470026_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

It -� � 6 e!(�' i � 6D
ZIMS ' 0
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 470026 Facility Status: Active Permit: AWS470026 ❑ Denied Access
Inppection Type: Compliance Inspection Inactive Or Closed Dale:
Reason for Visit: Routine County: Hoke Region: Fayetteville
Date of Visit: 10/31/2017 Entry Time: 10:00 am Exit Time: . 10:40 am Incident 0
Farm Name: Swine Relief LLC Owner Email:
Owner: Linard Woodall Phone: [phone]
Mailing Address: PO Box 535 Elizabethtown NC 28337
Physical Address: 1821 N Hilltop Rd Red Springs NC 28377
Facility Status: 0Compliant ❑ Not Compliant Integrator: Murphy -Brown LLC
Location of Farm: Latitude: 34° 53' 16" Longitude: 79° 19' 07"
From US 401 SW of Raeford&2.9 miles S of Bowmore, left (south) on SR 1101( N. Hilltop Rd), 1.4 miles to SR 1113 (N Duffle
Rd) , and New Beginning Church. Left (E), 0.5 miles to farm sign for 97386 and 98661, Turn left. (N).
Question Areas:
Oischrge & Stream Impacts Waste Col, Star, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Travis Ray Brown Operator Certification Number: 1004144
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Kathy Barker Phone
On -site representative Kathy Barker Phone
Primary Inspector: Bill Dunlap Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Calibration Sept 15, Sludge Survey March 2017 #1 0-2.9, P-4.4 36% #2 0-3.2, P-3.6 46%
page: 1

r
Permit: AWS470026
Owner - Facility : Linard Woodall
Facility Number:
470026
Inspection Date: 10/31/17
Inpsection Type: Compliance Inspection
' Reason for Visit:
Routine
Regulated Operations
Design Capacity
Current promotions
Swine
Swine - Feeder to Finish
15,840
14,201
Total Design Capacity:
15,840
Total SSLW:
2,138,400
Waste Structures
Disignated
Observed
Type
Identifier Closed Date Start Date
Freeboard
Freeboard
Lagoon
47-26
19.00
50.00
Lagoon
47-26-02
19.00
43.00
g
r
page: 2

I
Permit: AWS470026 Owner - Facility : Linard Woodall
Facility Number: 470026
Inspection Date: 10/31/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream ImRgg%
Yea
No Na No
1. Is any discharge observed from any part of the operation?
❑
M ❑
❑
Discharge originated at:
Structure
❑
Application Field'
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■ ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yee
No _WM
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6• Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7• Do any of the structures need maintenance or improvement?
❑
■ ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (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
❑
■ ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

r
Permit: AWS470026 Owner - Facility : Linard Woodall Facility Number: 470026
inspection Date: 10/31/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No Na Ne
Crop Type 1• Coastal Bermuda Grass
(Hay)
Crop Type 2 Coastal Bermuda Grass w/
Rye Overseed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
wagram
,
Soil Type 2
Goldsboro
Soil Type 3
Butters
Soil Type 4
Rains
Soil Type 5
Norfolk
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0- El
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
E ❑
❑
Records and Documents
Yes
No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
page: 4

rr `
Permit: AWS470026 Owner - Facility : Linard Woodall Facility Number: 470026
Inspection Date: 10/31/17 . Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No Na No
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑ ❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑ ❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑ ❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑ ❑
appropriate box(es) below,
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑ ❑
Oftrissues
Yee
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
❑
❑
and report mortality rates that exceed normal rates?
29, At the time of the inspection did the facility pose an odor or air quality concern? If yes, •
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
[]
Lagoon I Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

'BI 1'WS' ZI JO L I } b A"Q _
* iv slop of Water Resources
Facility NumberDivision of Soli and Water Conservation
Q Other Agency
Type of Visit:C,.,,ompliance Inspection Operation Review Structure Evaluation Technical Assistance
Reason for Visit: 04outine O Complaint O Follow-up O Referral O Emergency O Other 0 Denied Access
Date of Visit: l o .I gt-I'/b Arrival Time: �+� Departure Time: County:
Farm Name: "�`—SSW—�� LLC Owner Email:
Owner Name: �l'\��Gt W Phone:
Mailing Address:
Physical Address:
FacilityContact: KeAt (3a44461 Title:
Onsite Representative:
Certified Operator: 8
Back-up Operator:
Phone:
Region:
Integrator: " S'_
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Deslgn Current
Wet Poultry Capacity Pop.
La er
Qesign Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Nan -La er
EE
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Design Current
D Cow
Farrow to Feeder
Dr, I;oulte, Ca aci P.o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
OtherI
Other
Turke s
ITurkeyPoults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes []?Io`�❑ NA ❑ NE
a. Was the conveyance man-made? [:]Yes [:]No 20&A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No [3NA [] 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 [214A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes allo ❑ 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 21412015 Continued

AI
F cili Number: - Date of Inspection: 0 !y
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[?Jollo—
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
E TTA
❑ 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
o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
1 0
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[3] No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[3-go
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
�o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
P40
❑ 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
UQ "'o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[][1110
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
D4.0
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP [:]Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes 5a"7 o ❑ NA ❑ NE
❑ Yes 1. JAK0 ❑ NA [] NE
❑ Yes ❑17o ❑ NA ❑ NE
❑ Yes �10 ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yesg�o
No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

lFacility lumber: - Dated Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [R?d7 ❑ NA
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes C;kMt— ❑ NA
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes EEr'g'o ❑ NA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes O<o ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
Rio
❑ 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
EffNo
❑ 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
�fNo
❑ NA ❑ NE
33, Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[!rNo
❑ NA [] NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
g�rNo
❑ NA ❑ NE
Comments (refer to quesiiori °#,) 1✓xplain atEy YES' answei's.and/ar any additional "recommendations�or any other comments � :.; r
Use drawings,iif faeili'' to better ex lain situations (useadiiitiotal
p9W f U"rt P • - jr3- 16
Reviewer/Inspector Name:
IV
Reviewer/Inspector Signature:
Page 3 of 3
Phone: k3.1 -33V
Date: OS
2iar2aa

L C5 60
► Division of Water Resources
Facility Number L LC =1 LJ - lJ 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: _om Hance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Ca'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: i b H County: Region
I�
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: j?=O (W 4 U,,�,ej _ Title: Phone:
�rr
Onsite Representative: C L Integrator:V "l isCertified Operator: Certification Number: f 16 y7
Back-up Operator: 6�e'r�6 L° S Certification Number: r A !O
Location of Farm:
Swine
Latitude:
Design Current Design Current
Capacity Pop, Wet Poultry Capacity Pop.
Layer
Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
ellbQ
a
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Pullets
Poults
Design Current
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑,Application Field ❑ Other:
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Won -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes NA ❑ NE
a. Was the conveyance man-made? [:]Yes [:]No ❑'laA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No LJ "" ❑ 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 ZNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [I(No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facilily Number: - Date of Inspection:
,Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 3 t...? KqrAA4
B-1 o13 NA ❑ NE
D_Ko0❑ NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 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 ETIto ❑ 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 Q"No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 0111o__ ❑ 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 L.;,K(' ❑ 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 differ from
UOSIr,LId LOU Ill LIIG liri YY Jvlr
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?
IS. Is there a lack of properly operating waste application equipment?
Reoulred 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
2'<0
�lo
2<0
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
0 NE
[:]Yes
❑ No
❑ NA
❑ NE
❑ Yes
(fNo
❑ NA
❑ NE
❑ Yes
io
❑ NA
❑ NE
❑ Yes
[D No
❑ NA
❑ NE
❑WUP ❑Checklists ❑Design [:]Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes ONo ❑ 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 Inspections
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Zo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

