260039_INSPECTIONS_20171231

(Type of Visit: !`Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: DA6utine 0 Complaint 0 Follow-up O Referral 0 Emergency O Other 0 Denied Access
Date of Visit:s{p Arrival Time: a Departure Time: County: C �t t:P�r eglon:r
Farm Name: t(kv- E_^c ' 4—
Owner Name: Due, f,
Mailing Address; r
Physical Address:
Facility Contact: N7vq b, ((a. Title:
—�l
Onsite Representative: I
Certified Operator: L' j
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone:
Integrator: AY d
Certification Number:
Certification Number:
Longitude:
Design Current
❑ Yes
Design
Current
Design Current
Swine Capacity Pap.
Wet Poultry
Capacity
Pap.
Cattle Capacity Pop.
Wean to Finish
La er
[:]No
NA
Dai Cow
2. Is there evidence of a past discharge from any part of the operation?
Wean to Feeder
Layer
❑ NA
❑ NE
Dai Calf
❑.Yes
Feeder to Finish ——fit-
❑ NA
❑ NE
Dai Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
Dr. Point ,
Ca aci
P.o P.
Non -Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Qther
Turke Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [DX° ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes [] No []`IA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DW R)
❑ 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
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[3`'l�(o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑.Yes
[3] N
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facilit Number: It - Date of Inspection: yLli
Waste Collection & Treatment
4. Is'storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Q_No­0 NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No C] -19X- ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �D 7
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 04o
❑ 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
0_1rNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
2] No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[]'5o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [2] No ❑ NA ❑ NE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ED—No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Lt} <15
13. Soil Type(s):o Z)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [2'1�o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes FtKo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E3<o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes E�No ❑ NA ❑ NE
❑ Yes [Ej o ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [v]Tlo ❑ 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 F-1 Checklists [:]Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Ej`&o
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge'? E] Yes ENo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 6 No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
0 N ❑NE
❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: G - �' Date of Inspection: .1 ipw
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ED -NO
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �10
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 [L] -No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �o
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?
Us'e;dr:aw
A14
C.(, U
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 3 of 3
V) Cl
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes C3 -No [DNA ❑ NE
❑ Yes 0—No [DNA ❑ NE
[]Yes [3 -No ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes
FA—No
[DNA
❑ NE
❑ Yes
ff No
❑ NA
❑ NE
❑ Yes
[fNo
❑ NA
❑ NE
S
Phoneq(G `tJ • ` 3J
_�Z q
Date:-rg-
21412015
2/4/2015

01 9-C - d L, ,T� a 90
O'givislon of Water Resources I••___.
kaellity Number 0 Division of Soil and Water Conservation
0 Other Agency
type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ISO ArrivalTime: Departure Time: `r�OT County: �u„k(�,,�,. Region:
Farm Name: (� ����;, •� r�+ �u �+vt Owner Email:
Owner [Name:vx cQ Sccu [ �v.,a0 Phone:
Mailing Address:
Physical Address:
Facility Contact: Do, Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
IC
Latitude:
Integrator: L
Certification Number: ` � 7c2z
Certification Number:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle
Wean to Finish
Wean to Feeder
Feeder to Finish �✓ _ ��
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
La er
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
_Turkeys
Turkey Poults
Other
Discharges and Stream impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Dairy Cow
Dai Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Design Current
Capacity Pop.
❑ Yes D -ND ❑ NA ❑ NE
❑ Yes ❑ No [!rWA ❑ NE
b. Did the discharge reach waters of' the State? (it' yes, notify DWR)
❑ Yes
❑ No
L_f A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[: fiio
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[]Yes
ErNo
❑ NA
0 NE
of the State other than from a discharge?
Page I of 3 2/4/2015 Continued

