470029_INSPECTIONS_20171231

NUH 1 H UAHULINA
Department of Environmental Qual

i ype 01 visit: W i.ompuance inspection v vperauan iceview % 1 airuciure r vajuauon v i ecnnicai Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 11 Arrival Time: p' B Departure Time: County: D
r
Farm Name: ` ` Owner Email:
Owner Name: d G t� Phone:
Mailing Address:
Physical Address:
Facility Contact: CL-iC4'-r�-D Title:
Onsite Representative: N
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Region: Arzv
Phone:
Integrator: JAL .
Certification Number:
Certification Number:
Longitude:
(( II i019111l.i �iulM11PIPPoNM11111 a,E I _ E il!llyiili1 Y"1.40� P'll4 �' i1ttillllifllfiipllPi
f rI.
Design Current Design Current Design Current
Swine Capacity Pop. Wet. Poultry Capacity Pop. Cattle CupAcity; 3P p
iwuw„ IN. a a eiluu�,, all � wl�: bkMltlC>i inlnti„nau>a,I4 Ifl nl
Wean to Finish Layer I Dairy Cow
Wean to Feeder 1 jNon-Layer 1. Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish Layers I Beef Stocker
Giits [Non -Lavers Beef Feeder
Boars Pullets Beef Brood Cow
Turkeys
utlleri 1 , Il t,: Turkey Poults
Other Other
„,
D r
P,ouft
, ,
lfc
Milli1N��IlfDairHeifer
eiCurrenDCow
tll{ln�:r
a act
nllnl�1j�#l�
�l'o
Non -Dairy
Dischar�nd 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? (Ifyes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑Yes K]No ❑NA ❑NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑Yes No
❑ Yes] No
�] NA ❑ NE
NA ❑ NL',
P9 NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

Faci ky Number: 7 _2 Date o:Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No 0 NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Eja NA ❑ NE
Structure I Structure 2,tructure 3 Structure 4
Identifier: 04.0 "' f
Structure 5
Structure 6
Spillway?:
Designed Freeboard (in):
�rT
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[p No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
0 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[2� No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P] No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
� No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop indowf ❑ Evidence of Win Drift ❑ A plication Oa),
of ApproveddlArea
12. CropType(s): L.E7'e ✓l Py,.i` 1t°�r ct S I 61 (�'�4CS ss - tr"�rti t
13. Soil TYpe(s): /Vo.14-a1l�-
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
� No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[�]p No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[M No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
® No
D NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ pease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ;�] No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [� No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

•lFacillty Number: V - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [—]Yes [fl No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
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)
❑NA ❑NE
❑NA ❑NE
❑ Yes
No
❑ NA
[] NE
❑ Yes
]No
❑NA
❑NE
❑ Yes
[0 No
❑ NA
❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes [A No ❑ NA ❑ NE
31. Do subsurface the drains exist at the facility? Ifyes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ LagoonlStorage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/]nspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
No ❑ NA ❑ NE
rW No ❑ NA ❑ NE
No ❑ NA ❑ NE
[PNo ❑NA ❑NE
Phone: fie
Date:
21412015

® Division of Water Quality 11
Facility Number � - ® 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visitr ® Compliance Inspection O Operation Review O Structure Evaluation p Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 41 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 Arrival Time: Q .' eparture Time: County: Q i L�Region:
Farm Name: toW14114A �1J Owner Email:
1 1 .
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Jo�e &.�✓`8. Title:
Onsite Representative: t'f
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
Lt
Latitude:
Phone:
Phone: %
Integrator: 5�AIUA �
Certification Number: r ` ' M
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -Layer
Non -
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)
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.
DaiEy Cow
Dairy Calf
Dairy heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
0 YesAA
LP No ❑ NA ❑ NE
❑ Yes [] No
[]Yes []No
[j NA ❑ NE
T[QNA ❑ NE
❑ Yes ❑ No P NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes z
No ❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facility Number: Date of Inspection:
T-q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes�_n
No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No �TNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: (/ 2
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 37i4 _ 31 u�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes �5 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) T
9. Does any part of the waste management system other than the waste structures require ❑ Yes TNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �No ❑ NA
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes T 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 Cron ,Windpw ❑Evidence of Wind Drill ❑ Application Outside of Approved Area
IN 111111120210219=1VIVA ' A 12949Vra 10,
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
IT Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
CT
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
[] NE
❑ NE
❑ Yes
l No
❑ NA
❑ NE
❑ Yes
EpNo
❑ NA
❑ NE
❑ Yes
No
[] NA
❑ NE
❑ Yes
T No
❑ NA
❑ NE
[� Yes
® No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tran fers
❑ 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 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes NNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
[]NA ❑NE
Page 2 of 3 21412015 Continued

Fa ill N -mber: - Date of Inspection.
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0�No ❑ NA ❑ NE
T�
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No ❑ NA ❑ NE
Other Issues
2$. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No ❑ NA ❑ NE
and report mortality rates that were higher than normai?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No ❑ NA ❑ NE
0
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
P No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No ❑ NA ❑ NE
§5
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
ENo ❑ NA ❑ NE
��w(S Rio-�ezl-Har/
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 01 /o 33 33go
Date: ! [-1
21412015

yt t 77
pivislon of Water Quality
Facility Namber - Q 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
Date of Visit: 0
I Arrival Time: I Cq Departure Time: ® County:��
Farm Name:0`1�""jh � �'K �1.i1/1 Owner Email:
Owner Name: t) I- LC Phone:
Mailing Address:
Physical Address:
Facility Contact: <] 0se ('Q,' Title:
Onsite Representative: 1-1
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
M
Latitude:
Phone:
Region:
Integrator: f �"► '�6
Certification Number: 9 I7q Q 9)
Certification Number:
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
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)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes Q�? No ❑ NA ❑ NE
❑ Yes
❑ No
P NA
❑ NE
0 Yes
[] No
J�q NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [' No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Nutlber: jDate of Inspection:_ Lpr5111PI
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
Struc ure I Struck Structure 3 Structure 4 Structure 5
Identifier:
No ❑ NA ❑ NE
❑ No [PNA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ;L
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
I'llNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
[]] Yes
[P No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[jg 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
0 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes ❑ No ❑ NA
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 Drifl ❑ ApplicatiorjOutside of Approved Area
12, Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ
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'?
Reauired Records & Documents
❑ Yes [] No
❑ Yes []No
[]Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
NE
NE
❑ NA NE
❑ NA NE
❑ NA PNE
❑ NA NE
❑ NA NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA In NE
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check
❑ Yes
❑ No
❑ NA NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA 1�) 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
(] No
❑ NA
NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
NE
Page 2 of 3
21412015 Continued

