780018_INSPECTIONS_20171231

Type of Visit: 0 COMPHance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 6,,-i;1-/ Arrival Time: Departure Time: i 3 County: Region:
Farm Name: �ys;/'ryt� /—f" -., _::�6[1.� Owner Email:
Owner Name: /�i f fp t- �iy�� / a/er,5 Phone:
Mailing Address:
Physical Address:
Facility Contact: f'j IC-4014 //�.r-� Title: /714-7- Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator:
Certification Number:
Certification Number:
Location of Harm: Latitude: Longitude:
DesignILCurrent
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry` '' °Capacity
Pop.
Cattle Capacity op.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
I
INon-Layer
I
Dairy Calf
Feeder to Finish
G
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D , P.oult .
Ca aci
Po
Non -Dairy
Farrow to Finish
Layers
Non -La ers
Pullets
Turke s
Beef Stocker
Beef Feeder
lReef Brood Cow
Gilts
Boars
Other
Turkey Poults,
I��
Other
Other
y �y.
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify 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?
❑ Yes [Z No ❑ NA ❑ NE
[:)Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ONE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

-�[Facility Number: jDate of Inspection: -- AVI
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:
Spillway?:
Designed Freeboard (in): —� -
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
LM 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
® 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?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [ Cq No ❑ NA [] NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Tn, 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):�y`/ltu�a
13. Soil Type(s): p k Z C,0- "t
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
© No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Repaired 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
V�J_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
[KNo
❑ 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
[S No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[Eg-No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

Facility Number: T - Date of Ins ection: —/�-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [2,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 [g No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ® No
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes ® No
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
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
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes [g No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ® No
34. Does the facility require a follow-up visit by the same agency?
❑ Yes B-No
❑ NA ❑ NE
❑ NA [] NE
❑ NA [] NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
-. (__ .. �- �: P RF.. �" y" P. _ - ss•.. 'mii[eentsw
Comments refe..r to . on E P man YE 3 (nswers an or P gadditional. r6cyo)mmendations,or an other eo 7
Use drawings offac�h to better ex Iaiq srivat�oas_ nse�additional; pages as necessa ;," ...
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone:
Date:
21412015

I ype of visit: kZuompliance inspection tJ Operation Review O'tructure Evaluation U Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: O Departure Time: County
Farm Name:Owner Email:
Owner Name: dt> tS Phone:
Mailing Address:
Physical Address:
LRegion: F��D
Facility Contact: /� , Cf74ri� ff �e y �—� _ Title: Phone: `
Onsite Representative: Integrator:
Certified Operator: _jam_ Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design Current Design Current
Swine Capacity Pop.
Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
ILayer Dairy Cow
Wean to Feeder
I iNon-Layer—I Dairy Calf
Dairy Heifer
Feeder to Finish
Farrow to Wean
MDesign Current Dry Cow
D . P,oultr Ca aci P,o Non -Dairy
Farrow to Feeder
Farrow to Finish
Layers Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes EINo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
fZ No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
0 Yes
[4 No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: - / Date of Inspection: y
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:
Spillway 9:
Designed Freeboard (in):
Observed Freeboard (in): ----
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[R 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
E[No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4fi 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
S 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
0 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): /'o y�"4-�
13. Soil Type(s): AllQ d
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Q No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Eallo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes allo ❑ 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 UNo ❑ NA ONE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes f�j No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [a 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 INo
❑ 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 E No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Q No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection: 70­17
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ 0
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes allo
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 EINo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes n 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?
34. Does the facility require a follow-up visit by the same agency?
❑NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes 2jNo ❑ NA ❑ NE
❑ Yes CZNo ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
[] Yes [E No
❑ Yes allo
❑ Yes EE],No
Com Use drawun seof factli be plain btu lion (use add ttonal pages as necesendahons orA aten-�'othe>r co
g. ty
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone:
Date:
21412015