FaciliV Humber: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [�Mo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check []Yes ED-� [DNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes boo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus toss assessments (PLAT) certification? ❑ Yes Q-No ❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes R-90 ❑ 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 ❑ 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 io ❑ 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 ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes El"No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [ o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes E5"No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facilityto better explain situations (use additional ` `ages as necessar ).
C t
D+
S�
S �--1 S• 0 -y-, 7 C� �
71.1
\j -ib)
sS,
a --- q, J;, 15 o- 33 Y, F'-3,s/
Reviewer/Inspector Name. ! `L)
Phone: R �1 �~ I AV
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412014

ivision of Water Quality
Facility Number - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: GKompliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: �outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
A �- � I - ' t � r_2z ef.n TV4
Date of Visit: J, Arrival Time: Departure Time: G County: Region
Farm Name: Owner Email:
Owner Name: 1 U��`'�`' Phone:
Mailing Address:
Physical Address:
FacilityContact: 1 4 WIGS M `7 Title: Phone:
Onsite Representative: �( Integrator: V43
Certified Operator: �p�/—w� S Certification Number:
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
Gilts
Other
Other
Certification Number:
Latitude:
Design Current Design Current(-)
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Nan -La er
1VUIL-1-
Pul lets
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes Moo ❑ NA ❑ NE
[:]Yes [:]No [: NA ❑ NE
❑ Yes ❑ No a NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No FNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑ 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

w 3 �.It
Facili Number: - [Dated Inspection:
Waste Collection &Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No <A ❑ NE
Structure 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 E],i�o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes fo ❑ 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 I3sP ❑ NA ❑ NE
9. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [Zj,PF6 ❑ 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 sfo ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes io ❑ 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 &'K t �' s G O
13. Soil Type(s): 4CWY.[./ , or(k,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
K❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
FN
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes❑
NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
1._l No ❑ NA
[] NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
ED-o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
2 No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
[] Weather
Code
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspection
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

r
aclli Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 50
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.
❑ NA [] NE
❑ NA ❑ NE
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ NA
r-N-o
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ NA
❑ NE
Other Issues
29. 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:
❑Yes 2! (-No ❑NA ❑NE
❑ Yes EfNo ❑ NA ❑ NE
❑ Yes [ZNo ❑ NA ❑ NE
❑ Yes [�No ❑ NA ❑ NE
❑ Yes
ETNo
[DNA
❑ NE
❑ Yes
CNo
❑ NA
❑ NE
❑Yes
QNo
[DNA
[3 NE
Reviewer/Inspector Signature:
Page 3 of 3

Li 13
—�.- Divislon of Water Resources
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ampliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: , Departure Time: f l County:
t'
Farm Name: �/, �- S VU giAl-. Owner Email:
Owner Name: �j S Phone:
Mailing Address:
Physical Address:
Facility Contact: 1' rJ_1U 0 (`Q, Title:
Onsite Representative: I
Certified Operator: f i Lu�
Back-up Operator:(,/! 1 l
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Integrator:
Phone:
Region:
Certification Number: 171q7
Certification Number: / 7 a D
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Non-L
Pullets
Other
Poults
Design Current
Discharees and Stream Impacts
i . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes L7 T"" ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes [:]No
Gam' ❑ NE
2 A ❑ NE
[:]Yes
❑ No
�TA
❑ NE
❑ Yes
[jj?�o
❑ NA
FINE
❑ Yes
Z 10
❑ NA
❑ NE
Page 1 of 3 21412014 Continued

Faci ty Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Cg-No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the mtegre structures observed?
❑ Yes
�o
D 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
[ -W
❑ 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
50
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E5,W
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[3'lq—o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0,Wo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
22 o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): LO (.,5(oo)
13. Soil Type(s):
14. Do the receiving crops differ Wom those designated in the CAWMP?
❑ Yes
galqo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[Rwu
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Q o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
ZNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[5�<o
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
g To
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[ o
❑ 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
OD No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes �No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facilitly Number: - g Date of Ins eetion:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes
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:
eO ❑ NA ❑ NE
l ❑ NA ❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [�t ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
CDNcr
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
[] Yes
o
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
2] 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
E5'NVo
❑ 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
C; No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any, other comments..
Use drawines of faeilitv`to better explain situations (use additional pnges'�as necessary),
F-dJ -I
n - -b 3 of
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
,-'I tk LJ u
Phone: UW
Date: 6 l �G `
21412014

(ff Division of Water Quality
Facility Number - 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
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other �� 0 Denied Access TT
Date of Visit: Arrival Time: Departure Time: County:f RegionV
Farm Name: Stn—) j,&a lcm �di S Owner Email: 10
Owner Name: &6 1q,+ 'r`ul'G S Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 1 t
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
Gilts
Boars
Other
Other
Title: 0 /,J!Ie_ ✓\ Phone:
—v—
Integrator: { 1 l — 5
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
LayerI I —d
Non -La er
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)
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)
o,2. Is there evidence of a past discharge from any part of the operation?
3..,We're there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of 3
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ]o ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes [:]No
[:]Yes ❑ No
❑ Yes [�b
❑ Yes To
MlA ❑ NE
[RlA ❑ NE
['s N-A ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
21412011 Continued

Facility Number: - 66 D jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑4 Mo
❑ NA
❑ NE
a. If yes, is waste level into the structural Freeboard?
❑ Yes
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): --sell
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
52,4o
❑ 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
Q-No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�o
❑ 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
02�<o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E3 ISO
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[2'1Vo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [] Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): C g
S e a
13. Soil Type(s): L kAl,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2 1 q0
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�I o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[3'lqo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ -Mo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes Q o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes [BIZ
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
D Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking D Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes W
❑ 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: V I - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [7,-<o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ED-No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? []Yes gg, o (DNA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[ o
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yeses
❑ 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
Elio
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? if yes, check the appropriate box below.
Application
[Terms
❑ No
❑ NA
❑ NE
Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑Yes
[�Ao
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[Erl fo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
ja<
❑ NA
❑ NE
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Date: 1% _ D ` - �bG
21412011

( "Division of Water Quality
Facility Number `�� - ® 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: gCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0"Routine O Complaint O Follow-un O Referral O Emereencv O Other O Denied Access
Date of Visit: tiTZ Arrival Time: Departure Time: County:Ip1C�
Farm Name: Owner Email: ,
Owner Name: ��tiP t� Phone:
Physical Address:
Region: � KO
Facility Contact: p S Title: (3l.�nG(t Phone:
Onsite Representative: � O0 F_fti ilidy_$ Integrator: Muikpk'
Certified Operator: ? Ob>r RT nxkp S Certification Number: ] "7 (,g
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
Gilts
Boars
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Non-L
Pullets
Other
Poults
Design Current
Discharees and Stream Impacts
. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Caw
❑ Yes E�rNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes ["No
❑ Yes E�No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

'M
aciiity Number: LAI - 4,, x jDate of inspection: %0 1
24. Did the facility fail to calibrate waste application equipment as required by the permit? [] Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3I. 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?
[D'No ❑ NA ❑ NE
❑RNo ❑ NA ❑ NE
❑ Yes
[:kNo
❑ NA
❑ NE
❑ Yes
[allo
❑ NA
❑ NE
❑ Yes
[ o
[DNA
❑ NE
❑ Yes [v]'iVo [DNA [] NE
❑ Yes
E2'No
[DNA
❑ NE
[:]Yes
[2+No
❑ NA
❑ NE
❑ Yes allo
❑ Yes [2 No
❑ Yes [ ,"No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature: Date: 1 pb"L�
��rw ..
Page 3 of 3 2/4/1011

