260072_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

� Divl"lion of Water Resources
Facility Number - � ®Division of Soil and Water Conservation
9 Other Agency
Cype of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation, 0 Technical Assistance
teason for Visit: 40 Routine 0 Complaint _O Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access ^
Date of Visit: Arrival Time: -:l Departure Time: County tm �tLn� Region: F00
Farm Name: iq Owner Email:
Owner Name: i D iZld`V►�S .yY1C 1 Phone:
Mailing Address:
Physical Address:
Facility Contact: %� fj Title: Phone:
M
Onsite Representative: Integrator: -M M Certified Operator: Certification Number: O p
q l'7
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
11 Design Current
Design
Current
Design Current
ne
Capacity Pop.
Wet Poultry
C.len
to Finish
Z
La er
Dait Cow
an to Feeder
Q�
Non -La er
Dai Calf
der to Finish
DairyHeifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
Dr. I;ouIts
Ga aci
P.a
Non -Dairy
Farrow to Finish
[Layers
Beef Stocker
Gilts
Non -Layers
Beet' Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes � No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No [� NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No Un 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)
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 1 NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Faclllty ZNumber: Date of Inspection:
Waste Collection & Treatment l0
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): t y
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 to 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)
9. Does any part of the waste management system other than the waste structures require ❑ Yes F
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
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13, Soil Type(s):
14. Do the receiving crops
from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ NE
�No
❑NA
❑NE
No
❑ NA
❑ NE
No
❑NA
❑NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑Yes
�No
❑NA
❑NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1P No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

Facility ,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. fp
❑ 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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
¢o] No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Phone: 4ftLWy ?i aU
Date: 61, ezgr
21412019

Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 4D Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: M Arrival Time: i rj/j , yy(z/`j Departure Time: ; County: eA 4n0(Region: r-120
Farm Name: -�rb-14 2,� Owner Email:
Owner Name: �I'k? 1q2_7_^x3_ Phone:
Mailing Address:
Physical Address:
Facility Contact: 1%4 �et"Q gI Title:
Onsite Representative: N Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
7VP 1 AC4,ris
Certification Number: l A V1 7
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
er
Design
Capacity
Current
Pop.
Design
Cattle Capacity
DairyCow
Current
Pop.
Wean to Feeder
p'J
ULa
Nan -La er
DairyCalf
Feeder to Finish
Dairy Heifer
JCJ Farrow to Wean
Farrow to Feeder
D,r, P,oultr,
ign
Ga acit
Current
R;o
Dry Cow
Non -Dairy
Farrow to Finish
Layers
_
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
JPullets
Beef Brood Cow
Other
Other
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 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 [�a No ❑ NA ❑ NE
[:]Yes [-]No
[:]Yes ❑ No
C] Yes [:]No
[]Yes No
C] Yes No
NA ❑ NE
NA ❑ NE
NA
❑ NE
❑ NA
❑ NE
❑NA
❑NE
Page 1 of 3 21412015 Continued

Facili Number: - Date of Inspection: 4
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P9 No
❑ NA
[] NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
'� NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify 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
J] 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 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
eyo_f�Approved
'Area
12. Crop Type(s): — 1ST�i' �'�-- G' U ss ���, gmh � tJ�•� K C�'ae,, -�.d
13. Soil Type(s): r'
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
[�j 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
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
1PNo
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
M No
❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
[] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
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

I~acili Number: 2,L- Date of Inspection: 20
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
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
C, 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
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?
Reviewer/Inspector Name:
ReviewerlInspector Signaturrx_5;�V<�;'���
Page 3 of 3
❑Yes �No ❑NA ❑NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes
[r No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
[R No
❑ NA
❑ NE
Phone: 9,f0 `q i'7g�V
Date: -` I7
21412015

Type of Visit: 0 Compliance Inspection 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: Q Arrival Time: r► Departure Time: r pr p� County: C.141 E" i(1 Reglon:
Farm Name: M
Owner Name: —m m Favtvt,s
Mailing Address:
Owner Email:
Phone:
Physical Address:
Facility Contact: (V )e,W10 Title: Phone:
Qnsite Representative:
Certified Operator:
N
Integrator: TWK ►�5
Certification Number: ig L�l
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Deslgn
Current
Swine 0
Capacity np.
Wet Poultry
Cap —he ity
Pop.
Cattle Capacity
Pop.
W11
ean to Finish
Layer
Dai Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
2��
Design
Current
D Cow
Farrow to Feeder
Dr. P.oultr
Ca taci
P.o
Non -Doi
Farrow to Finish
DrH—
Lavers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
$oars
Pullets
Beef Brood Cow
s
Other
TurkeyPoults
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 No ❑NA ❑NE
❑ Yes ❑ No
[:]Yes []No
NA ❑ NE
NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facility Number: Date of Ins ection: O. 6
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: T�
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.)
T
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ 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 Window � ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s): f ( -aa `g"r��S� (&qn,�,-&-ako, & 5@f�0► --..
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
MNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
t3 No
❑ NA
❑ NE
I6. 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
0 NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
P No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
P No
❑ NA
❑ NE
the appropriate box.
❑W11P [:]Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes t 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 fait to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
. Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
[]Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
21412011 Continued