Facility Number: - -71 Date of Inspection: 0
2424. )3�cility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ NA ONE
❑ NA 1� NE
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ❑ No ❑ NA MPNE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA T
NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ❑ NA 1� NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑ No ❑ NA NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes []No [DNA NE
permit? (i.e., discharge, freeboard problems, over -application) ]T�
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No ❑ NA NE
34. Does the facility require a follow-up visit by the same agency? ]Yes ❑ No ❑ NA NE
Comments (r,efee to question#) ;Explain,any. YES answers,nnd/or.any additional recommendations or any other comments:
Use,drawings"pf;facility7to.better::ezplain>situatlons".(ase a: dditional pages as. necessary),
9��Vatg
Q6 q�D - 6�1� __V01( /
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1t
Date: '01
21412015

b I'M S
113
Type of Visit: Q'Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (5�Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: IN r//� Owner Email:
Owner Name: 4nkp LiLPv+nrL f i Phone:
Mailing Address:
Physical Address:
Region: EM -
Facility Contact: ZA.se-, (Sj} Uj2:e / (} Title: Honju - Phone: -JE I — g-aH 1
4 n�mOnsite Representative: awe (ogyp/(P4 It Integrator: _ _ + 1'-R
Certified Operator: To)e- ,Vu2ltevo Certification Number: ` ggos1
Back-up Operator: 3%P_ -1 2>/P1(ef Q Certification Number: 9qm ),
Location of Farm:
Latitude:
Longitude:
Design Current
Des€gn
Current
Design Current
Swine
Capacity Pap.
Wet Pouitry
Capacity
Pop.
Cattte Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
mr
Current
Dry Cow
Farrow to Feeder.
Dr Poultr ,
,Ca ac€
F1,P0 ;.
Non-Dal
Farrow to Finish
Layers
n
Beef Stocker
Gilts
. it
"€
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qthcr
Turkey Poults
Other
€:
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[—]Yes
tjjNo
[] NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
[] NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21417011 Continued

y
Facili Number: jDate of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[5j No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: ave to
Spillway?:
Designed Freeboard (in): 19 Ig
Observed Freeboard (in): _ 31
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
U No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
R No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
fp No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload D 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 WiW_Drift ❑ Application Outside of Approved
Area
12. Crop Type(s): p
13. Soil Type(s):
14, Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
�R Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
W No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
R No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Renuired Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
W 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 I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
(51 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
C' NA
❑ NE
Page 2 of 3
21412011 Continued

� r ,
Facili Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No ❑ NA ❑ NE
the appropriate box(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)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes
Z No
[DNA
[:]NE
[:]Yes
[3No
®'NA
[]NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes J@ No ❑ NA ❑ NE
❑ Yes (51 No ❑ NA ❑ NE
❑ Yes RrNo ❑ NA ❑ NE
❑ Yes ®-No
❑ Yes [' No
[]Yes 5 'No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments:
Use drawings of facility to better explain situations.(use additional; pages as necessary).;
a I, Trio �J11s we e. 4 iAA -(ig hy&avl1c ©e-lo#c b L we -NPI JAM-i-he- w m r_/1 * war
V
J Q A&+ ie-
�°�-s
rfcor�� �, �� s pro `}hr�s c � �f,
re-
-rm har GL nP_w MoAa r-
I5-1 aeFLIN nfPd1r11' ,P.
I Q.
TY� eeo�n �a e9 'fia e K,CO.,f ore, I Ikey,n fi+e Mail ,4n
cow _61 7 _Celc� 1143'0 _ 14,400) Cover�, vVel 1 MM41. �C �M
Reviewer/Inspector Name: irrA AA [r f ]h]rpl
r
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 11&}933,a3M(g a�
Date: Bor_ C:1
21412011

+ . , ..
Facility No._Farm Name 81U2FU Wh1'4c r6K--,, Date a 1 {-1 3
Permit COC OIC� NPDES (Rainbreaker PLAT Annual Cert Daily Pipe )
. / -1,,
1-1
RtlNieil���k:J�_---�
r
Lagoon Name, S forspillway
1
2
3
4
5
6
7
Design Freeboard 1 Last Recorded in
Observed freeboard
Sludge Survey Date
Q
Sludge Depth ft
Liquid Trt. Zone ft
,
Ratio Sludge to Treatment Volume if> 0.45
Date out of compliance/ POA?
'mom--�---
Design Ujam.
���---�-
Soil Test Date
pH Fields
Lime Needed
Lime Applied
Cu-I Zn-I
Needs S (S-1<25)
Crop Yield
Wettable Acres
WUP
Weekly Freeboard
1 in Inspections
120 min Insp.
Reeds P TT.- ..-
Transfer Sheets
RAIN GAUGE
Dead box or incinerator
Mortality Records
Check Lists
Storm Water
.,
..
o
t . #
2
V4771M #
ti
i5 ! JJ
Vo% (-b11-M 34-X ItWe_ SnZ tti � 0-01 %e (0(,
Verify �HONf NUMBERS a d affiliations
Date last WUP FRO FRO or Farm Records
Date last WUP at farm Lagoon #fit( 597K3q
App. Hardware Top Dike
Stop Pump
Start Pump �.� -7
Conversion- Cu-I 3000= 108 Iblac; Zn-1 3000= 213 Iblac