Foci Ii Number: 7,L- Date of Inspection:
❑ Yes
[:3'N'o
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
[211glo
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3"l a-
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[j, -NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfcrs
❑ Weather Code
[]Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
Spillway?:
❑Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[]Yes
o
Designed Freeboard (in):
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
1:3Yes
Pj
o
Observed Freeboard (in): -7
❑ NE
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Yo
❑ 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
E 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 [7 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [3"qo ❑ 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 [TNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [:rNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 2<o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [❑ Application Outside of Approved Area
12. Crop Type(s): C-1✓t.3
13. Soil Type(s): 1ND 60'
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [2'<o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [y No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes FZ�<o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [.]'iVo ❑ NA ❑ NE
❑ Yes F -7`5o ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[:3'N'o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
[211glo
❑ 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
[EfNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfcrs
❑ 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
o
[-]NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
1:3Yes
Pj
o
❑ NA
❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: - date of Inspection: ALO
24: D}d the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes &-No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0lo
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 Q -lo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes I TKO
Other Issues
2$. 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?
24. 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/]nspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes �o ❑ NA ❑ NE
E] Yes Fg-"qo F] NA E] NE
C] Yes Dl o ❑ NA ❑ NE
❑ Yes [3M ❑ NA ❑ NE
❑ YesfNo
❑ Yes [fNo
❑ Yes R o
❑NA ONE
❑NA []NE
❑ NA ❑ NE
Commentq (refer to question'#)'i:!Explain nny;YE5 answers'a'nd/or;anyfadditional itecommcndations;or'any other eorrmtents i:'
�.. I €tl. :a y�i` . .f E rU� I :
Use;drawings of faeill ,;to!hettcr ex'lain,sltnations,{use additionui; ages"ps. necessary) .':!:!!:!T"
c.� I � vw4l
pz�
CJ Cc;- 3D e--
Reviewer/Inspector Name:
Reviewer/Inspector Signatut
Page 3 of 3
Phone:
Date: IV�
1/4/21115

Ww's C"Is tt,UG (
Type of Visit: QJCo/mpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: (/Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:Arrival Time: .6 0 Departure Time: County:_ Region:
Farm Name: 1 X. ( V4 Owner Email:
Owner Name: DQU 4 Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
U c(
Certified Operator:
Back-up Operator:
Location of Farm:
5 3 (' 4 3@
Title:
Latitude:
Phone:
Integrator: 0 Do
Certification Number: I L ro
Certification Number:
Longitude:
Discharges and Stream, lmpacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 [g-Nv` ❑ NA ❑ NE
❑ Yes ❑ No
[]Yes [] No21TA [D
❑ Yes ❑ No
❑ Yes [3 -No
❑ Yes []'*No
[?-NW ❑ NE
NE
�NA ❑ NE
❑NA F-1 NE
❑ NA ❑ NE
Page I of 3 2/4/2015 Continued

Facill Number: - Date of inspection:
Waste Collection & Treatment
4. IS storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [/3 o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No S-11fA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): L
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [l`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
F?<o
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
[J No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an Immediate public health or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
Callo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[2 -No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
9. Does any part of the waste management system other than the waste structures require
[] Yes
['f No
❑ NA
❑ NE
maintenance or improvement?
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Waste Application
❑ NA
❑ NE
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[!fNo
❑ 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): L4
rr /�
13. Soil Type(s): Lo r'0
t4. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Ef"No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
LJ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[3No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[3 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
[2rl o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[J No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[�No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[�No
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

A 11
>E' acili Number: - Date of Ins ;"tion:
or
24. Djd the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 2 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �o
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a AOA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [�No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 2<o
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
0 N ONE
0 N 0 N
[] Yes ❑'No ❑ NA ❑ NE
❑ Yes 2No ❑ NA ❑ NE
[:]Yes E]lNo ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ Yes !rNo
❑ Yes [/] No
❑ Yes [21"No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3