[Facilit yNumber: Date of Ins ection: o
24. bid 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 §5 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
❑ 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
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
® Yes
❑ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
®. Yes
❑ No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
[B Yes
❑ No
❑ NA
❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signatu►
Page 3 of 3
Phone: I /0 -Y-; 713W
Date: 1179,
%
21412015

(Type of Visit: ® Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 'ODctiw Departure Time: '� County egion:
Farm Name: :IQ (vk ? Owner Email:
Owner Name:. Phone:
Mailing Address:
Physical Address:
Facility Contact: ` pkag _ _ Title: Phone:
Onsite Representative: Integrator: "
Certified Operator:
Back-up Operator:
Location of Farm:
i
Latitude:
Certification Number: W111
Certification Number:
Longitude:
Swine
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Cattle
Design Current
Capacity Pop.
inish
Layer
DairyCow
eeder
pQp Non -La er
DairyCalf
inish
Design Current
Dr, P,oultr, Ca acI P,o P.
Dai Heifer
D Cow
Non-Dai
Wean
Feeder
wolts
Finish
La ers
Beef Stocker
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other
Other
Discharges and Stream lmnacts
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 [P No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
[]Yes [:]No
❑ Yes P No
[:]Yes ® No
NA ❑ NE
1�1 NA ❑ NE
[� NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412014 Continued

Facili Number: - Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
No ❑ NA ❑ NE
No [� NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes P 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 1� No [DNA ❑ 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 PM No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDiication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? P
11. is there evidence of incorrect land application? if yes, check the appropriate box below. [:]Yes [N)No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
D 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
[P 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
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? 1f yes, check
[] Yes
No
❑ NA
r] NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
P No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[g No
❑ NA
❑ NE
Page 2 of 3 21412014 Continued

Facility umber: - 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 No ❑ NA ❑ NE
the appropriate box(cs) below. rM
❑ 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 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?
Comments (refer to question #) Explain.any:YES,answers�and/orany additionalerecom nei
Use firstwinQii.of;facllity.tnyli`etter:eynlain zitaationR (tile aiiditinnal nuuec gs neee kii- :
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
[] NA
❑ NE
❑Yes
No
❑NA
❑NE
❑ Yes
(� No
❑ NA
❑ NE
❑ Yes No
❑ Yes No
❑ Yes ® No
-t. : 9 �P. t. ..»
❑ NA ❑ NE
❑NA ❑NE
❑ NA [] NE
ominentst�
Phone:7/0 3?pl►j
Date:
21412014

Type of Visit: i♦ Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: & Routine 0 Complaint 0 Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: l LL{N Region: f
Farm Name: M %-6 Owner Email:
Owner Name: V NV wi S Phone:
Mailing Address:
Physical Address:
Facility Contact: G( /+/it°.J•nOj Title:
Onsite Representative:
Certified Operator: k
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: —10 M rjt%,S
Certification Number: i' g"I
Certification Number:
Longitude:
Design
Current
Design
Cttrrent
Design
Current
Swine Capacity
Pap.
Wet Poultry
Capacity
Pap.
Cattle
Capacity
Pop.
Wean to Finish
Layer -
Dairy Cow
»-..
Wean to Feeder
D490
Non -La er
I
Dairy Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
2.4011,
1400
gn
C►urrent
Dry Cow
Farrow to Feeder
Ity,
P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
OtherM1
ITurkey Poults
Other
Other
ji
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-made7
❑ Yes nNo ❑ NA ❑ NE
❑ Yes [] No [R NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
E4 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
[i 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 1 of 3 21412014 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:] Yes No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: f
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ER 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 CR 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
[;g No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
CR 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 Window ❑ Evide W�J'
e offWind Drift
� ❑ Application Outside of Approved Area
12. Crop Type(s): 1� 1 ��41, 4 �l 5�
'/
13. Soil Type(s): AElville�
�
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?
❑ 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
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists []Design [:]maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes UNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [A No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412014 Continued

acili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes LAI No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No
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 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 No
Other Issues
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes
P 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
M No
[DNA
❑ 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
E� 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
E� No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
E5] No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
TNo
❑ NA
❑ NE
Comments (refer to:queshon#) Explain any YESj answers,and/or Any additionai�recor"ebdatlons of any othercomments
l)sc,drawings offacilityto bettet:'eaiplainasituations;(usea'siiditiungl pa es asne�Cessary)
oc't46'a, V'a � rzp/�)'
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: ! G / �(
21412014