Facility Number: LkDate of inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
52rNo
❑ 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): aZ t b
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
gNo
❑ 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
ErNo
❑ 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
E3"'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
ENo
❑ 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
C2"'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): Zowr t*\ 7'a rmy,-' up a ! 1ta.t 5 Qn
1
13. Soil Type(s): �,p Qa, N)b N ?X p1b
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [vrNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [g"No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 2"No ❑ NA [3 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes Q No [] NA ❑ NE
❑ Yes [901�o ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Q"No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑Tio ❑ 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 G3'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 EZNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes []f No
❑ NA - ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: QfRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Q Arrival Time: Departure Time: ! County:ll Region: icZel
Farm Name: Owner Email:
Owner Name: zV, o s Phone:
Mailing Address:
Physical Address:
Facility Contact: .2dZ4 S Title: ia4A Ei= Phone:
Onsite Representative: �ZA&n1 /1 s Integrator: 114—
Certified Operator: ` iuLnl�/ x4s; Certification Number: %4%/ �
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Dcsign Current Design L@urrent
Capacity Pop. Wet Poultry Capacity Pop.
La er
Design Current
Cattle Capacity P.
DairyCow
Wean to Feeder
Non -La er
Design Current
DairyCalf'
Feeder to Finish
Farrow to Wean
DairyHeifer
D Cow
Farrow to Feeder
hr, P,o,ultrr Ca aci_ P,a .
Non -Dairy
Beef Stocker
Farrow to Finish
Layers
Gilts
Non -Layers
Beef Feeder
Boars
El
Pullets
Turkeys
ITurkeyPoults
10ther
Beef Brood Cow
Othe I
Other I
Discharp,es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of' the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes �lo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Lid" o
❑Yes 1 `0
02, A ❑ NE
iA ❑ NE
BlA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: - Date of Inspection:
4
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'? ❑ Yes E< NA
a. If yes, is waste level into the structural freeboard?
Structure I
Identifier:
42,
Structure 2 Structure 3
❑ Yes [gg?<A
Structure 4 Structure 5 Structure 6
❑ NE
❑ NE
Spillway?:
Designed Freeboard (in): Zq—
Observed Freeboard (in): ,L_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
lb?'T'o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑'N-o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
C io
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
0 Yes
Ei?<o
❑ 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 fo ❑ 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 Drill ❑ 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?
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?
❑ Yes
to
❑ NA
❑ NE
[:]Yes
No
❑ NA
❑ NE
[:]Yes
No
❑ NA
❑ NE
❑ Yes 5�Vo ❑ NA ❑ NE
❑ Yes <0 ❑ 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 ❑vM ❑ 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 19<0 ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stacking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [] Yes t j No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E3 110 ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

FaciliV Number: - Date of Inspection: ZI
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ 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
allo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
2No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
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
2- o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
RrNo
❑ 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
2-�o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q'No
❑ NA
❑ NE
33. Did the Reviewer/lnspector fail to discuss review/inspection with an on -site representative?
D Yes
[Rol�o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�o
❑ NA
❑ NE
Comments (refer to question ##):_ Explain, any YFS answers and/or any, add idon al„reco`m`meRdations orAny other comments
'additional
Use drawings of facility to better explain situations (usepales as, neeessary):"'t?.
?14C4Q41
y
k�4 ep, V4_
Reviewer/Inspector Name:
Reviewer/Inspector S
Page 3 of 3
Phone:
Date:
14/2011

Id 10
t gDivision of Water Quality
Facility Number 1a a Division of Soil and Water Conservation
— 0 Other Agency
Type of Visit f2rCompliance 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: 1 Arrival Time: Departure Time: County: h2 ke_ Region:
Farm Name: SIIPLT� B2621 G Owner Email:
Owner Name: _ R-C) bTI l U' ! Les Phone:
Mailing Address:
Physical Address:
Facility Contact: „! t _Qf, Title:
Onsite Representative: Rbb+ H111f _-
Certified Operator: R b-&-t M ._
Back-up Operator: ! ��
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
LJ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Phone No:
Integrator:
Operator Certification Number: 1-76 42
Back-up Certification Number: 12(�h.
Latitude: F___1 0 0 1 F7 is
Longitude: D 0 0 i 0 is
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer —
_--� ❑ Non_La er -- - -- -- —
Other
❑ Other -._ ...
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑Turkey Poults
T��
❑ Other
I
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
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 tRNo ❑ NA ❑ NE
El Yes El No [__1 NA El NE
[:]Yes [:]No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
®No
❑ NA
❑ NE
❑ Yes
C-No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: — a Date of Inspection
i.
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 15JNo, ❑ NA ❑ NE
the appropriate box.
❑ WUF ❑Checklists El Design [I Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 15kyes. ❑ No ❑ NA ❑ NE
15�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?
❑ Yes
21 No
❑ NA
❑ NE
f5jYes
❑ No
❑ NA
❑ NE
❑ Yes
fRNo
❑ NA
❑ NE
❑ Yes
�j No
❑ NA
❑ NE
❑ Yes
9No
❑ NA
❑ NE
❑ Yes JR No ❑ NA ❑ NE
❑ Yes [RNo ❑ NA ❑ NE
❑ Yes t'No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ® No
❑ Yes [RNo
❑NA [I NE
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? . ❑ Yes D37No ❑ NA ❑ NE
�d[I1ti0na)<`Qi1111tei1tSS��lid�. _.mv
T�k
bakn _ DCDraWln S i
91-q wor d 01 b ae s p+r 41 I a9oo, bal ks , 2�' Add I4n'o �0rso f! s eed arst
aid o, vtcA.
air P�� er N /�e crppL�a a-, 4t}�J'elJ Oa �IOn ClhD z9 sP�
pb�e6e_ .e+ Col 0 0 j Q,1a Iyys U, , Reim-��ef sh�'o' ry e-I>+7e c fr��
(A) Pb 9 �-��+ , P1�,,e corre&rvmhe_rf,(J* tv��fea�a cs'
ear, Ree ca'u blame
New _&6e slt,4� Call b! n�x�y� U
aoC s rvo*eot eal1 dct"'e >v� ns`i1a Or, s®
ay-�slv�jad-t�� ors Pleae 01 P'e 0-exLL5-wv7,r17oh_
.r
abQu� O�sp [�'�-HIo�M-so-ne numb pj,
Xt , Vv I I n-eect RAT asses��m� i � a o j�. �� e
ao , 1�0141 )16s yj�pw W o,4e- Plat io coder co+f iUo'(- &� poiy-0-1fh f.
�3r 1 eAP kyfO l I rtlDI bf6 kO- — Jy� neh- �v�►�,
600 -Qr01 " Ma %,�q P051-es_f Br, rec&ds
Page 3 of 3 12128104

Facility Number: -- a Date of Inspection i1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [gNo ❑ 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): __ Q
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [RNo ❑ NA ❑ NE
(icl large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes Rio ❑ 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? J'Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes allo ❑ 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 [!5kNo ❑ 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 [kNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)COnl-fal berrndatta„',5rra[I Amth Dvespcd,
13. Soil type(s) LkAj&f [S
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
J�,jNo
❑ 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
`•'SA 4
Comments (refer to qucsUo'ri #),Ezp[ain any YCS answers and/or, ai:y recommendations or a.:�ny'other,comments
Use dr'arvrrigs:af facility�to'better°exp[ain situations . (use'addihon�l page"s}aS nCCeSSary):y "``
es .
:, .: Y�
Reviewer/Inspector Name
ci T Phone: q10� 4�3� 3J33K 3o0
Reviewer/Inspector Signature:
Date: t/,S o1
`v 12128104 Continued

i
Facility No. Farm NameDate 1St1 Q
Permit ✓ COC OIC� NPDES(Rainbreaker U/ PLATS Annual Certt
FB
Drops
loll
�Iw 3
freeboard Tn)
Sludge Survey_�_
Sludge Depth (ft)
LiquidObserved
. -
Ratio Sludge to Treatment Volume
Actual Width
PtA-v- `k 1a p � &W
Soil Test Date
Wettable Acres RAIN GAUGE
pH Fields
WUP �� Dead box or incinerator
Lime Needed
Weekly Freeboard Mortality Records
Lime Applied
1 in Inspections
Cu-I Zn-I
120 min Insp.
Needs P
Weather Codes
Cmn Yipid /
Transfer Sheets
. _ -
`iM��1���rA:i�1'
{ A_
MA
iME
=
r
[rinr�
i,
' • r I�����
►TT L
r
uri'
= .
• , 1,
Verify PHONE NUMBERS and affiliations
Date last WUP FRO 3--� Date last WUP'at farm
-«O-tb
FRO or Farm Records _
Lagoon #
Top Dike
Stop Pump
Start Pump
Conversion- Cu-1 3000= 108 Ib/ac; Zn-I 3000= 213 Iblac
v 1-j . ;
App. Hardware
�, .
cl eC4-GY AM,C19+ (- sg�d COOD Ne