ur
Type of Visit: to compliance Inspection U Uperation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 04 outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Sz Arrival Time: Departure Time: 77 755 County; Region:
Farm Name: ;/&,wi�Q/`►^'�� Owner Email:
Owner Name: f Phone:
Mailing Address:
Physical Address:
Facility Contact: �20c-': :3 i r' nz Title: Phone:
417!r ..
Onsite Representative: fes✓ Integrator: ' Alif
Certified Operator: �r""� Certification Number:
Hack -up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Desi3nGErre.,t
❑ Yes
Design
Current
Design Current
Capac
Wet Poultry
Capacity
Pop.
Cattle C*apacity Pop.
Wean to Finish
Layer
[:]No
❑ NA
❑ NE
Dai Cow
Wean to Feeder
Non -La er
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Dai Calf
Feeder to Finish -�
❑ NA
❑ NE
of the State other than from a discharge?
Dai Heifer
Farrow to Wean
Design
C►urrent
D Cow
Farrow to Feeder
Dr, P,ouHE
Ca acct
P.a
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cowl I
Turke s
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?
[—]Yes 2—No ❑ NA ❑ NE
[]Yes ❑ No ❑ 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
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
+7 No
Whk
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�o
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2014 Continued

Facility Number: jDate of Inspection:
" Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
®-No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 4
Observed Freeboard (in):
5. Are "there any immediate threats to the integrity of any of the structures observed?
❑ Yes
allo
❑ NA
❑ NE
(i.e., targe trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
[]Yes
allo
❑ 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)
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
M No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Z[ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑.Outside of Acceptable Crop Window ` ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): jt?rn /wn"ol'
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 ❑ Yes E, No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes (S 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 0 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 E No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes S No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Facility Number: - 30) Date of Inspection:
❑ Yes
® No
❑ NA
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
rNo
❑ 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.
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
[] Failure to complete annual sludge survey ❑Failure to develop a POA for sludge
levels
❑ Non-compliant sludge levels in any lagoon
❑ Yes
No
❑ NA
List structure(s) and date of first survey indicating non-compliance:
permit? (i.e., discharge, freeboard problems, over -application)
26. Did the facility fail to provide documentation of an actively certified operator in charge?
[]Yes
No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
SO No
E3 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)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
allo
❑ 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
21 No
❑ NA
❑ NE
34. Does the facility require a follow -un visit by the same a2encv?
n Yes
r,No
i1 NA
n NE
Comments (refer;ta question #): Explain any YES answers°and/.ar any n
additioal Yecornmendatlons ar;any�otHer eorn
mentS4 p
Use drawings affacili to befterex lain situations (use. a'dditianal. a es:as necessa ,
• � �S Gl- ran.-� a-� i t r.��l � � ��{� � � � GS s ���
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:i3 33�
Date:
214/2014

ivision of Water Quality
Facility Number ®- ® O Division of Soil and Water Conservation
Q Other Agency
Type of Visit: (compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral 0 Emergency O Other O Denied Access
Date of Visit: iH Arrival Time: flc7 Departure Time: County: ee,.cf1,vayARegion:
Farm Name:c15 11 00 e -J f'Owner Email:
Owner Name: Da u CF['_ [ I Carol Phone:
Mailing Address:
Physical Address:
Facility Contact: 6W t -r/^ /%710 / T_ Title:
Onsite Representative: :! t
Certified Operator: &14 L
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Other
Other
Latitude:
. Phone:
Integrator: G„erl
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharees 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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Daia Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[]Yes 5kNo ❑ NA ❑ NE
[:]Yes ❑No
[:]Yes ❑No
❑ Yes ❑ No
❑ Yes Og-,No
❑ Yes y�io
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
[DNA ❑NE
NA ❑ NE
Page I of 3 2/412011 Continued

Facility Number: - 3 Q I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: _
Designed Freeboard (in): 19 _
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
No ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 5 Structure 6
❑ Yes & No [] NA ❑ NE
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
r No
❑ NA
❑ NE
waste management or closure plan?
ZNo
❑ NA ❑ NE
the appropriate box.
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)
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
9. Does any part of the waste management system other than the waste structures require
❑ Yes
C2.No
❑ NA
❑ NE
maintenance or improvement?
Page 2 of 3
2/4/2011 Continued
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
DZLNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes XLNo ❑ 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): �_/Y� /S L LC/h r — - -
13, Soil Type(s): � !�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ,&No ❑ NA D NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 5 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 52,No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes 2 No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes &No ❑ NA ❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
0 No
❑ 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 ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑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
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
® No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
RLNo
❑ NA ❑ NE
Page 2 of 3
2/4/2011 Continued

