770012_INSPECTIONS_20171231

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Division'of Water Resources
Facility Number `? - ® O Division of Soil and Water Conservation,
O Other Agency
Type of Visit: ® 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 O Denied Access
Date of Visit:, b Arrival Time: p9-% Departure Time: County: 11�41'n&'Region:O
Farm Name: ��� I -led SLJ1 Owner Email:
Owner Name: /l%.' Ao tS Phone:
Mailing Address:
Physical Address:
Facility Contact: ✓ �1-1 111649'� Title:
N
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone:
Integrator: A2 P44-L r/�
Certification Number:
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
Other
Design -Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Design o Current
Dry Poultry Capacity Pou.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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?
'Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes t No ❑ NA ❑ NE
❑ Yes ❑ No 2 NA ❑ NE
❑ Yes [:]No NA ❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes No
O NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili -Number: rJ - 2 Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 4 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [RPNA ❑ NE
Structure 1 Structure 2
Identifier:
Spillway?:
Structure 3 Structure 4 Structure 5 Structure 6
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes [h No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [��o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 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): , cold ' �+ ,0 (<(It ,) , 5r". ` -
13. Soil Type(s):
W11116A'
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
[IbNo
❑ 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
, bpNo
❑ 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 ❑ NA 0 NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield 0.120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [� No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Nacility-Number: 1'2-j Date of Inspection: /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively -certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
O)No
❑ NA
❑ NE
❑ Yes
K] No
❑ NA
❑ NE
❑ Yes No
❑ Yes No
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes
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
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑NA ❑NE
❑ NA ❑ NE
No ❑ NA ❑ NE
1
No ❑ NA ❑ NE
�No ❑NA ❑NE
[] No ❑ NA ❑ NE
QNo ❑NA ❑NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:�p�-/�'��3
Date: 2
2/4/201 S�

Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 5 Arrival Time: Departure Time• c d County: %11113ty Region: ilq
Farm Name: ��✓1��✓�, Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:Title: Phone:
Onsite Representative: Integrator: M�LA- ` ✓d3
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Swine
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
v
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Dry Poultry Capacity POD.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: _
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
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?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf_
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
NA ❑ NE
NA ❑ NE
[—]Yes
[:]No
KDNA
❑NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

r Facilio 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
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Structure 5
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
10 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
`r' No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
� No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�] No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes P No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable jCrop Window �1❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): COY H,( G� 6"QS'S t � /� y � r - � (��s rc P -j
13. Soil Type(s):
❑ NE
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
1�4 No
❑ NA'
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[�g 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.
j
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes F No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [�q No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes le
ru No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili. Number: - Date -of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [ No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non -compliance -of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Reviewer/Inspector Name:
Reviewer/Inspector Signatuc
Page 3 of 3
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
1P No
❑ NA
❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
�p No
❑ NA
❑ NE
❑ Yes P No
❑ Yes E� No
❑ NA ❑ NE
❑ NA ❑ NE
Phone: �l�"�� 3 - 33��
Date: 114:z
21412015

v�
Division of Water Resources
Facility Number- - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (& Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: I D _`. . Departure Time: a County: P {b eo Region: -�
Farm Name: / /10.,P Oil-Ict, Owner Email:
Owner Name:
Mailing Address:
J
Phone:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: y . Integrator: A,/�
Certified Operator:
'Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Certification Number:
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
�F��ALa er
I Non -La er
1V Vll-L"
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes PNo ❑ NA ❑ NE
❑ Yes
❑ No
�q NA
❑ NE
❑ Yes
❑ No
[4 NA
❑ NE
❑ Yes
[:]No
� NA
❑ NE
❑ Yes
IU No
El NA
❑ NE
❑ Yes
[T No
❑ NA
❑ NE
Page I of 3 21412015 Continued

Facili. Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
No ❑ NA ❑ NE
❑ No NA ❑ NE
Structure 6
❑ Yes V No ❑ NA ❑ NE
❑ Yes '� No ❑ NA ❑ NE
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 N No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �3 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there -any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes � No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence o Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Cms4.7 &cr
13. Soil Type(s): C1 G
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[79 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
9PNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
� No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[�] No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1� 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 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

a FaciliV Number: �- Date of Inspection:
-YI/,
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 C—A No
[—].NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes 99 No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes �j No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes �9 No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes [y No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes 1� No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes [ONo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: X E�
21412015

aAN-. a IN Gib
• Division of Water Resources
Facility Number �? - ® O Division of Soil and Water Conservation
O Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance.
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: f 0 Departure Time: (D.' 0 County: w.o„)
Farm Name: Z.- ["21 51j'�' Owner Email:
Owner Name: / G:nlj S Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: k
Certified Operator: k
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator: jo- Pwf^J
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Non-L
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: F-pp
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [] No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes [8 No
❑ Yes [13 No
® NA ❑ NE
NA ❑ NE
® NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412014 Continued

Facility Number: - 2 Date of Ins ection: g
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 8 NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes T � 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 M 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 [fl No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes � No ❑ NA ❑ NE
maintenance or improvement? •�
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes M No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Cmsk( �,ry a � �5' A,
13. Soil Type(s): iCL
14. Do the receiving crops iffer from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ 4 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
T 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
R 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 F No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: `? - Date of inspection:
2.4; Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes � No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes FM No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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:
❑NA ❑NE
❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes q No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes q No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes E4 No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 9 No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 10 '_t5y `53M
Date:
21412014

Facility Number
• Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit: QD Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: ry i Arrival Time: /,;?1�� Departure Time: ©I l i County: 1,MBI0 Region:
Farm Name: �A41— 5-W rkQ Owner Email:
Owner Name: n f ��- ��'✓ �� Phone:
Mailing Address:
Physical Address:
Facility Contact: 144GOle Title:
Onsite Representative:
Certified Operator: `V
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator: AAC1­11"" 3:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -Layer
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field 0 Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [] No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [:]No
[:]Yes [:]No
❑ Yes [5� No
❑ Yes �p No
® NA ❑ NE
NA ❑ NE
[�]o NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facility Number: ' ( - t 2— jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Q No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
jn�NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 1 `z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): j✓ N u
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes]
LP 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
[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
No
❑ NA
❑ NE
maintenance or improvement?
T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[] No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
E�] No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift ❑ Application
Outside of Approved Area
1
12. Crop Type(s):1.�+� c R
13. Soil Type(s): A-Ah
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[jj No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
fE No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage, for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?,
❑ Yes
® No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
T
❑ 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
[P No
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 17? - 0,— jDate of Inspection: (�
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes FM No
25. Is the -facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 0] No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes � No
Other Issues
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes
En 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
[D No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M 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 ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of facilitv to better exalain situations (use additional naves as necessarv).
Reviewer/Inspector Name: ( Wf A
Reviewer/Inspector Signature:
Page 3 of 3
Phone: qCD �W )�� 00
Date: �� �Y
21412011

