430008_INSPECTIONS_20171231

i
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
County: Region:
Date of Visit: Arrival Time: Q Departure Time: t7 : _
Farm Name: —H-'%hmti Hwv� rv!�•
Owner Email:
Owner Name: �On n+ %�QM. 0, h _ Phone:
Mailing Address:
Physical Address:
Facility Contact: ��++r►` C LI.W4 V\ Title:
tr
Onsite Representative:
u
Certified Operator:
Back-up Operator:
Phone No•
Integrator: n
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =]'
=' ❑ " Longitude: = ° 0' = "
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Design Current
ANo
Design Current Design Current
Swine
Capacity Population
Wet Poultry
Cpty Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑ NE
❑ Dai Calf
Feeder to Finish o O
❑ No
❑ Dai Heifer
Farrow to Wean
Dry PouEtry
❑ Dry Cow
Farrow to Feeder Q
❑ Layers
❑ Non -Dairy
Farrow to Finish
❑ Non -La ers
❑ Beef Stocker
❑ Gilts
❑ NE
❑Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Co
❑ NE
❑ Turkqys
•"
Qther
❑ Other
❑ Turkey Poults
- Numher of Structures:
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ANo
❑ NA
EINE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
ERNA
❑ NE
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
C�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
)9 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
❑ YesNo
ElNA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

ti
F
❑ Yes
1�No
Facility Number: —
Date of Inspection !
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1P No
Waste Collection & Treatment
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
fm No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No p NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Identifier: N�
Structure 5 Structure 6
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Designed Freeboard (in):
❑ NA
❑ NE
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ YesNo
ElNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes�(
No 1:1 NA El NE
through a waste management or closure plan?
r _
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?
❑ YesNo
[INA ElNE
(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
❑ YesNo
[__1NA [3NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ YesNo
[JNA [INE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
1,�d 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
13. Soil type(s) tQ21C
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
qq No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
�5No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
9No
❑ NA
❑ NE
Comments (refer to question#): Explainany YES answers and/or any -recommendations or any otherecomments
Use drawings of facility to better explain situations. (use additional pages as necessary):
No hoc)5 5 [[ ,Cf 4
Reviewer/Inspector Name ` r....:: I Phone: l �`'y S' 380
Reviewer/Inspector Signature: Date: _1-226f2
Page 2 of 3 12118104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes f�)No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ YesNo ❑ NA ❑ NE
the appropriate box. [:1WUp [IChecklists E]Design [:1Maps E]Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
KNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
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
O No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
JpNo
❑ 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
49 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
ONo
❑ 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
LCPNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
InNo
❑ NA
❑ NE
Page 3 of 3 12/28/04

41ti )h&100( JL/1
0Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit IR Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit p Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 9 }JQ Departure Time: 10'� County: Region: !- ' o
Farm Name: $S ;dL/ Owner Email:
Owner Name: L. 4Am 1,H _ Phone:
Mailing Address:
Physical Address:
qia'3 W—zjfr
Facility Contact: Ronnie, I6o1 i Title: 0 Wr Phone No:G
Onsite Representative: Renn1 oft-UlZ _ integrator: 1
Certified Operator: Ranl�l� i-,� Operator Certification Number: i983d
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑o ❑4 ❑ Longitude: ❑o ❑. ❑ Ai
h:
Design;;_, Current Design Current
Swine Capacity Population Wet,Poultry Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
i
Design 4
Cattle Capacity Pc
❑
Dairy Cow
❑
Dairy Calf k"
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes DjNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE,
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
t'No
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
12/28/04 Continued

IL
Facility Number: 43 —401
Date of Inspection ZZ O
U No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
CRNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'?
❑ Yes
RNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA EINE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
❑ NE
18. Is there a lack of properly operating waste application equipment?
Spillway?:
CgNo
❑ NA
Designed Freeboard (in):
Observed Freeboard (in): o�
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
IffYes
b 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?
RYes
❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
C'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
CKNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
JRNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
J'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) CAfww n l Urin'1 &%bL ( V#) Vej SG Oj
13. Soil type(s)
t
14. Do the receiving crops differ from t ose designated in the CAWMP?
El Yes
U No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
CRNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
CR No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
9!�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
CgNo
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name CAV SCS P16 I 61L Phone: 910A33-3300" 3
Reviewer/Inspector Signature: Date: haTh goo
11/18/04 Continued