Type of Visit: UCompliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 6_k�O'utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ll Arrival Time: A Departure Time: p County: phXf+r•— Region: a
Farm Name: r�it�'!n- l7`d%dr't- S1Uazp Owner Email:
Owner Name: / f fp�C� j m ; Th ��zllrls %� Phone:
Mailing Address:
Physical Address:
Facility Contact: ;��j Y! Title: Phone:
Onsite Representative: ���.� Integrator: 5�;�-�z-�� _
Certified Operator: Certification Number:43
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Desrgn Current Design Current Design Gurrent
FSwinet.op. Wet Poultry Capacity Pop. Cattle C►opacity Wean Finish Layer DairyCow
Wean to Feeder Non -Layer DairyCalf
Feeder to Finish 9,i0 00 DairyHeifer
Farrow to Wean Design Current Cow
ot
Farrow to Feeder D , P,oul Ca 'a.ci P,o Non -Dairy
Farrow to Finish Layers Beef Stocker
Gilts Non -La ers Beef Feeder
Boars Pullets I Beef Brood Cow
Turkeys
Other _ TurkeyPoults
Other Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
a No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[] No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
FA No
❑ NA
❑,NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

Facifity 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.)
0 No ❑ NA ❑ NE
[—]No ❑NA ❑NE
Structure 6
❑ Yes [ No ❑ NA ❑ NE
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
E] No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
i] 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
gallo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
KNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes [WNo ❑ 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): fts^%h /,o c/r _/•r-r&�
13. Soil Type(s): ,CJ a
l4. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [a 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 0 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?
Reauired Records & Documents
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
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
❑ 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
Eq No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
W No
❑ NA ❑ NE
Page 2 of 3
21412014 Condnued

j Facility Number: jDate of Inspection: / 6
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes allo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [E[ 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 ® 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 rile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑NA• ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
[DNA ❑NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No
❑ Yes 12 No
[:]Yes SE No
❑ NA ❑ NE
❑ NA ❑ NE
❑ 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 additionai pages as necessary). "'.44
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: �5--pp/�
214120I4

j ffG� S- r -'�qa /.s c.---
Type of Visit: om fiance Inspection 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: sr= Arrival Time: Departure Time: ; p County:Ll6�f---- Region: q
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Title: Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Caoultry
Wean to Finish
Design Current
Cacityap
La er
DairyCow
�Crltyy'nt
Wean to Feeder
Non -La er
Design Current
D . $oul Ca ac'. 1?0
Layers
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
�(
DairyHeifer
Cow
Non-Dairy
Beef Stocker
Gilts
Non -La ers
Pullets
Beef Feeder
Beef Brood Cow
Boars
Other
Other
Turke s
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?
❑ Yes 5?r—No ❑ NA ❑ NE
[::]Yes [:]No
[—]Yes [—]No
❑ Yes [] No
❑ Yes [5,No
❑ Yes �No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412014 Continued

lFacility Number. - Date of Ins ection:
(p
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[:]Yes
[7FNo
❑ NA
E] NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure
4 Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[S�,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
Callo
❑ 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
3,No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
ER No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2,No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0[No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ 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): / a
13. Soil Type(s): Q
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [3f-No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 2!�No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes 0,No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[:]Yes
Callo
❑ 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 El Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes E&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 allo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes JZLNo
❑ NA [] NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Condaued

Facili Number: jDate of Inspection: J
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes RNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�RNo
❑ NA
❑ NE
[:]Yes
0No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes 9 No ❑ NA ❑ NE
[3 Yes g] No ❑ NA ❑ NE
❑ Yes
O_No
[DNA
❑ NE
❑ Yes
M No
. ❑ NA
❑ NE
❑ Yes
�&No
❑ NA
❑ NE
❑ Yes
C&No
❑ NA
❑ NE
Comments (refer to question..#) Explain any YES answers and/or any additional recommendations or any other cottiments
Use drawin& of facility to better eaplain'situations (use additional pages as necessary). �; � •_. x
Reviewer/Inspector Name: �1��
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
Date:
21412011