�r3
Facility Number, ® -
® Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: '3 Arrival Time: :.32Yi-t Departure Time: % 2� 3e� County: NC11A� Region: I
Farm Name: G S.5 1_c Owner Email:
Owner Name: E61,2V_t'' f;L'rM S :'r' - Cl Phone:
Mailing Address:
Physical Address:
Facility Contact: �i-�-.� .yv-p Title:
Onsite Representative:
h
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: µj (S--
Certification Number:
Certification Number:
Longitude:
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean j
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes N No ❑ NA ❑ NE
❑ Yes
❑ No
[ NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No � NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes [�-_No ❑ NA ❑ NE
Y Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [L—SpNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility kniber: jDate of Inspection: I QZZ
3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 2—
Spillway?:
Designed Freeboard (in):
jWVj
Observed Freeboard (in): Aj 1 Z'
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
-0 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
V 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)
l�
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wi Driftt ❑ Application Outside of Approved Area
12. Crop Type(s): CcTa ��—r�'s�S 62-n/
13. Soil Type(§): LJ (10,
r
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes rU No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes EP 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
[P 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
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
i
❑ 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
[0 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[�'No
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facility umber: 2 ri- %2 Date of Inspection: V�
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. rj
❑ 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 No
❑ Yes No
El NA ❑NE
❑ NA ❑ NE
❑ Yes F9 No ❑ NA ❑ NE
❑ Yes ((�, No ❑ NA ❑ NE
❑ Yes E� No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes E& No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: q? o­q 33 33co
Date: 3 c t3
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 O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 161' 1 (q— I Arrival Time: Departure Time: County:
Farm Name: 0, L..O�'j 5c- ` Owner Email:
Owner Name: 0& A""- Phone:
Mailing Address:
Region:
Physical Address:
Facility Contact: Iv 10 Title: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
EEE� I Non -Layer
Design Current
Dry Ponitry C inacity Pon_
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [�q No ❑ NA ❑ NE
❑ Yes
❑ No
[�q NA
❑ NE
❑ Yes
❑ No
[�j NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
❑ No
251 NA
❑ NE
❑ Yes
[$�No
❑ NA
❑ NE
❑ Yes
bg No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Facility Number: - Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 2--
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): i
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
0
❑ 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
[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 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? _ r,
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes EpNo ❑ 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):
���11 f r
13. Soil Type(s): ll+�cl,�Gwl.(��
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E� No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes P 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ 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 1� 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 [� No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Ndmber: - Date of Ins ection: C
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes Co No
❑ Yes ❑ No
❑ Yes 10
No
❑ Yes OpNo
❑ Yes ? No
❑ Yes M No
❑ NA ❑ NE
[PNA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWW? ❑ Yes LM No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �10D' 3-3
Date: SL 2
21412011

0 Division of Water Quality
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 40 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
[teason for Visit: WRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 6 / , �� Arrival Time: � Departure Time: d .' County: ��%l�pRegion:
Farm Name: � L% hoe 1 -5&V i Owner Email:
Owner Name: !►}� pGc�a'S 1;4 fmS Phone:
Mailing Address:
Physical Address:
Facility Contact: ,�,,, Title:
Onsite Representative: 14
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator:
Y
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
ElLayer I I �::]
Non -Layer
Design Current
Dry Poultry Canacitv Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes N No ❑ NA ❑ NE
❑ Yes ❑ No M NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [—]Yes ❑ No M NA I 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes 0 No
❑ Yes MNo
❑ Yes [ No
[9 NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

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

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes MNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No aNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
In No
❑ NA
❑ NE
❑ Yes
Q No
❑ NA
❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes %P No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes Vg 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 E1 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 pales as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: q16-"133
Date: ZW/r_
21412011

Faeility Number
® Division of Water Quality
O Division of Soil and Water Conservation
® Other Agency
Type of Visit 4P Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Q Arrival Time: Departure Time: PCounty /Y0RegiFRO
Region:
t
Farm Name: &e
Owner Email:
Owner Name: ,�v iQ "wV s5 Phone:
Mailing Address:
Physical Address:
Facility Contact: ��'1 P 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
LJ Farrow to Finish
❑ Gilts
❑ Boars
Phone No:
Integrator• M57 GWV/
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 6 = « Longitude: = o = s = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Other
❑ Other----- — - -- -
Dry Poultry
❑
La ers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
[!Dry
Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: 'T
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
El Yes � No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
[;iNA
❑ NE
❑ Yes
E?Plo
❑ NA
❑ NE
❑ Yes
Eallo
❑ NA
❑ NE
12128104 Continued

Facility Number:
Date of Inspection L1619tho
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?
Struct e 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
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 nlNo ❑ NA ❑ NE
❑ Yes ❑ No ;RNA ❑ NE
Structure 5 Structure 6
❑ Yes MNo El NA El NE
❑ Yes Z) No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 91 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 n No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes [5 No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [j§No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus [:]Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ lyldence of Wind Drift [:]Application Outside of Area
12. Crop type(s)
V
13. Soil type(s) 11111 16-t I k
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[PNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
EQ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[] No
❑ NA
❑ NE
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 I f lG�►��J 1 Phone: d �js' 3�0
--
Reviewer/Inspector Signature: Date: Z10
Page 2 nf3 12128/04 Continued

Facility Number: — Date of Inspection 6 0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [� o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes WNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E�,No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes
[5 No
❑ NA
❑ NE
❑ Yes
M No
El NA
El NE
❑ Yes
LINo
❑ NA
❑ NE
❑ Yes
KbNo
❑ NA
❑ NE
❑ Yes
D No
❑ NA
❑ NE
❑ Yes
D§No
❑ NA
❑ NE
❑ Yes
O No
❑ NA
❑ NE
❑'Yes
[;!�No
❑ NA
❑ NE
❑ Yes
�'No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
Q�No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 3 of 3 12128104

til V j 0 1 I-L i IJf
Facility Number - 1�a�i]
�ivision of Water Quality
® Division of Soil and Water Conservation
® Other Agency
Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit I,gCRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: l' Arrival Time: I �/� Departure Time: County: _KI c-`li aIL Region: ` %
Farm Name: lk Oee( Si4l _ Owner Email:
Owner Name: } Pyvts 1h&�r Phone:
Mailing Address:
Physical Address:
Facility Contact: aDOY Mix'- Title:
Onsite Representative: 1,,
Certified Operator: - ` *vt
pen
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
PhoneNo: QQS-_ (o7T
Integrator: �� [�� Py fvlj
Operator Certification Number: a 03 S�
Back-up Certification Number:
Latitude: =.0 = ` =" Longitude: [� o f-7 ` n it
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer j
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifej
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
i
Number of Structures: ®'
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c: What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 5'No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
RNo
❑ NA
❑ NE
❑ Yes
qNo
❑ NA
❑ NE
12128104 Continued

Fa'-ility Number:-7 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
❑ Yes E'No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6 .
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in)' 7Z,4-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E"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
RNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
gYes
❑ 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
RNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) CLA& I 18a-MLA- Maj t �'r
13. Soil type(s) W G R— &) J 0f 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?
9Yes
f No
❑ NA ❑ NE
16. Did the facility fail to secure.and/or operate per the irrigation design or wettable acre determination?[-] Yes
ERNo
❑ 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/InspectorName .�dAti SC+1W61EL Phone o(0 - 300)
Reviewer/Inspector Signature: Date: C1 3 QO
.12128104 Continued

3
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E;kNo ❑ 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 El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Z Yes XrNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking M 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
2 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
® NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
2 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
[RYes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
BNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
IC9NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CR 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
MNo
❑ 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
ffNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ONo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
E� No
❑ NA
❑ NE
Additional Comments and/or Drawings:
-7• Neaj�_ cuts mail+rew-q-bruj� of S,s;de e 1 on, bchb 1#4) .
MBA c f (a, L;.elds�
1, �'1�2a se a. •
se, rnv I�h �a-�s��ir on I 0a)
al, POreca-ds keeo,� � , e„'1,
as, �008' S(�d9e S�Ne% n�cQa�e �' �Comm�frlo'�o���► copy
N�o w►� c,-oe Fla*d . Not needed 4• s �e�dr �4„� a�� ,
i CovP�
Page 3 of 3 12128104

Facility No. ©i Farm Name/'� ��'`v11�� Date 3 l31 O�
Permit COC OIC f e)t�Y�y NPDES (Rainbreaker PLAT Annual Cert)
Pop.Type Desi n • Current FB Drops
Lagoon
1
2
3
4
5
6
7
S illwa
Design freeboard
Observed freeboard in
Sludge Survey Date
Sludge Depth ft& %
Liquid Trt. Zone ft
Calibration Date
1
2
3
4
5
6
7
8
Design Flow
Actual Flow
Design Width
33 0
Actual Width
32
Soil Test Date _
pH Fields
Lime Needed
Lime Applied
Cu ✓ Zn ./
Needs P
Crop Yield
Wettable Acres
WUP
Weekly Freeboard
Rainfall >1"
1 in Inspections
120 min Inspections ✓
Weather Codes ✓
Transfer Sheets_
RAIN GAUGE
Dead box or incinerator
000
Pull/Field
Soil
Crop
RYE
PAN
Window
Max Rate
Max:,Amt
1 kv(a
Pf4 J 461,
Verify PHONE NUMBERS and affiliations
Date last WUP FRO Date last WUP at farm
FRO or Farm Records
-), —CLf k �Q%ej �fl�� �11�
Lagoon #
Top Dike
Stop Pump
Start Pump
App. Hardware