1 I/w 51�fo5 0vs
Facility Number
I Division of Water Quality
0 Division of Soil and Water Conservation
O Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit a Routine 0 Complaint 0 Follow,up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: A i0� Arrival Time: Departure Time: County: -� Region:
1,30 z'VS
Farm Name: S�'1l1?sth>a fFGTn'►'} . +ram Owner Email:
Owner Name: P D b$ 1r H.
++ H1 I-PC Phone:
Mailing Address: {�a 1 N. fTl �I-Ep� k� _ Red_ .%rind _ _ A377
Physical Address:
Facility Contact: ^!�S Title: lownpl- Phone No: 36q'1a5aI
Onsite Representative:: Integrator: H-o
Certified Operator: R0 H;12f Operator Certification Number: 176 q7
Back-up Operator:
Sack -up Certification Number:
Location of Farm: Latitude: 0 0 = I 0 1
1 Longitude: = o ❑ 4 ❑ 1i
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
00
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
ElOther�t
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ® Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
R Yes ❑ No ❑ NA ❑ NE
R Yes
❑ No
❑ NA
❑ NE
❑ Yes
U No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
E9 No
❑ Yes
® No
❑ NA
❑ NE
[I Yes
®No
❑NA
El NE
Page I of 3 12128104 Continued

Facility Number: 4 — a} Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
RNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identi Fier:
Spillway?:
Designed Freeboard (in): _� Q
Observed Freeboard (in): :39
5. Are there any immediate threats to the integrity of any of the structures observed'?
❑ Yes
RNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
RNo ❑ 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?
RrYes
❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
5� 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
C@ No ❑ NA ❑ NE
maintenance or improvement?
Waste APpliCatiDn
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
10 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
E'Yes
❑ No ❑ NA ❑ NE
❑ Excessive Ponding C3 Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
RPAN aPAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside
of Area
y
12. Crop type(s) _CnOJ-61 I�rmJA_ t 44aJ :SGol ; Cniql
.
13. Soil type(s) Ca .g S 8 /Lab S�A Is Ra)�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE.
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
5d No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
N1 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
N 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):
Plegcfax 0�c �ack�� f M Ca1�.+a *1-e1 Z1e7 o FRO q10 486 OV7,
'Crnt�r�vr� zeahe,
C WIlt check o►) 4Q3 -POfIvp ,3eIiew- raj hpj, Otri'ved b4r*ye+rr(flaIW_. MerjL,,Xp'J
" A*,s n6 t!h fAQm?'' C Pe .7
TrClar'
�, 1 r
IF
Reviewer/inspector Name �N��'E� Phone:
Reviewer/Inspector Signature: Date:
v 12128104' Continuer!

Facility ]Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E�iNo ❑ 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement'? If yes, check the appropriate box below. 'Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard 15 Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking RCrop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge'?
❑ Yes
JR No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
RYes
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
I? No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
5& No
❑ NA
❑ NE
26,
Did the facility fail to have an actively certified operator in charge?
❑ Yes
(2 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
IXNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
KNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
0 Yes
ErNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
1;� No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office ofemergency situations as required by
❑ Yes
)9 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
91 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
a Yes
KNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
i for Ieaks cr� i� Pee— r(iers #13�15�4aQ- t7"�-I1��, y `Frx r►�f'I'j1Ii� wef'�s`
AL
C,avJ i�q &small puddles new risps,
1. ?Ieaje. OdCLiov$) seeJAMVICh4o bwe aaevr on )a9a0,1s - be-ecue 11ex-t s'of 19► V*-
Inseecl3on.
i I - Maxi mu,,�'�1r eoch spa e>. �� iS 1 rf�acre Or a7� 15`l�'9JIa�s /acres , P)ege sr�� 1d
- C'o lwv P-Zk
cPi 1fo in o I � s o; is o n owi- 1 n off \owee+� it, t) $ e I .
Ls' I lid
Or� v� saJE Heal -c1af so-t h n ea",e
f deLqs
y s f ,� r�rl� r' net �l
1A rn unc�81 ►c� 1 k s ay `� a v,�i N o►�9"A 11rbr�i
-fra~► d ia�s t`
se orate. Co�►j ohs as rGas a,� re y �/,
a1 l vs o�},s (r cro ��Cry
yes � �� �
ke o�
be fi' hee`h
I,Wa�-e aia�mxt+&o da�s • pPoje_ e��Vida_ or lionnty sD �Ibv F9 on,e fey 3
LI?)1%2 g boos a,d e� aA Croy p s,
Or m ohs , er n y;
33, Fb1106,up` Ocj)eck a)1iserVaIle (,epir4revlert; phcy* reCad 4rpeph rMSM-644_
ivasie,pl �
a,4weN�o Ues) )v a re&e. Nt%eeml I yll nq `lo jamschrjeie,0Xnr, v
Page 3 of 3E'XCe00S no`ek able Wee I kpr1- `Volts form bey d la��(�r2i28iaa Ole( w i I I �
Lef+ IDIC- bock u+� d,�.sJnai��o1 4) ' rviock d-. h h��yh-hea)-h heed,,

! Facility No, 4a Farm Name 'e- Date 51Q I a q
Permit COC OIC
NPDES (Rainbreaker
PLAT Annual Cert )
.Design freeboard
Observed freeboard (in)
�I►A'iS15a7ti�tAL=,f.T_Tr,-*WFX.!EI1<<4�f117ri�1��1'�7ti�
•------�
R - •MINT.
��-----��
•----��_
Soil Test Date y II DE
pH Fields
Lime Needed
Lime Applied 40
Cu Zn
Needs P
Crop Yield ���a�i
Wettable Acres I
WUP
Weekly Freeboard
Rainfall >1"
1 in Inspections
120 min Inspections
Weather Codes
Transfer Sheets
RAIN GAUGE
Dead box or incinerator
Waste Analysis Date
still
MUMMI-0101
.,
..
-.
E=
,�qq S C 10 0
Verfy PHONE NIJMOERS and affiliations
Date last WUP FRO Date last WUP at farm
FRO or F rna Records Q000
Lagoon #
Top Dike
Stop Pump
Start Pump
Y
u"Ir
6&;, ' IveW" 4r Ca f 0 zaP6'
10`130''0- App° Hardware
lay-��p
k �

D lV (491ITiq ~y1
Q Division of Water Quality
Facility Humber ` M-]
O Division of Soil and Water Conservation--O Other Agency
Type of Visit Q Compliance inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint GrFollow up 0 Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: i�p b� Arrival Time: 10 P" I Departure Time: @-, 00 Ptl I County: Region:
FarmName:'S'rl►1 oip po_(M, Owner Email: Mberl rri;iE0W1"VJti0rM✓1
Owner Name: ,abt± Phone:
Mailing Address:
Physical Address:
Facility Contact: Qo b . ll�� _ I li EA Title: d 1y�If Phone No: 9��`7 )2jp
Onsite Representative: Integrator:
Certified Operator: D l7t✓�t M i I-er Operator Certification Number: AWA Meg?
Back-up Operator:
Location of Farm:
Swine
�o
Latitude:
Back-up Certification Number:
❑ " Longitude: = o =' =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
0 Feeder to Finish
0
I Ij 010
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dahy Cow
❑ Dairy Calf
❑ Daia 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: IN11
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?
'V1
❑ Yes 6? No ❑ NA JWNE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
['ENE
❑ Yes ❑ No ❑ NA VNE
12128104 Continued

r '
Facility Number:yj --M(al Date of Inspection
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 ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No ❑ NA 5 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 WNE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No ❑ NA I'NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
fRNo ❑ 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 CR NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No ❑ NA IRNE
maintenance/improvement?
11, Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
❑ No ❑ NA Q NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ 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
1�jNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
❑ No
❑ NA
P NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
❑ No
❑ NA
WE
17. Does the facility lack adequate acreage for land application?
❑ Yes
W No
❑ NANE
19. Is there a lack of properly operating waste application equipment?
❑ Yes
9 No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations, (use additional pages as necessary):
•
Reviewer/inspector Name Phone: q
Reviewer/Inspector Signature: Date: a
V 1212NV4 Continued

d a
Facility Number: Date of Inspection
Reauired 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 [3 Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes [--]No ❑ NA g 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 CRNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? PYes ❑ No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
i@ No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[:]No
❑ NA
GaNE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
5;'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[,;q-No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
RNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
JKNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
®'No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
allo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ONo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
WNo
❑ NA
❑ NE
Ad'dlfional Co'nments aridlurtDrawings s _ 'A =9" AM'
It Ply;eived- h0v,io Io f110rfhAPsa, Cyry#i>2AI4 I S"'F(, a, bR'mu%-_.
`
Vvi 1I heek new wa,e 0,alysl' sh&+ly
yca�� brafio� reed r io be d&e emr yP,, al 1'� rom
��,'�( ase i nr l�ii f�lin b,�r� ,. bdb(e nt)i+-61 h6 InC s'{-cv�, Prat -t r hos, W
on �� aqoa, h od- lopA add4_ w s�s� A beyi10! j ��ePats
�, �f e0hlt'�f
D
�,ea�rs I ,e6 yvfre~�rxpcLi main reeiia o110 tl
p
food . c JG4d below:
�G c�fyrry nale� aba�e1 nr o, �ia �[� �'j' s � Ps ) a oar ba►k work
1+ wps ra�+lbo/0 Sol I wal we+ Ghd d I�ne rn i 'j
Page 3 of 3 12128104

. . .
Facility No. 'a. (Farm Name
Permit COC
OIC
NPDES (Rainbreaker PLAT Annual Cert )
Lagoon
1
2
3
4
5
6
7
S illwa
Design freeboard
Observed freeboard in
y
Sludge Survey Date
Sludge Depth ft & %
Liquid Trt. Zone ft
Calibration bate ---
--------
Soil Test Date
pH Fields
Lime Needed
Lime Applied
Cu Zn
Needs P
Crop Yield
Wettable Acres
WUP
Weekly Freeboard
Rainfall >1"
1 in Inspections
120 min Inspections
Weather Codes
Transfer Sheets
RAIN GAUGE
Dead box or incinerator_�w
Pull/Field Soil Crop RYE PAN Window Max Rate Max Amt
Verify PHONE NUMBERS and affiliations DeAbQ" Wes
Date last WUP FRO Date last WUP at farm App. Hardware
FRO or Farm Records
Lagoon #
Top Dike
Stop Pump
Start Pump

Type of Visit compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 10 Routine O Complaint Q Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time:County:
Farm Name: u ,, rw_S4one, rr! T �y�►^�� Owner Email:
f)wnrr NaF 1 me- M3 �Lf l i 1'4.] phnnp!
Mailing Address:
Physical Address:
Facility Contact: + ' ��� Title: �Y Phon No:
Onsite Representative: >( t ks Integrator:
Certified Operator: 6V `T fn, w Y Operator Certification Number:/ r
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = e = 1 =it Longitude: = o = 6 =
it
11 ffl'7pin
apacity
Crrent DesigSwine
Population Wet Poultry Capacity Popu[ation Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
Van to Feeder
to Finish
Ott
❑Non -La er
❑Dai Calfder
Dry Poultry
❑ Dai Heifer
❑ D Cow
❑ Non-DaiEy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Cow
Number of Structures:
❑ Farrow to Wean
❑ Farrow to Feeder
❑ La ers
❑ Farrow to Finish
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Gilts
❑ Boars
Other
❑ Other
❑ TurkeyPouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
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?
Page 1 of 3
❑ Yes
16 No
❑ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
�TA
❑ NE
❑ Yes
❑ No
ONA
❑ NE
❑ Yes 55No
❑ Yes F No
12/2"4
❑NA ❑NE
❑ NA ❑ NE
Continued

Facility Number L f --�(y Date of Inspection 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
Struck re 1 Struct e 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier-.
Spillway?: N
Designed Freeboard (in): `i
19
Observed Freeboard (in): ZC) Z I
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes to 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 OIo ❑ 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? A Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes PM No ❑ NA El 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 U No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No ❑ NA ❑ NE
maintenance/improvement?
l l . Is there evidence of incorrect 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 Drifi ❑ 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
'ZNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
U No
❑ 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
.4 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
&No
❑ NA
❑ NE
Comments (refer to question 4): 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):
o Stvl r� sr r� �5; d'.
® r yte�cl i C Q Y t�
S [, e P r�� � N
AL
i S ► SP►�d �r roc 1s . +�
�Ic�-yy ar. .
a GLQ,a Cvl��u.dux" , LJ ti i tow
Reviewer/Inspector Name fj Sri N6,
6LfiA/_r@,&JPhone: 33
Reviewer/inspector Signature:
Date: 4 7
12128104 Confinue�)

Facility Number: —a(, Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes )ONo ❑ NA ❑ NE
the approprrate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
Waste Application ❑ 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 R No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
RNo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
N No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
O 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
�jNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes]
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
-A uS� e rimer P Q Z . ms �� r
PzoM a s4 .&-A f nqLwr (z6_:hjaL(j A_U6&,_4L L%)ZkAA-V Vr�,
t �U wv CPO �� Coo-rec.Y`., 0,nX VV>'r
-v
S k VO I.t fh t 4 IL j� ✓ ce, p w r rY'n V
u%Vt i I. ecor� S .
Qt�lGA3
S9
U
V
4,
12128104

Facility No.Time In Time Out Date
Farm NameIntegrator m—
Owner Site Rep
Operator��i No.
Back-up
COC
Circle: General or ( NPDES
Design
Current
Design
Current
Wean - Feed
Farrow - Feed
_Wean - Finish
Farrow - Finish
Feed - Finish,
OIrwo
Gilts 1 Boars
Fatr�w
Others
FREEBOARD: Design i r
Observed 7-01
Crop Yield "I xww'
Rain Gauge ✓
Soil Test
Weekly Freeboard
Spray/Freeboard Drop _
Weather Codes 120 min Inspections
Waste Analysis:
O 0 2
Date
'Nitrogen (N)
4 0
1, -5,J
a�
Z,lk 2
Sludge Survey V. ! $ L� 3 Z-
Calibration/GPM- 1 ��
Waste Transfers
Rain Breaker
Wettable Acres / PLAT
Daily Rainfall 1-in Inspections '�
Date Nitrogen (N)
�
Pull/Field Soil Crop Pan Window
IN - kol
4r
k Q
C—,
tx<
k
4