type of visa: W %.ompuance inspection v uperanon Keview lJ Structure r.vaivanon lJ iecnmca1 Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: I Departure Time: County: /T afk"
Farm Name: �4��� � W ��. Owner Email:
Owner Name:g&=O'LI\4- C Wt Phone:
Mailing Address:
Physical Address:
Facility Contact:Title:
Onsite Representative:
M
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Region: FF0
Phone: Q
Integrator: �411 L"
Certification Number:
Certification Number:
Longitude:
Des
iiii
Design
Current
Design Current
Gapaclty Pop.
Swin"toFinish!
Wct Foultry
Capacity
Pop.
Cattle Capacity Pop.
Wea
La er
DairyCow
Wea
P
on-Layer
DairyCalf
Feeder
Dairy Heifer
Farrow to Wean
?
Design
Current
D Cow
Farrow to Feeder
D. P,ouI
Ca acit
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [] Yes [ ] No [] NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) ❑ Yes ❑ No 0 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [ No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

hacili Number: I Date of Inspection: Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No
a. If yes, is waste level into the structural freeboard? ❑ Yes T❑ No
❑ NA ❑ NE
(ENA ❑NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: -'
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2<< ? 7 rr
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.c., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a []Yes ® No ❑ NA ❑ NE
waste management or closure plan? 7�
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes j No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes F
No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Znctc
❑ 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 4rea
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those
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 P No
❑ Yes ' [P. No
❑ Yes rV1 No
❑ Yes No
❑ Yes No
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
❑NA
❑NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design [:]Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes " No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
Page 2 of 3
❑NA ❑NE
❑ Weather Code
[]Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
21412011 Continued A'

Fflcihtj Number: Lo - Date of Inspection: J Q Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 7� No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern'?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32, Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes N No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes © No ❑ NA ❑ NE
❑ Ycs
® No
❑ NA
❑ NE
❑Yes
�No
❑NA
❑NE
❑ Yes
® No
❑ NA
❑ NE
Comrrients (refer to question ft Explain any YES answers and/or any additional recommendations. or any other. comments
Use drawings of facility to better explain situations (use additional pages as necessary):
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: U3'3 ~3 3 tip
Date: I eta 'L,
21412011

Division of Water Quality
Facility Number L - 0 Division of Soil and Water Conservation
0 Other Agency
(Type of Visit: tp Compliance Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance j
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access I
Date of Visit: Arrival Time: Departure Time: p' County: E_
Farm Name: 131ty 1iwm - 1dyim Owner Email:
Owner Name: }-�p� L,tyec,4C _ LLC Phone:
Mailing Address:
Physical Address:
Facility Contact: 9 r� 1'I qC� e� Title:
'N
Onsite Representative:
Certified Operator:
N
Region: F d
Phone:
Integrator: J of 1 — w U
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
L_L0thqy_
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer I :�:]
Non -La er
Design Current
Dry Pnuitry Canacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Daia Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes +ice No ❑ NA ❑ NE
❑ Yes
❑ No
P NA
0 NE
❑ Yes
❑ No
1P NA
❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) ❑ Yes ❑ No E�) NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes rpNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Number: - Date of Inspection: 7 $
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [] Yes ;a No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No IONA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3U
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
T
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
[] Yes
[P No
❑ NA
❑ NE
S. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0§ No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9, Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes jg 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): L�`�`' o►"M (�-�`tSS �/ .SM, �, a�t1U7�� , arm
13. Soil Type(s): (V 6 r4,. l ]L + Jvh
14. Do the receiving crops differ from those designated in the CAWMP?
[] Yes
M No
❑ NA
❑ NE
IS. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes.
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20, Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
KA 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
&J No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment`?
❑ Yes
No
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

1
facili Number: -23 Date of Inspection: 3 11
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[§No
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
2No
❑ 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
�n No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
2S No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
M No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
4] No
❑ NA
❑ NE
Comments (refer to 'question #): Explain any YES answers and/or any additional recom mend atlonsor any other comments c .1
;Ft
Use drawings.of facility to better explain situations (use additional pages as necessary). ' „ 1! ,, � ,, y a „ a;Ho
Reviewer/Inspector Name: *D !' I � PI
Reviewer/Inspector Signature: 44
Page 3 of 3
Phone: g10``(33- 3300
Date: r0 !3 11
21412011

Division of Water Quality
Facility Number �� 0 Division of Soil and Water Conservation
----- Q Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit i Routine O Complaint O Follow up Q Referral Q Emergency O Other ❑ Denied Access
Date of Visit: g (0 O Arrival Time: Departure Time: t_tat�T County:
`( r
Farm Name: Rt� �IM . h1 Owner Email:
Owner Name: A,) L;w.S� Pww, , (,LC _ Phone:
Mailing Address:
Physical Address: J�
Facility Contact: 7:5�rqr { Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
El Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
K
9
C)� Region:
Phone No.
Integrator:
Operator Certification Number: ZZ(r
Back-up Certification Number:
Latitude: 0 c = L = 1f Longitude: ❑ o = 1 ❑
.Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer I =]I
❑ Non -Layer
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity_ Population
❑ Dair Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: 101
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?
J
❑ Yes 1� No ❑ NA ❑ NE
❑ Yes
❑ No
V NA
❑ NE
❑ Yes
❑ No
V NA
❑ NE
® NA
❑ NE
❑ Yes
❑ No
❑ Yes
4 No
❑ NA
❑ NE
❑ Yes
oNo
❑ NA
❑ NE
-Page I of 3 12128104 Continued

Ira
~ Facility Number: — Date of Inspection o 4
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E] No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [PNA ❑ NE
Struct re 1 St ru ture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: a e
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in); 26
y
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2U No ❑ NA
❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
1,;allo ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement'?
❑ Yes
V) No ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
EgNo ❑ 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
ONo ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ANo ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
9No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Crop Window ❑ Evidence of WindDrift ❑ Application Area
//Acceptable �Outside
�
12. Crop type(s) [ DaS SS 67a _J ,ni • �� ® /3G�ad ,
/o�f
(�-'a� I ��►,�Q�t�_
13.
Soil type(s)ey-
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[RNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement'?
❑ Yes
[DNo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
W No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
�5 No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
�vfl e�'���kMs ; ,'` 4 si 4 ��':.,; ! - r" f ,�, t �� h �„�� a$'#�a-s.4
Comments (refer to;question #) Explain any YES'`answers and/o',r any recommendat+ons or aiiy other comments
se
E`:« �7 �ki,.::pi� I �.1' } .. faddltional; a es as.n.::'�
sedrawingspof facility�to better,earplam situations: (use p g ecessary):
v,�S�kh'i
4
Reviewer/Ins ector Name RAN- rat"
P I_t- .+'i g<� Phone:
Reviewer/Inspector Signature: Xkaa Date: O /�
Page 2 (�f 3 12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes VNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0No ❑ NA ❑ NE
the appropriate box. ❑ WUP [] Checklists ❑ Design ❑Maps [3 Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes ;9 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge`? ❑ Yes ® No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �] No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit'?
[I Yes
F] No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
(jNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�kNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
19 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1�2 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
JB 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
O No
❑ NA
❑ NE
General Permit? (iel 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
14 No
❑ NA
❑ NE
Page 3 of 3 12128104