Facility Number (j
VDivision of Water Quality
® Division of Soil and Water Conservation
® Other Agency
p Type of Visit ,Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
IReason for Visit V Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: _' Arrival Time: Departure Time: County:
Farm Name: r / 4 c -( Z w i {i c Owner Email:
A Owner Name: /y , r Uj V1 '�'_ �&'7Y) S Phone: _
Mailing Address:
Physical Address:
Facility Contact: M C0 r e- Title:
Onsite Representative: rl r
Certified Operator:
Back-up Operator:
Location of Farm:
Region: ��OL
Phone No•710 .Z-_S- / (O 5'
Integrator• put` V I s
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = ` = " Longitude: F-1 ° 177 ' F-1 "
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La er
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean ZOS ['Z t
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑
La ers
❑
Non -Layers
❑
Pullets
❑
Turkeys
TurkeyPoults
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifej
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
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
V'No
❑ NA
❑ NE
❑ Yes
❑ No
�,NA
/ �
❑ NE
❑ Yes
❑ No
[�NA
❑ NE
19NA
❑ NE
❑ Yes
❑ No
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number.-7— % Z
Date of Inspection 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
l r
Observed Freeboard (in):
t $Lf +
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 XNo ❑ NA ❑ NE
❑ Yes (t�,No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes (, No ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? XYes ❑ 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, diy stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �d No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes ANo ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes NNo ❑ 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) QC.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
JKNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1% No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
A No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
kNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
N�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 crl (Z[ Jr I �c LA N-`1 0 ; Phone: �( %�Tj3 300
Reviewer/Inspector Signature: Date: Eg�
12128104 Continued

Facility Number: — 2 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 �INo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps [I 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 ),No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
�NA
``❑
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
Pa.No
NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
TR.No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
tS�No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
J,NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
(� No
El NA
El NE
and report the mortality rates that were higher than normal?
/ `
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
Q No
❑ NA
❑ NE
Comments and/or Drawings:
I�Ivs-4 use -11U ma's" "U ".w R ,) rc�� �n ( UL-2y
— cue 1 ,-% Zim$ -
fZ�o os s :
12128104

Facility No. _ 7 " — Time In—'l W Time Out Date
Farm Name 610 Oanl�u Integrator V; n/
Owner Site Rep.,
Operator ---7— No. 1") Ck b o
Back-up No. O. .
.c
COC Circle: General or NPDES
Desi n
Current
Desi n
Current
Wean — Feed
Farrow - Feed
Wean — Finish
Farrow — Finish
Gilts/ Boars
Others '
FREEBO : esign L��
Sludge Survey
Crop Yieff
Rain GaugeSoilTest ' WettableAcres_Weekly Freeboard k-- Daily Rainfall
Spray/Freeboard Drop ft� fyov
Weather Codes
Waste Analysis:
120 min Inspectio
Observed 31 j
Calibration/GPM
Waste Transfers-- -�
Rain Break�� \�
PLAT
1-in Inspections
Date Nitrogen (N) Date Nitrogen (N)
? o
Pull/Field Soil Crop 'Pan Window
n !-

-`-r
Facility Number
P
V Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
(Type of Visit 0Com Iliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit $ Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: �� Arrival Time: ® Departure Time: Ll County: t Region:
Farm Name: ��(I ! y�� 1 Ylf°, Owner Email:
Owner Name: Ea-u OYIS - Phone:
Mailing Address:
Physical Address:
Facility Contact: f `� n J Title:1
Onsite Representative: on Mayc-'
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
Phone No: 1 /Q a[-!� ��
Operator Certification Number:
Back-up Certification Number:
Latitude: =' =' =" Longitude: = ° =' = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
I�❑ Layer
❑ Non -Layer EEE]
Other
❑ Other 1
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys'
❑ Turke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the -State
other than from a discharge?
❑ Yes 'kNo ❑ NA ❑ NE
❑ Yes
❑ No OTA
❑ NE
❑ Yes
❑ No ONA
❑ NE
❑ Yes
❑ No �A
❑ NE
❑ Yes
k No ❑ NA
❑ NE
❑ Yes
o ❑ NA
❑ NE
Page 1 of 3 12128104 Continued

i
Facility Number: `7'1 —Q2 Date of Inspection `� n
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
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 (E�No ❑ NA ❑ NE
❑ Yes ❑ No 5bqA ❑ NE
Structure 5 Structure 6
❑ Yes ,No ❑ NA ❑ NE
❑ YesNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Ayes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [�To [I NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) / v
9. Does any part of the waste management system other than the waste structures require ❑ Yes o ❑ NA ❑ NE
maintenance or improvement? �V
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 10 ❑ 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) LLU c L 1 0
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Yo
❑ 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 A No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
�YNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PkNo
❑ 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):
nA
bk
Reviewer/Inspector Name 150AREh LA N Ali j Phone:-1 'D 01;D -71
Reviewer/Inspector Signature: ) Date: (,Xr
Page 2 of 3 12128104 Continued

r.
Facility Number: -0 f Date of Inspection 0-7
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 ElNA [I NE
the appropriate box. El �p El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ElYes L4 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
ANo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
)_9BNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
hMYes
❑ No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
'mNo
//❑
El NA
El
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
loss
❑ Yes
No
V1 NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
� No
El NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
ElNA
ElNE
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
PO No
ElNA
ElNE
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
I 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
�INNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
�j No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Lts-Q. 4COJC'LL6-�
�(0
I o - cNm 9
Page 3 of 3
12128104

Facility No. 1 r o Time In�(4-0 Time Out Date cr
Farm Name�c� Integrator Gc.d�l1 S
Owner .�Lx�,�, ' Site Rep
� / M LA MR,( '
Operator ��'L� 1' C%� �"` ti No.�
Back-up No."----.
COC Circle: CGe!!rair .-NPDES
Design
Current
Qesi ri
Current,
Wean -.Feed•
Fa -
Wean — Finish
FaF - .finish
Feed. Bini
Gilts/ Boars
Farrow =Wean
Others
-
FREEBOARD: -.Design Observed '
Calibration%GPM
k/a 2 .
Judge Surve • _ - -
Crop, ie d Waste Transfers
V , ,• Rain Breaker
Rain Gauge - Yam'
Soil Test PLAT Wettable Acres
Weekly Freeboard ; % Daily Rainfall✓ 1-in Inspections
Spray/Freeboard'DropJtt.��—
Weather Codes 120 min Inspections.
'Waste Analysis: -
Date Nitrogen (N) Date Nitrogen (N).-
lea
� �` .�

r0 Division of Water Quality �L
Facility Number O Division of Soil and Water Conservation
O Other Agency
Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ' Q Departure Time: County:
Farm Name: � 11_11yW i vi ", Owner Email:
Owner Name: �N. �' ��U d' ✓ ! Phone: _
Mailing Address:
Physical Address:
Facility Contact: - pz- Title:
Onsite Representative:�►+�
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other'
❑ Other
Region: R o
Phone /_ 2
Integrator: _, P,Ie /i_
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = ` = " Longitude: = ° = ` = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er I Eli
I1 10 Non -La ei — -- ---- -- ---
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
[I Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifej
❑
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?
❑ Yes ,LNo ❑ NA ❑ NE--
❑ Yes
rUt No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
PQ No
❑ Yes
X, No
❑ NA
❑ NE
❑ Yes
IRNo
❑ NA
❑ NE
12128104 Continued

