Date Last Operated or Above Threshold: ................. .......
Farm Name: f r.....�'r! .....c..lir�...�.t.� `. ........................ County: ......... .._................. .......................
Owner Name: ............�/.�/...../.�i.�.r...��.'....................................................... Phone No:...L..LO�..�j0.......� �f��................
Facility Contact: �%�'i /T �i�elQNr Title. ...�.................... Phone No:...........................................-.......
Mailing Address:..... r¢ ... /✓, ice./ '`y1 !..!! ..5 .. v�- ...... ..i•.•--------.....------....._.....................................
Onsite Representative:fq�'(J�l�,C�•�lf ..... Integrator:,r�----!Cjr.....................
Certified Operator:.-- ......
4......_ ...i20l.JTN Operator Certification Number: .........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 41 Longitude ' 6 .4
Design Current
Swine Canarity Ponnlation
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I I[] Non -Dairy
Other
Total Design Capacity
Total SSLW
Number of Lagoons Z ❑ Subsurface Drains Present ❑Lagoon Area ID Spray Field Area
_ -
Holding Ponds Solid Traps, ❑ No Liquid Waste Management System
_...., _ _
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes J4' No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made`? ❑ Yes 'KNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes KNo
c. If discharge is observed: what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes Id'No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ENo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ,fNo
01/01/01 Continued

Facility Number:
Date of Inspection
Waste Collection & Treatment
4_ Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ;W No
Structure i Structure 2 Structure 3 Structure 4 Structure ] Structure 6
Identifier:
Freeboard (inches): Y ��......................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes RNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes P 'No
EIf any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes K No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes kNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes /kNo
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type p
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes XNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes CKNo
b) Does the facility need a wettable acre determination? ❑ Yes IgNo
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
17. Are rock outcrops present?
18. Is there a water supply well within 250 feet of the sprayfield boundary?
❑ On -site ❑ Off -site
❑ Yes KNo
[]Yes XNo
[-]Yes ;j(No r1.4
77
�
❑ Unknown o /"lA
Required Records & Documents
19. Fail to have Certificate of Coverage & General Permit or other Pen -nit readily available?
20. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WU� cheeky, design, m�ps, etc.)
21. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
22. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
23. Did the facility fail to have a actively certified operator in charge?
24. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
25. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
26. Does facility require a follow-up visit by same agency?
27. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Odor Issues
28. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
❑ Yes PkNo
❑ Yes egNo
❑ Yes I�No
❑ Yes F110
❑ Yes RIN0
❑ Yes 'QNo
❑ Yes N, No
❑ Yes KNo
❑ Yes t<No
'15(yes ❑ No
29. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes )A No
01/01/01 Condnued

♦' ,ti
FacilityNumber: D Q —/p Date of Inspection 7 a/ Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes K-No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes XTNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ONo
30. Were any major maintenance problems with the ventilation fan(s) noted? (Le. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes( No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
J

Type of Visit: 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral 0 Emergency O Other 0 Denied Access
Date of Visit: / r] Arrival Time: D Departure Time: County: Region:
Farm Name: `J!i`j �Or.✓ vt+ Owner Email:
Owner Name: rLi ftG �� i Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:r+
j� n
Certified Operator:
Back-up Operator:
Title:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
C►apacity
Pop.
Cattle Capacity Pap.
Wean to Finish
airyCow
Wean to Feeder
I JNon-La er
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D . P,oul
Ca it—
P,o
Non -Dairy
f)njFarrow to Finish
2'L
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
c7 D
Pullets
Beef Brood Cow
Turke s
Other
Turke Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
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 F No ❑ NA ❑ NE
[:]Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
O Yes No
0 Yes No
P NA ❑ NE
IR NA ❑ NE
P NA
❑ NE
❑ NA
❑ NE
❑NA
ONE
Page I of 3 21412015 Continued

I'aci umber: - 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 �o] NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: '
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33f 7
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes p6:j No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
FINE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 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 Acce table Crop Win
dow ❑ Evidence of� Driift 6�.
❑Application Outside of Approved Area
12. Crop TYpe(s): I9Je � GAS 1v�1 ! t C/! -r '� - QI" olt'e']
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?
IT Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
� No
❑ NA
❑ Yes
F3 No
❑ NA
❑ Yes
� No
❑ NA
❑ Yes
❑ Yes
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes
the appropriate box.
❑ NE
❑ NE
❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below.
❑ Yes
EP0
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Tran
fens
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ANo
❑ NA ❑ NE
Page 2 of 3
21412015 Continued

4.11 loft
Fac' '' ,Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1� No
❑ NA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
[] NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes 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 fn 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
No
❑ NA
❑ NE
❑ Appitcation Field ❑ LagoonlStorage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [PNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes P No ❑ NA ❑ NE
Reviewer/inspector Signature: Date: Date: _0441--
Page 3 of 3 21412015