Facility Number: 72L Date of Inspection.
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes (aNo ❑ 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 [gNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [Z No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
C,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
ELNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EZ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
RLNo
❑ NA
0 NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
RLNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: / �� �1��3—;VQo
Date:
214/2011

J2>134vision of Water Quality S' , l
Facility Number - ® 0 Division of Soil and Water Conservation I's 7
0 Other Agency
Type of Visit: ompliance inspection Z5 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: E�utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: '� County: r Region:
Farm Name: &jj,d 4?4V Owner Email:
Owner Name: -- aa4je,4e_4 iZ „p /� Phone:
Mailing Address:
Physical Address: �,A
Facility Contact; �7TGfrt //G©Dr'` Title: Phone:
Onsite Representative: f./ �yf(}�!`� „ „ Integrator:
Certified Operator: �,� Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Swine
Veanto Finish
dean to Feeder
eederto Finish
arrow to Wean
arrow to Feeder
arrow to Finish
Gilts
Boars
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkev Poults
Discharees and Stream Imoacts
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes (�No [:]NA [:]NE
❑ Yes ❑ No
[:]Yes ❑No
❑ Yes [] No
❑ Yes allo
❑ Yes ZLNo
❑ NA ❑ NE
C—] NA C—] NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 3 2/4/2011 Continued

Facilit Number: iv - = jDate 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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
Z 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
�]C No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Callo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
O No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
� No
[3 NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
gl No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Cqykq
100,
13. Soil Type(s): ��kwm.
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ® No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes �No E] NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes FXl No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MMU l No [DNA ❑ NE
the appropriate box.
❑WUP ❑Checklists [3 Design [:]Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ZNo
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Z„ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA F-1 NE
❑NA ❑NE
Page 2 of 3 2/4/2011 Continued

Facili Number: C2&- Date of Inspection:'
13—,5A9111
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes JZNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes gg No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ®, No ❑ NA ❑ NE
❑ Yes LKNo ❑ NA ❑ NE
❑ Yes 5U No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes No
❑ Yes ,� No
❑ Yes MNo
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Comnietits (refer;to question #); Explain ;any YES answers and/or any additional recommendations or any other comments.
Use drawirigs'of,'facility to. better, explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 410-14/.J3_.33up
Date: ZZ /
2/4/2011

Date of Visit: Arrival Time: IJ: o J Departure Time: ; D Li I County. Region: (7
Farm Name: �, J�j 1c� ,epi�r/'m- Owner Email:
Owner Name: ro U i t,t [ IQ ✓� Phone:
Mailing Address:
Physical Address:
Facility Contact: rv- Y— Title: Phone:
Onsite Representative; Integrator: 6,'/"'d
9
Certified Operator: u� �/G�a�/ Certification Number:
Back-up Operator:
Certification Number:
j
Location of Farm:
Latitude:
Longitude:
Discharees and Stream Imnacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
DesignC*urrent
❑ NE
Design
C•urrcnt
Design Current
SwiCapacity Pop.
ne
Wet Poultry
Cap acity
Pop.
C►attle Capacity Pop.
Wcan to Finish
Layer
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish /
Dai Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to FeederDr,
P,ou.ltr,
C*_a aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
s
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream Imnacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑Yes
No
❑NA
❑NE
Page 1 of 3 2/4/2011 Continuer)

lFacility 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:
Spillway?:
Designed Freeboard (in): �� 9
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes SLNo ❑ 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 [Z 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 S 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 ® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [ No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop W{ indo+w D of Wind Drift ❑ Application Outside of Approved Area
/Evidence
12. Crop Type(s)= / ,1,X uu
f
�
�� iFF -O <
13. Soil Type(s): 1 /L) L J4 ro .• •...._.. ---
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
[—]Yes ED No ❑ NA ❑ NE
❑ Yes [E No ❑ NA ❑ NE
Re uired Records & Documents
t9. 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 EK No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes � No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes Z[No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 214/1011 Continued