,,
Facility Number: - Date of Inspection �n
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes .4 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes M No El NA El NE
Structure Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ne /� �
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
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
LQ 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
,ZNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes
J4 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
[K No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
,g�No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
M-No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare.Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) - j_3��:n� M(Zf oral dr 67YOE 2. e ZZ V�7- O'_ ye a-
13. Soil type(s) U2 1�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
4 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
qNo
❑ 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
RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ONo
❑ NA
❑ NE
Comments refer to question # • Explain any YES answers and/or any recommendations or an oilier comments:-
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name I 7 T- v -r - Phone: 42-1 1//
Reviewer/Inspector Signature: Date: oZ U�
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [4 No A [kNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ yes o No ❑ NA K NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. X Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ;Z 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
PNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ZNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the pen -nit?
❑ Yes
L4 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
9 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
LA�No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�No
El 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
W 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
El NA
El 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
VLNo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

f
.".?t,'r�"; �'tis'•f rs-,.,r„»+,>"�-f ice': :i R."'�r^'-.+T.i:T a""n _�'tC ::kr "'�"",,-.i_.,,:.y.,,e«-.',. €;�r-..rr..,,_ _ - .�b'^r,E�'^;;: -
-a�
�,:�> i�T�;^i�•a
$.. '�v
ivU
So<i5lr:'
Cons�e�r•.y�{-s".*a;te;: ta"'i.
gas;-4. 's, ':>w,,, ��W,a•,'
6,,
E
Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine 0 Complaint O Follow up. O Emergency Notification O Other ❑ Denied Access .
Facility Number Date of Visit: 6t Time:
rO Not Operational 0 Below Threshold
❑ Permitted 13Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold
Farm Name: iJi WU�ps 4-e'^h' County: Flo
Owner Name: T;a r 4e.e-9— 90� r, -2. Phone No: 9 /_� q4R —
Mailing Address: 2 sn� S n?`e1% R oe,� rL o 6 h r'n s - /.f C. 2 3 -0.5'
Facility' Contact: TO h ti M b o m Title: Phone No:
Onsite Representative: i{VI 0, n r-e, Integrator: �tLr X) .e
Certified Operator: <rrt, Operator Certification Number: :1 ).,3,? c/
Location of Farm:
0 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ' K Longitude • 6 u
Design Current
Swine ('anarifv Pnnnlafinn
❑ Wean to Feeder.
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
6a &Z
iboo
❑ Farron• to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Ca acity Population
❑ Layer ❑ Da'
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of 1 agoons `'-u a ❑ Subsurface Drains Present' . ❑ Lagoon Ar"ea ❑ S `rav Field area''
'AHolding Ponds /Solid Traps', _. ❑ No Liquid Waste Management System'
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): 3 0-
05103/0I
❑ Yes qNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes _[R No
❑ Yes R No
❑ Yes 5D No
Structure 6
Continued

Facility Number: :7-— Date of Inspection cY
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes allo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes � No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes � No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? — ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes C .No
12. Crop hype
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [E 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 5� No
16. Is there a lack of adequate waste application equipment? ❑ Yes ®No
Reauired 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
MNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
®No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
D No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
P No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
®No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
E4 No
24. Does facility require a follow-up visit by same agency?
❑ Yes
E] No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
L�)No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑ Field Copy ❑ Final Notes��
Reviewer/Inspector Name �-
Reviewer/Inspector Signature: Date: (j
05103101 G Continued

? . .
Facility Number: T`f- 1 Date of Inspection 3 0
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Additional Comments and/or Drawings:
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes ®"No
❑ Yes RNo
❑ Yes No
❑ Yes No
❑ Yes ❑ No
O5103101

Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification 0 Other ❑ Denied Access
Facility Number "} Z Date of visit: 10 0 Time: �t i7
0 Not Operational 0 Below Threshold
13 Permitted [3 Certified 13 Conditionally Certified 0 Registered DateLast Operated or Above Threshold: .........................
Farm Name: ..... ..._:? ac...R.Iat......_. kS%!.k!'r........... ....................................... County:............ �!. .✓! Q!! ......_.. _ .........._..........
OwnerName: _... ...... _...................................... .... ........... _................................................ 'Phone No: ... _................... ..._.......... _._.... _...._.... ......... ..............
_ .
MailingAddress: ... _... _._...._._._....... _.._.................. _........................... ....................... _..._.._.__...._._.. _ _._... .................... ...........................
Facility Contact-......................._...................................._............... Tide: Phone No:
OnsiteRepresentative: ........ _.... _... _ .__......._�......._...._............_......._....... •Integrator: _._..........._ .. ............. _... .................. _._...... _........... _..
Certified Operator: ._........ _....... _._.............. ..... __...._... _...._..... _ ................_........... Operator Certification Number: ....... _._...._........ ..... ..........
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• ��
fiaviep "
❑ Wean to Feeder
❑Layer
';
❑Dairy
❑ Feeder to Finish
'
❑ Non -Layer
;
❑Non -Dairy
Farrow to Wean
Other
Farrow to Feeder
-
Farrow to Finish
uaL'D:rx
.,i-Ti—
a u�� -
Gilts
Boars
Discharges
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yeg- ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 'Structure 6
Identifier: ....... .._._....1..I........_.....2-.._.. `..... ........._:._.... ........... ...... _...
_._.....__...._...
Freeboard (inches): 3 (D
.12112103 Continued

Facility Number: -.+ T— (,Z Date of Inspection 0 0
�5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ yes ElNo
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes. ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No
elevation markings?
Waste Application .
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ,❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No.
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre'determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? - 1 ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)-
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional . ❑ Yes ❑ No
Air Quality representative immediately. _
o . � th,e a.sa❑��;
,u�.:��; '. .•:�:" w;�� ;�;_.. :fix _ ���.: �; �� ° - � �.*�,�.. �� :�:' a �.xvv�.=:x�.,. 'rFk�C
.4e-' Vi!@r'ards{�: a�i{{e�ai
lE6�Ci�WjO�l�
a.
II,...N,,..-�,.oe
#n}l'
IW. mY,l�i�f���w�i.itn.
B/M��
�3t: :4�-lL»S•$:�•gr�.
�i.l
r+ PC$
F�i.,nr�a:..Fl t.,es
C-.,.�
�l�l�.t.,•,,;.(.l=•,-1.`es., ./Vw�e.ji>.�T•,��.:.jQ�_ .e f�JV:�p4�t
�,-.=nOgya.l�- pi
. i Sp�'�ilp1��Y�W���iPd�a-�,aa,r
A�9y�}IIW���Ry�i�V1'���,M.y�liwi,'a:F:n.,
�YyI.t.�9.�_
❑Field Copy
':�t
- >,..(..
,�,i.
,fa��'t'�•4`.Ab
(A r�
,- �/� t�1� �� ��1 �V � ����\ v� � -�/\/yam � ♦ -
oo��. 40 . JC,
ryq�q
�i+s-�^,',w,'i'a.,-A-,sa �. n✓*".v�'. 3'd �.,"-"` a^J'R1 `'»✓,,�"'"Y^+•—o,rw.*'^iN i ,'F'�.. '2�'�n�L,`;.;
Reviewer ector Names '� :: E P z. ` > „ ;�:w,,. -
P : 0 y M,
> x,Kgm Win.<y
ReviewerAnspector Signature: Date:
12112103 - ` Continued

4'. -. r
.YF e, S i xh
..r .. mod. .-...=ci`�...'+....,rvn_ ... .... .....
IType of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation J I
Reason for Visit @ Routine 0 Complaint 0 Follow up Q Emergency Notification 0 Other ❑ Denied Access
Facility• Number
Date of Visit: 63 Time:
�' 1
Not O erational 0 Below Threshold
® Permitted [3 Certified [3 Conditionally Certified ❑ Registered Date Last Operated or Above Threshold
Farm Name: pwrkas Fcrw.c Count: . �.6e—L
Owner Name: TGr- ! 'a trl IPhone No:
Mailing Address: ? S O Z� j2 e� 9 b (7 n .s jar _C _Z
Facility Contact: w,14 vYl(-� o re. Title: Phone No:
r
Onsite Representative: ___'I v- Li cM.0L) r0 Integrator: l O --7-V 3 C. F) O * 4.,rd`is
Certified Operator: IfLU-e. Pe- r^ Operator Certification Number: 2-03 feg
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 Du Longitude • 4 OK
Design
Current
Design . Current
Design Current
Swine Capacity
Population Poultry
Ca acity Population Cattle
Capacity Population
❑ Wean to Feeder
1, ❑ Layer
I ❑ Dairy
❑ Feeder to Finish
I IEJ Non -Layer
I I JE1 Non -Dairy
❑ Farrow to Wean
Farrow to Feeder p b
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
Number of Ligoons
g
Subsurface Drains Present ❑ Lagoon Area
`= ` ¢, , ❑ S �•ra, • Field Area
olding Ponds / Solid Traps
;: ❑ No Liquid Waste Management System
..,
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a: If discharge is observed, was the conveyance man-made? El Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes O No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes R No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): ag,
05103101 Continued