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 4D Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: t6 Arrival Time: ! eparture Time: p:� County: AL� Region:
Farm Name: p/ fl �} C /42—, J0 l•✓ rtb►'i" Owner Email:
Owner Name: I l �►?ac e )I" aC Phone:
Mailing Address:
Physical Address:
Facility Contact: 64W Title: Phone:
Onsite Representative: Integrator:
Certified Operator: A"
��( G-.4
Back-up Operator:
Location of Farm: Latitude:
Certification Number:
Certification Number:
Longitude:
Design Current
=
Design
Current
Design Current
Swine
Capacity Pop.
Wet 1'otiltry .
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -Laver
Dairy Calf
Feeder to Finish
U4Dairy
Heifer
- Farrow to Wean
en
Dry Cow
Farrow to Feeder
D , Pso�l ..
Ca aci
Pa P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
/
Pullets
Beef Brood Cow
Turkeys
OtIthier9f,Turkey
Poults
Other
10ther
_.. ai►�ls.. . ,...
-x.aiaN ._.., ..., .
-.,,iYWWyw.t.+W.e.�..aba.�.:swr-aiar..
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes 1;5 No ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No V9 NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ® NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No VS 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 �9 No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: -14=5
/ jDate of Inspection: �J/Jlf //y j
Waste Collection & Treatment ! q
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 (9 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ 33 1 -2i`'
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 DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes �No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) T
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 P No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes q No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable
Cr p Window %❑ Evidence( of Wind Driiftt ❑Arpplica1tion Outside of Approved Area
12. Crop TYPe(s)'1UANn� I �'�i s�'-Ian, / , tom% V} l Cs-1'13►(v l._ �'L�
. ►�L-'��,!]li]�'7���'�Jlt'���!.:i'►�/lam
14. Do the receiving crops diffel from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
0 NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
01 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
Ir
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[] Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
tNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Ep 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 1� No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �q No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili 'Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [P No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ` 9 No ❑ NA ❑ NE
the appropriate box(es) below. T
❑ 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 T No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 99 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 4 No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
❑ Yes 1� No ❑ NA ❑ NE
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
Ir
❑ 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
M 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
[M No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
fp No
❑ NA
❑ NE
,or any aaw
nal nattes;as
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: %
21412015

i ype ui v isit: W i.ompuance inspection v mperanon xeview lJ airucture Gvaivauon v IL ecnnacal Assistance
Reason for Visit:y Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 23 Arrival Time: OQ•Departure Time: WnazlCounty:
Farm Name: �11 aC ��.-� Owner Email:
Owner Name: M cQaeevt t !? . - .o" Phone:
Mailing Address:
Physical Address:
Facility Contact: V-zho
Title: Phone:
' Onsite Representative:
N
Certified Operator:
Kt'citael
Ct,�G(i1
Region: )q90
Integrator: / �� �j1ayo
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
battle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder Non -La
D Calf
Feeder to Finish
jC
'-aaci
D Heifer
Farrow to Wean
2
n
Current
Cow
Farrow to Feeder
D Pont
P,o
Non -Dairy
Farrow to Finish
Z
Layers
I
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
19
Pullets
Turke s
Beef Brood Cow
Other
Other
I
Turke Poults
I 10ther
7
i
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [:]Yes [:]No WA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

jFaeWty Number: - lysj 1 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
O No
❑ NA
❑ NE .
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
Vg NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 37 a 2'v
5. Are there any immediate threats to the integrity ofanyof the structures observed?
❑ Yes
00 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
FM No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [B No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes [P No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes 1�] No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 5 No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [2T 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 ❑ Evide ce of Wind Drift Application Outside of Approved Area
12. Crop Type(s): eQS4 SCi ` -1 Sp ` CW'r'L_0
13. Soil Type(s): un2&IdsmzZ EC
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
P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E0 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[�LNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
P No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
2l . Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [$INo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ® No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

e �
Faei6 Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes 09 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes f�) No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
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?
necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
[�] No
❑ NA
❑ NE
❑ Yes
Q3 No
❑ NA
❑ NE
❑ Yes
El No
❑ NA
❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes No
[—]Yes ® No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: 110_ ? _3
Date: kbqh�3�1
21412014

611t/3
Dwrs-nn of W-------------------
UM'
Facility Nber 1�... 1 - Division oftSoil and Water Conservation
® Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: l - Arrival Time: Departure Time: O: County:D
Farm Name: /!l1t4G{e SOGv fii� _ Owner Email:
Owner Name: `1' rky10.C12 F,, w- U-C Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:ry�
Phone:
Region: ?C)0p
Integrator: &a24e14_A0 tcAP7
if
Certification Number: [ rZ
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
:.
Design Currents` Design Current
Design Current
Swine Capacity Pop Wet Poultry . Capacity Pop.
@att]e Capacity Pop.
Wean to Finish
Layer
Daily Cow
Wean to Feeder
STO
Non -La er I I
Dairy Calf
Feeder to Finish
R�
" Design Current
Dairy Heifer
Farrow to Wean
D Cow
Farrow to Feeder
_
:D Point" Ca aci P,o
Non -La ers
Pullets
Non -Dairy
Beef Stocker
113eef Feeder
Farrow to Finish
Gilts
—.Layers
Boars
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes [P No ❑ NA ❑ NE
❑ Yes
❑ No
M NA
❑ NE
❑ Yes
[:]No
0 NA
❑ NE
❑ Yes
[:]No
❑ Yes
jP No
TV
❑ Yes
No
NA ❑ NE
❑ NA ❑ Nlf
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