� t
Facility Number: 43 710 Date of Inspection 1 Q
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 1)iNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes Wo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q 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
UNo
❑ 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
RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
tRNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
CErNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
DjNo
❑ NA
❑ NE
24.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
19 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
ffNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 t.
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
P5No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
29No
❑ NA
❑ NE
Additional .:Cotnineots andMr Drawings: '
Cv 0Idla9oariest�,1-, Fcrm er (r IQl��-},o ;jos abowt J03fh 1Ocooj �9�h
1
I pleae.rlr f nside of (aT', iw1k.S� glso badcfde
PtiC4ae. F06&, s
a S011 Av ?r ovfl� QateiivOk
anal 09 8o�± 60 day5,
�(A �1 �r lYps r2a qtr sal1q,
ib 00%
Page 3 of 3 12/28/04

Facility No_ Farm Name 13, '0j Date 3/aof dq
Permit COC OIC NPDES (Rainbreaker PLAT Annual Cert )
FB Drops
Lagoon 1 2 3 4 5 6 7
Spillway
Design freeboard
Observed freeboard in
Sludge Survey Date {
Sludge Depth ft & %
Liquid Trt. Zone ft
Calibration Date
MEM
Actual Flow
Soil Test Date � � 3 f Crop Yield oyaalf _ 120 min Inspections
pH Fields Wettable Acres �_ Weather Codes
Lime Needed 1 WUP a Transfer Sheets
Lime Applied Mae . Weekly Freeboard RAIN GAUGE
Cu Zn Rainfall >1" Dead box or incinerator
Needs P 1 in Inspections
f hn"
0
00 0 Ga; c+
Pull/Field Soil Crop RYE PAN Window Max Rate Max Amt
A,AR IM 06 G
tq
Verify PHONE NUMBERS and affiliations
Date last WUP FRO d I 0D, Date last WUP at farm App. Hardware
FRO or Farm Records
Lagoon #
Top Dike
Stop Pump
Start Pump
MOW,"",
FB Drops
Lagoon 1 2 3 4 5 6 7
Spillway
Design freeboard
Observed freeboard in
Sludge Survey Date {
Sludge Depth ft & %
Liquid Trt. Zone ft
Calibration Date
MEM
Actual Flow
Soil Test Date � � 3 f Crop Yield oyaalf _ 120 min Inspections
pH Fields Wettable Acres �_ Weather Codes
Lime Needed 1 WUP a Transfer Sheets
Lime Applied Mae . Weekly Freeboard RAIN GAUGE
Cu Zn Rainfall >1" Dead box or incinerator
Needs P 1 in Inspections
f hn"
0
00 0 Ga; c+
Pull/Field Soil Crop RYE PAN Window Max Rate Max Amt
A,AR IM 06 G
tq
Verify PHONE NUMBERS and affiliations
Date last WUP FRO d I 0D, Date last WUP at farm App. Hardware
FRO or Farm Records
Lagoon #
Top Dike
Stop Pump
Start Pump

049 PO) OA7
C�-CghN
� IPIp)D)
\J+u4
Cow
u
'r -09

10 Division of Water Quality '
Facility Number0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 125 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
Date of Visit: 5 o Arrival Time: �� Departure Time: County. Region:
Farm Name: "!..In
Owner Email:
Owner Name: Yxrkj _ �lv Y Yl.t l Y1 Phone:
Mailing Address: No C +� e t G[ n.-- l t lim
Physical Address:
Facility Contact: t r 1 Title: V_y i Phone No:
Onsite Representativ 41,415 oh Integrator:
Certified Operator:, Operator Certification Number: 3
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: 0 =' ❑ Longitude: =0
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ La ye
❑ Wean to Feeder ❑ Non -Layer
.Feeder to Finish I 1VC0 I % C>O
❑ Farrow to Wean
Farrow to Feeder Z
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current:;
Cattle Capacity.. Population.�i
❑ Dairy Cow
❑ Dairy Calf
❑ Daia Heifer
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 'K No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
93 NA
❑ NE
❑ Yes
❑ No
❑ Yes
�Q No
❑ NA
❑ NE
❑ Yes
'LI No
❑ NA
❑ NE
11/18104 Continued

Facility Number. 3 —��
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PQ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 0 No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 01 e4
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1 3 3
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 K�No ❑ NA ❑ NE , /
❑ Yes 0 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 'No ❑ NA ❑ NE
8. Do any of the 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 J�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 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) 6qX � CSI Fo I G
13. Soil type(s) Ala Ca') Ci( -4 11 F� d Can f
1 l ' br &0nj
14. Do the receiving crops differ from those designated inge CAWMP?
❑ Yes
39 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
PNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
AL
Reviewer/Inspector Name CA r u;�' A)T_ Phone: 3 33233
Reviewer/Inspector Signature: — Date:
12/28/041 1 Continuerh�

Facility Number: 4 1— Q Date of Inspection s J
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWW readily available? If yes, check
the appropirate box. ❑ WP ❑ Checklists
❑ Design [I Maps El Other
❑ Yes )PNo ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes J?j 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
❑ No
f �NA
❑ NE
❑ Yes
Lk -!E No
❑ NA
❑ NE
❑ Yes
Pd No
❑ NA
❑ NE
❑ Yes
R; No
❑ NA
❑ NE
❑ Yes
❑ No
'm NA
❑ NE
❑ Yes Wo ❑ NA ❑ NE
❑ Yes {KNo ❑ NA ❑ NE
❑ Yes V No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
Additional Comments and/or Drawings:
v _�'a avis 66zkc �Or �P {' S/t SUr
UV � j(
l�►���-�S UU
t�cc.p �. � bra-�er� .��n r�•�.�� an W ��� � �l�n f � Cir �S ,.
(� d:_e.A_X.s .
12/28/04

Facility No. 1� 3_^ y Time in Time Out Date
Farm Name e-`. S + For— Integrator_ ter, � ` `]
Owner `1io Site Rep 07
Operator 11- No. W J
Back-up No.
COC Circle: CGene or NPDES �=
Design Current
Desi n Current
Wean — Feed
rrow — Feed
W . h
Farrow — nish
eed — Finis
Gilts 1 Boars
Farro — an
Others
FREEBOARD: Design
Observed
Crop Yield
Rain Gauge /
Soil Test V
Weekly Freeboard
Spray/Freeboard Drop
Weather Codes
Wettable Acres
✓ Daily Rainfall
120 min Inspections
Waste Analysis:
Date Nitrogen (N)
Sludge Survey t--�
Calibration/GPM
Waste Transfers
Rain Breaker
PLAT
1 -in Inspections
1
Date Nitrogen (N)
Pull/Field Soil Crop Pan Window
� r Y
y G � C - ✓
1

cl<
------------------
j�

Type of Visit 6 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
Date of Visit: Arrival Time: t3. Departure Time: County: Qf� Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: KUyll V%.Y _____ (i )K t-ron Title: v Wr Phone No:
Onsite Representative: Integrator: n
Certified Operator: 1'hi� Operator Certification Number -
Back -up Operator:
Back-up Certification Number:
Location of Farm: Latitude: E__1 o =' ="
Longitude: = ° = I = "
Swine
Design Current
Capty Population
Design Current
Wet Podltry Capacity ,Popula#'ton
Design Current
Cattle Capacity Population
❑Wean to Finish
❑ La er
❑ Dairy Cow
❑ an to Feeder
❑Non -La er
❑ Dairy Calf
ceder to Finish{�.,:.
�`
❑ Dai Heifer
El Farrow to Wean
4:.''' .
El Dry Cow
ISTDry�P�°G�t�.
arrow to Feeder
�.Li
ElNon-Dairy
E) Farrow to Finish
❑ ers
El Beef Stocker
❑ Gilts
ElN Non -La ers
❑ Beef Feeder
Boars
El Pullets
❑ Beef Brood Co
-.-5--,
ElTurke s
Other
❑Other
El Turkey Pouits
El Other
Number of Structures:
12/28/04
Continued
Discharges &Stream Impacts
1. Is any discharge observed from any part of the operation? Ll Yes r_ �No ElNA ElNE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made? El Yes ❑ No [*NA ❑ NE
b. Did the discharge reach waters of the State'? (If yes, notify DWQ) [I Yes ❑ No PVA ❑ 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) El Yes ❑ No CkNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? F] Yes J�jbNo ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State El yes P -No ❑ NA ❑ NE
other than from a discharge?
Page 1 of
12/28/04
Continued

Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: i
Spillway?: q e
Designed Freeboard (in): " - -- �m j a,"
Observed Freeboard (in): �;2 LO
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?
El Yes No [j NA [I NE
❑ Yes ❑�__ No CRQ�A ❑ NE
Structure 5 Structure 6
❑ Yes t4qo ❑ NA ❑ NE
❑ Yes VNo [INA [jNE
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 T]rNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes k 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 tNo ❑ NA EINE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
mai ntenance/improvement?
❑ Yes N No ❑ NA ❑ NE
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes ')�o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > l0% 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) 1- 4e u Ake —
13. Soil type(s)
14. Do the receiving crops differ from those'4signated in the CAWMP?
❑ Yes
t9dqo
❑ 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
1 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
tj�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Wo
❑ 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):
C c�C car, CIQS J Yr. S�e� S o)
Reviewer/Inspector Name E -I ME t�� �
Phone: rQ 33
Reviewer/Inspector Signature:
Date: r
Page 2 of 3 12/28/04 Continued

Facility Number:q-3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ YesIo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yeso ❑ NA ❑ NE
the appropriate box.VV
ElWUP El Checklists El Design [I Maps E] Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Wo ❑ 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
C�y0
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
)1A
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
f i No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
_V�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
1KNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
SaJNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�'No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
MNo
[:1 NA
C1 NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
P No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
ONo
❑ 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
Vj No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ID No
❑ NA
❑ NE
AdditionalComments:and/or Drawings .
C.o_U bra ,o -r\ ckkv- i,n x-00"1 LdcrU
C.t-e ar Lr vt3 k a.r vun � hou'-p? s .
RAC-LUP o►n
S-�c� r n0u�% �. ke7rmS U r
U
Page 3 of 3 12/28/04

IAl
ti3
U
0S
rj
Facility No. J ~ Time In Time
Farm NaPaA
Owner
Operator
)ut Date r K10
Integrator h
Site Rep-!'z.�a _
No. I ?Y3 a—
Back-up No.
COC Circle:Gener or NPDES
Cr
r
E
M-MMEN INIMMIN
ININEIN wI M -7 -ft, ��flt.mIM W'
Wo H
31 -TI
INMENE
- J CJ
FREEBOARD: Design ,Ir-� Observed o[ J a�'`llp
Sludge Survey `r' Calibration/GPM 1 �11v
Crop Yield Waste Transfers
Rain Gauge Rain Breaker
-��
Soil Test L/ PEAT _ r~ Wettable Acres
Weekly Freeboard V Daily Rainfall 1 -in Inspections_ _
Spray/Freeboard Drop
Weather Codes 120 min Inspections �-
Waste Analysis:
Date Nitrogen (N)
1
10 o
Date Nitrogen (N)
3U 3.
Pull/Field
Soil Crop Pan Window
Wo H
31 -TI
7
5�
a
'�j

Type of Visit QrCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Y� �U Arrival Time: a {7 Departure Time: County: nr'
Farm Name: ,�ZE-± t ri"t— %DSI f `arr�z 3 Owner Email:
Owner Name: _ Z 4219j -7i z Jh_lxz,� i 1_f `o— Phone:
Region:
Mailing Address:
Physical Address:
/Ve-ty MO. Pd-)- 51'."
Facility Contact: lett -;! _ Title: Phone No:
Onsite Representative: S � Integrator:_ 4"/
Certified Operator: — Operator Certification Number: j9S�3
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish 1 #00 13 CrO
❑ Farrow to Wean
Farrow to Feeder 0
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other .
❑ Other - -
Back-up Certification Number:
Latitude: =]' 0' E Longitude: = ° =' = u
Design Current
Wet Poultry Capacity Population
❑
Layer
❑ Non -La et i
Dry. Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current:;
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf I.'
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Co t;
"
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes RrNO ❑ NA ❑ NE
❑ Yes
[$ No
❑ NA
❑ NE
❑ Yes
[K No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
,K Yes
❑ No
❑ NA
❑ NE
[]Yes
ZNo
❑ NA
❑ NE
12128/04 Continued

Facility Number: Date of Inspection LPA
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes J0 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
R9 No
Spillway?:
❑ NE
Designed Freeboard (in):
[3 Yes
Observed Freeboard (in): 22(
❑ NA
❑ NE
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.)
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
[X No ❑ NA ❑ NE
through a waste management or closure plan?
rC4 No
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
JA No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
ZNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
❑ NE
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
2) No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
Z No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10%or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
t2. Crop type(s)
t3. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
[:1 Yes
R9 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
[3 Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ,❑
Yes
W No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
rC4 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
evitst/7�s e;j '.9 "d '7 � S'tc�rO /ilouJ� i 4 Tnt�dS�.
eFfK
ludo tf;r1d sjn I �v v- m- eJu o�-6 ralS
Reviewer/Inspector Name �, _ _ (j t� Phone:
Reviewer/Inspector Signature: Date:
12/28/04 Continued

t
Facility Number: 10 — Date of Inspection
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
Required Records & Documents
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
ZYes
❑ No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
� No
❑ NA El NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
21. Does record keeping need improvement? If yes, check the appropriate box below.
C0 Yes
❑ No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking O Crop Yield U 120 Minute Inspections [S Monthly and V
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
F%J_I No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,Q No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
RINo
❑ NA
❑ NE
Other Issues
28,
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
t0 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
5� 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
No
❑ NA
❑ NE
A�ddthoual Comments andlor D17awittgs ;< �� � `'$'"
�.. mom. , Z;
C✓z't-r.�..i
12/28/04