N
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes M No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes IF No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [ f No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes P No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes JP No
Waste Application
10. Are there any buffers that need maintenance/improvement? - ❑ Yes E� No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [5No
12. Crop hype /3 U'., "- . 4— Wll
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [j 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?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes EP No
❑ Yes ® No
❑ Yes [RNo
❑ Yes EgNo
❑ Yes EM No
❑ Yes [Z(�='] No
❑ Yes PNo
❑ Yes EN No
❑ Yes ONo
❑ Yes 91 No
❑ Yes QNo
113 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 drawings of facility to better explain situations. (use additional pages as necessary):ElField Copy El Final Notes
Reviewer/Inspector Name i(I !<Ga;�_ k"
Reviewer/Inspector Signature: Date:
0510310I `i Continued

Facility Number: -.. — 1 2- Date of Inspection
Odor Issues
26. Does the discharge pipe'from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage.pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
2.8. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes [ 2 No
❑ Yes P No
❑ Yes [BNo
❑ Yes 1� No
❑ Yes R No
❑ Yes N No
❑ Yes t� No
05103101

Division of WaterQivaility
Q Division: of Soil and Water:Conservatidn
w Q;Qther.;Aen+ey F,
r
Type of Visit ® Compliance Inspection • O Operation Review O Lagoon Evaluation'
Reason for Visit. *Routine O Complaint 0 Follow up 0 Emergency Notification O Other ❑ Denied Access
Time:
rO Not Operational 0 Below Threshold
Facility Number Date of Visit:
Permitted ® Certified ®Conditionally Certified 13Registered Date Last Operated or AbovV Threshold:
Farm Name: �� �.yie%1✓ County: r•� aa✓�
Owner Name: A)- ,��/J ,ti �«/. Phone No:
Mailing Address: Z S �Z4,-)" V C
Facility Contact: Title: Phone No:
Onsite,Representative: ®y Integrator: /Is'- G• /��r�d%� ` �i�/t.�,.1
Certified Operator: AasyrL f_ .PG✓ Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
��" °= , °�'­ - Design =. Current ;.Design + ui ienU D'esigri , ® �Cutrent
Swine��..;- =Ca `acitv,: Po ulation- Poultrd� Ca D8CiiV., Population Cattle
:C
J apacity Population
❑ Wean to Feeder, ❑ Layer _ ❑Dai }
❑ Feeder to Finish ❑ ,
�. Non -Layer ' ❑Non-Dai
❑ Farrow to Wean
r
Farrow to Feeder ❑ OtherI`j',
❑ Farrow to Finish Total Design Capacity.'
J `?
❑ Gilts
El Boars Total' �SSLW
htumkier ofSubsurface Drains Presentagooris; 0 ❑ ❑ Spray Field Area ❑ La oon Area
Bolding Ponds:/.Solid Trap 10 No Liquid Waste Management S stem t'
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes RNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes N[No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes R 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 U No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes FNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes e No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

Facility Number: 72 — J z I Date of Inspection 0
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
12. Crop type 6r s f7 _ � � /O�ol iSsvi�r��
13. Do the receiving crops differ with those designated in the Certi
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Doe facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(i checkljsts, des, ma j, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis soil sample reports
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes tWNo
❑ Yes N'No
❑ Yes 'KNo
❑ Yes �gNo
❑ Yes �fl No
❑ Yes ®^No
❑ Yes 0 No
LJ Yes ,jJ No
❑ Yes 0 No
❑ Yes No
❑ Yes MNo
❑ Yes R No
❑ Yes KNo
❑ Yes 0 No
e19Yes ❑ No
❑ Yes 2'No
❑ Yes P"No
❑ Yes RNo
1
❑ Yes P No
❑ Yes �SNo
❑ Yes No
❑ Yes DRNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments,(refer to question #)i Explain. any YES answers and/or,any recommendations or anv other comments. --
Ilse iirawings.of facilityfto.better explain.situations:use additioAal pages as necessary):.
,•,. ❑Field Copv❑ Final Notes��
7 .E
loll, 7 4:ii
Reviewer/Inspector Name
Reviewer/Inspector Signature: 42Date: 8 .,Z/ 22_
05103101 1,2Continued
��Aoop

of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
IReason for Visit
Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access I
2
Date of Visit: 3'- _ (.7 Time:
Facility Number
O Not Operational O Below Threshold
Permitted [3 Certified PConditionally Certified 13 Registered Date Last Operated Above Threshol
Farm Name: ! � G z /l Count G / ��n................................
........ �...................................................... Y• .....X../.......... L..2..............
Owner Name:......... /�.� �l.....F ................................................ Phone No:...........1...��'.2.Z. r�
J.�:..(.�.....7...................................
Facility Contact:.....29 ... Ri�re..........................Title:...11!:........:.......................... Phone No:....................................................
MailingAddress: .......................................................................................................................................................................................................................................
OnsiteRepresentative:.... r ..............1...!..�lf......f.............................................. Integrator:.......................................................................................
Certified Operator:.,,, �E �. %�� �"'t�' Operator Certification Number: ....
........................................1................ �..................................
Location of Farm:
❑ Swine ❑Poultry [I Cattle ❑Horse Latitude �' �� �« Longitude
Design ..: Current
Swine' Capacity. Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
Q�
❑ Farrow to Finish
❑ Gilts
❑ Boars
Nuuilier?o£La' ooris �/ _' ❑Subsurface Drains Present Lagoon Area ❑Spray Field Area
g..
...........:.. .
Holdiq `.Ponds:/Soliihra' s ; ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes *No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes � No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes P No
c. If discharge is observed, what is the estimated flow in galhnin? ��
d' Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes )ro
2. Is there evidence of past discharge from any part of the operation? ❑ Yes A No
i
S. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes I*To
01/01/01 Continued

Facility Number: 72 — l2 Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ,R No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes KNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes allo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? R'Yes ❑ No
Adiliti nil Gomments�andlorDrawXngs: ': Ae-
O510310I

A
#-
=f{
=` D'
wisioi•�of.W ?f a er= -
iali s -
Q..
ty�-
�� _ 141
i j ,P
Type of Visit /,0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ARoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
: E Date of Visit: S'_ " I, Time:
Eacilit:yNumbeir '% Z
rO Not Operational O Below Threshold
a(Permitted 0 Certified Conditionally Certified 13 Registered Date Last Operated Above Threshol
Farm Name:.......1....CIC .G / /ill County:............./...G.
Ar j.........�f................................................................. yL/.....................................
Owner Name:......1.........�� .� � .... Q,r� �? 1 .............................. Phone No:...........1../..�� 2.2. ��., ...............................
FacilityContact: ...... .. ...,1..�. 4.0Ci.......................... Title: * ..........................
Phone No:....................................................
Mailing Address:
OnsiteRepresentative:.... l .................. Cj7e.7:•J�............................................. Integrator:.......................................................................................
Certified Operator: ••.•�iE �. ... x'!i` O orator Certification Number. ................... ................!.................................. p
Location of Farm: /
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• �� �«
Design Current
Swine (`anacity. Po " `12tion
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Subsurface Drains Present Lagoon Area Spray Field Area
Number„o£I�a"'oons'�i ❑ ❑ g ❑ P Y ?�.
..................
_ Holdm Ponds/Solid+:Tra's No Liquid Waste Management S stem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes *No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes gNo
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 VNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes A No
i
3. Were there any adverse impacts or. potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes F2KNo
01/01/01 Continued