.r-
Faci[i Number: - Date of Inspection:
3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Q9 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
P NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: Jq-
Spillway?:
Designed Freeboard (in):
Freeboard
Observed (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[Ig 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
[P 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
P No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[j4 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below.
❑ Yes
§P No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
licationOutside of Approved Area
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind DriftZ.(�J.Ras
12. Crop Type(s): Ci9,k6e C9ryre
13. Soil Type(s): 6V , —
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
Eig No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
® No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[i] No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes
® No
❑ NA
[] NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes [V No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Q9 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes f No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

acili Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 1% No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below. 1P
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes $ No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 14 No
NJ NA
❑ NE
�rA
❑ 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
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)
T'
31. Do subsurface the 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
5g No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
M No
❑ NA
❑ NE
34, Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any addittonal recommendations or any other comments:`
Use drawings of facility: to _better 'explain- situations use additional: pages-.as•neeessa
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 40 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time •/,� County: /g� Region: C
Farm Name_ rnkta,G "5,-yJ t-,A— Owner Email:
Owner Name: lot it 11Z�2 _�;►v PAI.V_w CLC Phone:
Mailing Address:
Physical Address:
Facility Contact: CqA. Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator: 2A -AW"-11111
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current
Swuie Capacity Pop.
,.
' FDesign Current
Wet PtiultryCapac�ty Pop.
La er
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Finish
Wean to Feeder
Layer
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
22
K Z
Y�6'LDesign
=*ram
Current
D , .Point : *Ca acl Pao ,.
DairyHeifer
D Cow
Non -Dal
Farrow to Finish
La ers
Beef Stocker
Beef Feeder
Gilts
Non -La ers
Boars
/ v
Z p
Pullets
Beef Brood Cow
Turke s
Qtl�er
Turkey Poults
F-F(—)ther
Other
Discharges and Stream Impacts
1.. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes ❑ No ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes [] No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes E] No ❑ NA [D 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 ❑ No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Zg No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[:]Yes
❑ No
[P NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3Cf 3 tj
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.)
7�
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
a No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[' 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
[� No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
l I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [5 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 r Window ❑ Evidence o ind rift /❑ Appliicc��ation Outside of Approved ea
12. CropT e s : %+ 5 � S ��?- � (9 ^
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?
I S. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes No
❑ Yes [ No
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [P No
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [0 No
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes M No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? E] Yes rn No
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facili ;umber: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes F No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below, 91
❑ 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 fn No ❑ NA 0 NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes EP No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes EANo [] 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
10 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
T
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
M No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
j� No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
To
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[' No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other cowmen#s
Use drawings of facility to.better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: ���,G
Phone: 3
Reviewer/Inspector
y
Signature:
Date:
Page 3 of 3
21412011

Type of visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation p Technical Assistance
Reason for Visit: tine Q Complaint O Follow-up O Referral O Emergency C) Other O Denied Access
Date of Visit: ,Arrival Time: Departure Time: 3 ; i > County• r+w
FarmName: �� S'pw �r/s�1 Owner Email:
Owner Name: ��� L L G Phone:
Mailing Address:
Physical Address:
Facility Contact: �J�/yly�p� Title: Phone:
Onsite Representative: ,�1_. = Integrator:
Certified Operator: w1 yiLGtiyr-�I _ Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Region:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
La er
Non -La er
D , P,oul
DesignCurrent
Capacity Pop.
Design Current
Ca aci Po
' Design current
Cattle capacity Pop.
Da Cow
Da' Calf
Dai Heifer
Cow
Non -Dairy
Wean to Feeder
Feeder to Finish
p
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
on -Layers
Beef Feeder
Boars
U319
Pullets
Beef Brood Cow
Other
Other I
Turkeys
Turkey Poults
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?
❑ Yes Eg No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
nNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facifi Number: - /5?-grl 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 I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: pZr 3 r
Spillway?:
Designed Freeboard (in): 15? 7-
Observed Freeboard (in): 5_3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
C. 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
RNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4.6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
®No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
� No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[g No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes allo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop TYpe(s) r n �lUft/Sf5��6r'v�. s f�j zp✓/tLCe /due-^S�'�--d
13. Soil Type(s): /iJDL1`C lcii1W /4��%�s`oro�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes fallo ❑ NA ❑ NE
15, Does the receiving crop and/or land application site need improvement? ❑ Yes � No ❑ NA ❑ NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes allo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes Co 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 ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes (2 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [] Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Qd No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [U No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ONE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Ins ection: �—
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes B No ❑ NA ❑ NE
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [A No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes � No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes a No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes �No ❑ NA El NE
❑ Yes [S No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [�j No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes C@'No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [allo ❑ NA ❑ NE
Comments (refer to gnestlon ft Explain any YES answers and/or any additional recommendations oranyfother comments ;
Use drawings of facility to better explain situations (use additional pages as necessary). x
fB e i�c CO �.vr.-r vcvr�,cur�✓ �/'•� T S,,-I�
Reviewer/Inspector Name
�?'Ue
Phone: 9/p-!!3,�`-'.�3t)a
Reviewer/Inspector Signature:
Page 3 of 3
Datery�d ��-
2/412011

