630002_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual
II

S Division of Water Quality
Facility Number—� O Division of Soil and Water Conservation
Other Agency
Type of Visit 0 Compliance inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up 40 Referral O Emergency O Other ❑ Denied Access
Date of Visit: s tip d Arrival Time: ©3D Departure Time: County: Afev v.. Region: L�1_
Farm Name: t4jjAe*j FAA-%, Owner Email:
Owner Name: 6w -, o) &I ;—a-) �7Phone: 9f'0 — HbY — S q& y
Mailing Address: f �--�rc."kgA Kd • ed�ia'. KS
Physical Address:
Facility Contact: &%iJ All t—e.d w.Title:
Onsite Representative:y i) Ard c-eJ / Alerry A al
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Integrator: Ps F
Operator Certification Number:
Back-up Certification Number:
Latitude: [7] o [7-'] ' [7N Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver S ❑ Non -La et
❑
Wean to Finish
Wean to Feeder
Feeder to Finish
Z3
El
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Roars
Other
❑ othu
Dry Poultry
❑ Layers
❑ Non -Layers
El Pullets
❑ Turke s
El Turkey POUIIS
El Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
El Dairy Caw
[I Dairy Calf
El Dairy Heifei
❑ D Cow
❑ Non -Dairy
El Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
12128104 Continued

aclllty Number: (V3 — Date of Inspection o 0
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard'? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No ❑ NA ❑ NI-
(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 ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination;❑
Yes
❑ No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NU
18.
is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
ll�fer to question #): Explain any YES answers and/or any recommendations or
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone: `%10- 4-s
Reviewer/Inspector Signature: Date: 3 Aao O
12128104 Continued

Facility Number: (r $ - L Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available'? ❑ Yes ;344o ❑ NA ❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
allo
❑ NA
❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
B No
❑ NA
❑ NE
❑ Waste Applicatioe ❑ Weekly Freeboard [:]Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and l"
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 (o calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[]No
❑ NA ❑ NE
General Permit'? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
KNo
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? [:]Yes [:]No ❑ NA ❑ NE
L4dftlanal Comments and/or Drawiags:
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CrIt
w f`ar Pie - lam.} 'jt o Whoa.-�` cx-cr� - {�trwtJP�, WL Gage (ld
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.� Nov,
013 K Z. 3T. ass gb �6lac
4H a 6. Zs aAtv_ s `fld (L /ate
.61
H Y a S y• 23 a +b (b &C, I2/2&04

q
• Division of Water Resources
Facility Number - 0 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:1 vn r/ Departure Time: I Mj County: �QSr� Region:
Farm Name: Owner Email:
Owner Name: d A I I red Phone:
Mailing Address:
Physical Address:
Facility Contact: f. _ayI IT [jre Title:
tr
Onsite Representative:
w
Certified Operator:
Back-up Operator:
Location of Farm:
Wean to Finish
Wean to Feeder
Z
Feeder to Finish
Z
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
( other
Discharges and Stream Imaacts
Latitude:
Phone: fn�
Integrator: �ml � r"IeN
Certification Number:
Certification Number:
Longitude:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Non-
Pulle
Other
Poults
Design Current
Deeigit Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
I. Is any discharge observed from any part of the operation?
❑ Yes
1� No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[2) NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
q NA
[] NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
❑ Yes
❑ No
NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
[] Yes
{ 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 21412015 Continued

• 1
Facili Number: - Date of Inspection.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'?
❑ Yes No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
19�11 NA
❑ NE
Structure I Structure 2_ Structure 3 Structure 4
Structure 5 Structure 6
Identifier: VO '7
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(i.e., large trees. severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Anmiication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑Hydraulic Overload ❑Frozen Ground ❑Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): C, & � Q � (9,
-A . r
/
r �z�,•s'�d
1.3. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes V No ❑ NA []NE
l5. Does the receiving crop and/or land application site need improvement? [] Yes t No [DNA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E,:� No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[2 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E� No
❑ NA
❑ NE
Ekguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ N E
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 T No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes NM No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑NA ONE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3
21412011 Continued

•Facili , Number: Date of Ina ction: / ?
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?
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)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage' Pond ❑ Other:
❑ Yes
`T No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[] Yes
No
❑ NA
[] NE
❑ Yes q No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes T No ❑ NA ❑ NE
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? ❑ Ye, No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recornmendation% irr anN o her comments.
Use drawings of racility to better explain situations (use additional pages as necessary).
P o� ��lP (Ctw 9lo-bz�-Yat(
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 910-_1'323' 33oa
Date: 1/1 (
fb 7
21412011