Division of Watcr Quality
n.� `1
oil of- —� 0 DivisionSand Water Conservation
-- T 0 Other AgencyJ_ oil
IType of Visit * Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 1� %Iy Departure Time: County: r 'Dx� Region:
(� ] w l Tc
Farm Name:—C1[�. �rw► �vt S r !._-�T Owner Email:
Owner Name: [,� t Uy4,T , ,_ LLC Phone:
Mailing Address:
Physical Address:
Facility Contact: s4,rry dqooTitle:
Onsite Representative: tt
Certified Operator:
Back-up Operator:
It
Phone No:
integrator: P t.�,-i�►-oc ]n LLC
Operator Certification Number: - 3
Back-up Certification Number:
Location of Farm: Latitude: 0 0 ❑ 1 = Longitude: ❑ ° = , =
Design Cnrrent
Design Current
Design Current
Swine Cap}a�ct�ty Populat€on
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑Dai Cow
❑ Wean to Feeder
❑ Non -La er
❑Dai Calf
❑ Feeder to Finish
❑ DairyHeifer
Farrow to Wean
U
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
El Non -Dairy
❑ Farrow to Finish
❑ La ers
r
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Other
❑ TurkeyPoults
❑ Other
Number of Structures:
Discharges & Stream Impacts
Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes [--]No
ERNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes ❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
❑ Yes ❑ No
rENA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes fQNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

-
Facility Number: — Date of Inspection Z7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ONo ❑ NA LINE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in);
Observed Freeboard (in): tt
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) �"
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes El 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 �PlNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes §No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes RIo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes P No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 1�fNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) CWSW Va
13. Soil type(s) ftr44 l k--, EZCrtn
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17, Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
No
El NA
El NE
No
l�
❑NA
❑NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
C�No
❑ NA
❑ NE
Comments {refer to to #) Expiain any YES?answers and/or any recommendations or any other comments
[Ise drawings of facilityto better, 'explain.situations..(use additional pages as necessary):
Reviewer/Inspector Name 1, Mwbke I Phone: Giip` -300
Reviewer/Inspector Signature: Date: 72
Page 2 oj'3 12128104 Continued

Facility Number: — 02 Date of Inspection
Reruired_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 1PNo ❑ NA ❑ NE
the appropriate box. ❑ WUP [1 Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 50 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
t No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
55 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
BNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
U�jNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[5�No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes V No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes'V 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 nNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes �j No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewerdnspector fail to discuss review/inspection with an on -site representative'? ❑ Yes EpNo ❑ NA ❑ NE
Page 3 of 3 12128104

Facility Number �7
r;,
Division of Water Quality J
O Division of soil and Water. Conservation
Q Other Agency e
Type of Visit 0 Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit 0 Routine O Complaint Q Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: 01 Arrival Time: 00 Departure Time: County: 0 Region: rI 4
jr �.-w_
Farm Name: fin Owner Email:
Owner Name: 06 C �►� CLC— Phone:
Mailing Address:
Physical Address:
Facility Contact:, ew-rg Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Gilts
Boars
Other
❑ Other
Integrator:
Phone No:
►,vvo"
Operator Certification Number: �aq �3
Back-up Certification Number:
Latitude: ❑ o = s = Longitude: ❑ e = t
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ on -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Fleifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: [El
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (Ifyes, 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 ofthe State
other than from a discharge?
❑ Yes to No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
NA
❑ N F
❑ Yes
❑ No
❑ Yes
�'No
❑ NA
El NE
El Yes
PNo
❑ NA
❑ NE
12128104 Continued

Facility Number: Z4 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes M No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [hNA ❑ NE
St'ru1ctur 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: W r ��
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes L!] No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ® No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ElYes n No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [9 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes allo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required butlers, setbacks, or'compliance alternatives that need ❑ Yes Q5 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. []Yes (9No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind 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
M No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
q@ 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
V No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
[a 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):
Revie►er/Inspector Name Phone: /0 33"-13M
Reviewer/Inspector Signature: Date: 2 %
IZIZ61t14 C.onunuea

. . i
Facility Number: — Date of Inspection 1 !
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZI No ElNA [INE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0] No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 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
[N No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility tail to calibrate waste application equipment as required by the permit'?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes�
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
t No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
6 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0 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
t 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
[t 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
t] No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
05No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 / Arrival Time: 0 j• 3�QM Departure Time: �•` 4M County: b
Farm Name: Alu.0 � E �k;FP GLJ�M T Owner Email:
Owner Name: eta& Llye4*1 Fayw$ Phone:
Mailing Address:
Physical Address:
Facility Contact: Je 'fiptar;�AS Title:
j tI
Onsite Reoresentative:
Certified Operator:
Back-up Operator:
m
Region:
Phone No:
Integrator:. /4lli��►'P �^'!
Operator Certification Number: .2.9'Z3
Back-up Certification Number:
Location of Farm: Latitude: = = 4 = Longitude: O c = 1
Designff_U__U;rent
Design Current DesignCurrenine
Capacitpulation
Wet Poultry
Capacity Pop€ ulat�on.^ =,Cattle ,., Ca aci Po ulation
.. p.t3' p
❑ Wean to Finish
10 Layer
t
%' ❑ Dairy Cow
❑ Wean to Feeder
10 Non -Layer
' ❑ Dairy Calf
❑ Feeder to Finish A
❑ Dairy Heifer
Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
�. El Beef Brood Cow
Other
❑ Turkeys
❑ Other
❑ Turkey Poults
❑ Other��
+t�� th+ t
fiStruc
.s`u'..
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
59 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
1P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
Fza NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
?3 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
1� No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
P No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