Type of Visit (9-Compliance Inspection Q Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit outine 0 Complaint O Foilow up Q Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: ! �County: Region:
Farm Name: _ _`n h,I L-%- —SDUJ '^-' Owner Email:
Owner Name: GI L _ Phone:
Mailing -Address:
Physical Address:
Facility Contact: rrl f ew& y i 1QD n i S Title: _ _ Phone No:
Onsite Representative: Jy Integrator:
Certified Operator: ! tU�r,f' _ Operator Certification Number:y
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o ❑ ' = " Longitude: ❑ ° ❑ ' ❑ "
Design Current
Design Current
©esign Current
Swine
Capacity Population
Wet Poultry�C pac ty N, ulation
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Da Cow
❑ Wean to Feeder
,_5_00
❑Non -La er
❑Dai Calf
❑ Feeder to Finish
Y
❑ Dairy Heifer
❑ Farrow to Wean
-
Dry Poultry �*
❑ Dry Cow
❑ Farrow to Feeder
❑Non -Dairy
❑ Farrow to Finish
❑ l.a ers
❑ Beef Stocker
❑ Gilts
❑ Non -La ers
❑Beef Feeder
® Boars
3 D
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Ed No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (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 adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
59 No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: — Date of Inspection
r
s
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes Ug-No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: +�
Spillway?: C�
Designed Freeboard (in): v77 Q2
Observed Freeboard (in): 31 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes C,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 5Q No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4fi were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
RYes lFl�o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 1
9. Does any part of the waste management system other than the waste structures require ❑ Yes allo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes RNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes VLNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. CroPhPe(s) ��"�7`e2y��C9/`�2//� l�fl,41r.�
13.
Soiltype(s) gZeeFallr, Z�Ku��/f23 no I/�% aaati
dor
_
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
RNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
KNo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
54 No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
Wo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
Q_No
❑ NA
❑ NE
Reviewer/Inspector Name I �— R ..j Phone: %O`erCrD
Reviewer/Inspector Signature: Date: /
Page 2 of .i /l/l81U4 uonunmea

Facility Number: 91 — 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 E) No ❑ NA ❑ NE
the appropiate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekiy 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
E,No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[,g No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
C9 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
95No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
PNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
&No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
4 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
9 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
&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
0 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
O-No
❑ NA
❑ NE
t/r M t..r0
Page 3 of 3 12128104

K
Type of Visit O-Co-mpliance Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 01foutine 0 Complaint O Fotlow up O Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: `/p` Arrival'l'ime: QQ Departure'fime: ,dp County: _234-1".-
Farm Name: �r >7 rt.� v �� Sfaul /Car r.-h_ Owner Entail:
Owner Name: �i��7� Phone:
IMaiting Address:
PhysicM Address:
Facility Contact: 9 %j Title: Phone No:
Onsite Representative: ,S�r t� lutegrator:
Certified Operator: " rf" Y GU A7 d` Operator Certification 'Number:
Hack -up Operator: Back-up Certification Number:
Region: t C� 90
Location of Farm: Latitude: ❑° Longitude• =° =1
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
6DQ I 1 IE]Non-Layer__
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: a]
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 XNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes jj� No ❑ NA ❑ NE
❑ Yes i. rRNo ❑ NA ❑ NE
12128104 Continued

Facility Number: :�-
Date of Inspection �-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? WYes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes •allo ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure: i Structure 6
Identifier:
Spillway:?:
Desiv-ned Freeboard (in):
Observed Freeboard tiny .3 �-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[9No
❑ NA ❑ NE
0e/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
X 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
GgNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
�No
❑
El 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
1No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
UR[No
[DNA ❑ NE
maintenance/improvement?
11. Is then; evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
allo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or i 0 lbs [:]Total Phosphorus [:]Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [:)Evidence of Wind Drift Application Outside of/Area
j❑
12. Crop type(s)--
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ff-Z�o
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
U4,No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'[)
Yes
WNo
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
O�No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
12 No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name _
Reviewer/inspector Signature:
Phone:
Date: 2_ i /'b
12128104 Continued

facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ZNo ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Jallo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 5kNo ❑ NA ❑ NE
.23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Z�No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
®.No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
RNo
❑ 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
B No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
O-No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
®-No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
JRNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
Wo
❑ NA
❑ NE
12128/04

1�
[vision of Water Quality ✓
I �__ 2 _� � Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason far Visit IDIroutine O Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I
=a Arrivaal Time: d Departure Time: ,J✓�Q County:
Farm Name: Z 1'Lit a(�/ �{ZGIJ_ 1Gi• "1, Owner Email:
Owner Names- /{ f �� II ( phnna-
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:l
Back-up Operator: +
Location of Farm:
Swine
Regiony
Latitude: = o =, [—] Longitude: = ° =' = u
Design Current Design Current
Capacity Polulation Wet Poultry Capacity Population
❑ Layer
❑ Non-Layet
F0 Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
130
L30
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-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: FE.J�
b. Did the discharge reach waters of the State? (I Eyes, 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
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
12128104 Continued

Facility Number: - Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
RNo
❑ 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): c3 _
Observed Freeboard (in): 32 (p
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
Q 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
[K No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
KINo
❑ 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
W1 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[.No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
9No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outs e of Area
12. Crop type(s) l / w
13. Soil type(s) �-
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[KNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
KNo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
JgNo
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
LgNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[RNo
❑ NA ❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name U.� Phone:
Reviewer/inspector Signature: A Date: A — zqy
I 7/12//1.I 9'0711i"71i d