4 • Division of Water Quality
Facility Number ®- FTTI 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
[season for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:j Departure Time: Z: d vh County:(.'Q/�WRcgion: F"P0
Farm Name: �� %�24 Owner Email:
Owner Name: �"1 Fb ,,s Phone:
Mailing Address:
Physical Address:
Facility Contact: / Title:
Onsite Representative: K
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish'
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Other
Other
u
Latitude:
Phone:
Integrator: —/-P/hf Certification Number: /9'711
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
a-ngpl tD OI I Non -Layer I ]EI
Discharees and Stream Impacts
Non-L
Pullets
Other
Poults
Design Current
Longitude:
.Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
FM NA
LP
❑ 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
0 NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
LIP No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
171 No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

[Facility.Number: - Za Date of Inspection: 2� Z—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No � NA ❑ NE
Strut re 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? [:]Yes EpNo [DNA ❑ 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 closute 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 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 [PNo ❑ 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 Co No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lb.s. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wip4 Drift ❑ ApRlication Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops
from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reuuired Records & Documents
❑ Yes
❑ Yes
❑ Yes
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [P 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 9 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 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: _ y- Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
2;No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
R 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 structurc(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
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
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32, Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34, Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ 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),
2a/q
Reviewer/Inspector Name:
Reviewer/Inspector Signature: \
Page 3 of 3
Phone: ?lo— —3— W
Date:
21412011

?,XKAS 8-11-2010
/ ivision of Water Quality
Facility Number cp ' % Z O Division of Soil and Water Conservation
O Other Agency
Type of Visit
ompllance 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: %-2 —/0 Arrival Time: Departure Time: 7; dG ,., County:
Farm Name: T,b & -2 6' Owner Email:
Owner Name: / b 44 I z '."S Z^<<- Phone:
Mailing Address:
Physical Address:
Region: 10�2t7
Facility Contact: �)Ocerq ke44t"�`� Title: EN✓, '�fr Phone No:
Onsite Representative: 4).oV4 _�44 d integrator: +%b /ff
Certified Operator: � '�
-K'e ua'` d Operator Certification Number: 8 y17
Back-up Operator:
Location of Farm:
Swine
Other
❑ Other
Back-up Certification Number:
Latitude: 0 0 0' 0 " Longitude: 00 0' 0"
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Puliets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream lmnacts
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 Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes
2 o
❑ NA
❑ NE
❑ Yes
❑ No
VA'
❑ NE
❑Yes
❑No
,�
MINA
El NE
D A
❑NE
❑Yes
El No
❑ Yes is<o ❑ NA ❑ NE
❑Yes al ❑NA ❑NE
12128104 Continued

Facility Number:
Date of Inspection 7,- z -/O
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �}Z
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes R�o ❑ NA ❑ NE
❑ Yes Q'1qo'- ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ❑llo'- ❑ NA ❑ NE
❑ Yes ❑"15o­ ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes G�N'o ❑ NA ❑ N I-
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
0-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 El Yes
o
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
�,�
l± o
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ElB Yes
o
❑ 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 ElEvidence of Wind Drift Application Outside of Area
/❑
12. Croptype(s) eP'A4ttC1P_ efAxj 'S�Ma[r arn:r.l_
R
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
0<o
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
Q o ❑NA ❑NE
E�,,-�No ❑ NA ❑ NE
,i_�,,I'No� NA ❑ NE
LSNo LI NA ❑ NE
Comments" (refer to,question #}: Explain any',YES answers` and/or any recammend'a`tioiis urany other coniments°','�t'
Use drawings of facility to hotter ekpIain situations: (use`addiI11)naI pnges`is iieccssary), � P. t ' : �
a
•
Reviewer/Inspector ]Name I
�i � Zede Phone: 9/0, $�33. 330 a
Reviewer/Inspector Signature:
Date: 7--2 6 -
12128104 Continued

As T
Facility Number: Date of Inspection
Required Records & Documents ,, ��
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes LTNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 871 o ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Ell o ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ t20 Minute Inspections ❑ Monthly and 1 °
Rain Inspections ❑Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
ElL yes
N"oo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,'
B<o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
IJ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[ 1'go
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
0-i<o_
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ETT or
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes E<o ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
21qo—
❑ 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
01qo'
❑ 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
fo
❑ 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
NA
El NE
33. Does facility require a follow-up visit by same agency?
El Yes
,�--}�'❑
Iw�o
0 NA
❑ NE
12128104