Type of Visit: 4ErCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 04outine O Complaint 0 Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: Arrival Time: Departure TimeCounty: Region:F
Farm Name:"— J��'1 W (.4 Owner Email:
Owner Name: A gck g4f-It" ' Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator -
Back -up Operator:
Title: Phone:
r Integrator: & 0! ly 0 r
e r Certification Number: _Z_-03 81
Certification Number:
Location of Farm: Latitude: Longitude:
Current
Design Current'
Design Current
" Ca SCE
Swine �, i Pop
r- l? tyw. 'uuu
!� WetFPoultry Capa ty. Pop.
Cattle
Capacity PoP.
Wean to Finish
La er
Dairy Cow
Dairy Calf
Wean to Feeder
Non -La er
Feeder to Finish
t'�p
._ _.:... , _ ..- ...- . _.
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
D , P.oul Ca aci P,o P.
Layers
Non -Dairy
Beef Stocker
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
_
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Imuacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[D,9'
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
E>A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[]Yes
❑ No
®,KA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[:]No
NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
[:]Yes
[jKo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [—]Yes [ja'*No ❑ NA ❑ NE
of the State other than from a discharge?
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
&�
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[:]Yes
[::]No
[3'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
Zle
❑ 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 ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [3 Ilo ❑ 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 D o ❑ NA ❑ NE
maintenance or improvement?
Waste Application ,--,�
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [21 o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 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): Abel.-fi(ldokk
13. Soil Type(s): �� k &) 0 -, 6,
i
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�o
[] NA
❑ NE
IS. Does the receiving crop and/or land application site need improvement?
❑ Yes
[}-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
EE�No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
ffNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[�Ko
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[ld'o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Eg No
❑ NA
❑ NE
the appropriate box.
❑WUP El Checklists ❑ Design [:]Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes �o
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes EfNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes �o
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
[] NA ❑ NE
Page 2 of 3 21412011 Continued

a
Facility Number: - Date of lns ection:
21. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes L 000 ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes gj.6 DNA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes F4 t ❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
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 Ea�' ❑ NA ❑ NE
[—]Yes ❑' ]�o [DNA ❑ NE
❑ Yes [0,do ❑ NA ❑ NE
❑Yes �o ❑NA ❑NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [:]Yes Q01 o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? [:]Yes Q N ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [—]Yes ❑- o ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendationsfor.any othercommen
Use drawings of facility to better explain situations (use additional pages as necessary).
C"ttr'b
9 _�
-
6-g,l r>'6'1D
Reviewer/Inspector Name: N PhobPv L -J J Jt V - -
ti
Reviewer/Inspector Signature: it4±A&Date:
Page 3 of 3 21412011

A2113 Q
Type of Visit: ($'Com ance Inspection O Operation Review Q 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: Arrival Time: Departure Time: Countya 16ti
Farm Name: Q *(4)0 _ S' Lt1 1`t�--� C4 Owner Email:
;j �
Owner Name: [ ti- 'gv k[ +--a ✓t n't IF) Phone:
Mailing Address:
Physical Address:
Region: Fczo
c�r�
Facility Contact: l
�
`-1/� lip.
�/�
Title: I LO Ctd2 Phone:
[�
Onsite Representative:
Integrator:
Certified Operator:
!i'^6[
fL o-y
A_q- Certification Number: p
Back-up Operator:
l`gc,6•--�'�Q
- Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current =
Swine Capacity Pop. Wet P601try
=,
an to Finish La er
Design Current
Capacity Pop _
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Non-ILa er
Dairy Calf
Dairy Heifer
Feeder to Finish
arl.";
It
"
Design Curreut=`
aci 1'd
Farrow to Wean
Farrow to Feeder
D Cow
Non -Dairy
Farrow to Finish
Gilts
Layers
Beef Stocker
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
10ther
Dischar es and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes � No ❑ NA ❑ NE
[:]Yes [] No ❑ NA ❑ NE
[:]Yes [] No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
02 No
❑ NA
❑ NE
[—]Yes
[]"No
❑ NA
❑ NE
Page I of 3 21412011 Continued

41
Facili Number: Date of Inspection: 13
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'? ❑ Yes o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 0 No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
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.)
❑ Yes U3 No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes M 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 [:<o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[DAo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[DAo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[L*io
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Cep ` H�j _.
T
13. Soil Type(s): L) 60
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[140F10
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[DAo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Q-'No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
� o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
(1Qo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[j] No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[jWo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ®'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Mlvo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes T�(No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ONE
Page 2 of 3 21412011 Continued