Facility Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Callo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 53,No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes tZ No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30, Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
RApplication Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the ReviewerlInspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑NA ❑NE
❑ NA ❑ NE
(DNA E] NE
[DNA [D NE
❑ Yes SNo ❑ NA ❑ NE
❑ Yes EL No ❑ NA ❑ NE
❑ Yes [3 No ❑ NA ❑ NE
Yes ❑ No ❑ NA ❑ NE
❑ Yes [� No
❑ Yes No
[—]Yes ® No
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.,
Use drawings of facility to better explain situations (use additional pages as necessary).
ReviewerlInspector Name:
ReviewerlInspector Signature:
Page 3 of 3
Phone: -T3 4 0
Date:
2/4/2011

'1
ivision of Water Quality
Facility Number - 3 %- 0 Division of Soil and Water Conservation .rhW- -
0 Other Agency
Type of Visit:()'Compliance Inspection
Reason for Visit: t�tine 0 Cowl
75 Operation Review 0 Structure Evaluation 0 Technical Assistance
int Q Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time:
Farm Name: atyra W �
Owner Name: llu & e d
Mailing Address:
Physical Address:
Owner Email:
Phone:
County: �doojee Region:
Facility Contact: IM -Per Title:,(, _SQA s Phone:
Onsite Representative: Integrator:�� /Carr•+ ..__
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
[iLayerNon-Layer
U Noultr
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
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)?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dg Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [S No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
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 ja No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes RNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

Facilit Number: a Lg- Date of inspection:
Waste
ns ection: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 (DNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 27
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [�S No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes ® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ® Yes No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Cg 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 Ej No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No
[DNA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [] Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus [] Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Wi'n'd/ow Evidence of Wind Drift ❑ Application Outside of Approved Area
�❑
12. Crop Type(s); 4—Berl
alt s. _.
13. Soil Type(s): /
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Q No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes © No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [g 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 Q 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 EQ 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 J No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes 24 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facili Number:- Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ Yes "No F] NA E] NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes E�No ❑ NA ❑ NE
[:]Yes K No
❑ Yes � No
❑ Yes ED No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or a.ny other commentst:``
Use drawings of facility to better explain situations (use additional pages.as necessary).
k,or71-- e---.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9jD y 33ao
Date:
2/4/2011

- ()R a/L-
Type of Visit,6`ommppliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit (7 ttoutine 0 Complaint Q Follow up Q Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time:�Departure Time: ��,/3_ County: w"r6`-r��a Region:
Farm Name: 3,j //'7 ' at Cat_dA_ Owner Email:
Owner Name:. ___Zk_ka v aL Phone:
Mailing Address:
/4�
Physical Address:
Facility Contact: _ AW rt- Title: _ SPe,L- / Phone No:
Onsite Representative: Integrator: 60yloI I V114
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =0
❑ 1 =11 Longitude: =0=S
°=S ❑
td
DesignC►urrent
Design Current
No
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Yes
❑ Wean to Feeder
❑ Non -Layer
❑ NE
❑ Dai Calf
❑ Yes
Feeder to Finish 115-P-1
GM
❑ Dai Heifer
c. What is the estimated volume that reached waters of the State (gallons)?
Farrow to Wean
Dry Poultry
❑ D Cow
Farrow to Feeder
❑ Yes
❑ Non -Dairy
9-mC
Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ro
Gilts
❑ Non -La ers
❑ Beef Feeder
❑ Yes'
Boars
;t,Hel-
❑ Pullets❑
Brood Cow1­0
other than from a discharge?
Turke s❑Beef
TurkeyPoults
12/28/04
Fill—Other
PEI OtherNumber
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
❑ No
�A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
GM
❑ 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
9-mC
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ro
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes'
9 -ND
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