• Division of Water Quality
Facility Number - O Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 49 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine O Complain) O Fotio►►-up O Referral O Emergency O Other O Denied Access
Date of Visit:
��
Arrival Time:®
Departure Time: County:
Farm Name:
Q
106C roa S
Owner Email:
Owner Name:
A)
Phone:
Mailing Address:
Physical Address:
Facility Contact: pay.4 kL4 Title:
Onsite Representative: 4
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
Othrr
It
Latitude:
Phone:
Region:^
Integrator: S n, ,-,A 4 r. !a/
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
L
ayer
Pullets
Other
Pouets
Design Current
Discharges and Stream lmnacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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?
Longilude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
D Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Reel llrood Cow
Yes 62 No 0 NA ❑ NE
❑ Yes ❑ No C@ NA ❑ NE
❑ Yes ❑ No [R NA ❑ NE
❑Yes
No
NA
❑NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 1 of 3
21412011 Condnned

r'acili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
" No
rLP
❑ NA ❑ NI
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 12
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2SN ��Q 7Z"
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Z 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? T
If any of questions 4-6 were answered yes, and the situation }poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit'? ❑ Yes ® No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
T
Waste Ap2lication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes �No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
T
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window Evi ence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): .Q$C
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes No
❑ NA
❑ NE
acres determination?
IT Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes � No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [] Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes EpNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes TP No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number:2,, Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ N E
25. is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No ❑ NA ❑ NF
the appropriate box(es) below. �G
❑ 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 0
No [:] NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes JANo ❑ NA [:]NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[] Yes �d 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 ❑ N I.,
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 ❑ N F:
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 [d No [] NA ❑ N F.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes LANo ❑ NA N i
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ] Yes g No NA N l
34. Does the facility require a follow-up visit by the same agency? ❑ Yes E;� No ❑ NA Nil
otnments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
--7
Use drawings of facility to better explain situations (use additional pages as necessary).
?4D6e ' 'I' M Q 6o[ e —P W F--
(et( #) 91 a--6,zq-goq 1
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:9149—c/33 33m
Date: L4 1
21412015

r
t 1
• Division of Water Resources
Facility Number ®- 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 40 Compliance Inspection 0 Operation Review Structure Evaluation `Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Fallow -up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: �� County:
r
Farm Name: '}ilrer 1t- vks Owner Email:
Owner Name: �4� Allred Phone:
Mailing Address:
Physical Address:
Facility Contact: 1pcivI 4 rc Title:
ti
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
N
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer I I :::::]
Non-L'aVei
Wean to Finish
Wean to Feeder
Feeder to Finish
/
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
-
Boar,
Other
_.. __! _.. — _ .J
La
Pullets
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 DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Region:
Design Current
C & Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
lieei' 13rood Cow
❑Yes [Z'No DNA ONE
❑ Yes ❑ No
O Yes ❑ No
❑ Yes ❑ No
❑ Yes [ No
❑ Yes No
p NA ❑ NE
�] NA ❑ NE.
,FONA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412014 Continued

lFacility Number: 42'�- jDate of Inspecdo�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P] No 0 NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 4 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: r? ) 0
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z—� t h � 33 �
5. Are there any immediate threats to the integrity of any of the structures observed'? ❑ Yes [7) No ❑ NA ❑ N L
(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 [P No ❑ NA ❑ NE,
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement'? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit'? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No [j NA ❑ NE
maintenance or improvement? T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes F
No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 1p 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 Hare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Approved Area
12. Crop Type(s): Co-,•1 , 1v 4-004 5sOL Q s^ Ke
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NF..
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
qNo
❑ 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 [3 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
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412014 Continued

J
FacHity Number: IDate of lns ecdon: 0
4LUOL/5-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes P 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? 0 Yes jP No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No []NA ❑ NE
Other Issues T
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes P No [] NA 0 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?
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 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes `P No ❑ NA [:) NE
[3Yes P]No DNA ONE
❑Yes �jNo [:]NA ❑NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? El Yes
® No
T®
[] 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
q No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Nei CA-.��tK skc,�e ._ ANI 1.it5cerlf
sr bm 1"'"j A,•.pz 4
Reviewer/Inspector Name:
Reviewer/Inspector Signature;
Page 3 of 3
Phone: 9i©-Y33 -33d0
Date: /-/9
21412014

V?dI
JP Division of Water Quality
Facility Number - 0 O Division of Soil and Water Conservation
O Other Agency
type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Resson for Visit: 0 Routine O Complaint O Follow-up Q Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: !( County: 00AFz—
Farm Name: I(t� �KM5 Owner Email:
Owner Name: TOIV 'A ((ffj Phone:
:Mailing Address:
Region: i__R�
Physical Address:
Facility Contact:&yt-j/]� A " 14 Title: Phone:
U
Onsite Representative: integrator: A&V4
L eng"k-,.
Certified Operator: t� Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
f ]tlt�t
Design Current Design Current
Capacity Pop. 'Vet Poultry Capacity Pop.
La er
Non -La er
Dry too
LaL,ts
Non -Le
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)?
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?
DVSigII ( IlrrclII
Cattle apavit.% Pop.
—
Dairy Cow
Dairy Calf
Dairy Heifer
Da Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Yeti [r No ❑ NA ❑ Nil'.
❑ Yeti ❑ No
❑ Yes No
®NA ❑NE
16NA ❑NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
No
❑ NA
❑ N I
❑ Yes
No
❑ NA
❑ N F
Page I of 3 21412011 Continued

Facility Number: T jDate of Inspection: 3 3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No O NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ No ❑ NA Ej 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 [B No ❑ NA ❑ NE:
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ® NA ❑ NE
Other lssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
0 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
�3 No
❑ NA ONE
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
[P No
❑ NA ON E
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
[B No
❑ NA 0 NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
5D No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
EP No
❑ NA ❑ NE
Comments (refer to question 0): Explain any YES answers and/or any additional recommendations or any other comments. —7
Use drawings of facility to better explain situations (use additional pages as necessary).
st"j5e
"
'Iziw/
K0� �
S[ �
s t�-�
hD"I" �
�1Vr
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: _c 3,3 -33oo
Date: -3 6 d I
21412011