F
Facility Number: —19k Date of Inspection --/®
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ff No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ANo ❑ NA ❑ NE
the appropiate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes allo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes PINo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes K No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
14 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
19 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
.BSI No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
� No
El NA
[I NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
9 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
J, 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
K No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
5No
❑ NA
❑ NE
Comments and/or Drawings:
l2/28/04

Type of Visit Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit autine O Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: d! 9 Departure Time: � County: -'� Region:LL i1
Farm Name: B r2k'Lr1 1 1-e �!20uJ Owner Email:
Owner Name:'tr Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:��r
Back-up Operator:
Title:
s..
Phone No•9 7 `Dq- _7V
Integrator:
Operator Certifica on Number:
Back-up Certification Number: "
Location of Farm: Latitude: = e E__1 1 Longitude: 0 0 = i [� I,
Swine
Design
Capacity
Current
Population
Des. i Current
VS'et Pou try Capacity Population
P
Design Current
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dai Cow
Wean to Feeder
D
5`v0
1❑Non-La er
❑Dai Calf
Feeder to Finish
❑ Dairy Heifer
Farrow to Wean
Dry Poultry
❑ Dry Cow
El Farrow to Feeder
i
❑ Non -Dairy
Farrow to Finish
El Farrow
Layers
❑Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Bcef Brood Cowl
❑ Turkevs
Other
❑ Other
❑ TurkeyPon Its
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
M-No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes. notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
N No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
bd No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

r
�
Facility Number: 7— Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 10No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Struc re 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: !�
Spillway?:
Designed Freeboard (in): ,31 _ 31
Observed Freeboard (in): 3 I rl
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
R 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
CQNo ❑ 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? ZI Yes
WNo ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
KNo ❑ 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 El Yes
M No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
jQNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > I0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of AcceptableCrop Window ❑`Evidenc`e of Wind Drift Application Outside of Area
%❑
/
��it�t j
12. Crop type(s) ��f' Bva�I G Zn_ ! �At�f� z� � � � 1_1i�/
13. Soi 1 type(s) /VD 1,6 1
14_ Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
14 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[R No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[2 No
❑ NA
❑ NE
17_ Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[R] No
❑ NA
❑ NE
M. p ' ;�
Comments (refer to question #) Ezplatn any YES answers andlor any recommendatipnsYor any other comments
Use drawingslof facility to better elplain situations. (use additional pages as.necessa ) Wiz. '� s
Reviewer/Inspector Name Phone: '�7/0
Reviewer/Inspector Signature: Date: p2— /mod
Pane 2 of3 1212RI04 Continued

1,
r
Facility Number: Date of Inspection EZ
Reuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ZLNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes FX[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
W No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
RNo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
P�No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Q[No
❑ NA
❑ NE
Outer Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q& No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RNo
❑ 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
P 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
KNo
❑ 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
IWNo
❑ NA
❑ NE
33_ Does facility require a follow-up visit by same agency?
❑ Yes
4 No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: �� Departure Time: �% �dCi County:
Farm Name: I ' n na �_ L, Owner Email:
Owner Name: _ .ELT. r% L G Phone: _
Mailing Address:
'L Region: �I U
Physical Address: A 9
ii"49r � Facility Contact: /'4 Title: Phone No: l23x_
Onsite Representative: _Sa-wG� Integrator:
Certified Operator: p �w1 e Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: ❑ o = = N Longitude: E1o ❑ ' = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
1 � 1 s't-a- � ❑ Layer
So Spa ❑ Non -La e.t _-
(Wean to Finish
O Wean to Feeder
El Feeder to Finish
Bfarrow to Wean
IO
El Farrow to Feeder
❑ Farrow to Finish
El Gilts
❑ Boars
Other
❑ Other ----
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure El Application Field ❑ Other
a. Was the conveyance man-made?
Design Current,
Cattle Capacity Population
El Dairy Cow
El Dairy Calf
j
❑ DairyHeifej
❑ D Cow
'
El Non -Dairy
El Beef Stocker
El Beef Feeder
❑ Beef Brood Co
Number of Structures: lad
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?
H
El Yes U]No El NA El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
SLNo
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
12128104 Continued

.
Facility Number:
Date of Inspection — +f' 0'
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
j$ Yes
No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: 3 f 3a
Spillway?:
Designed Freeboard (in): 6 3 2
Observed Freeboard (in): (96' &2- ?
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
9No ❑ 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
JZ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
® No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
% No ❑ NA ❑ NE
maintenance or improvement?
Waste Avolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
I No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
P9 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[I PAN ❑ PAN > 10% or ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
NNo
❑ 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
[, No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
� No
El NA
[I NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
DkNo
❑ NA
❑ NE
Comments (referto'question #): Explain any YE ;4savers ari&or any recommendations orMaoy other comments �a
is E Ar i�
Use drawings of facility to better explain situations (use addrho al pages as necessary)..:.r $r' ,
psi -5- _ 7X e y ja > CLIFI p C 4
r--
Reviewer/Inspector Name I . C _ Phone: O— .33 -33cx:�
Reviewer/Inspector Signature: Date: 07
rage L OJ 3 Il/LIB/U4 uonnnuea