'f
Division of Water Quality
Fl "`
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of VIsItV
Compliance Inspection
O Operation Review O Structure Evaluation
0 Technical Assistance
Reason for Visit
Routine O Complaint
0 Follow up 0 Referral O Emergency
0 Other ❑ Denied Access
Date of Visit D 00 Arrival Time: Departure Time: County:0
Farm Name: (� +(���Y'e. �C�{ I'ill� Owner Email:
Owner Name: Phone:
Mailing Address: _ �Z
Physical Address:
Region• FF--o
Facility Contact: - l „ , $„J�` MSLU16 Title: _ L ofy- ✓ Phone No:
Onsite Representative: env Integrator: [
Certified Operator: Operator Certification Number: 7
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
fg�Cccder to Finish
U Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Back-up Certification Number:
Latitude: = c = I = 1
1 Longitude: = ° = 4 0 1{
Design Current Design Current
Capacity Population, Wet Poultry Capacity Population
❑ La er
,awl ❑ 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design . Current
Cattle Capacity Population .
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy 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: ®'
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 [ &o ❑ NA ❑ NE
❑ Yes
❑ No
ONA
❑ NE
❑ Yes
❑ No
NbNA
❑ NE
❑ Yes
❑ No
[)tNA
❑ NE
❑ Yes
%No
❑ NA
❑ NE
❑ Yes
[Q�qo
❑ NA
❑ NE
12128104 Continued

FacilLty Number: q — 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 ttt❑��` No
0 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: —
Spillway?. -
Designed Freeboard (in):
Observed Freeboard (in): pt
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes o
[INA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 0 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?
P(Yes ❑ No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes �To
❑ NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
rr
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
[INA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes )(No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes VNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [--IPAN > 10% or ] 0 Ibs ❑ 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) ynj a-- C r
13. Soil type(s)
d fl
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes 5?tVo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 5No
❑ 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 NANo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes %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):
�d� rnaw harL 51qks 01 � 2- I�c�� rnuldi �x'i- aw
`
II-U.
` -ci 4o p iz-v o5 a av t
1 S , I nR
U
O�SS 5 to V1 C.Q.
Reviewer/Inspector NamehkA Phone: 3
Reviewer/Inspector Signature: ca Date:
12128104 0 Continued

6.
Facility Number: Wh Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
_)k
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El No ❑ NA ❑ NE
the appropiate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. *es
o ElNA ❑ NE
ElWaste Application ElWeekly Freeboard Waste Analysis ElSoil Analysis ElWaste 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 jj�No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ONo
❑ 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
❑ 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 VNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 'qgNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yeso ❑ 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 1]Vo ❑ 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 "ANo ❑ 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 �fNo El NA El NE
33. Does facility require a follow-up visit by same agency? Yes ❑ No ❑ NA ❑ NE
Additional Comments and/or Drawings:
LX
i•�l u S Inla,.v �. v o._l '� � s �
!r + _
�g �
�. UL -'L �Ims �: s6w� Q_Zffe_c_-�
pro f t 4 � K�C� mn^er� i C� tin ff V
sty' a C1 l R,- D t�w�;o CL %'r c
ovu�� a�
91 c JS 0 C; 11
=2M l4 .
12128104

'l J
Facility No. 14" Time In Time Out Date
Farm Name Integrator tuL.
Owner 129 Site Rep 646
Operator f�' No.
Back-up No.
COC Circle: General or C
Design
Current
Design
Current
Wean - Feed
Farrow — Feed
Wean —
Farrow — Finish
ed, Finish
a
Gilts ( Boars
o an
Others
FREEBOARD:
Design g
Sludge Survey
Crop Yield
Rain Gauge
Soil Test
PLAT
Weekly Freeboard _A-,—� Daily Rainfall
Waste
120min Inspections
ir?!!e Nitrogen (N)
m . n-
Observed
Calibration/GPM (JU
Waste Transfers
Rain Breaker
Wettable Acres
1-in Inspections r• r`
Date Nitrogen (N)
.III 1��MWOM
1 Ali
,,

Facility Number Q
111�uivision of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit Com Hance 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: Z Arrival Time: ! D Departure Time: I .I County. Q Region:
Farm Name: ��ru' Owner Email:
Owner Name: " Rdcu i i "t " �e"s Phone:
Mailing Address:
Physical Address:
Facility Contact: r V'_C Jb f 4 mloy
Title: � )U_-)Y1Q 1fr Phone No:
l
Onsite Representative: _ O.�ZY ! Vl `es Integrator:
Certified Operato r 1 J �- .,..._., ,_.._ Operator Certification Number: J I (Ogg
Back-up Operator: ����/1c Back-up Certification Number:
Location of Farm:
Latitude: = e = d Longitude: = 0 ❑ 1 ❑
.Design Current Design Current, Design; Current
Swine Capacity Population
Wet CapacityPopulations CattleCapacity. P"opulationa
❑ Wean to Finish j
❑ Wean to Feeder
eeder to Finish I ji;"9q0j I&DbO
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
'Other
❑ Other I1
❑ Layer '
❑ Non -Layer
Dry Poultry
❑ Layers
ElNon-Layers
❑ Pullets
ElTurkeys
❑ Turke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure El Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures -
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes �4 No ❑ NA ❑ NE
❑ Yes
❑ No
�WNA
❑ NE
❑ Yes
❑ No
JINA
❑ NE
NNA
❑ NE
❑ Yes
❑ No
❑ Yes
"7m
❑ NA
❑ NE
ElYes
� No
❑ NA
❑ NE
12128104 Continued

Facility Number: ? q G Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes*'�Iwo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No N NA ❑ NE
Structure l Structure 2� Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): I J1
Observed Freeboard
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes JCNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes p(No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes %No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes INo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes )allo ❑ NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes %ONo ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes )Q No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Y.
❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�fo
❑ 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
o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
Cl Yes
❑ 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): s f X
Reviewer/inspector Name C_mm
I Phone: " I 0 3.'� ,
Reviewer/Inspector Signature:
Date: 2�
Page 2 of 3 12/28.104 Continued

Facility Number: 14 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
Cl Yes *0 ❑ NA ❑ NE
❑ Yes t� No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections
22. Did the facility fail to install and maintain a rain gauge?
❑ Monthly and 1 " Rain Inspections ❑ Weather Code
❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes /WNo
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes //❑ No
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 ❑ No
❑ Yes o
❑ Yes�lNo
El NA ❑NE
❑NA ❑NE
❑ NA >NE
❑ NA'ANE
❑ NA ❑ NE
El NA El NE
❑ Yes o
!!Y`
❑ NA
❑ NE
❑ Yes 1` o
❑ NA
❑ NE
❑ Yes �*o
❑ NA
❑ NE
❑ Yes ANo
❑ NA
ElNE
ElYes b No
❑ NA
❑ NE
❑ Yes 'f RNo ❑ NA ❑ NE
5Ik1eSofv 8/4/0L .
Pro V �co ed crop i�i' e ld bowryi .
D1 sC.w� USat ns d {{� �P'y ryL , f r
-le. CV16LI(v VOJUts t'7L encin 4 �' "'t 'k�t� �roL_nu -

is
1 5
1
Facility Number �� ��� Date 2- Time IN out
Owner
Farm Name;
O.I.0 %✓ No.
C.O.C. General D
Design Currentv Design Current
We tWean to Feeder
eede�to-z� 1 Farrow to Wean
Farrow to Feeder Farrow to Finish
Gilts Boars .. .
Other
Soil types ' No ci
Crop Types & Pan Window
s-Ak—
. �U.
�Soil Test Plat
Designed Freeboard ✓ Observed Freeboard
y�
Rain gauge Rain breaker `' Daily Rainfall LI Waste Transfers }
Calibration of spray a ui ment G.P.M. 2�
P Y �. P
Sludge Survey C Crop Yield 120 Minute inspections
1 in.'Rain inspectionsWeather code Weekly Freeboard '--�
Pumping time
��.Z 2°34) .3 33.L
Waste Analysis % & Month
Comments