Faciff Number: - Date of Inspection:
I
C —7
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[Z] No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[!3/No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Nan -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
E No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
[jkNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [j�No ❑ NA ❑ NE
❑ Yes [R'f,Io ❑ NA ❑ NE
❑ Yes C'No ❑ NA ❑ NE
❑ Yes [!J No ❑ NA ❑ NE
[:]Yes [jjNo
[:]Yes ['No
❑ Yes [B"No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature: Da1e:Zjjjj 41,3
Page 3 of 3 21412011

type or visit: w t ompnance inspection lv uperanon xewew V Structure r.vatuation V iecnnical assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ; E S Departure Time: t+l` County:%)DEsp ri
Farm Name: fA `Y,,s�P Fo�cir��a Owner Email:
Owner Name: i� ��(� ��F'QRr� t. Phone:
t
Mailing Address:
Physical Address:
Facility Contact: � x' 4kR9 b4�e_S Title: 'y\P.c\Aqr_4 Phone:
Region: F R &
Onsite Representative:
?c kd i"
Hgytz 5
Integrator:
61kovirl
Certified Operator:
ES
Certification Number:
QO3S 1
Back-up Operator: 'I
F, _�\qi'b
Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current:..::, Design Current
Swine Capacity Pop Wet Poultry Capacity Pop,
Design Current
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
V30
Design Current
D P,oultr, Ca aci Po
Dairy Heifer
Farrow to Wean
Farrow to Feeder
lDrvCow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes [gNo ❑ NA ❑ NE
[:)Yes [:]No
❑ Yes ❑ No
❑ Yes [::]No
❑ Yes [SI No
[] Yes &N0
[fNA ❑ NE
[fNA ❑ NE
Ef NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

[Facility Number: '7 jDate of Inspection: a /
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:
Spillway?:
Designed Freeboard (in): L
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [�FNo ❑ 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 CfNo
❑ 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 [DNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [g 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 [2No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [ f No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Er 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): (h 0.t^Nk)OA l < I �'P,4 na 0
13. Soil Type(s): A k. Cro A, N o A
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes [UXo ❑ 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 ❑ No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[D 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
[E� No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Ej 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 [3No
❑ 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 1� N
o
Page 2 of 3 21412011 Continued

M
R
Facilit Number: jDate of Inspection: 3 TWta
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [E�No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No CErNA ❑ 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 [g No ❑ NA ❑ NE
27_ Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [!TNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ff 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?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit'? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes allo ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
❑ Yes tQ No ❑ NA ❑ NE
❑ Yes 0 o
❑ Yes [a No
❑ Yes [V]"No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question_ ft Explain any YES answers and/or�any additional recommendations orAany4otherFcomrnents.
Use drawingsof facility to better explain situations (use addit�onal'pages as necessary). , g
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone: L! to CQ6�S 1
Date: l a—R f
2/4/2011

-I&t Iw.s F
M
(Type of Visit: 0 Com�RR uHance Inspection U Operation Review U Structure Evaluation U Technical Assistance
�
Reason for Visit: tine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: j //fir//1 Arrival Time: Departure Time: /�, r County: Region: 10
Farm Name: 4 Z= Owner Email:
Owner Name: _ aD� - 5L!t� rv,, L Phone:
Mailing Address:
Physical Address:
Facility Contact:—LCIN:krC� Title: MCLKJ e� Phone:
Onsite Representative: C\lLle/ urd _e_5 Integrator: — 3,Certified Operator: -k'L1'.' Ll Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Design
Capacity
Current Design Current
Pop. Wet,Poultry_ Capacity Pap = Cattle Capacity Pop.
Wean to Finish
,
-��
La er
a
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
j)
D " r �
Design Current.
DairyHeifer
Farrow to Wean
- x - _
D Cow
Farrow to Feeder
r
r D {Pouit , Ca aei :P.o
Non-Da'
Farrow to Finish
+,j' Layers 'k
Beef Stocker
Gilts
fi
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other a
R; Turkey Poults
Other
"' Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
10
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[:]No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
BNA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
UNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
R3 No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
iI ,110
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412011 Continued