' Division of Water Quality
t
Facility Number ®- ® 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: Q 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: Arrival Time: Departure Time: 491 CountyAi egion: 449
Farm Name: �Ni z�rj Owner Email:
Owner Name: Phone:
Phone:
Mailing Address:
Physical Address:
�f�
Facility Contact: nog(, �ltan0 Title: Phone:
Onsite Representative: Integrator: %>M Aarms
Certified Operator: 0 Certification Number: A //q
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
Boars
Other
Other
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
HLa er
gar Non -Layer
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
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?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes W No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
NA ❑ NE
NA ❑ NE
c. What is the estimated volume that reached waters ofthe State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [] Yes ❑ No M 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 1 of 3 21412011 Continued

Facilif Number: 21 - 7.2 Date of -Inspection: G
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [] Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes []No F NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �n 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 r{.No [3 NA 0 NE
waste management or closure plan? `P
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environ ental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any ofthe 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? i
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement? T
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E� No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[M No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑,Yes
PQ 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
q No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
`'P' No
❑ NA
❑ NE
20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check
❑ Yes
®No
❑ NA
❑ NE
the appropriate box.
TT
❑WUP ❑Checklists C] 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 j" No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �[!RNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fadili - Number: - 'l Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ED Yes RD 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 tail to discuss review/inspection with an on -site representative?
Reviewer/Inspector Name:
Reviewerllnspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[� NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes �@ No ❑ NA ❑ NE
[:]Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Phone: [phone]_?OD
Date:
21412011

�r-
Division of Water Quality
Division of Soil and Water Conservation
_. = 0 Other Agency
Facility Number
I
EZJ
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: jl q Q Arrival Time: Departure'rime: D; County: FMB W Region:
Farm Name: DM Owner Email:
Owner Name: 1 M m S Phone:
Mailing Address:
Physical Address
Facility Contact: Pa ,U 1 e m _ _ Title: Phone No:
�t
Onsite Representative:' ­'
integrator: i�-��-^D t,l+'�M__
1Bt 7
Certified Operator: Operator Certification Number: .�
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = e = I =" Longitude: = e =' 0
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
�0 2 ❑ Non -Layer
❑ Wean to Finish
ER Wean to Feeder
Feeder to Finish I I —d
Darrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
El Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
ElNon-Layers
El Pullets
❑ Turke s
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1, is any discharge observed from any part of the operation?
Discharge originated at: [I Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ DairyCow
El Dairy Calf
ElDai Heifer
El Dry Cow
ElNon-Dairy
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
�Number of Structures: 1
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: jl q Q Arrival Time: Departure'rime: D; County: FMB W Region:
Farm Name: DM Owner Email:
Owner Name: 1 M m S Phone:
Mailing Address:
Physical Address
Facility Contact: Pa ,U 1 e m _ _ Title: Phone No:
�t
Onsite Representative:' ­'
integrator: i�-��-^D t,l+'�M__
1Bt 7
Certified Operator: Operator Certification Number: .�
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = e = I =" Longitude: = e =' 0
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
�0 2 ❑ Non -Layer
❑ Wean to Finish
ER Wean to Feeder
Feeder to Finish I I —d
Darrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
El Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
ElNon-Layers
El Pullets
❑ Turke s
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1, is any discharge observed from any part of the operation?
Discharge originated at: [I Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ DairyCow
El Dairy Calf
ElDai Heifer
El Dry Cow
ElNon-Dairy
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
�Number of Structures: 1
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
Other
❑ Other
Dry Poultry
❑ Layers
ElNon-Layers
El Pullets
❑ Turke s
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1, is any discharge observed from any part of the operation?
Discharge originated at: [I Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ DairyCow
El Dairy Calf
ElDai Heifer
El Dry Cow
ElNon-Dairy
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
�Number of Structures: 1
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
Discharges & Stream Impacts
1, is any discharge observed from any part of the operation?
Discharge originated at: [I Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ DairyCow
El Dairy Calf
ElDai Heifer
El Dry Cow
ElNon-Dairy
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
�Number of Structures: 1
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
c. What is the estimated volume that reached waters of the State (gallons)?
�Number of Structures: 1
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
❑ No
[RNA
❑ NE
❑ Yes
❑ No
IP NA
❑ NE
❑ Yes
IF No
❑ NA
❑ NE
❑ Yes
g No
❑ NA
❑ NE
12/28/04 Continued