is
0'l Ido
❑ NA
EINE
Facility Number: — 3 Date of Inspection
ETKo
❑ NA
❑ NE
Waste Collection & Treatment
D'ldo
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
F-1Yeso
❑ 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?: Nn
Designed Freeboard (in): / 9
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0<o ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
D o ❑ 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
❑ NA
El NE
8. Do any of the stuctures lack adequate markers as required by the permit?
ElLs 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
[I-Ko' ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 019o_ ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) co,A 44 eu vS lJi N -/W AAIAI &41
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 determinations[:] Yes
0'l Ido
❑ NA
EINE
17. Does the facility lack adequate acreage for land application? ❑ Yes
ETKo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
D'ldo
❑ NA
❑ NE
Reviewer/ins ector Name c ,`S 1=' :; ` r1/O, y3 3.333 0
P !� i r_ 2 \i Q. - S ::,aPicone:
Reviewer/Inspector Signature:Li�A.ke� Date: /Z—/$-2DD$
12/28/04 Continued

4J
Facility Number: 2& --3 Date of Inspection yz
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ff'NNo ElNA ❑ NE
[
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 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 3<o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 01�o ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑<o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ NA
El NE
26.
Did the facility fail to have an actively certified operator in charge?
ElLJ Yes
,[�'�lo
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ErNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
,,.�,/
L�"1vo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[3To
❑ 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
,��
EINo
❑ 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
❑ l<o
❑ 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
O'go-
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
El -go'
❑ NA
❑ NE
Additional Comments and/or Drawings:
12/28/04

g, W5, /z /,9/0oo 7
Q'wision of Water Quality
Facility Number Z 3 q Q. Division of Soil and Water Conservation. x
O Other Agency
Type of Visit Otompliance Inspection 0 Operation Review C) Structure Evaluation 0 Technical Assistance
Reason for Visitoutine 0 Complaint 0 Follow up C) Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 17'17-07 Arrival Time: �.' S" Departure Time: S'Oo County: Cu,�bwfadd Region: f/Z0
Farm Name: Z'klla VA Fayr'� Owner Email:
Owner Name: R. Cka --d $4-11 &v j Phone:
Mailing Address:
Physical Address:
Facility Contact: Grt t r /�oo�tr Title:
Onsite Representative:/�vorL-
Certified Operator:r/ A gJdc.Ks R, Og jofi�
Back-up Operator:
Location of Farm:
Phone No.•
Integrator: — &41•141"d F tm Skop �H
Operator Certification Number:
Back-up Certification Number:
Latitude: =0
=1
Longitude: =0=1
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish 1157q
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & 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?
Er
Design Current
Capacity Population
f
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dai
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures;
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
9 No
❑ NA
❑ NE
❑ Yes
[XNo
[INA
❑ NE
❑ NA
❑ NE
❑ Yes
[59 No
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
1;0 No
❑ NA
❑ NE
12/28/04 Continued

If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. 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/improvement?
11, is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l b 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) Cov-jl , S o� joe&,,S . W 1 "4 c-+, XN
13. Soil type(s) &b f}
Facility Number: 'Z& — 3y Date of Inspection 11-17-0 -71
❑ Yes
0 No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[� No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: �-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .3 9
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[A No
El NA
[:1 NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
[6 No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. 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/improvement?
11, is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l b 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) Cov-jl , S o� joe&,,S . W 1 "4 c-+, XN
13. Soil type(s) &b f}
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
O 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
[M No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Namer c-l� !ZQ v �[ S Phone: 940, 1133. 33 o 0
Reviewer/Inspector Signature: �' �-�-� Date: /Z —17 -Ze47
12/28/04 Continued

. =.
Facility Number: Z(p — 'a 1
I Date of Inspection 1247.07
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ONo ❑ NA EINE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P� No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
(j 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
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
!!
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[� No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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
No
❑ NA
❑ NE
12/28/04
E

.'i
Type of Visit
ompliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
outine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: I� Arrival Time: 'DD Departure Time: ILI County: CU4812 Region:
Farm Name: BY. Owner Email:
Owner Name: Z_ . 4a �I2t 80-s [p c AL3 drat Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =0 0 I =" Longitude: =0=6
°06 = f!
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ Layer
❑ Wean to Feeder ❑ Non -La ei
❑ Feeder to Finish 1'30Q
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
R:,Turkey Pouits
Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ D 'Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system`? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
[RNo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
®,No
❑ Yes
ERNo
[INA
❑ NE
❑ Yes
O No
❑ NA
❑ NE
12128104 Continued