Facility Number: - Date of Inspection:
Wastee 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
TA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): --
Observed Freeboard (in): -3a
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E 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
io
❑ 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
Eg s`o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
LJA'o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
is
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[E1Yo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
E]-iVo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift Application
Outside of Approved Area
�❑
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�10
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[D Igo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[2'iClo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E;3r&o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Io
❑ NA
❑ NE
Required Records & Documents
No
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
C3
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
2 Flo
❑ NA
❑ NE
the appropriate box.
❑WLIP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements [—]Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [3No DNA ❑ 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 ErNo [DNA S❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 2-9A ❑ NE
Page 2 of 3 21412011 Continued

jFaciHty Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes 2< ❑ 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? [—]Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [] Yes ❑ No ❑ NA
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 [3"Ro ❑ NA ❑ NE
[—]Yes [5'No
❑ Yes 19<0
❑ Yes E3 No
❑NA ❑NE
❑ NA ❑ NE
[DNA ❑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? 0 Yes FD/No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes Q No ❑ NA ❑ NE
Comments (refer to question #) Explain any YES answers and/or any additional recommendations or:-anyaotlher comments:
[Js�-
e drawitigs.of facility to better exlsinsituations (use additions] pages as -necessary).: r
r?r; aQJ C u" w/ 0-_-, bate-,
Reviewer/Inspector Name: Phone: 1 Q -363
Reviewer/Inspector Sign e: Date: 7/,?X /
Page 3 of 3 4/2011

Fs �-av -zoio
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit &I routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: y Zg '%0 Arrival Time: : Jrg Alta Departure Time: County: RC+bGSO^� Region: FieO
Farm Name: AA" N swo" (Fdrp"-a2 � _ Owner Email:
Owner Name: R Fc v 6— L P Phone:
Mailing Address:
Physical Address:
Facility Contact: �+ 4L,'t ✓ d �—S Title: Q hrQ�c t.1r Phone No:
Onsite Representative:
Certified Operator: R "& c s
Back-up Operator:
Integrator:
Operator Certification Number: �' D 3
Back-up Certification Number:
Location of Farm: Latitude: = 0 0 ` E__T Longitude: = °
DesignMR.urrent
sign CurrentSwineiy
1-spacity
Population
Wet Poultry Population
C►attle Capacity Population
❑ Wean to Finish
❑ La er
❑ Da' Cow
Feeder
❑ Non -La er
❑ DairyCalf
o Finish 7 9 Z O b 00
❑ Da Heifer
o Wean
Dry Poultry
❑ D Cow
to Feeder
rGilts
❑ Layers
El Non -Dairy
to Finish
❑ Non -Layers
❑ Beef Stocker
El Beef Feeder
❑ Pullets
❑Beef Brood CoTurke
s
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
DNA
El NE
❑ Yes
❑ No
,er
2 A
❑ NE
Q NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
E3 1VA
❑ NE
❑ Yes ❑ No �A ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: "78 — g Date of Inspection -Zg
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,�, N"o ❑ NA El NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [3 o ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �3.2
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 property addressed and/or managed ❑ Yes
2 o ❑ 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 thre t, 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
[R o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑Yes
NA NE
No ❑ El
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
Q o ❑ 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 the ❑ 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)&�'wur
h' _� 0., 66!ji S ma_I I G mi nj (ov c.r5� s4
13. Soil type(s) L�j ��y,.. Ge, A 14C i
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
3No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
,, �_ �NNoo
NoNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,L7
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
7No
❑ NA
❑ NE
Comments (refer to question;#) `Explain any YES^answers and/or any reeommendat�ons or any other .11 comtents�
Use draw*s�df facility to better;explain situations: (use additional pages as„necessary)'
Reviewer/Inspector Name I` 1i C_- R." Phone: 410, gf33, 33 DO
Reviewer/Inspector Signature: R ��.•-e+ts� "Date: Z/ -Z $ - Zo/O
12128104 Continued