Date of Inspection ll
facility Number: 02 — 72
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
PNo
❑ 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
F
❑ NA ElNE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
ElNA ❑ 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
[PNo
❑ 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 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 10 IN ❑ 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
[6No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
P No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
M No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E�l 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):
t
AL
Reviewer/Inspector Name Phone: q1D 415 3,90
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available'? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1PNo ❑ 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
( 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
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 P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�RjNo
❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CpNo
❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[p 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
qiiNo
❑ 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
N 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
1�No
❑ NA ❑ NE
Page 3 of 3 12128104

Type of Vlsit *Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint Q Follow up O Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: TDNA Owner Email:
Owner Name: M5 Phone:
Mailing Address:
Physical Address:
Facility Contact: DOU0,M-emo Title: Phone No:
Onsite Representative: ►I Integrator:
Certified Operator:
Operator Certification Number:
Back-up Operator: I Sack -up Certification Number:
Region:
Location of Farm: Latitude: = e = 0 Longitude: = o =' =
Design Current
X Design Current
Design Current
Swine
Capacity Population
Wet Poultry Capacity Population
Cattle Capaclty Population
❑ Wean to Finish
❑ La er
❑
Dai Cow
Wean to Feeder
��
❑Non -La er
❑
Dairy Calf
Feeder to Finish
❑
Dai Heifcr
Farrow to Wean
pry Poultry
❑
D Cow
Farrow to Feeder
❑ Layers
Non -Dairy
❑ Farrow to Finish
❑
Beef Stocker
❑ Gilts
Non -Layers
❑
Beef Feeder
❑ Boars
❑ Pullets
❑Beef
Brood Cow
❑ Turkeys
otl
10 Turkey Pou Its
❑ Other
ther
Number OWN
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes
�No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
P NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
W 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
EP NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ERNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters ofthe State
❑ Yes
® No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Date of Inspection
Facility Number: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
INo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
i❑ No
Z NA
❑ NE
Stru Lure 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
ONo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
f 9 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
E' No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 29 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/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 Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)-�,., V
r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
gg No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
?0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
V No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
K,No
❑ NA
❑ NE
Reviewer/Inspector Name777
Phone:
Reviewer/inspector Signature: Date:
Page 2 of 3 121,
Continued

• %' Facility Number: — Date of Inspection
Required Records &_Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes PNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �_kbNo ❑ 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
[PNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ff No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
PNo
❑ 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
M No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Wo
❑ 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
9No
❑ 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
a No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
Page 3 of 3 12128104

Division of Water Quality
Facility Number d1 0 Division of Soil and Water Conservation O Other Agency QQ l�101 / n 1
Type of Visit ,Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 1) Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: a Arrival Time: ® Departure Time. County: Region: Jzi' a
Farm Name: `-[ om-4 2'k [ _ Owner Email:
Owner Name: ID M t`al` YYIS 1 I(1i� Phone:
Mailing Address:
Physical Address:
Facility Contact: W� le Yl _ Title: V ty 12r Phone No:
Onsite Representative: �, I t V � �.If_Y1b`(�� Integrator: — TD � r l
Certified Operator: ,,_ Operator Certification Number: %'T ` _
Back-up Operator:
Location of Farm:
L Swine
Wean to Finish
,Wean to Feeder
Feeder to Finish
farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Back-up Certification Number:
Latitude: = o = A = i1 Longitude: = 0 0 ` 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
Z~] ❑ Non -La et
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dai Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
c, What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ITI
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 VNo ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
RNA
❑ NE
❑ Yes
%No
❑ NA
❑ NE
❑ Yes
fANo
❑ NA
❑ NE
12128104 Continued

Facility Number: -- 07 Date of Inspection 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Wo
❑ NA
[IN E
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): ILt
y
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
19 No
❑ NA
ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes"10
❑ 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
V 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
[P 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 P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindow ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop typecc
s) ` 9j mJ-0.. AA C"1 f Cij S
13. Soil type(s) A Awk �Ve_ ^
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
1� No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
1 JNo
��
[I NA
❑ NE
17. Does the facility lack adequate acreage for land application?
[I Yes
//
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
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):
a
Reviewer/inspector Name PUS-7/ AJ AT7Q Phone: C) 9) V'3a..3 M0
Reviewer/inspector Signature: rc - Date:
12128104 V Continued

+ Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design [I Maps ❑Other '
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes M,No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
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
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
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
�INo
/�
[I NA
El NE
29,
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El 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
/
3 L
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
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
C$No
❑ NA
❑ NE
Additional Comments and/or Drawings:
V Qxly 'I ce �v M
o
12128104