-
Facility Number: — Z,
Waste Collection & Treatment
Date of Inspection V --D
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structup 2 Structure 3 Structure 4 Structure 5
r,
Identifier: ...... �5.............................................................................................................................................
Z.
Freeboard(inches).........�Gt..........................................................................................:.. _.................................................,
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? ❑ ExJcessiv, Ponding, P
12. Crop type , c� Z e a( 7M
13. Do the receiving crops differ with those designated in the Certified Erin
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Epp .• rr•ri• 3.irr
Hydraulic Overload
❑ Yes gNo
Structure 6
❑ Yes No
a
❑ Yes Wo
❑ Yes ( No
❑ Yes KNo
❑ Yes JKNo
❑ Yes ONo
❑ Yes P(No
Management Plan (CAWMP)? ❑ Yes EECNO
18 Is thu"A ater-t„ pp1y: 1w_q wit ' sn_feet--ef-the-s»rayftelcl-haundar
Repaired Records &Documents ❑ On -site El Off -site
19. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
20. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
21. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
22. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
23. Did the facility fail to have a actively certified operator in charge?
24. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
25. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
26. Does facility require a follow-up visit by same agency?
27. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Odor Issues
28. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
29. Are there any dead animals not disposed of properly within 24 hours?
01/01/01
❑ Yes o
❑ Yes No
❑ Yes ❑ YesINO
o
■Yes E(NIJ.
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes I
❑ Yes IfNo
❑ Yes '�Mo
❑ Yes qNo
❑ Yes. 5No
❑ Yes qNo
❑ Yes jNo
Continued

Facility Number: Z2 — I--
Date of Inspection
Printed on: 1 /4/2001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover?
❑ Yes N0
❑ Yes o
❑ Yes ❑1No
❑ Yes [�(No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Reviewer/Inspector Name�
Reviewer/Inspector Signature:
Date:
01/01/01

® Division of Soil and"Water 'Conservation - Operation Review.
® ivision of Soil and,�!ater"Conservation "Compliance Inspection
Division Hof Water Quality -Com liance Ins ectioiD
Q tY p p
® Other:Agenty=.OperationReview,:"
Routine ® Complaint Q Follow-up of DWQ inspection ® Follow -tip of DSWC review O Other
Facility Number % z Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Permitted ® Certified ® Conditionally Certified ® Registered JE3 Not Operational 1 Date Last Operated:
=/ 5��� County: QL
l`�Ci1 Farm Name:�..........................................................�.�...............................................:......... . -.y.......................................
Owner Name : ...... .......:.. 2.r............ �[ /' / �- 2
/U C........//.................................................................... Phone No:.................. z.......................
Facility Contact: ......z &.w. ......AQ i... ........Title:... ..4�j'1...�............... Phone No:...............................
Mailing Address: Q "i'� S //�o� `7 ✓ (: ...�...................... 2.7-5 �.�
.... ........................... ........
........ �...
Onsite Representative: „ 7z !.".1.�3�� Integrator: ..........:...........................................................................
IG....y............................................
Certified Operator: ... /�Q{�� r(` ............ Operator Certification Number: ..........................................
Location of Farm:
Latitude F7710
Longitude 0•
Design Current
Swine ' Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
67-1 p
❑ Farrow to Finish
❑ Gilts,
❑ Boars
-Design .'.-Current Design Current
Poultry Capacity. Population Cattle Capacity Population
❑ Layer I I ❑ Dairy .
❑ Non -Layer I 1 ❑ Non -Dairy
❑ Other I I
Total Design Capacity vj
Total SSLM
;Number -of Lagoons : 0 ❑Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
Holding Ponds /•Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 1 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance roan -made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
ructure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): ...........y..�r.................'3%..//.............................................
.. ...................................................................... ..
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes MN o
❑ Yes P No.
❑ Yes M No
Structure 6
❑ Yes ,� —
Continued on back
3/23/99

Facility Number: 77 — Date of Inspection
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 Yc
12. Crop type cm (X rat-z e /-e.
13. Do the receiving crops differ with those designated i the Certd
14. a) Does the facility lack adequate acreage for land application?'
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there"a lack of adequate waste application equipment?
❑P
Required Records & Documents
IT. Fail to have Certificate of Coverage & General Permit readily available?
Waste Management Plan (CAWMP)?
18. 'Does the facility fail to have all. components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20_ Is facility not in compliance with any applicable setback criteria in effect at the time.of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
{��'�10 �yiolaiioris'or clef ciencies •mere poted• dix:ing •this:visit: • ;Y:oix wiil •r, eeeiye Rio further
correspondence* aboi ut this visit •................................... .
comments (refer t6question`#)c` Explain any'YES,•answers and/or;any recortimen lations o :any=othe'rcomriierits.
[Jse:dirawnn 'of facili fo tietter:ez lain`situations use additional ' a"'es asznecessa
&s h' P . C P g ry)=
❑ Yes No
❑ Yes ,{] No
❑ Yes O No
❑ Yes R No
❑ Yes DNo
❑ Yes A0
❑ Yes RNo
❑ Yes 0!No
❑ Yes No
[IYes No
❑ Yes gNo
❑ Yes O'No
❑ Yes ANo
❑ Yes allo
❑ Yes J�fNo
❑ Yes VNo
❑ Yes VWNo
❑ Yes 16No
❑ Yes E(No
❑ Yes Q:No
❑ Yes 090
A6
Reviewer/Inspector Name x
Reviewer/Inspector Signature: Date:

Facility Number: 7 T — Z Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e..residue on neighboring vegetation, asphalt, ❑ Yes XNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes XNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes 0
No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes gNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
ona ;-,, ommen . an
or•.<
Q
AL

Division of Soil and Water Conservation - Operation Review
0 Division of Soil and Water Conservation- Compliance Inspection
(Division of Water Quality - Compliance Inspection.
0 Other Agency - Operation Review..
10 Routine Q Complaint O Follow-up of DWQ Inspection O Follow-up of DSWC review O Other
E:
EaciityDate of Inspection
Time of Inspection ISM 24 hr. (hh:mm)
® Permitted 0
Certified ® Conditionally Certified ® Registered JE3 Not Operational Date Last Operated:
Farm Name: ............... ../...�?t'.:..... '! "`�••..... ��'���'�........................................... County:..............�%Ch/!'7t!1-a�............. ...... ..............
Owner Name: ........ !.....`....4�..r.........f 1tT?n 5 ....... 6;VM. . L��...................................... Phone No:.............�....-".......�d��,l
Facility Contact: ............... 7&.0/O�C'� .Title: , . Phone No:......................,
Mailing Address:
vr.o ............ ? ..:..............�........................................................�'fo� .j.an.'.. '�.. /vnC
2 �az5
Onsite Representative: ............�G� .......>' t -°/L'................................................ Integrator:...........(V....:..... �`1!n.5......
Certified Operator: ............�Q '�-. .... -S • On—" Operator Certification Number:
...............
Location of Farm:
I
...................................................................................................................................................................................................................................................
�..::::::::.................................................................................................... ...................................................................1 T
Latitude Longitude • �� �«
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
[X Farrow to Feeder
&000
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer JE1 Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 000
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If dischargc is observed, did it reach: ❑ Surface Waters ❑ Waters of the State
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: P0417-w S cn
Freeboard (inches): .............. Zj/O /.o �!
..............................................................................................................................................................
❑ Yes 0 No
❑ Yes "No
❑ Yes P No
AIA
❑ Yes [ No
❑ Yes No
❑ Yes 1_% No
❑ Yes A No
Structure 6 1
1/6/99 Continued on back