x• �
Facility Number: —,2 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
j No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[:]Yes
No
❑ NA
❑ NE
Structure I St`r cture 2 Structure 3 Structure 4
Structure
5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): `r 23 tl
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
�g 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
0 No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation puses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [�LNo ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes KI No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) x�hh
9. Does any part of the waste management system other than the waste structures require El Yes M No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ,2 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �kNa ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable] Crop Window ❑ Evidence
�,,of Wind Drift ❑ Application Outside of Area
12. Crop type(s) "YriuOtiQ l9-✓ci'% C at` — &m4 GV4-
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
5d No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
W,JNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
SINo
❑ NA
❑ NE
.:. i
Comments (refer to question,#): - Explain any YES answers'andlor any recommendations or any other, comments.
a
Usebdrawings otfacility to better; explain situations ;(use addihonal pages as necessary):; n
Reviewer/inspector Name 1 1 Phone p
Reviewer/inspector Signatur Date: .7
Paue 2 of 12128104 Continued

Facility Nurnber: — ag Date of inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 1P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �S No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes PgNo ❑ 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 M No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0 No ❑ NA ❑ NE
24,
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�gj No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
$1 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
N No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[5 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
D9 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
F No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
CS No
❑ NA
❑ NE
Additional Com' 'rnents and/or Drawingg;.
w
Iwo
Page 3 of 3 12128104

C
Type of Visit om iance Inspection 0 Operation Review 0 Structure Evaluation O Technical Assistance
Reason far Visit outine O Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: '7 6 Arrival Time: ® Departure Time: I� County:
Farm Name: L3 ��i I /�Fa_r1'►'1 d wfA;' e, arm Owner Email:
Owner Name: Ofke• L i b`_Sock Phone:
Mailing Address:
Physical Address:
Region:�s✓
Facility Contact: rLA,�6&ns Title: Gen M n,r Phone No: 91 o !30q .3z)(.0
Onsite Representative`- E 11.5 Integrator:
Certified Operator: ( c % Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 0 0 ' = Longitude: ❑ o = , 0
Desiggg
Design Current
Wet Poultry Capacity Population
Design
Cattle Capacity
CurrenCapaculation
Population
❑ Wean to Finish
JEI Layer
❑ Dairy Cow
❑ Wean to Feeder
110 Non -Layer I
I
s
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑
❑ Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
Dry Poultry
Soo
Un
❑ Layers
Non -Dairy
❑ Beef Stacker
❑Beef Feeder
❑Beef Brood Cow
MNumber of Structures:
❑ Farrow to Finish
❑ Gilts
❑ Non -Layers
❑ Boars
El Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Other
❑ 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?
❑ Yes
ANo
❑ NA
❑ NE
❑ Yes
❑ No
?kNA
❑ NE
❑ Yes
❑ No
FUWA
❑ NE
[�?NA
❑ N E
❑ Ycs
❑ No
❑ Yes Wo
❑ YesVo
Page I of 3 12128104
El NA El NE
❑ NA ❑ NE
Continued

facility Number: : Date of Inspection D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ;E0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ g Other
p
2 L Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA [IN E
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
3N No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
tie
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
Cl Yes
*No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge'?
❑ Yes
KNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�LNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
_�Go
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
P9 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
M No
ElNA
❑ NE
General Permit? (ie/ discharge, Freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative'?
❑ Yes
50 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
19No
❑ NA
❑ NE
dittnnal;Comment Ads`nnd7or Drawings ' . .
Foam Rj (-04S .
NO -re PL4-T (-eS 0IDS kkvt 4-p;dds (1,5fed QS (� .
19.5Tc PL qP M lk4 .6 r r) o 'Ye- O e �-4
� ) . -R earn rn.evLd Ccracc
� �
T-e dn ti, cd Zptc,' CLI 1, 3f- 'n Y71fV-4 _P�_60 M0
�ft Ss � Ss e ea,r
Page 3 of 3 12128104

Facility Namber: —D Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No r NA ❑ N E
tructure I n ctur 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LAC —
Spillway?: r
Designed Freeboard (in): nn
Observed Freeboard (in); f 47G�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes lNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes � No ❑ NA ❑ NE
through a waste management or closure plan? '' ��
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 4No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes O 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 A No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes N,No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Oko ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
O No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
J�Jlo
❑ 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}No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
'9No
❑ NA
❑ NE
s� a �5 r
;Comments (refer to question,#) Explatn,any YES.answers and/or any. recommendations or any other comments'.t3 }
Usefdrawtngs of facility to better explaim situations. (use additional pages as necessary):
Reviewer/Inspector Name - — _. .f -� J Phone: 1 00
Reviewer/Inspector Signature: Date: '!7-,t A 4
Page 2 of 3 12/28/ 4 Continued

1 7
Facility Number 1- � --�01 Date Time IN,., „-, ._ Out
Owner
Farm Name
O .0 Na. ,� �9/7
C.D.C. .General 6�-q
Design Current Design Current
Wean to Finish Wean to-Eeeder
Feeder to Finish t6wi to W � t55
Farrow to Feeder Farrow to Finish
Gilts : Boars
Other
Soil types - ' " Qlk-
Crop Type;
Soil Test !V J Plat
Pan ��A-Z�Z/�`Window ►' — Q
13Z- 5 12o
I j7.7 85 7.7 lybI — l
5b L--
jq 170 r
w� ay
Designed Freeboard - Observed Freeboard 6A( 3 q
U
Rain gauge `/ Rain breaker Daily Rainfally�Waste Transfers
Calibration of spray equipment G.P.M.
Sludge Survey Crop Yield 120 Minute inspections
1 in. Rain inspections Weather code Weekly Freeboard
Pumping1 time
w
Waste Analysis % & Month 2 1 6 to - r)"'A /A/j*
o� ) ,7 y/. w &/"� Vq/() /oz 4�J
Comments
PIC L�P�'i4 I IvLod4
�h�

r
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason far Visit ®Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
[late of Visit: � Time: /
Facility Number 2,
Nat Operational Below Threshold
Permitted 0 Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: /`f ulrc+[ • v P s T�� l� �f"�tv r1C Z C County: 1'' e
Owner Name: at" �E1� T�-k�� ! aN`k, _ --- Phone No: J/0 kV-- 371 q
Mailing Address: ro l�rX ram{ �aa�Or �.�L�,( I
Facility Contact:
Title:
Onsite Representative: Integrator:
Phone No:
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a • « Longitude 0
s, ..:. ;Design < CeirrentjI :: 1 Qes[gn �Current ,' E EDesign i`Currcut
Swine Ca aGtV' 'Po UlahOn .:. `Pouft tf I l fi
Ca 'actty,.Po `ulat o>i Cattle Cii achy: ,P.o eilstion '
❑ Wean to Feeder d ❑ Layer ❑ Dairy
❑ Feeder to Finish ;fit ❑Non -La Non -Layer ❑Non -Dairy
Farrow to Wean
El Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Desig'n Capacity
❑ Gilts i
Boars ,Tot al,SSLW
Discharees R-Stream Im,-pacts ,,..,,//
1. Is any discharge observed from any part of the operation? El Yes M o
Discharge originated at: ❑ Laaoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is obsen'ed, 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 ves, 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 or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection &: Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: % _
Freeboard (inches): / g' L/4 �L
05103101 I Continued
rk
f ��t
a

,, Facility Number: &2 —
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ 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 maintenancefunprovement? ❑ 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
I I. 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 atior 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.
ii;l°14td9 rr .U" k k f * 5 s3t 9°1 i M°s" f !� 'Lldv"'ft4 '�1 "NYit'iTiL' � M'. r4k tlr i+ e><ss.7^ ti i
4^ MMIgS 1! "+i fk"StSdf9i7¢Mi� ,•• J ift'1 ' i1R`�k:7�11AaG+lSiCili�.•(refer tt►�gaetaon;#) Fatplain:atsy YB$an�w+ere undlor say,t+aeatnnneaulatlans or agy atber' omm�tents, : t` `'E..veiiS6"?G.'<.,t''C:,ae.'� ! - 4aJr'iwi:ar,'.`.Mse drawlu�gs bta,ility�to fetter �rpI i�a {aa oAal pasas;U"==r ' ❑ );field Copy ❑ Final Notesy� gr �'� Y� ���ti� �n+ j y a p"i �' �'�t?IJ u . ll
1-.H(! V 1 t.Zii.f 1<fNQkt:•.'izW'f!k�AAARI"�u':I iDww:25..s�ls.ui'"#`. .:t,. ��I.i�. FI�i7cVi : ��fiW'S:4f N•Flt_�e�132tS" .N&Niu.' i.s
Reviewer/Inspector Name �!�j+�
Reviewer/inspector Sipature: 6duLL A Date: �-
12112103 Cowed

Facilin. 'umber
Date of Visit: � Time:
10 9
Not Operational 0 Below Threshold
® Permitted ® Certified Q Conditionally Certified 0 Rehistered Date Last Operated or Above Threshold:
Farm .Name: 'g ] t,.e _1-C.C,� ! l J ht-I� �C. County: _
Owner Name: EC Ca l� Phone No:
Mailing Address: LA. ISY
Facility Contact: Title: Phone No:
On site Rep resentatiye: Integrator: Clai-rzi H i.
Certified Operator: .l e,!'r 4z.1"s- Operator Certification Number: alg4A
Location of Farm:
9 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 " Longitude ' . 0"
Design Current
Swine Canneity Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow- to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Ca acitv Population Cattle Capacity Population
❑ Laver I ED
Dairy,
❑ Nan -Laver Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons l I ]LJ Subsurface Drains Present ] LJ Lagoon Area JU Spray Field Area
'Holding Ponds / Solid Traps 0 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any, discharge observed from any part of the operation? ❑ Yes [14 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man -matte? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If ves, 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 ves, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 19 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �'No
Wa a Collection 8 Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [R No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: _ LL-_ L,
Freeboard (inches): — a_-T-
05103101 Continued

Facility Number: — A4 Date of Inspectionf-�—�f=y
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Annlicati
❑ Yes GQ No
❑ Yes Q9 No
❑ Yes [ No
4
❑ Yes RNo
❑ Yes MNo
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
allo
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
Po
12.
Crop type se Spv�' C'_nt:. L b r
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
EZ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre deten-nination?
❑ 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
09NO
Required
Rewords _& Documents
17,
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
� No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
60
(iel 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
M No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
�dNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes �No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes (ko
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
rComments, refer to_s uestlon # �En lainFan YES answ"'�` `
ers'�and/or any recommendations or any other commentsd tf � ,,, ,�,�,� ,��
-
as necessary) � � , �� d�- s of f cili to better.expluin situations {use ud
t ww A � Field Coy ❑ Finat Notes
. �,p i�Ny � I Ildltionatpagcs .* *
..s
H.,
Reviewer/inspector [Name
Reviewerllnspector Signature: Date:
O5103101 1_1 Continued

Facility Number. — gDate of Inspection
Odor lssues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring Vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30, Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? ❑ Yes ❑ No
,Additional Comments.and/or'.Drawings: ! ':` .5 .R...; €! . Li.: ,. "•i
05103101

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. L. M. Upchurch, Jr.
P.O. Box 440
Raeford, NC 28376
Dear Mr. Upchurch:
M12i
1Dr-=HNFZ
DIVISION OF WATER QUALITY
April 2, 1997
SUBJECT: Annual Compliance Inspection
Hoke Livestock Swine Farm
Registration No. 47-29, 47-30
Hoke County
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
Wachm4a Building, Suite 714, Fayetteville % �FAX [phone]
North Carolina 28301-5043 NVf An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