Facility Number: Date of Inspection +t -0 7
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ;KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? if yes, check ❑ Yes � No [:I NA El NE
the appropriate box. ElWUP ❑ Checklists El Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes N No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
IR No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
®,No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[3 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[X No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
X No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
RNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[2 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
H 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
F1 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[allo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
;qNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
"No
❑ NA
❑ NE
Additional'0&rnents andlorDrawings
12/2&04

I
C�ltivision of Water Quality
Facility Number /9 0 Division of Soil aniI Water Conservation
Other,�geacy
Type of VisitC-ommppliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
O Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: � Arrival Time: a Departure Time: County: ` a '-n' Region: 7-"r- U
Farm Name: _ �+ +'ti-� a e- - e- :�ir7Ui kCre^-- _ Owner Email:
Owner Name: _ Te- T- . L L Phone:
Mailing Address:
Physical Address:
to A,' + ; S eri ; -6 3�
Facility Contact: Title: :Phone No:
Onsite Representative: _Su-,-:� Integrator: t!
Certified Operator: rr Operator Certification Number:�aZ
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = e =' = « Longitude: 0 0 ❑ ' =
Design Current
gn CaSwine
Capacity Population
Wet PMDesil
apacity Papu anon Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ DairyCow
Wean to Feeder
OD D
❑ Non -La er
I ❑ DairyCalf
Feeder to Finish
/ O
❑ DairyHeifer
®Farrow to Wean
Dry Poultry
❑ Cow
El Farrow to Feeder
.... ' ' ` "� ❑ Non -Dairy
El Farrow to Finish
❑ La ers'
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
' ❑Beef Brood Cowl
_ - -
El Turkeys
Other
❑ Other
_
❑ Turkey Poults
❑Other
Number of Structures:
Discharges & 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
M No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[M 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
M 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
LKNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/2"4
Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ® No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ® No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 0913 l --g21 3 ?L---
Spillway?: e-3
Designed Freeboard (in): �P2> _ .3,3_
Observed Freeboard (in): J62 33
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes C9 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 Eg 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
$. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 19 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 W No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes RNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes EANo ❑ 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
O No
❑ NA
❑ NE
' NV
Comments (refer, to question #): Explain any YES~ansRers and/or any recommendations orx y other comment
,UwArawin s offaciliJto better explain situatins (use additional pages as necessary).
��.
I r eV� t n k Y t 'il r ki r`�- � , -'//Uvr�.l.0 /': & 4-1 , f/�y �vr +-e( j�p�• Wit V r
Reviewer/Inspector Name d -C Phone: gj0-y.33r` 3 3_3.;2—
Reviewer/inspector Signature: Date: —7— 0rc
Page 2 of 12128104 Continued

Facility Number: --l`j Date of Inspection S� 719
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,SNO ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 21 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 19No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Pj No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
14 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
H3 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
0No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ZNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[RNo
❑ NA
❑ NE
29.
Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑ Yes
WNo
❑ 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
KNo
❑ 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
5d 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
KNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
KNo
❑ NA
❑ NE
Page 3 of 3 12128104

I
Type of Visit (OCompiiance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint 0 Follow up 0 Referral O Emergency 0 Other El Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: i K n a C f� J h J�Dcc! ra✓& L Owner Email:
_
Owner Name: — = . 4 e Phone: J, /0—S
Mailing Address: � .� l ins Z-5-2- f ' ; & Ale —
Physical
Physical Address: R J
Facility Contact: �� gl�rftTitle: Phone No: 2a
Onsite Representative: �-- ..'' Integrator:
Certified Operator: ����/'1�ir- Tlyr Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [� o [� . 0 Longitude: = o =, =
it
Swine''
DesilnrC--"urrent
Capaulafion
W1.et`Poultry
❑ Layer
❑ Non -La et
Design
Capacity
CprrenC'
Population
Cattle,
❑ Da Cow
Design
Ca�paci ty
Current
Populafion
❑ Da Calf
Dai Heifei
AIV
DtPoul
4, -
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
;.
❑ Beef Brood Co
a
_.4
Other
❑ Other
Huinher oIS tructures:
�
❑ Wean to Finish
� � Wean to Feeder
p D
�? � Feeder to Finish
�
Farrow to Wean
❑Farrow to Feeder
-ti
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges &Stream Impacts
❑ Layers
❑ Non -La Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑ Other
. Is any discharge observed from any part of the operation?
El Yes
9No
❑ NA
❑ NE
Discharge originated at: ❑ Structure El Application Field El Other
a_ Was the conveyance man-made?
El Yes
�No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
2No
❑ 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?
El Yes
(ffiNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
�.No
❑ NA
❑ NE
other than from a discharge?
11/28/04
Continued

r
Facility Number: D j --1
Date of Inspection a
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
ElNA [INE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: sZ
Spillway?:
Designed Freeboard (in): -.5—/ }.
Observed Freeboard (in): _ ! 31
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
XNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
R No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
5& No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 9No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) Ca
No Does any part of the waste management system other than the waste structures require ❑ Yes Callo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes MNo El NA El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Callo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) 6_014 f —AzQ
14. Do the receiving crops differ from those designated in the CAWIAP?
❑ Yes
®.No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
W No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes
94 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
RLNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[4 No
❑ NA
❑ NE
�drti i s LSD GPrfiF�
Reviewer/inspector Name y`� , r `, Phone:
Reviewer/]nspectorSignature: Date: IOG:z
1212AV04 Continued