Facility Nor)'� Time InC�GQQ Time Out Date 0�
Farm Name Dm Integrator ti i + 1 �yVyl S _
Owner -7D M Tc-.v �S , ( n CG _ Site R 1p
Operator �- a� No. ,�
Back-up No.
COC Circle: General or NPDES
Design
Current
Design
Current
can = F
6 C).0
U-1
Farrow — Feed
Wean — Finish
Farrow — Finish
Feod.,Fini
Gilts / Boars
arrow — Wean
`7a
Others
FREEBOARD: Design
Sludge Survey
Crop Yield
Rain Gauge
Soil Test
PLAT
Weekly Freeboard Daily Rainfall
Spray/Freeboard Drop
Weather Codes ✓~
Waste Analysis:
120 min Inspections
Observed
C�
Calibration/GPM
Waste Transfers
Rain Breaker 4--�
Wettable Acres Z,
1-in Inspections
Date Nitrogen (N) Date Nitrogen (N)
101 1 . -? 'i�, I I . Z
'Z
I �, C)

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 ❑ Denled Access
Date of Visit: Arrival Time: : 4�OA Departure Time: ��/f" County: t Region:
Farm Name: �r�ly% 2t� Owner Email:
Owner Name: 724f �Z Phone: (/0 5-911 02
Mailing Address:
Physical Address: �J
Facility Contact: oua it 434..j J Title: Phone No:
Onsite Representative: boua A�WQ1J i - Integrator:
Certified Operator: /i%/e on/d Operator Certification Number: _/5-/ 7
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = e = 6 Longitude: = o = t
Design Current Design Current
Design Current
Swine
C►apacity Population Wet Poultry Capacity Population C►attle
C►apacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
Wean to Feeder
d .2
❑ Non -Layer
❑ DairyCalf
❑ Feeder to Finish
❑ DairyHeifer
Farrow to Wean
Z(p/
Dry Poultry ❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers ❑ Beef Stocker
❑ Non -Layers El Beef Feeder
❑ Gilts
❑ Boars
❑ Pullets Beef Brood Cow
❑ Turkeys
Other.
❑ Turkey Poults
❑ Other Number of Structures:
❑ 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?
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
�Z No
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[A No
❑ Yes R No
❑ Yes RN No
Page 1 of 3 12128104
❑ NA ❑ NE
❑NA ❑NE
Continued

Facility Number: 2 7 Z
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. if yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: /
Spillway?:
Designed Freeboard (in): 9
Observed Freeboard (in): 4 %
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes [&No ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes P No ❑ NA ❑ NE
❑ Yes [ANo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Q0 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 [ 1 Yes [M No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 4p No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes M 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 CropWindow ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) ei-hfu 0/ a - �t. , �INull magi N --
13. Soil type(s) AU 14,_
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1KNo
❑ 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
K 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
WNo
❑ 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):
i
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 `" 12128104 Continued

if . .
Facility Number: ;Z& —']'Z Date of Inspection ~O!o
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily availabie? ❑ 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 El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [,2 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
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
[,WNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
rQ No
❑ 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
;?No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[XNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P 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
RQNo
❑ 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
Pa 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
5MNo
ElNA
[INE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
1
Nir
.-0
Page 3 of 3 12128104

Type of Visit 9 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
C �jbe. -/AAOF
Date of Visit: Arrival Time: a ; d Departure Time: County: Region: 600
Farm Name: Owner Email:
Owner Name: T_D_M._.:Fawt c -------__-.. Phone:
Mailing Address: O 13o tc .3 0 �_— aU� w �'��. irxro ui A e- A 73
Physical Address:
Facility Contact: 004, Me-04o..ed h Title:
Onsite Representative: d�_ryrc iMn�ri'
Certified Operator: •. �' .wok
Back-up Operator:
Location of Farm:
Phone No: q&O -
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ e = Longitude: ❑ ° = ` = "
Design
Swine Capaeity
Current
Population
Design
Wet Poultry Gapaeity
Cur"rent h # Design Current
Population Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
El Dry Cow
❑ Non -Dairy
❑ $eef Stocker
❑Beef Feeder
❑Beef Brood Cow
Number of Structures:
❑ Wean to Finish
❑ Layer
® Wean to Feeder
JAjo00
I I IS
❑ Non -La er
❑ Feeder to Finish
I
A
Dry Poultry-
® Farrow to Wean
OLGIG
❑ Farrow to Feeder
❑ La ers
❑ Farrow to Finish
❑Non -La ers
❑ Gilts
❑ Pullets
❑ Turkeys
❑ Boars
Other
,
❑ Turkey Poults
❑ Other
I
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[B 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
®,No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: are — ki2 Date of Inspection 2-4-oS
Renuired Records &_Documents
19. Did the facility fail to have Ccrtif ieate of Coverage & Permit readily available? ❑ Yes 9 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [jg No ❑ NA ❑ NE
the appropirate box. ❑ VAM ❑ Checklists ❑ Deeign ❑ w4n ❑ Other
21, Does record keeping need improvement'? If yes, check a appTropria+� blow. ❑ Yes @ No ❑ NA ❑ NE
❑ Waste AppimoRt ❑ Vk-ck-fTrMbrard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Amiuttl49eAX4cf►tion
❑ ge�whtii - El S4"k-i"g ❑ Cmr�� ❑ 1 ions ❑ ❑ Weatim. a de
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did ReviewerAnspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
[?j No
❑ NA
❑ NE
❑ Yes
[] No
❑ NA
Pk NE
❑ Yes
❑ No
❑ NA
[R NE
❑ Yes
Z No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
® NE
❑ Yes
Y9 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
K No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes Pq No ❑ NA ❑ NE
D�rjawings:
Additional Comments and/or Drawings:
Kt t7 k ;to
12128104