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the.structures observed? (ie/ trees, severe erosion, ❑yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes KNo
(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? ' W Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? �s �No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 9No
11. Is there evidence of over application). ❑ Ponding ❑ Nitrogen \ El Yes XNo
12. Crop typed251�L.!......!�ry�...... �� ..t ..... )............. .............(�1225..\ �,,z.....................................................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes rj No
14. Does the facility lack wettable acreage for land application? (footprint) //�� ❑ Yes No
15. Does the receiving crop need improvement? /vcWe 1.1. CAWP 5 7G�" 15 aZER-57 ❑ Yes No
16. Is there a lack of adequate waste application equipment? n� (%f '' ❑ Yes No
a� CutrLela _ G�
Required .Records & Documents -fizw itzj
1rz
17. Fail to have Certificate of Coverage & General Permit readily available? LW >?i6� r'evtS-qe ❑ Yes TNo
c�f2, F \
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 ,j�No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ,U No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ElYes 10 No
21. Did the facility fail to have a certified operator in responsible charge? ElYes jo No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes YNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 9No
24. Does facility require a follow-up visit by same agency? ❑ Yes #NO
�: No.vialations:or.deficiencies .were noted during-this;visit. You will -receive nar further .:. :
; ecjrrespgiidertce; about; this visit.; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;
Comments (refer'to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to betterexplain situations. (use additional pages as necessary):,
!
s% Jj
ev (yo �e�c,�v� � /, duo cn� to (.��� e" �- A
.��� � •. 0 � `� 1� �.a,rv�o�-r� �iZa�-►� ��-5 ��r�.P� l�� --tom a,� ..
Reviewer/Inspector Name " -:Sq
Reviewer/Inspector Signature: �j�jr,�� Date: 11/6/95

[3 Division of Soil and Water Conservation ❑ Other Agency
]&Division of Water Quality
® Routine 0 Complaint 0 Follow-ug of DW inspection 0 FoIlow-up of DSWC review 0 Other
Date of Inspection /, 7
L Facility Number 7-2« a tZ j
Time of Inspection = 6 24 hr. (hh:mm)
® Registered a Certified [3 Applied for Permit 13 Permitted 10 Not Opera Date Last Operated:
..........................
4
Farm Name: ........
/.e..........k..........�........ C✓ivf.................................................
Owner Name: County:.....%.....1SlLh?^.........................................
� : � `e�i/i Phone No:...1�. `�%6�
.............. ...............T ...................................................................................................................................................................
Facility Contact: 6o � ��d ......................... Title: ...... Phone No:
Mailing Address:......... U j'�/ S /F ....I ........... 1. ..... .1V ........ 2�........................ ..........................
.J............ .�. .... 7
Ons►te Representative: ....... 10 .................................................... Integrator:.......%1�:.f ...1�!�,a...................................
Certified Operator;........... 4�le ..,.................................................. Operator Certification Number:..................
Location of Farm:
Latitude r_�• �° ��� Longitude �• �° ���
Design. ' ' Cuirrent
Swiane.: ; Capacity Population Poultry.',:
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
rraa
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons !Holding Ponds;. Z ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach'Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes '�No
❑ Yes PQFNo
❑ Yes PINo
❑ Yes (t No
11
❑ Yes XNo
❑ Yes KI No
❑ Yes ] No
?211-❑ Yes R.No
❑ Yes FO No
❑ Yes 0 No
Continued on back

Facility Number: 77-
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes EN No
Structures (LagoonsHolding Ponds, onds, Flush Pits, etc.)
9. Is.storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
�.............�................ ..................
........�:........................
Freeboard (ft): ........ �Z S`� .,3
...............................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes M No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
R No
12.
Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
® No
Waste Application
14.
Is there physical evidence of over application?
Q Yes
No
(If in excess of WNT,, or runoff entering waters of the State, notify DWQ)
15.
Crop type!/..// ..........�L ...../jalrL�'........................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
RNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
.RNo
18.
Does the receiving crop need improvement?
Yes
Q' No
19.
Is there a lack of available waste application equipment?
❑ Yes
.[No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
[ No
22.
Does record keeping need improvement?
Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
[RNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
No
N.o.violitions,ar d6riciencies.were-noted,dirriug this" visit., You:will- recei�e:iro:furtlier,
.. • corresOiWeiice about : .
��? /✓1C. d �/7` �¢:Lw!!iE Y'�c� �i�/�t� /�� �f�lti/,•�T/'��,2;t�,c. ����`�
i
Reviewer/Inspector N
r
Reviewer/Inspector Signature: „ / Date:
i _ /1, / ., _/_ _ / . . 76_ 7 / /_ ... =7✓. 77-

b
S A N J H I L 1 S
McKIHNEY LAKE
FISH HATCHERY

Modtine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection a !!
Facility Number,
Time of Inspection- o Use 24 hr. time
Farm- Status: Total Time (in hours),Spent onReview
or Inspection (includes travel and processing)
Farm Name: County: ------
Owner N&m;e:, r%,c riz aa-9.)
MallingAddress: _1501-f C___
Onsite.Rep.resentative: Integrator t, L r v
Certified, Operator. Uw ) .e- F� Operator Certification Number.
Location of Farm:
Latitude
Longitude
jU Not Operational Date Last Operated:
Type of Operation and Design Capacity
"X,
.Poultry',Swine
e e
Ll Wean to Feeder
Dairy
El Feeder to Finish
AU Non -Layer Beef . . . . . . . . . . . . . . . . . . . . . . .
-Farrow to Wean
0
FIFarrow to Feeder
alt.,
elEl Farrow to Finish
A
0 Other Type of Lives
C1 Subsurface Drains Present
Lagoon Ar=e.. Irl Rn rsivField Area
General
1. Are there any buffers that need maintenancelimprovement?
2. Is any discharge observed from any part of the operation?.
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
J. JS Lac= evidence of past discharge from any part or the opemnonli
4. Was there any adverse impacts to the waters of the State other than from a discharge? -
S. Does any part .of the waste management system (other than lagoons/holding ponds) re
quire
xnnintenanczPimnmvPm&nt?
[3Yes ;-PNo,
E3 Yes. . PNo
E3 Yes RNo
E3 Yes PVo
13 Yes )UNo
E3 Yes E090
E3 Yes IffNo
E3 Yes MNo

6. Is facility not incompliance with any applicable setback criteria?
D Yes o
7. Did the facility. fail to have a certified operator in responsible charge (if inspection after 1i1/97)?
❑ yao '
8...Are there lagoons or storage ponds. on site which need to be properly closed?
=
Ll Yes N o
�
_ •
Structures fLaeoons and/or Holdin?Ponds)
9. Is structural freeboard less than adequate?13
Yeso
,Lagoon 1 J Lagoon 2 (.14,f sue.' Lagoon'3
.-lagoon 4
10. Is seepage observed from any of the sa'ucttues?
,..
Yes BNNo
11- Is erosion, or any other threats to the integrity of any of the structures observed?
-
❑ Yes Mo
12. Do any of the stiuctures.nee d mamtenancerimprovement? -0 Yes [] No :
(If any of questions.9-12-was; answered yes, and the situation poses an
Immediate public health or environmental
" ' - '' C CAe-Mn-6,5+- is o) ► l3, "
threat, notify DWQ)
-13.1 Do -an of the stivc :: _ • -.
Y tares lack adquate niaikers to identify start and stop pumping levels?
: :: -%F' , .
❑ No
Waste Anvlication y ! . i• - - .: r.i D.•>..,
. Ja` �Aes
-'Cy,►1 �1, IyA 5+4� � �LQM'OV�
14. Is there physical evidence of over application?
❑Yes EI-No'
(If in excess bf WMP, or runoff' entering waters of the State, notify DWQ) -
15. Crop type C a,a,,, s P21Q... W
16. -Do the active crops differ with those designated in the�Ania�al-Waste Management Plan?..`
17. Does the facility have a lack of adequate acreage for land application?
Yes *o
18. Does the:cover crop beed mprovement?
13 Yes Mo
19. Is there a lack of available irrigation equipment?
0 Yes o
For Certified Facilities Only
-.
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
M Ye 40 `
21. Does the facility fail to comply with the Animal Waste Management PI in any way?
n� A [�Yes_81To
22. Does record keeping need improvement?
23. Does facility require a follow-up visit -by same agency?
_
24.
�-3'es 13 No 9
(Aker cv. V%dV0 II
Did Reviewer/Inspector fail to discuss nwiewf lion with owner or o
- mspec operator in charge?
$ot, %
❑ Yes Iallo
Go"lstr cco? �(fA s (_ L00-/o<E aV C�Lti �'� ac_rrs
as S�cG,�It�� i1�sBec`�►'dl• — t�10 �r�ca��..
6
Reviewer/inspector Name
Reviwer/Inspector Signature:

174cility Number: -_ ZZ
Division of Environmental Management"
Animal Feed.19t Operations Site. Visitation Record
Date: 2I6� 19(0
Time: a:3o
General Information:
Farm Name: Ta a Gte-e "i. Sw ► A e County:
''Owner Name: WAV't'A e;3 s \r i s Phone No: lgl e l 9Y 8 -
On Site Representative', 1R . Integrator: l '.
Mailing Address:- 25oq S o" e s " /C 0CJ n
Physical Address/Location: t.
F_o. 4_CA O A -Irv-p- le�T
' Latitude: 3T . / o o Longitude: -7.1
Operation Description: (based on design characteristics)
Type of Swine No. of Animali. Type of Poultry No. of Animals Type of Cattle No. of Animals
❑ Sow .0 Layer ❑ Dairy
0 Nursery O Non -Layer ❑ Beef.
❑ Feeder
OtherType of Livestock Farm w 'w ea►rII Number ofAnimals: jesro S'ow .% ' o29, h ati r
Number of Lagoons: 2 .. (include in.the Drawings and Observations the freeboard of each lagoon)
Facility Inspection:
Lagoon
Is lagoon(s) freeboard less -than I foot + 25 year 24 hour'storm storage?: .
Is seepage observed. from 'the, lagoon?:
Is erosion observed?:
Is any discharge observed?
O Man-made D Not Man-made
Cover Crop ;
Does the facility need more acreage for spraying?:
Does the cover crop need improvement?:
( list the crops which need improvement)
Crop type: Cz& sf J Be_r r ., o jc_ . Acreage: s v �r.V sis
- LJ r:�'F�r e
Setback Criteria
Is a dwelling located within 200 feet of waste application?
Is a well located within 100 feet of waste application?.
Is animal waste stockpiled within 100 feet of USGS Blue Line`Stream?
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? '
AOI -- January 17,1996
Yes ❑,
No 0
Yes a,
No JR
Yes.
No Q
Yes ❑
No W .
Yes a
Yes ❑
Yes ❑
Yes
Yes ❑
Yes. ❑
No lR
No 1
Now
-.No P
No far
No W
J

State of .North Carolina.';.
Department of Environment;_1, .
Health and Natural Resources •`�
:James B. Hunt, Jr., Governor
Jonathan B.'Howes, Secretary
-November 12, 1996
N.G. Purvis Farms
Tar Heel SwineVEU_
2504 Spies Rd
Robbins NC 27325 NOV 2 :1996
SUBJECT: - Operator In Charge. Designation AYMEVILFacility: Tar Heel SwineFacility ID#: 77-.12 F(_!• .QFFICE . .
Richmond county
Dear Farm Owner: ;
Senate Bill 1217, 'An Act to Implement _Recommendations of the, Blue Ribbon Study
Commission on Agricultural .Waste, enacted .by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 190.­ The owner of each animal waste management_ system must submit a.. '
designation form to the Technical;Assistance and Certification Group which designates -an
Operator in Charge and is countersigned _by the certified operator. The enclosed form must be -
submitted by January 1; 1997 for all'facilities-in operation as of that 'date..Failure to designate a'
certified operator for your animal waste management system is a violation of'15A NCAC 2H
0224 and may result in -the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact. your ,local -North Carolina" Cooperative Extension Service agent or our office.
Examinations have been offered, on: an on-goirig'.basis in many counties throughout the state for
the past several months and will continue to be offered through:December,31, 1996. '
Thank you'for your cooperation. If you'have any questions concerning this requirement please -
call Beth Buffington or Barry Huneycutt of our staff at 919/733-0026.
Sincerely;
A'. Preston Howard, Jr., rrector:
Division of Water Quality
Enclosure ;
cc: Fayetteville Regional Office
Water Quality Files
P.O. Box 27687;. CCAn
AFAX-919=715=3060Raleigh, North Carolina 27611-7687 Equal Opportunity/Affirmative Action Employer.,—
Voice 919-7,15-4100 : - 50% recycled/1.00/. post -consumer paper

Site Requires Immediate Attention:
Facility No. 7 7 —/ Z
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 7 , 1995
Time:
Farm Name/Owner:
Mailing Address: z506X 7-14>
County: %e.-64r "PAI-6
Integrator: Phone:
On Site Representative: �v,'zVPhone: 9lD — ,9�8 - z 97
Physical Address/Location: _t�, , m i 46' A+ kez* a -A SdNG T/ON w,,n% S�? 14 so
Type of Operation: Swine _y_ Poultry
Design Capacity: w - Fr2 -�Oe-Aa Number of
DEM Certification Number: ACE I
Latitude• 0 9 11Longitude: °
Cattle
Animals on Site: /oo0 So,J
,EM Certification Number: ACNEW
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot '+ 7 inches) &3or No Actual Freeboard: Ft.-" /Yr Inches
Was any, seepage observed from the la oon(s)? Yes or&Was any erosion observed? Yes or(SD
es
Is adequate land available for spray? r No Is the cover crop adequate? es or No
Crop(s) being utilized: CoA-s Vic_ "e�� w-Te m op, -i "K v t5—
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? 0 or No
100 Feet from Wells? or No AD
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or ®o
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or�o
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes oro If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or
Additional Comments:
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

April 15, 1981
B . Chsrriker.
Route 2, Boa 41 A
Ellarbse, o th Carolina 26338
SUBJECT: Compliant Investigation
Tar Vool Swine Farm
Ric3_nond County
Dear Mr. Charrikers
This 3e:tt:ar is in raference to sa investigation made by Mr. Pommy Stevens
of ray staff on April 14, 1981. iA sa:gard to Your coaplaint about odors irom
Tar Uee l Swi na Tarza. fir. Vma�r >3 mar. with Mr.illiaza TAwlap of Tar Seea.1. Sums
Farm and Mr. Wallace Flynt of the Richmond County Agriculturasl. Extensioa
Searviaa and mud* an inaspesatiotTt of tho ,facility.
The Division of Enviroumeesntsl management has the responsibility to admin-
ister the Animal F'oodlot Ye ul ation. This regulation uddreasev Wad method
by which tM wastewater froya an animal feedlot, is dii)poaod ?'at Boas not apply
to odlaxs Senaratad at taw: feedlot. Thin operatian does uaso a cloo*d circuit,
re ireulati.on type wastewater' treatment seyste m, with periodic land appl.i.cati.ou
Of thu Wastewater. the: system in use 13 "state of the art" and is in cam-
pl iance with. the aai.wsil feedlot ra uiation.
Ti4A ,ag€ancy also haa the raGpousibi.lity to assure goat air pollution
asoUrees ate in Compliance with the established ftlasioa standards. The
e:misssiou suadards were established to achieve and malutain Specific ambient
atauda;rds daaigae4 to protect the public Nuaslth and walfare. There is no
specific air amissmiou limiting regulation applicable: to swine farms; however,
t] tre xs au applicable re3ulation which applies to all operations that produce
odorous emissions.. The regulAtion as stated in the North Carolina Administrative
Code, Title 13 Department of Natural Pasources anti. community Development,
Chapter 2. Environmerntaal YvAnagaute nt, SubchapteAr' 2 D .fir Pollution Control Require -
meats, subsection .0522 outrol dud Prohibition of odorous "Emissions dew laarFas a
""No person alvill, cause, suffer, allow, or par►ait any plant
engaged in they processing of auivAl, mineral, or vegetables matter
to be operated witlwut employing suitable measures for the coa-
trol of odorous a mistioust including, wet scrubbers, incintrstors,
at such other devices as may be approved by the V;omission."
In this case, odors from the swine farm would not be covered by this
re,gulati.on, as it applies only to protests operations that produce odors.

Mr. J. B. Charriker
Wage 2
April 1.5, 1981
If this office can be of further assistance to you►, please do not hesitate
to contact Mr. Stevatus at 486-1541.
Sincerely,
Dennis R. Rumsey
Regional Supervisor
T3/Ir
cc: Mr. apace Uynt