Facili Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No M NA ❑ NE
Structure I
Structure 2
Structure 3
Structure 4 Structure 5 Structure 6
Identifier: `us
t� I
-A 10
4 JZ
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2-5`j 37" Sq�`
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
b 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
R No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
V] 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
0 NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�g No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes MNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop W,iPdow ❑ Ev' nce o Wind Drift ❑Application Outside of Approved Area
r~! lam
12. Crop Type(s): SC&ce t'/as� r-� Cat, i i!r `"' 05,
1 _ I
13. Soil Type(s); L �
1.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[�No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
1p No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes y No ❑ NA ❑ NE
Reaulred Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ N E.
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.
0 Yes
® No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
® No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
M No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

31;'
Facility Number - O Division of Soll and Water Conservation
0 Other Agency
TN pr of N isit: 0 Compliance Inspection 0 Operation Revie►v 0 Structure EN aluation 0 Technical Assistance
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 3 Z- Arrival Time: Departure Timer County: q)/
Farm Name: J"T�f l��({ryts Owner Email:
Owner Name: VQUll klrej Phone:
Mailing Address:
Physical Address:
Facility Contact: &Vjq �Jr Title: Phone:
Onslte Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
tf
G
Design Current
Swine Capacity Pop.
Wean to Finish
` Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Region:
Integrator:
Certification Number:
Certification Number:
Design Current
Wet Poultry Capacity Pop.
Laver
Non-l.avcr
Pullets
Other
Design Current
U
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 ycs, notify DWQ)
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
l iLe f Stocker
Beef Feeder
Beef Brood Cow
❑ Yes PNo 0 NA ❑ NF
❑ Yes
❑ No
'NA
❑ NE
❑ Yes
❑ No
0 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 [?5 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes -�N No ❑ NA 0 NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters 0 Yes `g N(, ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

>Faielllty Number: - Date of Inspection: I �—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No NA ❑ Nl-
Structue l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: [ 1 b
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): j+ 37
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes M 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 0 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
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 [P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10, Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA [3 NE
maintenance or improvement? T'
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes q No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [] PAN > 109/6 or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�] No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
ii''
[3 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
5P No
[] NA
[] NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ ()ther:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes PNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ONo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [P No
❑NA [:]WE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

lForifity Number: Date of Inspection: 3 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 ❑ N A ❑ 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, frecboard problems, ovcr-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
P No
❑ NA
❑ NE
[:]Yes
❑ No
NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑Yes 0No []NA ❑NE
❑ Yes C� No ❑ NA ❑ NE
❑ Yes T
No ❑ NA ❑ NE
32, Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional Pages as necessarv).
Reviewer/Inspector Name: 16-012"- IV M119LC _
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Division of Water Quality
Facility Number O Division of Soil and Water Conservation
O Other Agency
Type of Visit & Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine 0 Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date or Visit: 1 t Arrival Time: Departure Time: t , �%*. County: Region:
Farm Name: _'ftd r 4 FCWm S Owner Email:
Owner Name: _11u la A I ce J Phone:
Mailing Address:
Physical Address: //,, �ff
l Faciilty Contact: �r,d .ri'�ru'i Title:
U
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ \kean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
LJ Gilts
❑ l3oars
Other
❑(W, ,
Phone No:
//��
Integrator.!rt '1 'bW&.44
Operator Certification Number:
Back-up Certification Number:
Latitude: =1 cF E__1 " Longitude: [= ° 0 6 = 4.
Design Current Design Current
Capacity Population Wet Poultry (-.'apacitr Population
PEE]
La yer
Non-I_a er
Dry Poultry
❑ I. -Livers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ urkey Poults
❑ ()(her
Discharges & S ream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
J1
❑ Yes P No ❑ NA ❑ NE
❑ Yes
❑ No
[DNA
❑ NE
❑ Yes
❑ No
[P NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
ElYes
No
NA
❑ NE
❑ Yes
to No
❑ NA
❑ NE
Page I of 3 1V28/04 Continued

Faciliiy Number: — Date of lnspeCtionI_�[:�j_/[_l�
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 -4�1 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I I D
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �� s
5. Are there any immediate threats to the integrity of any of the structures observed:' ❑ Yes No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7, Do any of the structures need maintenance or improvement? ❑ Yes 19No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 29 No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes ® No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu. Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
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 No
❑ Yes ❑ No
El NA El NE
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes S No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes §9 No ❑ NA ❑ NE
Comments (refer to question #): Explain any YNa answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name a4, We Phone: 10-1-33en
Reviewer/inspector Signature: 0 ' Dale: -: a.t
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection
Reguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes tallo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes fQ1 No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes ;5 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26, Did the facility fail to have an actively certified operator in charge'?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems rioted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes A No ❑ NA ❑ NE
El Yes ❑No �NA ❑NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ,F91 NA ❑ NE
❑Yes
PNo
❑NA
❑NE
❑ Yes
® No
El NA
❑ NE
El Yes
PNo
(3 NA
❑NE
❑ Yes
Q9 No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
Page 3 of 3 12128104