AUG-2-2006 11:49 FROM:FPYETTEVILLE USDA SE 910-484-3157
T0:19103694741
Phosphorus Lose Assessment Tool Completion
Name oFFacility — Facility Number.�� - 2 �
Owrtar(s) Name:_, �_._. �1 �,...._ Phone
Mailing Address:e44
--
Check the appropriate box below, and sign at the bottom:
@No fields received a high or very high rating.
CI Yes, the fields listod below received a high or very high radng.
Field Number Size Acres Rats or Ve
ly Hi
Please use as many additional attachment forms (PLAT-A-10.31-03) as needed for additional fields.
By cornpleting the above section and any additional attachments and by signing this fb=, the facility
owner and Technical Specialist acknowledge all application fields were evaluated using the Phosphorus
Loss Assessment Tool, All necessary calculations were completed to conduct the Assessment. A copy will
be kept on site with the Certified Animal Waste Management Plan. Any future modifications must be
approved by a technical specialist and filed with the Soil and Water Conservation Dietriet prior to
implatnentation. Waste plans with fields baving a high or very high rating wiU have to be modified to
address phosphorus loss by the next permit cycle beginning July, 2007.
Owner
Owner
TccWcal Specialist Name: ` C�.ce • _ �s _
Technical Specialist Signature:• Q� •_ e a t _ Date: ks U_ G
Affiliation: _ Q 5 c) fl _ LN ?I I-C .S_ . .�.. Phone No: F, j b r-.,i gti x 3
Submit this roan to:
Attn: Keith Lorick
'Non -Discharge Compliance and Eafmatnont Unit
NC Division of Wader Ouahty
1617 Mail SerAce Center
Raleigh, NC 27699-1617
PLAT-12-I1-03

1 V
Type of Visit ® Compliance Inspection 0 Operation Review O Lagoon Evaluation
Reason for Vlslt ®Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
I]ate or visit: Time:
10 Not Operational Below Threshold
©Permitted [3 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: /Ac County: �� I'X 0
Owner Name: 4g0y-+�•�2 Phone No:
Mailing Address: f rz Nor f it�r� fob Rol �0a .5p.—
Facility Contact:
Onsite Representative:
Title: Phone No:
Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude 0 �y
",; Design; ;i Current Design Current Design. �Cttrrent
`;,Swine -Ca acitv.' Po ulgtion Poultry, . „' - Ca achy, Po ulation Cattle "Ca achy , `Pa ulatian
"l. [� Wean to Feeder Ii;; Layer ❑ Dairy
,, ', Feeder to Finish a ❑ Non -Layer I I " ❑ Non -Dairy
Farrow to Wean , . . , _ 1, .._
❑ Farrow to Feeder ❑Other
S., ❑ Farrow to Finish T&al;Design Capacity
,.
I E�' ❑ it '} i t b }I
J�� Boars �Tots1j9 LW,
Numbe'r,of Ligooin " "; ©' , e; Subsurface Drains Present ❑ Lagoon Area S ray Field Area
'' A /WSo11d,Ti•aps i : {;, No Liquid Waste Management System
Discharges & 5trearn lmpgcts
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 yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Co tin & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier:
ay„
Freeboard (inches): �..,.
05103101 Continued

Facilfty Number: Date of Inspection _d
c
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or Yes ❑ No
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attar below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
❑ No
Air Quality representative immediately.
Feld Covv ❑ Final Notes
Reviewer/inspecter Name V1 " ' : " ��11 ,. '( & _ �`' `�� ,�`'
ReviewertInspector Signature: — Date:
12112103 Cowed

Informa,tion contained in this database is from non agency sources and is considered unconfirmed.
Animal Operation Telephone Log
DWQ Facility Number 47 26
Farm Name ISwinestone Farm, Inc.
Caller's Name No call/ Inspector visit
O Reporting O complaint
Caller's Phone # NIA
Access to Farm
Farm Accessible
from main road 10 Yes O No
Animal Population
Confined 10 Yes O No
Depop 10 Yes O No
Feed Available 10 Yes O No
Mortality 10 Yes O No
Seray Availability
Pumping
Equipment
10 Yes O No
Available
Fields
10 Yes Q No
Date 9/9/2004
Time 1:47
Control Number 14630
Region JFRO
Lagoon Questions
Breached
10 Yes O No
Inundated
Q Yes O No
Overtopped
10 Yes Q No
Water on
O Yes O No
Outside Wall
Dike Conditions
O Yes O No
Freeboard Level
Freeboard
Plan Due Date Date Plan Date Freeboard
Inches
(? equals blank) Received Level OK
Lagoon/ 18.5
9/11/2004
Lagoon2 24
I�—J
Lagoon3
Lagoon4
Lagoons
o
Lagoon6
Farm inspected as result of storm lagoon checks being conducted by DWQ staff. No notification was
mcieued..fr.am..the.. permittee....................................................................................................................................................................................................
N/A
Comments2

(Type of Visit O Compliance Inspection O Operation Review 4D Lagoon Evaluation
Reason for Visit O Routine O Complaint • Follow up p Emergency Notification O Other ❑ Denied Access
Facility Number Date of visit: 9 f3 8 Tune: ��
Q Not Operational Q Below Threshold .
© Permitted D Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .._._._._.._ ...._.
Farm Name: ..... ...... ! S.W t.MA.S. ....... Fa r V,% _Y.tit�................ County:.....».» Sl k......»...._.».»»...............__..........
OwnerName: _.._._._............. ........»..... ...... .._.. _...._..........»._ .....__ .._ ._ .... 'Phone No:
MailingAddress:.._ __.__._..._ ................... ---- __....._--------....__._.._...... __.._ ...._
Facility Contact:
Title: .._ .._ ... _. _ . __. ».„_. Phone No:
OnsiteRepresentative: »» .».». _ » ..»..».. .»...».».»» ».».».».».. .. Integrator:
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 « Longitude • 4 «
Swine
irhmt yDesiga '.Correa!
�nlat,an'. r:Csttle `, r,Casac�ty."Peniilatien.. ;
Ej Wean to Feeder
Layer
ElDairy
El Feeder to Finish
❑ Non -Layer '? Non -Dairy
EE3
❑ Farrow to Wean
y
❑Other
Farrow to Feeder
r�+ y }
1 oLt b-Ca a�
�°P �',
Ij Farrow to Finish,C"R
Gilts�,�a
Boars
k
�
�^' s� : a `Tota!'SSLW
Discharges & 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 gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
12112103
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
Structure 6
Continued

Facili N mu ber: t j 4 — Z (o Date of Inspection
1
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are, there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ❑ No
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenanceJunprovement? ❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ❑ No
Air Quality representative immediately.
W1e v6rv-c .
1 K. S 61
00— Wa-S
+Ir'� tee. c C.
v+e s u�ra�e
. �ava�s
1Cr 0", Fr,j&f
1►,►+C of 4r-wl�
ReviewerAWspector Name a
Reviewer/inspector Signature:
❑ Field Copy ❑ Final Notes
1 o.&.+
I'L'L trr� w ke oP a ro.�c S
-��►�5 -tom t`twev"s
`M,s [&worn. was S*, vt a7V 2,4 "
Date:
i w� riw a.wrsasrscu