Rodtine O Com hint O Follow-up of DWO 1ae ecdon O Follow-up of DSWC review O Other
Faefitty Number Date of inspection
Time of Inspection r 2 :OO I Use 24 hr. time
Farm �• ,e,4r(A I. _ Total Time (in hours) Spent onReview
or Inspecdon (Includes travel and processing)
Farm Name:' i�al �i4G��-- h6t& --
... I I I11�� ���
Owner Name: 14AE ` 01��,rCW4 A, e. Phone No: L &�O I ?7S-- 371 E
Mailing Address: d• y�0 . AG F3 W
Onsite Representative: Lategrator.
Cerdiled Operator: - -4 C7 • Operator Certification Number: 2- !g 9 L
Location of Farm:
Latitude Q0 4 0W Longitude Qa �a
03 Not Operational I Date Last Operated:
Type of Operation sad Design Capacity
.vt { .r�::��+�^ �� P'.."�`! �.'x`. l,' T '_ ''1Y �1!c. s '� �:.T.: � .�'��.� .", ri,�,z:t.y�k" r3'�•�: ^� e'�1••. '�"�� air�+"�#S.
�Swlne ;/; 1µ 4 .ram'" {, ,zNamber #: . Poa1t�► • f .'Number a'" ;Cattle � �Tumber� r{,, �
Wen to Feeder
Feeder to Finish Non-r73 Beef
Farrow to W,i�8#
Farrow to EMda
3, w to Einigh I Type of Uvestock ; r
`i'. tin}' P.:�•ti.i '. M, 7:« ti C_n 'i rxi"t• s,!G:. : *.� xyA '� # s -t x w rTl F k I+,° ! , R L�" Y
�4�S.jr.++•I'.'�'^, ��,<7„�'`.. I`..+.'`i N,. �jjY�.`.',�.,',''.'•a.�.. •.l. -JCS
Number of Ligoons JKHoldiag Ponds, : Subsurface Drains Presenta�
�.a� 8 ra Field Area
r:
1. Ate then any buffers that need maintemn�� d Yea 10 No
2. Is any discharge observed from any part of the operation? Q Yes ® No
a. If discharge is observed, was the conveyance man-made? E3 Yes Ji) No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) 13 Yes 13No
c. If discharge is observed, what is the estimated flow is SaUmin?
d. Does discharge bypass a lagoon rystem? (If yes, notify DWQ) C1 Yea IRNo
3. L mere evidence of past discharge hom any part of the operation? 13 Yea ®No
4. Was there any adverse impacts to the waters of the State other than from a discharge? D Yes )a No
S. Does any part of the waste management system (other than lagoonsUldiag ponds) require Q Yes 0 No
maintenanee--ilipt?

6. b spy not is oomptiw= with any applknble w6ad amnia? `
7 Did she facility 69 to hvm a used operator In responslbie charge (if inspection slier 1/1/97)?
B. Are then boons or storage ponds on s* which need to be properly Ckm0
Strictures (lagoons and/or Hoidiap-&j sl
9. L a=ft ral 5+e Mud less than adequate?
Fraboard (R): Lagoon 1 Lagoon 2 Lagoon 3
32'- -
10. L seepage observed from any of the stmcknO
11. h erosion, or my other dt P I to the integrity of Any of the en,wbires observed?
12. Do any of the stmeaues need maintcpaaa:efinrpmvzment?
(if any of guesdons 9.12 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
13. Do stay of the strucam lack adquate markers to identify start and stop pumping levels?
Waite Aoalieatio�
14. Is their physical evidence of over application?
.(1f in exoess of WMP, of ramoff entering waters of the State, notify DWty
is. Crop type h1t...u%t
16. Do the Active crops differ with those designated in the Animal Waste Maaageaasat Plan?
17. Doe: the facility have a lack of adequate acreage for land application?
1 B. Does the cover crop need improvement?
19. 1s theca a lack of available brigation equipment?
FaT Certified Facilities t?aly
20. Does the facility fail to have a copy of the Animal waste Maaagemznt Plop readi;y available?
21. Does the facility fail to comply with the Anima Waste Management plan in any way?
22. Does rtcord keeping need inimvement?
23. Does hdhty require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discs n reviewCrnspection with miner or operator in Charge?
;oirimettts:(refer ta�que�tions#):•YFaeplain;may YES:
�it;,drB�IDg6•o�faCl�liyr;O bettEr:ElCjl181a ai�tlraRCI15.•
z qA" Act of
Oyes No •
Q Yes ® No
Yaa IM No
13Yes X No
Lgooc 4
E3 Yes ® No
p Yes JgNo
AD Yes ❑ No
0 Yes ® No
13 Yes MNo-
Yes Q No
13 Yes 10 No
Ci Yes ® No
0 Yes MI No
p Yes 19 No
[] Yes M No
❑ Yes ® No
[3 Yes 9) No
❑ Yes Z No
71
V.�r/lr 9 � 0<44WA-' 'C4 ,
Reviewer/lospector Name ,tu +� r °a' Y "
ReviwerflnspMer Signature: Date:
PP. Dlvielnw of B elOV I)rIellfg_ Wel.. 6unlln+ .C...w... 1._. ,_

I
State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. L. M. Upchurch, Jr.
P.O. Box 440
Raeford, NC 28376
Dear Mr. Upchurch:
IDEEHNFZ
DIVISION OF WATER QUALITY
April 2, 1997
SUBJECT: Annual Compliance Inspection
Hoke Livestock Swine Farm
Registration No. 47-29, 47-30
Hoke County
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 MRCS 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) 48&
1541.
Sincerely,
Robert F. Heath
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine - FRO DSW
John Ray - Hoke Co. NRCS
Wachovia Bullding, Sutte 714, Fayetteville N%0CAn Equal FAX [phone]
North Carolina 28301-5043 Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/ 10% post -consumer paper