Facility Number• — Date of Inspection
kc Waste Collection & Treatment
y 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2L No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ZNo ❑ NA ❑ NE
Structure ) Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes g No ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes ® No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes C,No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 04 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 D Yes 91 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there anyrequired buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [,No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Area
12. Crop type(s) (#:)/'Yl / Sam, •.� / Lvi
Reviewer/Inspector Name 't� ; Phone:
Reviewer/Inspector Signature: Date: it /a --U(
12/28/04 Continued
13. Soil type(s) is—OA
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ZNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
RNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre detcrmination i ❑ Yes
®-No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
9INo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
®,No
❑ NA
❑ NE
Reviewer/Inspector Name 't� ; Phone:
Reviewer/Inspector Signature: Date: it /a --U(
12/28/04 Continued

t
Facility Number: — Date of Inspection —` O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑'WUP ❑ Checklists
❑ Design El Maps ❑Other
❑ Yes ® No ❑ NA ❑ NE
❑ Yes [XNo ❑ NA EINE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes D No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
S No
NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
(SNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[QNo
[:1NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�No
C:1 NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
R1 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ NoWhILNA
❑ NE
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [K 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 odI or or air quality concern?
❑Yes
R 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
EgNo
❑ 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
4 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
KNo
❑ NA
❑ NE
Additianal Comments.tindlor,Drawings (�` 4 N ep m . "r �� '
12/28/04

, f h, Division of. Soli and Water Conservation
�� Ot6er� 'Agency
v;",s r 4 l Xh Pds
..F»;,+(�.L�..n��.w.�... �N'. 1t_SS. $�.� .... :L u..�� ��.�[•� W
Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evalu'atiori
Reason for Visit ®Routine Q Complaint O Follow up 0 Emergency Notification O Other ❑ Denied Access
Facilih• Number i Date of 1'isit: (e Time:
707O er tional 0 Below Threshold-
Permitted
h esholdPermitted M Certified ❑ Conditionalh• Certified © Registered Date Last Operated or Above Threshold:
1 --_
FarmName: 2 s< ClnGri� L dGa([L Cur. Count.: CLAI w.berf s9
3a�-3ce6 Grer�
Owner Name: (ajecka La u 6Lr,( _ - - -- Phone No:
Mailing Address: _31 �t Pis il,. (�n�- /.C�_�--- _ -- L C . 2P..� f
Facility' Contact: k; cj_.rpa R iJ1AnZtU Titie: .lv-Ll Phone No:
Onsite Representative: E idna/l guAc-rU Integrator:
Certified Operator: Operator Certification number: 17.91.2_
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current Design Current Design Current
Swine Capacity Population Poul!ry Ca sew Population Cattle Ca acitv Population
❑ Wean to Feeder Abo 1 10 Laver I I Dairy I
® Feeder to Finish ❑ Non -Layer I 1 10 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
Gilts
❑ Boars Total SSLW
Number of Lagoons Q ❑ Subsurface Drains Present ❑ Lagoon Area 10 S ra"V Field Area
Holding Ponds /Solid Traps ❑ No Liquid Waste Mana ement System
L
Discharges 8 Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 09 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b, if discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes JBNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05/03/01
Continued