9 -
Facility Number: 04;L— Date of Inspection O— -0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes CffNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [Z No ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P9 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge'? ❑ Yes CKNo ❑ 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
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[0 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[ANo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
X[No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
(A No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
(9 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
P 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
5a 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
ANo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
❑ NA
❑ NE
AdditionalComtneotstand/or¢Draavtgs
w
12128104

Time: ;fi �
rO—N'otOperational O Below Threshold
Mrrermitted EKertified © Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: _ p n n u. G I jow �u�n, _ County: 06�aa%.� .E-9 2
Owner Name: 1 CT-4„ 1 -6 •• . Phone No: 2L0- -1 k1-.l I ` !
lading Address: P D_ oac 2S 9 /?asc H. '// NC. -2g ys8
Facility Contact: &.011� Title: Phone No:
Onsite Representative:._ .1.�a _6ke nr_. Z46,. / Fay. l� ,..__„ Integrator: M ��
Certified Operator. ogr-�z Fowler _ Operator Certification Number: �18 9,g2
Location of Farm:
a u Longitude • �u
o Feeder
Soo
to Finish
I
to Wean
r.{ 2
to Feeder
rErrow
to Finish
DischarEes & Stream Int cts
I . Is any discharge observed from any part of the operation? ❑ Yes ©No
Discharge originated at: ❑ Lagoon ❑ Spray Feld ❑ Other �
a. If discharge is observed, was the conveyance man-made'? ❑ Yes E Flo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) El Yes M'!�o
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes D-Ko
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Of4o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Elfio
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
❑ Yes ENo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): 3y s O
12112103 ContUmed

IFacility Number: p —
Date of Inspection 1 f1
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate pnblic health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance-limprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste_ Application
10. Are there any buffers that need maintenanoe/mmprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
P '7�7pI ? 3 Iva 1 t �sw 3,7 v
12. crop type U -eA vdu _ S o..�E 4A r a A , A l,0�1' / /"-,
13. Do the receiving crops differ with those designated in the Certifed Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i_e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
Reviewer./Tuspector Name
Reviewer/Inspector Signature:
Date:
❑ Yes L1�o
❑ Yes B7 o'
❑ Yes 21�o
❑ Yes Bol�o
❑ Yes 0<0
❑ Yes [fio
❑ Yes Q'No
❑ Yes Egf4o
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0-K0_
p Yes e<0
❑ Yes ❑ No
❑ Yes Lgvo
❑ Yes Olio
❑ Yes allo
❑ Final Notes
12112103 Continued

4
Facility Number. - of Date of Inspection O
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
22. Does the fgcil:�u t�av all co nents of the Certified Animal Waste Management Plan readily available?
❑ Yes
®M
(e! c tom""" s, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes " iINO
❑ A$pliaa . ❑+=ebm& ❑,WWft-Aft*Sis O-S a hig-
8•0.5-1 G - ;LP —,> 0.oa y-»> 0' 3y
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ M
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
MWO
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
Quo
27. Did Reviewer/Iuspector fail to discuss reviewimspection with on -site representative?
❑ Yes
[Wo
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑'No
29_ Were any additional prow' :ns noted which cause noncompliance of the Certified AWMP7
❑ Yes
EI-No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
Etles
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
S-No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
8wo-
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
Epro
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
E3 No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate
box below. ❑ Yes
0-m
❑ ❑ flexn-T L- [a�
12112103

Facilin lumber Datc of Visit: .5'�.SQ� Time:
77 Q erational Q Below Threshold
Permitted 13 Certified ❑I Conditionally Certified 0 Registered Date Last Operated or above Threshold:
Farm Name: Iihl?a� l � 1 A:;;& r County:
Owner Name: CT LLc
Mailing address:
Facilitv Contact: � 7- 1 G Title:
OnsiteRepresentative: L%al+ dU.rn't
Certified Operator: W c,. IA Au rn !r=6e
Location of Farm:
Phone No:
Phone No:
Integrator. YY1 L& v
Operator Certification Number: 1;0 1 y ST
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude C' �• o i
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Po ulation Cattle Capacity Population
❑ Laver Fo
Dairy
❑ Non -Laver Non -Dairy
Farrow tc %Vean
Farrow to Feeder JVO O ❑ Other
Farrow to Finish Total Design Capacity
Gilts
❑ Boars Total SSLW
Number of Lagoons I r2 f 1U Subsurface Drains Present f LJ Lagoon Area JU Sprav Field Area
Holding Ponds /Solid Traps JE3 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharue originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is obsen-ed, did it reach %eater of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated low in gaUmin?
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 R Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure
Identifier: i.Yrcr St
Freeboard (inched: o? 1'
46 "
05103101 5 ea% - W n�
❑ Yes P No
❑ Yes
No
❑ Yes
No
❑ Yes
� No
❑ Yes
[�l No
❑ Yes
It No
❑ Yes P No
Structure 5
Continued