a
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 I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: j
Spillway?: A e
Designed Freeboard (in): I Q if
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ 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
m No
❑ NA
❑ NE
8. Do any of the stuetures 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/improvement?
11. Is there evidence of incorrect application'? If yes, check the appropriate box below.
❑ Yes
R No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of
Area
12. Crop type(s)Zerk�,.�i���a--J��,..,.�,��iva�
13. Soil type(s)
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
® 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
® No
❑ NA ❑ NE
Reviewer/Inspector Name 113.1t Jlaa - 'L" ' firk . f e .; Phone:
Reviewer/Inspector Signature: Date:
12128104 Continuer!

f fY.a`��,` P. x3...'..'�.ii . hE tFg j `F { -Y IS, r
.Other' fY �l a. �i r -i i . ; ri o ,& d° #� + fit 'E i•lcd°( r lit je
A};encY "y im _ ..ttMs r teL s!?' t �. k , . #r1N� t j C i Y
n�=�1 ,.,+ � wil s l���¢¢^^°
i :i �.S..F,,. t —.,» �;'. ,fi r}:h .,�F id?:3'rn��T,�^4 f ��'.i�....+.e.G ,.»� .0� ,'.1. i. .. . �� r .. a.. �,. ...c._ �f.f ,._ �i_�f... � 5. _....61...�e,L .. ti .�.'�..r3..�"��.�Y. �..1L e'•��
Type of Visit .® Compliance inspection O Operetiori Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: ime:
Facility lumber
QN t-Operational 0 He
® Permitted ® Certified 0 Conditionally Certified Li Registered Date Last Operated or Above Threshold:
Farm Name: Countv:--
Owner ?dame: � �il1j��� Phone No: q UN
Mailing Address: 3bQ
nn O
Facility Contact: MU[ _ ]e,vLaOndl Title: Phone No:
Onsite Representative: �1%u1t.A 4_ &_ csvj Integrator: i —
Certified Operator: ha 0-aOperator Certification Number: '1 aTis0
Location of Farm:
JW Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 6 " Longitude 0 1 �µ
Design Current
Design Current Design Current
Swine Capacity Population
Poultry
Capacitv Population Cattle capacity Population
❑
Wean to Feeder
❑ Laver
❑ Dairy
El
Feeder to Finish
Non -La er
❑ 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 ❑ Lagoon Area 10 S rig Field Area
• Holding Ponds 1 Solid Traps' ! "� ` ❑ No Liquid Waste Mana emert Svstem
Discharges 8 Stream Impacts
1. 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 yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ves, 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 & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure S
Identifier:
Freeboard (inches):
03103101
❑ Yes A No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes [% No
❑ Yes [5kNo
Structure 6
Continued

Facility Number: — bate of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Ycs �] 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 M] 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 U No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [2 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste AnWication
10. Arc there any buffers that need maintenance/improvement? ❑ Yes No
11 • Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No
12. Crop hype erw,4ey
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 QjNo
15. Does the receiving crop need improvement? ❑ Yes MNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Rewired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[S No
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
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
[71 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
[P No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
M No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
M No
[� No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
J mments'(ieferta*questiun�#) i+xpaln, i«y YES answer and/or-anyr ect►mmendations grant' other comments 'Cn
�...
,
Usedrawings of farllity to b'ctter explainrsltuations .(itse,addlt€onal pagcsasnettssary) ❑Field Cony ❑Final Notes
s.
I��, wt., � S �°� �-P�.Q. �/v � o� [�-. t,�r-�i'���/ •ice s., � f L
F64-r`a tJ-,�""�����Ql.��se �r�v` d CC��¢�. °�S GS�N �-'
`��•��(y u�,(5�('"`�
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: (,— . Date of Inspection
Odor Lssues
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.)
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?
❑ Yes ❑ No
❑ Yes IM No
❑ Yes ® No
❑ Yes E�No
❑ Yes [&No
❑ Yes 1�9 No
❑ Yes ❑ No
r dditl"onul(,Cnmments endlo`_r Drawln �: ; r, „ti
05103101
05103101