Division of Water Quality
Facility Number—� O Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: a�j O Arrival ^ Time: 4M Departure Time: ; ' � County: M DOf2F
Farm Name: �l�Yed rttw-►rts Owner Email:
Owner Name: Dgad 411,d Phone:
Mailing Address:
Physical Address:
Facility Contact: Pewid '`tflnN Title:
r
Onsite Representative:
Certified Operator: —
Back-up Operator: _
Location of Farm:
Swine
No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region: CWC
Latitude: =" =1 =° Longitude: Qo[�' Q•,
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Nun -La per
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ 'Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Deir co
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: IT
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 PA No ❑ NA ❑ NE
❑ Yes ❑ No 1� NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No ONA ❑ NE
❑ Yes T No ❑ NA ❑ NE
❑ Yes ERNo ❑ NA ❑ NE
Page 1 of 12128104 Continued

F"icility Number: toy:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. if yes, is waste level into the structural freeboard?
Structyre I Structure 2 Structure 3 Structure 4
Identifier: CJ. j / Z?—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
N
5. Are there any immediate threats to the integrity of any of the structures observed'?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes rNo ❑ NA ❑ NE
❑ Yes ❑ No IFNA ❑ NE
Structure 5 Structure 6
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
If any orquestions 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 ❑ N F
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes PNo ❑ V\ ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes Nu ❑ NA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ 1'cti �O N,i ❑ NA []NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes F No ❑ NA ❑ N F
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:)PAN ❑ PAN a 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement'?
❑ 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
1$. Is there a lack of properly operating waste application equipment? ❑ Yes
IrNo ❑ NA ❑ NE
�No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
ERNo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/InspectorName b(,C Phone: [phone]CO
ReviewerAnspector Signature: Date: 312AJIV
Page 2 of 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 IRNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes F
No ❑ NA ❑ NE
the appropriate box. ElWUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �FNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ :%nnual Certification
❑ Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
IP No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
Pn 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
1� No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
LwNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
❑ Yes
❑ No
® NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
(q No
❑ NA
❑ NE
29.
Did the facility fail to property dispose of dead animals within 24 hours and/or document
❑ Yes
ONo
❑ 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
JpNo
❑ 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
EpNo
❑ 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
17?No
(❑ \ A
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
tPNo
❑ NA
❑ NE
Additional Comments ant!/or Drawings:
Page 3 of 3 12129104

9IM\ 5111t,0 6v)
0
Division of Water Quality
Facility Number 1 63 Division of Soil and Water Conservation
Other Agency
Type of Visit 91' Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit %Routine Q Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ®1 trA--rrri�val'rime: 1 _0 f Departure Time: r �.SQ County: ire
Farm Name: n I led Fi,/Al' Owner Email:
Owner Name: pa-1 t_. A I ln°d Phone:
Mailing Address:
Region: FRO
Physical Address: I /i
Facility Contact: DQ✓rd . i411 P4 'Title: Own& Phone No: 46q-3q6 4
Onsite Representative:: ^
Certified Operator: Al ✓U_ Tti
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Integrator:
Operator Certification Number: IS 313
Back-up Certification Number:
Latitude: =o =, = Longitude: =o=, =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
6q," 1 y� 1 � ❑ Non -La ei
HFarw toto Wean 1
Farrow Feeder
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Fleilei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Becf brood Cow
Number of Structures: a
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 CirNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
2kNO
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
12128104 Continued

Faci4ity Number: -M)
Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[]Yes
)4No ❑ NA ❑ N1
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NI
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 0
Identifier: VVmko P 5 hlr&e ,�� L'0 1
Spillway?: It
Designed Freeboard (in): i F �) r
Observed Freeboard (in): 31 3y Sy
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ ye,
I"No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which arc not properly addressed and/or managed
❑ Yes
P No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or em
ironmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
PNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
WNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
C"No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
EjkNo ❑ NA ❑ NE
maintenance/improvement?
It. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
t-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 1bs ❑ 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
Jallo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NF.
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'?❑ Yes
'R[No
❑ NA
❑ NE
IT 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
9No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
i
Reviewer/inspector Name Smirtek Phonc:91 g33aDUaM
Reviewer/Inspector Signature: Date:
121281174 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IRNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes JRNo ❑ NA ❑ NE
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps []Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes $�No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes N�No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakcrs on irrigation equipment? ❑ Yes ❑ No IN -NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[]Yes
Wo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�jNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
RNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
CRNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E�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
,b,r
tS! 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
$a 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
Iallo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
5'No
❑ NA
❑ NE
Additional Comments and/or Drawings:
�5k 'To, /& Lime Are(iPd- 7PAC a0o9�
a3 4 I.a9aas wf rn w k&s. A11 s 1po( d e below 1.,s'f�}-, n aoog,
EX ^� ^-4- f�im� aid- good. r je(q�s ,
[[
p a�'-4or., shad
Pag e 3 of
3 12129104

roll
Facility No. Farm Name i _ Date
Permit COC OICNPDES (Rain breaker PLAT Annual Cert)
Design
.J
-besign freeboard
Observed freeboard (in)
Sludge Survey Date
Liquid Trt. Zone (ft)
- I i • rati • Date
©r��■
Soil Test Date
1 in Inspections
f'�
Crop Yield
v
pH Fields
Wettable Acres
120 min Inspections
Lime Needed
WUP G
Weather Codes
Lime Applied
Cu ✓Zn
i,"�Ir0,�OC -(
�
Weekly Freeboard _t
Transfer Sheets .�
RAIN GAUGE
Needs P
1) - TI-5
Rainfall >1" ,--{-n
t ✓
• 1 r .
.� r
yf �. ��,
` .
111
'
MOM
1p r
"
.
..
•.r
TOM
..
Iwi • Ta
r
f
Verify PHONE NUMBERS and affiliations
Date last WUP FRO 01.0 Date last WUP at farm
FRO or Farm Records 7 $ 9' Ir0
Lagoon # A y �°
Top Dike
Stop Pump 1
Start Pump
App. Hardware
's -- qa-l63