Facility Number: 11 — Date of Inspectiong
comments ;:
❑ Field Coov ❑ Final Notes
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
No
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
❑ Yes
O No
closure plan? (If any of questions 4-6 was answered yes, and the situation poses an
Reviewer/inspector Name�'5
Immediate public health or environmental threat, notify DWQ)
Reviewer/inspector Signature:
7. Do any of the structures need maintenance/improvement?
❑ Yes
5+ 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 Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
IF No
12. Crop type
13. Do the receiving crops di er with those designated in the Certified Anima Waste Management Plan (CAWMP)?
El Yes�No
No
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
�*o
16. Is there a lack of adequate waste application equipment?
❑ Yes
JY61 No
Rhe uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
� No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
❑ Yes
';zp;7' No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
1p 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
JA No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes [�S No
23. Did Reviewer/lnspector fail to discuss review/inspection with on-site representative? ❑ Yes �No
24. Does facility require a follow-up visit by same agency? ❑ Yes 1ANo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [ No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Xoommentt (refer.to question #): Explain any YES answers and/or any recommendations or anyrother
��i'drawmgs of facility to better explain titui tionls:t(use 6dditiona3 pages.esnekef0ry)' ,
comments ;:
❑ Field Coov ❑ Final Notes
7
Reviewer/inspector Name�'5
Reviewer/inspector Signature:
Cr4Date:
05/03/01 0 Continued

Facility Number: (a — Date of Inspection (o Q
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?
34. 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.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
05/03/01
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes V No
❑ Yes XNo
❑ Yes [Q No
❑ Yes IR No
❑ Yes ❑ No
J

State of North Carolina
Department of Environment,
RXA
Health and Natural Resources 4A6ja
Fayetteville Regional Office
00
James B. Hunt, Jr„ GovernorIDC
Jonathan B. Howes, Secretary G
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
September 6, 1995
Messrs. Richard & Roscoe Bullard
Rt. 2, Box 250
Autryville, NC 28318
SUBJECT: Compliance Inspection
Cumberland County
Gentlemen:
On July 28, 1995, an inspection of your animal operation was performed by the
Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance
Inspection Report for your information. It is the opinion of this office that this facility is
In compliance with 15A NCAC 2H, Part .0217, and that Animal Waste Management is being
properly performed.
Should you have any questions regarding this matter, please feel free to contact me
at [phone].
Sincerely,
��� wa'- i
Ricky Revels
Environmental Technician N
RR/bs
Enclosure
cc: Facility Compliance Group
9RO
Wachovia Building, Suite 714, Fayetteville, North Carolina 28301-5043 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Site Requires Immediate Attention: Yes
Facility No. 2 &- 3S
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 3- ' $ , 1995
Time: } I ' 37
Farm Name/Owner:
Mailing Address: Rf, 2 Box Z4,0, XWVyV,'i/c am NC z sr3�9
County: Caw bevigA111
Integrator: Phone:
On Site Representative: I.3u! c ed Phone: X9/0 53! — 3�e _
Physical Address/Location: SR2o'Ll 1z ►ujc_ we -z , of 5-9 go -'s o ,-
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: /700 Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 34 ° 5) ' io " Longitude:71 ° 37 159 "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm
(approximately 1 Foot + 7 inches) Yes or® Actual Freeboard: / Ft. lnches
Was any seepage observed from the lagoon(s)? Yes or(pWas any erosion observed? Yes or&
Is adequate land available for spray? (&) or No Is the cover crop adequate? (Y�O or No
Crop(s) being utilized: Re "i CV.: s
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin s? r No ?
100 Feet from Wells? Ue i or No
Is the animal waste stockpiled within 100 Fat of USGS Blue Line Stream? Yes or(o
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes odR
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes org) If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes ord9
Additional Comments:, .. &.&ems.. I'eCot!jer•v14%/ 'Ahe'/ 99WNcr Idoa/a! 4uµ4 k1cVAkm/±v e,y
r"aV•a/ eVI./i5 Mfr. 3.ai6N.r.1 !iRcr c •sue AeCiiirl elf law•d 4�vo, V, 'L BfaK+- . 7 /t- Mk, X
event
5."& /f0;'S;eV x4&wC
25*0 k415S,
N/r AXCot
13.r//-ecl
eegdCLW_11V o//'hoc _
w;lL ,b_e. /aWaYtcd o,V
oN- s,Ve_,
OtNyosJ-e
b4`av ard
rlsrW0AA7Se**'Wft
'4
_A/u�
%NSQ4�c'1�ir1J <<
6e Cr�e�a.c�r�
�k Re,vGI s L -
Inspector Aame Signature
cc: Facility Assessment Unit Use Attachments if Needed.