- -
Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit IS Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
F3Clli[1" Number Date of Visit,: _Rwn Time: ! D
1\ot Operational 0 Below Threshold
® Permitted ®'Certified Conditionally Certified 0 Registered Date Last Operated or Abase Threshold:
Farm Name: — 4,r4 r+1 lea ^n rAo& F=a r rn Count-:
Owner Name: C' v-,% 4xr. _ — Phone No: I89.Z --32&(, 4„Q&j
Mailing Address: L 02U-�►.
1
Facility Contact: t4x-,. _ _ Title: Phone No:
Onsite Representatives Rf�eNn.e 4.n.��a-.-. Integrator: r,dep
Certified Operator: (Z r, n -I e 1-6, m; (4 -ay-, _ ___ Operator Certification Number: i qt.93 Z _
Location of Farm:
® Swine ❑Poultry ❑Cattle El Horse Latitude Longitude �' �• ��
Design Current Design Current Design Current
Swine Ca acity Population Poultry Capacity Population Cattle Ca achy Population
❑ Wean to Feeder ❑ Laver I I ❑ Dairy
® Feeder to Finish I 4ob I JE1 Non -Laver I ILI Non -Dairy
❑ Farrow to Wean
® Farrow to Feeder other
Farrow
❑ Farrow to Finish Total Design Capac'it'y
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons :: • ❑ Subsurface Drains Present ❑ Lagoon :area ❑ S rav Field Area
,Holding Ponds / Solid Traps ^- ❑ No Liquid Waste Management System
Discharges R Stream Impacts
1. Is anv discharge observed from any part of the operation?
Discharge ori,inated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is obsen-ed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharse is observed, what is the estimated flow in gal/min"
d. Does discharge bypass a lagoon system? (Ifves, 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 I Structure 2 Structure 3 Structure 4 Structure
Identifier:
Freeboard (inches)_
05/03/01
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 29 No
❑Yes MNo
❑ Yes R No
Structure 6
Continued

Facility Number: — & I Date of Inspection
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/impruvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Anolication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type —r n - --—lhe�.�� _�- e S Cue �c 51-
13. Do the receiving crops differ with those designated in the Certified Animal Waste
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
e) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
R
Plan (CAWMP)?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22_ Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes] No
❑ Yes Q No
❑ Yes W No
❑ Yes No
❑ Yes [] No
❑ Yes MNo
❑ Yes PONo
❑ Yes 29 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes VQ No
❑ Yes P9 No
❑ Yes 0 No
❑ Yes dfl No
❑ Yes [qNo
❑ Yes No
❑ Yes] No
(ie/ discharge, freeboard problems, over application) ❑ Yes Q 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 9 No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.

Facility Number: 46 — ?
ab
Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
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 permanentitemporary cover?
❑ Yes ❑ No
❑ Yes 53 No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
,Additional;Commentsisudlor Drswings
05/03/01
05/03/01