� 4.,�i�� 'lAn••�.. .. ... •. ., m.:..m.�]Sn's:�33.1. •.. .. •. •..�.•w..,.w:«.rrwA ..a+. :'.:fXc'..:Ni3r �i � ',
^ a' Division of Soil and Water Conservation ❑ Other Agency
�# Division of Water Qualityy
Routine O Complaint O Follow-up of MVQ inspection O Follow-up or Dswc review O Other
Date of Inspection
Facility Number Time of Inspection 24 hr. (hh:mm)
© Registered Certified 13 Applied for Permit 0 Permitted 113 Not Operational Date
'lLast
+Operated :
Farm Name: .......''..+.T��..� � � Countv:....i....�.N!�YJtr..l. 0..!1 s� ...............................
Owner Name:..4,.,,....PAC �t........... Phone No: ��`t. Z i� I., .............
FacilityContact:.....pp.....................................................•.................. Title: ................................................................ Phone No: ...................................................
Mailing Address: .... I� �... ., ...?...1../"!'••..................................... :.......... ...kl.psat'1Qr•q. f p1 c........................... ..'a3
Onsite Representative:... Oehe.........i le ..I..kv..ker.......................................• Integrator:.......,..,..�'..........�Zzl./l.............................
Certified Operator; .............................. •................... ..................................... •....................... Operator Certification Number .........................................
Location of Farm:
Latitude U• 0' « Longitude • 4 ir
General
1. Are there any buffers that need maintenance/improvement?
El Yes
I
2. 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? r
❑ Yes
❑ No
b. If discharge is observed, dill it reach Surface Water? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gaVmin?
.d. Does discharge bypass a lagoon system'! (If yes, notify DWQ)
❑ Yes
❑ No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4• Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
*No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
A No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
WNo
7I25197
Continued on back

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes No
Structures (Lagoons,Ifolding Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes f No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
7"..........................................................................................................................................................................................
Freeboard(ft): S................. ...................................................................................................................................................................................
IU. Is seepage observed from any of the structures? ❑ Yes tNo
o
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes
12. Do any of the structures need maintenance/improvement? ❑ Yes /t<No
(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? Xyes ❑ No
Waste Application
14. Is there physical evidence of over application? ❑ Yes 'gNo
(If in excess of WMP, or runoff enteri g waters of the State, notify DWQ)
15. Crop type 6en
r..�r ..............................
NL +�.......°�: ((.......................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ANo
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes *No
18. Does the receiving crop need improvement? ❑ Yes A No
19. Is there a lack of available waste application equipment? ❑ Yes *NO
20. Does facility require a follow-up visit by same agency? ❑ Yes XNO
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ,KNo
22. Does record keeping need improvement? ❑ Yes No
For Cerlif5ed or Permitted Facilities Qnly ' \
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes XNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 0 No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes ❑ No
No'NiolatiOnS°or de'riciencies.were noted during this.visit.-:Yoia"VdH i6ce' i've-na•€urther�:
:: - cprrespotidence ah:out this:visit.-: � � :: � :. -' � �' • � � � � :. � � - � . � � � � :. :.. � . : � � . � :.
�:� Y '�9',h �k r "�' I - 'W --'� d
Cnrnments (refer to3yuestlon #) ,''xplatn3anytlr)�S answers and/ar any rergm#ttendatlons or any pfher c6tnrnents ,' '� k
Use drawings of'ftcllity'ta bbettee. explatrt sttuahonsll(u8d d,cion�l ptsges eces�lc�ary)^;?'I
i.se
1 niS Is 0` ►1eU3 4xrM cs-A-A 6_4411 AAe-t'� L' 0&S 4)1` .
Aa jrr1547k'O t Pe1�rw1.eA f ralm6lj be_43m S(Awt ter 199?,
13 . nl eec� i A.-S40-k1 S tr S�p ►►'�crker I�/� 1��17
t
7/25/97
Y
Reviewer/Inspector Name 2,
Reviewer/Inspector Signature: Date:zb-
MAOF