'IWLDivision of Water Quality
Facility Number O Division of Soil and Water Conservation ct
O Other :tKenev
Type of Visit ?, Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit )RI Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time:
Farm Name:
Owner Name: 1.-1t..V ct. fy
Mailing Address:
County: Ir e- Region �' -0
Owner Email:
Phone:
Physical Address: ,,,�✓
Facility Contact; Ck-V+ ` 1_ ` 'Title: , Wr 1'It+,ne No:
Onsite Representative: 00—Vy C ,Y ee (L Integrator: Qr etn •j c ­0 I i t
Certified Operator: (iVV I C (I.QL P (r Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: ��=4 = Longitude: a" =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
�i ❑ Non -Layer
❑ Wean to Finish
eanto Feeder
eederto Finish
v2b
❑ Farrow to Wean
El Farrow to Feeder
❑ Farrow to Finish
El Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
ElNon-Layers
El Pullets
ElTurke s
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State`? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
El
Dairy Cow
❑
DairyCalf
❑
Dai Heifer
❑
D Cow
❑
Non-Daill
El
Beef Stocker
El
Beef Feeder
❑
Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (if yes. notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes K,No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NkNA
❑ NE
❑ Yes
❑ No -14YA
❑ NE
❑ Yes r4, No
❑ NA
❑ NE
❑ Yes
$6No
❑ NA
❑ NE
12128104 Continuer!

Facility Number: - Date of Inspection 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NI-.
a. if yes, is waste level into the structural freeboard? ❑ Yes 5, No ❑ NA ❑ N L
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: X�; '7
Spillway?:
Designed Freeboard (in): 19 19
Observed Freeboard (in): mZQ 32Q t
5. Are there any immediate threats to the integrity of any of the structures observed'? ❑ 1',s l`91 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 PNo ❑ 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'? N Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [�L]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 UNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need []Yes ;6 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes %No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop
2.'opWindow ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) LOf n �l1 - -&111[__�&ylq FeSC,t,.te H
13. Soil type(s)
14. Do the receiving crops differ from those 3esignated in the t_'AW'Ml'!
❑ Yes
PNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
W No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
W No
❑ CIA
❑ NE
17. Does the facility lack adequate acreage for land application`?
❑ Yes
[�jNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I Use drawings of facility to better explain situations. (use additional pages as necessary): I
D� v S4rUCJLveeS rvi�
q10 V33 333
Reviewer/Inspector Name _cnftEl Phone:
�{!�Q r`
Reviewer/Inspector Signature: Date: Mat!/ D
12128104

. Facility Number: Date of Inspection JI f I QLQ�
Required Records & Documents {
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �No [I NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Q No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" 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
❑ No
XINA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
EZNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
V No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
NLNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
&NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
X No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
_[XNo
❑ 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
f4 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
X 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
M No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
�INo
❑ NA
❑ NE
Additional Comments and/or Draw ings:
C�„-k► nut ay,, ba..vr. cotas n, dawn t o 9 1�
irnfroy-ernen4r .
S1 kX45� dkjuA Z az)-j % -7 10 .
L. c_ .4cjc_ Y1t7�,.,� V P W'+t)1 t c �t n i �� Gltii -f' ? r f N
0-11mo-d , (�
Need Sru e Svr � J
vu rkw-c
IW&104

fo
A)
Facihty No. Time In /b Time Out Date
Farm Name !-1 ra4. `. Integrator lun
Owner _ &A-i d Site Rep
Operator
Back-up
COC
No.
No.
Circle: (ter;,
ver or NPDES
_--
esi n
Current
Design 1
Current
can —Feed-,
S
Z
Farrow — Feed
Wea —
Farrow — Finish
eed — Finish
Gilts I Boars
Farrow — Wean
Others
FREEBOARD: Desigr}/'_
Sludge Survey ✓ �h
Crop Yield
ERa'5reeboard
e �
ettlTttable Acres
Daily Rainfall
Spray/Freeboard Drop
Weather Co 120 min Inspections
aste Analysis:
Date Nitrogen (N)
Observed z / Z_
Calibration/GPM bil4y z c;L/()
Waste Transfers
Rain Breaker
PLAT
1-in Inspections.
Date Nitrogen (N)
Pull/Field
Soil
Crop
Pan
Window
y.1
Z
t d
Fes Gti t
t
u'
�t cu
A S d,,

Facility Number
'16bivision of Water Quality bms
O Division of Soil and Water Conservation
O Other Agency 4-1
Type of Visit
ompliance Inspection
O Operation Review O Structure Evaluation
Q Technical Assistance
Reason for Visit
Routine O Complaint
O Follow up 0 Referral O Emergency
O Other ❑ Denied Access
Date of Visit: �J b 01 Arrival Time: Departure Time: ® County:
Farm Name: 1 5 Owner Email:
Owner Name:�""'� �� Phone: _
Mailing Address:
Region: t`—(ZJD
Physical Address:
Facility Contact: ' de U1 414 Title: Phone No:
Onsite Representative: '� Q ` ��� Integrator:,���n
Certified Operator: t 0.l1 �t Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification number:
Latitude: 0 a 0 I= Longitude: 0 I=
Design Current Design Current
Swine Capacity Population Wet Poultry UapacitN Population Cattle
❑ Wean to Finish
can to Feeder rJ
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -La ci
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouhs
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (if yes, notify DWQ)
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifet
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: Eil
d. Does discharge bypass the waste management system? (Ifyes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑Yes El No
0NA
El NE
❑ Yes ❑ No
bA
❑ NE
El Yes ❑No
;R fA
El NE
❑ yes ANo
❑NA
❑NI
❑ Yes § No
❑ NA
❑ NE
12128104 Continued