Facility Number Q
Date of Inspection
Time of Inspection ' 24 hr. (hh:mm)
Registered 13 Certified © Applied for Permit © Permitted 113 Not Operational Date Last Operated:
Farm Name: ... IN►.L....U:...".a... County :.......:.... �[R �{.!...................................................
....
O,Omer Name:.. y r lg. ...'t...bont7.l. f... k!� �1. .............. .. Phone No: � 2...: �j. �t�.........................................
.... ....
Facility Contact:... l5.rdlrS.Y.l.Le....Yasnd.4.m ............... Title:AW.,/l e�.... Phone No:c?Q..............
..................................... AA `` "."'ate
14Yailing Address: -�f... 70 .................... �... � r.�!.�� ................. ....... ....� . ....
f.... ............................................... �"" r 2
Onsite Representative............................................................................................................ Integrator:..._-�.. ......... Q!'... .... ........ ............. ..
Certified Operator: ............ ........... ... ...................... ........................................... .................. Operator Certification Number-, .......... _.............................
Location of Farm.
Qk............... igiz ......st e............... .....G...,r ;Ies.....lo ..........-O ... 7# ..
w.....l+ 2.7.► L . .......N... ............... ................................. .............. ..................................
.".......................................�
Latitude • 6 64 Longitude • =1 "
�` Destgny ;Current Art ' Design Current Destgrt Current
r�
S me: ACa actt x P ulatton Potif " C act P ulahou #Cattlez. w ct Po elation$
.. p» . Y. .!� . tFy a ap . oh'•> ..aP ., ,. �. C9P$ . ty. P,,
_
❑ Wean to Feeder
, .
k ❑ Layer Dairy
❑ Feeder to Finish
'I0
❑ Non -Layer �`' ❑ Non -Dairy
❑ Farrow to Wean
max.
❑ Other
❑ Farrow to Feeder
Farrow to Finish iS`�
.:
-: ❑ Gilts
y (Total DestgnECapacity„p�3
�s-
Y zv y,M ”
vWw; ❑Boars
,Total SSL�?�?•
x Number of Lagoons 1 Holduig Winds'
❑Subsurface Drains Present ❑Lagoon Area 10 Spray Feld Area
❑ No Liquid Waste Management System
�� ,�„t^°x N. � �-R,..• n .^,� � r�`ro
t,,,, � - •,�$..,,
,� »., ,
General
l" Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the conveyance man-made?
b. If discharge is observed, did it reach Surface 'Vater? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/47
❑ Yes No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes U No
❑ Yes No
❑Yes I
❑ Yes No
❑ Yes No
❑ Yes o
Continued on back

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed?
Yes
❑ No
Structures (Lagnons,HoldingPonds, FIush fits, etc.)
Neto to-oows ace `Dein
9. is storage capacity (freeboard plus storm storage) less than adequate?
Yes
❑ No
Struc ure 1 Structure 2 .rr Structure 3 Structure 4 Structure 5
Structure 6
Identifier. � A[l ()OZ J r
..................................."...................................
..................... ............."..
Freeboard ft 4 , l
( ): ........+..................................... .........................................................................................................................................................
10. Is seepage observed from any of the structures?
❑ Yes
$No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
4No
12. Do any of the structures need maintenance/improvement?
❑ Yes
VNo
(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?
(WYes
4 No
`'Paste Application
14. Is there physical evidence of over application?
❑ Yes
;FNo
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop type ........)3e ................................... .................................... ............................ ..........................................
.......................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
❑yy No
17. Does the facility have a lack of adequate acreage for land application?
Yes
El1�
No
18. Does the receiving crop need improvement?
❑ Yes
EKNo
19. Is there a lack of available waste application equipment?
❑ Yes
M No
20. Does facility require a follow-up visit by same agency?
❑ Yes
JANo
21. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
Yes
No
22. Does record keeping need improvement?
❑ Yes
❑ No
For Certified _.-or_Permitted Facilities Only
_.......-'",.' , ........
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
No.vioEation`or deficiencies werenoted during this.visit..Yo4.*iH i&e' i've-no-ftirther-: -
correspondence ab:uut this:visit::: : ::. : :::: : ::: :
Gomuments (reietcFtoqueshon #}Explaitta'any YES answe sndlor,anyrecouimendati ns o alp otberctirnminettt�
�`�'�--�'
Use''"d a�egs flf facility to beftes explaaie s►tuations (use addtt�onal pages as �n'�ecessary} ''��"` ��, ���g�
a '.'.:?�e., "�, �< ». 4'° a.��',�?".ux� ,�¢. ;sF ,�� .w?•°.'. rr ,,��-�L ».Y?{.� .�. �.,�.:#�- vz.'�:,,;;x<. ys. [`�' .�.c•'�. �, r. �,�g�� r;�,�:�»...,��'°`:7?�n_.,.,� ,�AE%��zrN%'�,',.`...,.
kk"' 4S -O" i5 wc�"�C�9 w1� NRC5 .Gr- CeV-r-Aw a��o�-,
Neto to-oows ace `Dein
jagao#%- wt 11 6t° used 4t lcj,�O"
Tk,,j -,Leied 4 6p- Ptd ed A-5AA' , K-6 new tarolAs
7/25/97
Reviewer/Inspector ,Name ,. '
„k
.. 9 y
Reviewer/Inspector Signature: Date:
U 0