Facility Number: — ZJO Date of Inspection
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
closure plan? ❑ Yes [� No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Anolication
10, Are there any buffers that need maintenance/improvement?
❑ Yes
No
11.
Is there evidence of over application? ❑ Excessive Ponding [:1 PAN ❑ Hydraulic Overload
❑ Yes
No
12.
Crop type _ BePl�sr1�4. �r . Sma /j �ra 1 0 - SoV 1,el Aes_ AjAe, .Cl �-�' W
13.
�' T
Do the receiving crops differ with those designated in the Certified Anima] Waste Management Plan (CAWMP)?
❑ 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
m No
c) This facility is pended for a wettable acre determination?
❑ Yes
[4 No
15.
Does the receiving crop need improvement?
❑ Yes
C No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required
Records &&Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18.
Does the facility fail to have ali components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
(j No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes 09 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes [Q No
24. Does facility require a follow-up visit by same agency? ❑ Yes [6 No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes JA No
Ito No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
t j'e'l14%W ws 1 C,ro�s a—&9. r e .Cora+[
Reviewer/Inspector Name I
Reviewer/Inspector Signature:
Field Copy U Final Notes
Date:
051031V I . I Continued

Facilih• \umber: Date of Inspection S -O
Odor lssuec
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge arlor below
liquid level of lagoon or storage pond with no agitation?
27, Are there any dead animals not disposed of properly within 24 hours?
28. is there any e-6dence of wind drift during land application? (i.e. residue on neighboring vegetation. asphalt.
roads, building structure. and/or public property)
24_ is the land application spray system intake not located near the liquid surface of the lagoon?
30. W'ere any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters_ etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
Comments
❑ Yes ❑ No
❑ Yes No
❑ Yes ® No
❑ yes �0 No
❑ yes VNo
❑ Y•es ;O No
❑Yes ®No
05103101

r/
40 Division of Water Quality .. .
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of visit: 3-28-2002 Time:
Facility Number 9 198
0 Not Operational 0 Below Threshold
® Permitted 13 Certified ® Conditionally Certified Q Registered Date Last Operated or Above 'Threshold: .........................
Farm Name: l'imptaClls., A.TX.kaxll[L................... County: DLattCnt............................................... k..Q.............
Owner Name:...................................................K.L.I.LG...................... Phone No: 9t.0-590:3264.............................. .
-Mailing Address: k(?AVx.1.9....................................................................................... R.Os� .IIIIl.k1G.... 89 ..............
Facility Contact: Wal.t.RIACney .......................................... •..... Title:....................... Phone No:.............................................. ..
Onsite Representative: V.4AI1.I#.ulydl.i�y..................................................... ....................... Integrator: Njurpby..1~.;jxuily..kaCFFAS......................................
Certified (}perator:Nyaltpt .................................. Xlriacy ......... Operator Certification Number:2.14 Q.........................
Location of Farm:
runt Elizabethtown take US 701 South for 5 miles to left on SR 1711 to intersection with SR 1700, go right on SR 1700 for
1.8 miles to left on SR 1712 at Bluefield, go right on SR 1710 for 1.5 miles, cross SR 1760 to farm entrance on left
® Swine [I Poultry El Cattle ❑Horse Latitude 34 'F 29 54 « Longitude 78 • 34 59 11
Design Current
Swine Canacitv Ponulation
N Wean to Feeder
500
0 Feeder to Finish
1224
® Farrow to Wean
4462
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
130
Design Current Design Current
Poultry Capacity Population Cattle Ca acit V Population
❑ Layer ❑ Dairy
❑ Non -Layer IM Non -Dairy
❑ Other
Total Design Capacity 6,316
Total SSLW 2,164,286
Number of Lagoons 2 ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Fietd Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1- Is any discharge observed from any part of the operation? ❑ Yes N No
Discharge originated at: [:]Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ NO
b. 1 f discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
e. If -discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notiti, DWQ) ❑ Yes ❑ No
2. is there evidence of past discharge from any part of the operation? ❑ Yes N No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes N No
Waste Collection & Trea(ment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes N No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Iclenritier: Primary
......... .... SecaLttdart' ..........................
Frethoard {inched: 32 64
05103101 Continued

Facility Number: 9-198
Date of Inspection 3-28-2002
-. Are there any inunediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Coastal Bermuda (Hay) Small Grain Overseed Soybeans Wheat
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination'? ❑ Yes ❑ No
15. Does the receiving crop need improvement'?
16. is there a lack of adequate waste application equipment'?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available'?
S. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
® Yes ❑ No
[:]Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES ans-,vers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑ Field Copy ❑ Final Notes
18- There was a reduction on the PAN produced used in the WUP. Supporting on -farm records and calculations need to be included
with the WUP.
Well maintained farm.
Reviewer/Inspector Name Paul Sherman
Reviewer/Inspector Signature: Date: 1-2$
05103101 Continued

Facility Number: 9-198 Date of Inspection 3-28-2002
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
3 l . Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tams lack a submerged fill pipe or a permanent/temporary cover?
ngs:
❑ Yes . ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
J
05103101