Facility Number Z. Date of Inspection—tb/b'/1
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 freebo d? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structulyff au U Icture 3 Structure 4 Structure 5 Structure 6
Identifier: d"
Spillway?: q
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ANo ❑ NA ❑ NE
Oe/ large gees, severe erosion, seepage. etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No [I NA El 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`? AVYes ❑ No ❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit'? ❑ Yes �No ❑ NA ElNE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes A No ❑ NA ❑ NE
maintenance/improvement?
It. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ko El NA El NE'
[I Excessive Ponding [I Hydraulic Overload El Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate .Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the C
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ,dNo
❑ Yes _Lklo
❑ NA ❑ NE
❑NA ❑NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application'? ❑ Yes No ❑ NA ❑ NE
18, Is there a lack of properly operating waste application equipment? ❑ Yes -� No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name / _r/,k /lid Phone: 73
, _�)11 �Qp�
Reviewer/inspector Signature: Date: 0231
­f 12128104 Continued

FaEllity Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ W­Up ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Wo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�tNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
U No
*NkVA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Wo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
V No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
4NA
❑ NE
Other Issues
28, Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�No
❑ NA
❑ NE
and report the mortality rates that were higher than normal`?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
)tNo
❑ 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
ppNo
❑ 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
�PNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
C4 XYes
Wo
❑ NA
❑ NE
Additional Comments and/or Drawings:
a t lA,1 I rw�- (a r. d -�o S1XJ; Y� UcV rD4a -'V' 0" LkY4 `
S � /YhLICA br ye, ar o dr 10
H"If:11S) lyn
`� i„�-�'A d s '� n �o �' 10. I
12128104

Facility No. 5 T Time In 0�i Time Out Date t'
Farm Name IntegratorP�°�r'ti'1 U
Owner A++ _ej, Site Rep
Operator No.
Back-up
COC
No.
Circle: �enea or NPDBS
Design
Current
Design
Current
Wean -
(
Farrow - Feed
Wean - Finish
Farrow - Finish
F fi5tv
J3�0
Gilts 1 Boars
Farr — can
Others
FREEBOARD: Design
Sludge Survey t----7 i
Crop Yield
Observed
Waste Transfers
Rain Gauge Rain Breaker
Soil Test PLAT Wettable Acres
Weekly Freeboard Daily Rainfall 1-in Inspections��
Spray/Freeboard Drop .20V
Weather Codes 120 min Inspections
Waste Analysis:
Date Nitrogen (N)
i•D C c� (J 4.l�.
Date Nitrogen (N)
0 0 IN�
��
M1 �r �/
��'�

49 Division of Water Quality
facility Number ��> O Division of Soli and Water Conservation
t0 [1t1UW weftffi&W-- r _. .
Type of Visit 0 Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Dote of Visit: Z arrival Time: Departure Time: County: /WWA.£
Farm Name: JAI 11244- Ealerh 5 Owner Email:
Owner Name: P'g V I'd Allred _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Pi Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Region: FAO
Integrator: 5ar4
Operator Certification Number: 1' ;;W5 ...
Back-up Certification Number:
Latitude: ❑u ❑ ❑" Longitude: ❑o a
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver S3 Sa3o ❑ Non -Layer
❑ Wean to i inisi}
Wean to Feeder
Feeder to Finish
:.
XaGD
❑ Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
❑ Giits
❑ Boars
Other
❑ Offier
Dry Poultry
ElLayers
El Non- Layers
❑ Pullets
❑ 'Turke s
El Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacih Population
❑ DairyCow
El Dairy Calf
El Dairy Heifej
❑ D Cow
ElNon-Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of 8tructunW. 1=
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 [4 No ❑ NA ❑ NE
❑ Yes
❑ No
®NA
❑ NE
❑Teti
❑No
WNA
ONE
N NA
❑ NE
❑ Yes
❑ No
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
4 No
❑ NA
❑ NE
12128104 Continued

. r
Facility Number: 63—a Date of Inspection DS
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[R No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
® No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[7No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
P No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
F Yes
❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. []Yes �O No ❑ NA ❑ N E
❑ 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) s2y&R,r S, C<d:g�uw 1 -c£S[kf
13. Soil type(s) L3L 11�a �J� �q �dT G-o C
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes (51 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
[ZNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination` ❑ Yes
" No
❑ NA
El NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
W No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
1p No
❑ NA
(:1 NE
r to 4d ii'n LrtiWiftli — IirlWeffnWdW Feii1"i ciiiilizieb'ds+ifons a�aiayYii r c6mmi
se drawings of facility to better explain situations. (use additional pages as necessary):
Fle
�
tLf
" I S K o+ 11 n Sir � F' ca c�. of n l y Ina S s L �CAr 1' "� Hots %•
wl�lA�� pry
l &kc, 3 0) i rjWA `1 v e-vojioc, a4 U Al teAaur �w�� .4�+�e� eJt b A
r _•
Reviewer/inspector Name 0MCK6 I�e Phone: � JD eb� j
Reviewer/[uspector Signature: Date: Q'S 4 D�
12128104 Continued