W ti
r�r r.�''• t'"sPN-v!xr ,Y,.. a f.: Ar,s`�vi• -,9r� .,..,� t *'•'
id�',"x w;a
�� t
1. k .r ",. ;,Tr� r �� ,' �,, �, s�' "�d.,7�•'17_+, ,'. ,�1y, A,y k yxL Q1 D'val'n +�oe-iaxcoryw i!-anP.4da Water
� C'bnsewrwvaht. tto� n
trQ Other Ag
> r w
.. A•l�iii�T�k, �4-},rh? "�''' `"�',.�' '" "e'.sti.Sifi ..:�"�.n� :'fy!v+i'`Y�, . v 4. , t+� r s.} _
Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine ()Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Faciliri' Number Date of Visit: Time: lO a0
Not Operational 0 Below Threshold
® Permitted ® Certified O Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: __ 4LJ;,,AX" lf�&i C= County: On
Owner Name: &Q_4er— M-L['4 - — - _-- Phone No: _��� 0 I 3 3L`f - 2,5�3
AlailingAddress: ���1 IJ r�b�, lf'dlaxv 12cQ, _[�F�D� �, 2,R3,-G
Facility Contact: fz,04&r1L— M t' a Title: Phone No:
OnsiteRepresentative: Integrator: C.clallokk±
Certified Operator: -- Cher (Z Ae,4 M 16 : Operator Certification Number: 1-& 41 4—
Location of Farm: f eta q'
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• ���
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Ca acity Po ulation
Wean to Feeder I 1 1[:] Layer I Dairy
Feeder to Finish ❑ Non -La er I Non -Dairy
❑ Farrow to Wean 147
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons
Holding Ponds / Solid Traps
MI❑ Subsurface Drains Present JI❑ Laaoon'Area J❑ Spra} Field Area
i x ❑ No Liquid, Waste Management Svstem I,:
Discharges 8 Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Laaoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c, if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts of potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: C S — A. M_S W i
Freeboard (inches): �, a
05103101 Continued

A. I
Facility Number: — d Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [ 0 No
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 ❑ Yes CO No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [ -No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes W No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 0 No
Waste Aanlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes [� No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 5No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes CWNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ® No
16. Is there a lack of adequate waste application equipment? ❑ Yes [No
Required Records & Documents
17,
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[4No
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
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
W No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
N No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
[7l No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[RNo
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
�Co ments�`(reler to questlj'ii #).. Explain any YES answers airy recommendations or any oiliergo
-and/or
"iJse.'drawings uf.facillty to better explain situatlons., (use Akldl11onai pages as necessary) .: [] Field Copv Final Notes
"�
Reviewer/inspector Name
Reviewer/Inspector Signature: A4 tdegDate:
OS163101 ` Continued

Facility Number: — Date of inspection
Odor lssucs
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 ;Q No
❑ Yes 0 No
❑ Yes [A No
❑ Yes No
❑ Yes No
❑ Yes ❑ No
05103101

State of North Carolina klpm;%
Department of Environment,
Health and Natural Resources 1 •
Fayetteville Regional Office
James B. Hunt, Jr., Governor [DIEHNFZ
Jonathan B. Howes, Secretary
DIVISION OF WATER QUALITY
April 2, 1997
Mr. Robert M. Miles
1821 North Hilltop Road
Red Springs, NC 28377
SUBJECT: Annual Compliance Inspection
Milestone Swine Farm
Registration No. 47-26
Hoke County
Dear Mr. Miles:
On April 1, 1997, staff from the Fayetteville Regional Office of the Division of Water
Quality inspected the subject swine facility. Please find enclosed a copy of our Compliance
Inspection Report for your information. It is the opinion of this office based on the
information provided and observations made during the inspection that the facility was in
compliance with 15A NCAC 2H, Part.0217 at the time of the inspection. Please refer to the
comments section on the rear of the inspection form for information regarding your facility.
Please be aware that all swine facilities with a liquid waste collection system designed for
a minimum of 250 hogs must have a certified waste management plan on or before December
31, -1997. The district NRCS office, Agriculture Extension office, or the Division of Soil
and Water have specialist available to assist you with upgrading of existing facilities and
certification.
If You have any questions concerning this matter, please call Robert Heath at (910) 486-
1541.
Sincerely,
Robert F. Heath
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine - FRO DSW
John Ray - Hoke Co. NRCS
Wachovia Building, Suite 714, Fayetteville FAX [phone]
North Carolina 28301-5W3 NOC An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

Fadhty Number s
Farm Status:
Date of inspection i V-/ =UJ
Tbae of Inspection : o Use U br. time
1 Total Most (in boon) Spent onReview j
or Inspeetion (indodes travel and processing)
Farm Name:'County:
Owner Name: �� L t Phone No: /6 l • .Z S�1.3
Mailing Address: • . / .rs .� w /1�G�77 .,.. ^..�.,..`
OnsiteRepresenative:../�i�0t�irl 1�4 ---- ----'- .,,. Integrator••
Certified Operator. - ��1 Operator Certification Number. ! ZACX2
Location of farm:
Lstitude �'� �� Longitude
113 Not Operational Date Last Operated:
Type of Operation and
Other Type of Uveatocit
]. Are there any buffers that need mainteaanYea XNo
2. Is any discharge observed from any part of the operation?
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Watm? (If yes, notify DWi )
e. If discharge is observed, what is the ea ftnated flow in gaumia?
d. Does discharge bypass a lagoon ryatem? (if yes, notify DWQ)
3. Is time evidence of past discharge f mm any pan of the operation?
a. Was them any adverse impacts to the waters of the State other than from a discharge?
S. Does any part of the waste management system (other than lagoonLlolding ponds) require
maintenan-. - rtt?
C Yes 10 No
E3 Yes V No
13 Yes JM No
Yes A No
13 Yes I[No
13 Yea 11 No
Q Yes WNo

6. Ic wility Dot in compliance with any applicable setback criteria?
7. Did the facility fi til to have a certified operator in maponsible charge (if inspection after 1nin?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons and/or Holding ponds)
9. Is structural freeboard less than ad%uft?
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
10. Is seepage observed from any of the stiuctraea?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/
(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 adquate markers to identify start and stop pumping levels?
Waste Aoalication
14. Is there physical evidence of over application?
.(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. top type _Est
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for lead application?
18. Does the cover crop need improvement? •
19. Is there a lack of available irrigation equipment?
For Certified Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Play readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in nay way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did ReviewerlInspector fail to discuss review/inspection with owner or operator in charge?
17 Yes ®No
13 Yes ®No
D Yes 4 No
13 Yes 19 No
Lague 4
❑ Yes io No
13 Yes $j No
El Yes ® No
❑ Yes JM No
Yes ® No.
❑ Yes jo No
E3 Yes JR No
❑ Yes ,q No
Yes ALNo
13 Yes
29 No
IA Yes No
R Yes
❑ No
D Yes
IN No
❑ Yes
1KNo
aunent5` questioa.fi� y�YEs aas9i►era
...,...• .. as
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SeilraCn Ong,0I8�►:Ott1CrC0Ir1�¢IItS.'..a:'';���:-•"' `�:�°:�'• :;�
n..... }�vmgs offacilr .to batter. lam.situations• ...�.
,.....: aY.,: :.:...:..,..., �oz
*�P.:.,......,... �......:...�:�use,»dd�onal pages
LL. �l',e. /� ,%ss .•ie,F� � �t,� ,C,�� o� �v:�y�✓ 6•,�•rce �',� .i•'r ee�o• 4
.1 RR IX /
.2 /• /% ll�.f_C �t/f,F•O1 eo%s� u� 0-4047s7r p;P 7011 .100001M.
Reviewer/Inspector Name
Reviwer/Inspector Signature: 1�� Date: 9%