.:
06 Routine O Complaint O Follow-up of DW2 Insection O Follow-up of DSWC review O Other
Facittty Number Date of kspeedon -/
71me of Impecdon L. use U hr. time
C..
Form Status: g4k � Tots! Time (in boon) Spent oaReview
or Inspection (Includes travel and processing)
Farm Name: �i{ ./jC �itvrati.•�-► County:. .. , ........
Owner Names—�►��r-��'�"* .. Phone No:
Mailing Address: 6• l �'1�GT_�iIrE✓iAi� , /� C 2�3
Ondte Representative: , �� --- -hftrxbr. C; ►. Wd0&' Z:' �:—
CerWed Operator. _ L . �. e!! SFA,._ , Operator Certification Number. aaJ S6
Location of Farm:
Latitude �e0• L,�...�" Longitude
MI Not Operational Date Lost Operated:
of Operation and Design
to
0 Other Type of Livestock
!. Are there any buffers that need meinteaaaoe!mVVV%ment? 13 Yes ja No
Z. Is any discharge observed from any part of the operation?
a. If discharge is observed, was the conveyance mart -made?
b. If discharge is observed, did it reach Surface Water'l (if Y. notify DWQ)
e. If discharge is observed, what is the estimsted flow in galhmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is then evidence of past discharge from say part of the operation?
4. Was there any adverse impacts to the waters of the State other than from a discharge?
S. Does any part of the wore management system (other than lagooaslbolding ponds) require
' maintmaace/mrpr+ov+ement?
❑ Yes RNo
E3 Yes QN*
E3 Yes MNNo
0 Yes RNo
Yes RNo
E3 Yes GINo
j W No
_.Coxdnued on back

& Is sty Dot is eompU=n witb my applicable erA&7
7. Did the faulty $d to have a eatiSed operator in Tapota ble charge (if inspection after 1/1/M?
$. Are there lagoons or storage ponds on site which need to be propedfy closee
S=gWW aAR00IMS and/ar oldina Pondsl
9. L structural Swboard Iess than adequate?
Fret a(ft ' IAPM 1 ,.sz=2 rain 3
10. L seepage obsmvW from my of the structuresI
11. Is aosionw or any other threats to the integrity of any of the structurn observed?
12. Do any of the strucxunca need . '
(if any of questions 9-12 was answered yes, and the situation poses an
Immediate public health or environmental threat, no* DWQ)
13. Do nay of the structures Zack adquate marker to ideaft scan and stop pumping levels?
Waste ADoliraHaa
14. L there physical evidence of over application?
.(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
is. Crop type--
16. Do the active crops differ with those designated in the Animal Waste Management Pisa?
17. Does the facility have a lack of adequate acreage for lend application?
1S. Does the cover crop need improves>ieat?
19. b there a lack of available irrigation equipment?
For Certified Factitties M
20. Does the facility fail to have a ropy of the Animal Waste Management Plan readily avabble?
21. Does the ihcility fail to c mpiy with the Animal Waste Management Plan in any way?
22. Does record keeping need improven=17
23. Does facility require a follow -tap visit by same agency?
24. Did ReviewevInspector fail to discuss reviewfiaspection with owner or operator in chap?
h
13Yes PI No �►
13 Yes PI No
0 Yes XrNa
Yea JR No
Iagoon 4
O Yea 10 No
L3 Yes IBNo
0 Yes ja No
0 Yes Ww
E3 Yes UNo
Yes 13 No
Yes 13 No
13 Yes 11 No
13 Yes JRNo
0 Yes XLNo
it Yes ❑ No
❑ Yes ® No
❑ Yes ® No
Co4tb matt: '
mments (ref:T.to quest, t1J Ex plain'atryxEl ausw a>jdlorapy.reCcmmrimdali0n3 orwiy
Usc iswmgs ai fecrhty to better expkiasrtuabons;,(use additional pages as aeci ►�: `� ,
a .Pr - --r'" v.4CX_-%� ,..b
*P70
- ,2 COW ~-
4
1�• I
a
Reviewer/Inspector Name
ReAwer/inspector Signature: _ eeA� _ _ _ rho: �` i%" f 7
��I.rlr P
c Division of Water Qwalhy, Water Quality Seerlon. Fu*kv Aseeemeat tr,.r.

Cs, -o
,Vex
\ XN
N-1
�411
brk—

N t-, L I I ,
8" PVC OUTFLOW PIPE
INV. EL. = 87.49'
I
Q I<
`1
l�
TOP OF CC)NCPETE FOUNDATION LAGOON NO_ 2 � �I
Cs (ASSU�1 01 I SURF ACE AREA = 38.538 SO. FT. ;
1# (AT OVERFLOW EL = 83.95')
11 II
1
f
8" Pv,- OUTFLOW PIPE � ,
WASTE TREAMENT LAGOON NO. 1
ELEVATION
CUBIC YARDS
CUBIC FEET
GALLCNS
89.65(OVERFLOW EL.)
15479.28 CY
3126412,50
88.18 ..
12543.01 CY
338661.27,
2333362.23
87.47(OUTFLOw INV. EL.)
1.1277--92 CY
504503.84
22778�-6.91
85.15
7344.92 CY
198312.84 -
1 483483, E06
84.65
17&829.75
132.2773.39
5-;�,LLoJLq
I r5 j
f 11
{I1
Y q
LAGOON NO. 3
fr SURFACE AREA - 89,505 50, Fi.
(AT -;,1,)
�IrI' 1f =i
WASTE TREAMENT 'LAGOON NO. 2 INV. Et = 81.19r
LLEVATIIiN CUBIC )'APDS�- CUBIC FEET I GALLONS
A 83 95{nvEPF,_<�w FL) 9344.87 CY 252311.49-1887421.01
Et ,82.45 -- --- - 7288.55 t�Y 196790.85 -14 72097.79 I 1 l
8i.s9{u_ :=T -lAl
F-_ ---_•�G.39 rCY 153721.53 - - - --11499-16.90
_ ;'683.23 91F.79
4.454LS87J C. 6581J8
'WASTE TREATMENT LAGOON
SURVEY FOR:
N. G. PURVIS FARMS, INC.
DEERFIELD FARM
BENSALEM, TOWNSHIP, MOORE COUNTY
NORTH CAROLINA
OCTOBER 15, 1996 a
50 150 c
n ft
~- -- WASTE TREAMENT LAGOON NO. 3
ELEVATION 9 rI_lBIC YARDS
68.74(0VEPFLOW EL) 30761.75 CY
CUBICFEET
830567.25 _
-
GALLONS
6213074.,.9
67.24 ----' --
25936.55 CY
700286.85
5238509. 12
65 24
19907,01 CY j
537489.27
4020698. 35
- 63.74 -- __
15966.62 CY
431098.74
3224842. `)2`