I
. Facility Number: — Date of Inspection eS�
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps
p ❑Other
2 L Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
U No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbrcakers on irrigation equipment?
❑ Yes
❑ No
[?9NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
f% No
&
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
10 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge'?
❑ Yes
0 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
C1 NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
09 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
IC No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
M. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
I Comments anti/or Drawings:
/jl)� 'r 0 vtrau U eV I 5cm 4j rvc ,
12128104

T rub
TkAc.}
Facility Number ' Date 06 Time IN 1 D : 10 Out
Owner -PVJ A! Ce `� f�— `��t}-3g� I
Farm Name A ( rtd Axrv✓1S
0.1.0 / No.
C.O.C. General J NPDS
Design Current Design Current
Wean to Finish 2:j�M Wean to Feeder_ T53 §�,?,o
Feeder to Finish ' A5V Farrow to Wean
Farrow to Feeder Farrow to Finish
Gilts Boars
Other
Soil types (re-8 8�16 68, Go C
• acf 4v
Crop Types 1.3 Lok&.� an Windowpr
Soil Test Plat .JA
Designed Freeboard f; /I`l Observed Freeboard 3
Rain gauge ✓ Rain breaker �� Daily Rainfall Waste Transfers
Calibration of spray equipment J G.P.M. ! 8 A,�= 2/,o ( ",
Sludge Survey Crop Yield 1- 120 Minute inspections
1 in. Rain inspections k/ Weather code
Pumping time $ u/� o<
1 �1
Waste Analysis % & Month
4.41
J, 3
lj"a-, C400.114- PL,
rye.^ aps,--4 Pry.
pi A-j f f �, 1-1 4W
J
oy��1�� oar
Weekly Freeboard
lie Y'VY0,
o
i;k1y r�
1 S t �% 3
'lad �� ob

4
0 Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit O Compliance Inspection Operation Review 0 Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Darr [if � kit: 3 t Timc:
Facility Number -
1ot O er tional 0 Below Threshold
Permitted 0 Certified [3 Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: .(red F-Cs-'At Count%- r oe F L
Owner Name: f-e& _ , _ Phone No: _51 OT(4 - 3 4 4.4 _
Mailing Address: T S e" Q e r- PLC �Z�2 � k c _
Facility Contact: Urtj Title: Phone No:
Onsite Representative: L&L A Ail mJ Integrator: 46f, .L-1wll&d
Certified Operator: L cOperator Certification Dumber: 1
Location of Farm-
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' • •• Longitude 0' �•
Design Current
Swine i-nnanih, Pnnutatinn
Wean to Feeder
00
Feeder to Finish
o
5 D
Farrow to NVcan
Farrov-to Feeder
Farrow to Finish
Gilts
Boars
Design Current Design Current
Poultry Ca acity Population Cattle Capacity Po ulation
10 Laver I I Dairy
IL] -Non -Laver I I on -Dairy
Other
Total Design Capacity
Total SSLW
Number of Lagoons 1 3 1 1L1 Subsurface Drains Present 1 U Lagoon Area JLJ Spray Field .area
Holding Ponds 1 Solid Traps I J FCJ—N'o Liquid Waste Management Svstem
Discharges & Stream ImRacts
1. is any discharge observed from any pan of the operation? ❑ }'es ERNo
Discharge originated at: ❑ Lagoon ❑ Sorav Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ }'es ❑ No
b. 1f discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. if discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ERNo
Waste Collection & Trestmeat
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillwav ❑ Yes UNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: At_
Freeboard (inches):
05103101 Continued

Facillty Number: — Z Date of Inspection DMZD
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes (3 No
❑ Yes ® No
❑ Yes [;2 No
❑ Yes Q No
❑ Yes ® No
❑ Yes W No
❑ Yes EP No
12. Crop type k r^1
13, Do the receiving crops differ with dose designated in the Certified Anim 1 Waste Management Plan (CAWMP)?
❑ Yes
PNo
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
M No
16. Is there a lack of adequate waste application equipment?
❑ Yes
® No
R&quired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[A No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
Q No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
Q No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
Q No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
P No
24. Does facility require a follow-up visit by same agency?
❑ Yes
50 No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
R No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use dra%ings of facility to better explain situations. (use additional pages as necessary): ❑ I idd t . m ❑ I rrurl jute.
e, r.o� LD Ova. rz,
Reviewer/Inspector Name C
Reviewer/Inspector Signature: Date:
05103101 % Continued

4 +
Facility Number: 6,3 - g Date of Inspection
W" hlfitg
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon'?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan bells, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
05/03/01
Cl Yes ❑ No
❑ Yes No
❑ Yes [ No
❑ Yes Q No
❑ Yes R No
❑ Yes ® No
❑ Yes ❑ No

111
_ ,
Division of Water Quality
Q Division of Soli and Water Conservation
O Other Agency
Type of Visit IM Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 4PRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date ut Vi0t: 0 Time: ITV-�
10 Facility dumber
Not D erational 0 Below Threshold
0 Permitted 0 Certified O Conditionally- Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: _411 Pe_ CA &tcryN � County: an 0 rye. i- f2O
Owner Tame: Q-larr_& _. _ Phonc No: � I D 44,4 —-?:q44
Mailing Address: Tqgt le .5A — t2-0 A _ b�:.S /\ C
Facility Contact: I]GvTt-L reSk Title: t� Phone'No: sc.__a- .
Onsite Representative: �J)cy tJ At I rtJ _ Integrator:
Certified Operator: �^�G�4a_ Heed Operator Certification Dumber: La -I5.3
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 0 1 0 - Longitude ' 0' 0
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Ca acity Population
® Wea❑ to Feeder I (a c ❑ Laver ❑ Dairy
Feeder to Finish Non -Laves I 1 10 Non-Dain
❑ Farrow to Wean
❑ Farro« to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons © ❑ Subsurface Drains Present ❑ .Lagoon Area Sp,-,, Field Ares
Holding Ponds / Solid Traps I0 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any pan of the operation? El Yes M No
Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. If discharge is observed was the conveyance man-made? El Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) El Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge b)Tass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there e%ndence 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?
❑ SpiIlwav
❑ Yes 5 No
Structured Structure 2 Structure 3
Structure 4
Structure 5
Structure 5
Identifier: 844ftII23N N W,�, ,ri n i n
4
E�er.� (
1� �'
i,�,�� d �.
Freeboard (inches): 3 ?.3 .41
13
4L
05103101
Continued

Facility Number: — Date of Inspection U11,2LAI
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 muctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Auste Application
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type CCX C. ^ _ S o tl �w C... . 'e. S Ct.IL
El Yes E3No
[:I Yes ®No
❑ Yes Qallo
❑ Yes BNo
❑ Yes �a No
❑ Yes P No
❑ Yes ❑ No
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
F&] No
16. is there a lack of adequate waste application equipment?
❑ Yes
[p No
Required Records & Documents
17, Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
W No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[,No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
[A No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
IM No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
O No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
R No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
Uj No
24. Does facility require a follow-up visit by same agency?
❑ Yes
Q'No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
W No
❑ No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): lain any YES answers and/or any recommendations or any other
Use drawings of facility to better explain situations. (use additional pages as necessary); [ J I I. IL! Copv ❑Final Notes
�. of 4- re CP PCJa lu V L + ^JL .
Reviewer/inspector Name AsK
Reviewer/Inspector Signature: Date:
O5103101 — Continued

1
Facilih Dumber: t, .3 — Date of Inspection
Odorlasuex
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at or hclou
liquid lcyel of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation. asphalt.
roads. building structure. and/or public propetn•l
29. Is the land application spray system intake not located near the liquid surface of the lagoon'.
10. 'Were anv major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan bells, missing or
or broken fan blade[s), inoperable shutters. etc.) ~
31. Do the animals feed storage bins fail to have appropriate cover?
32, Do the flush tanks lack a submerged fill pipe or a perrttanenutemporary cover?
05103101
Yes ❑ No
❑ Yes No
❑ Yes 0 No
❑ Yes ® No
❑ Yes ER No
❑ Yes No
❑ Yes Qf No
J

DIVISION OF ENVIRONMENTAL MANAGEMENT
September 23, 1995
Mr. David Allred
F & D Allred Farm■
799 Jasper Road
Robbins, North Carolina 27325
SUBJECT: Compliance Inspection
F & D Allred Swine Farm
Moore County
Dear Mr. Allred:
On August 1, 1995, I had the opportunity to inspect your swine operation
in northern Moore County near Robbins. A copy of our Compliance Inspection
Report is enclosed for your information and review. Please note specifically
the comments concerning minimum freeboard requirements and the need for
mowing around the lagoons. This will be of benefit in future inspections.
Thank you for your assistance in conducting this inspection. Should you
have questions concerning any item■ on the enclosed inspection form, please
contact me at [phone].
Sincerely,
Ken Averitte
KA/ka
cc: Facilities Assessment Unit

Site Requires Immediate Attention:
Facility No. !0 -4
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 75- — 4 , 1995
Time: ,;0 03 - Z .' * %
Farm Name/Owner: d i k ►+r
Mailing Address: ?99 --5_/}spE*_ R�
County:
Integrator: W
On Site Representative:
Physical Address/Location:
. 3 mr/iryiav-""y sxtI�122
✓►dr H6I*Ec
d Z 3ZS
me:
Phone: v - sF -
710 5__ T1 a�
J00W�
Type of Operation: Swine Poultry Cattle
Design Capacity: 4ayso , Number of Animals on Site: f SAD orow 4 rA.r...=
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude• 0 Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event 1
(approximately 1 Foot + 7 inches) Yes oi(Ia Actual Freeboard: Ft. Y/0- Inches (""W
Was any seepage observed from the lagoon(s)? Yes o�D Was any erosion observed? Yes or No
Is adequate land available for spray? (Epor No Is the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet SCS minimum shback criteria? 200 Feet from Dwellings? © or No
100 Feet from Wells? 'm r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or®
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes o No
Is animal waste discharged into water oe state by man-made ditch, flushing system, or other
similar man-made devices? Yes o N If Yes, Please Explain.
Does the facility maintain adequate waste management records (vo mes of manure, land applied,
spray irrigated on specific acreage w h cover crop)? Yes of No)
Additional Comments: - _W?".
W
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

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