Facility Number: 7 — / Date of Inspection
Required Records & Documents �
19. Did the facility fail to have Certificate of Coverage & Permit readily available? Elf Yes L� No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes B o ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design El Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
B No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
,,`f//❑
LNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,f<o
Noo
[I NA
❑ NE.
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
,L..�,, �o
�
El NA
El NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
,L
lY oo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
,L�
L'1<o
❑ NA
❑ NE
Other issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[E o
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
L5'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
R o
❑ 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
L_` <
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
,�,�
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
El Yes
oo
El NA
❑ NE
33. Does facility require a follow-up visit by same agency?
El Yes
,L'�S,
L7No
❑ NA
❑ NE
Additional q- mm tgan-/or Dr w ngs
Page 3 of 3 12128104

e14.S � j 6; — 0 `1
Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation ��i O Other Agency
Type of VisitCommpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance & Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1}"��}- �% Arrival Time: ://40 Departure Time: �,�3C County: Robe-be
Farm Name: _ filZY�'hC__ �i.ttAl�a iJ l r-a.w► 2 } Owner Email:
Owner NAme- R. Aote- &,.; (, LP Phone_
Mailing Address:
Physical Address:
Region: `'e©
Facility Contact: Title: luAllia l e.y— Phone No:
Onsite Representative: 1Rhl av A Ock4es Integrator: M,4rp +� Bout)
Certified Operator: KAjLC_ Pn154a,,r Operator Certification Number: 20390
Back-up Operator: Ricti.avd kk.T Back-up Certification Number: 2-039 1
Location of Farm: Latitude: = e 0 i = Longitude: = o = 1 = u
Swine
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedej
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La et
Discharges & Stream Impacts
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design. �Clirreikt<
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
1. Is any discharge observed from any part of the operation?
❑ Yes
[TNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
El Yes
El No
�.�
3 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
EKA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
[I Yes
No
,_,/
L7 NA
El NE
2. Is there evidence of a past discharge from any part of the operation'?
El Yes
�❑
L'1
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
�NNo
B o
❑ NA
❑ NE
other than from a discharge?
12128104
Continued
I

f �
Facility Number--7 —
Date of Inspection -19-01
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
Identifier: %- F
Spillway?: -
Designed Freeboard (in):
Observed Freeboard (in): 2 04
Structure 2 Structure 3 Structure 4
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 LI No
❑ Yes LTNo
Structure 5
❑NA El NE
❑ NA ❑ NE
Structure 6
❑ Yes L7 No ❑ NA ❑ NE
❑ Yes [ Vo ❑ 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 ETNoo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes E3 o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) �
9. Does any part of the waste management system other than the waste structures require ❑,�,
Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 2reNo ❑ 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 / Drifl ElApplicationOutside of Area
12. Crop type(s) �¢rr(Nay i : Sp&flf Gam, r,, C 0ytrSce d
13. Soiltype(s) (,Jrze�reLw„ GrA NcA
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
ErNo ❑ NA
ZNo ❑ NA
Q N ❑ NA
No .❑ NA
L�'ivo ❑ NA
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name R j ck RSV irks Phone: Ci 10.4�33.33311
Reviewer/Inspector Signature: tinQ Date: �L `/ — Z00`)
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [' ] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes WNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes M 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 ❑ NA ❑ NE
o
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
L'J No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
E No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
VN o
❑ NA
❑ NE
Other Issues
/
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ NA
❑ NE
�No
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
L� 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
L'J 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
ON
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
LJ No
❑ NA
❑ NE
Comments and/or Drawings:
12/28/04

,T.Z-fus 7-0/-08
Type of Visit C'FCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (346utine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: O S Arrival Time: 2 w ..,. Departure Time: 6100 County: �CSo�/ Region:
Farm Name: ! S�ir� + %� w+ itZ t'�v#-,ad lwyp Owner Email:
Owner Name: • L_ P Phone:
Mailing Address:
Physical Address:
Facility Contact: iM 1 �4— �Q i S ry Title: 1 N ��—+� A (Phone No: WO,
Onsite Representative: t ��— PC is 46 "1 Integrator: A&t 13PIF[-.1 A./
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm -
Back -up Certification Number:
Latitude: =0 a ' [_] Longitude: =e =' = u
Design Current `
Design Current Design Enrrent
Swine
C►apacity Population Wet Poultry
Capacity Population -Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑ Dairy Calf
Feeder to Finish
Z�
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
a ❑ Da Cow
❑ Farrow to Feeder
- � El Non -Dairy
❑ Farrow to Finish
.' Layers
El-
El Beef Stocker
❑ Gilts
Non -Layers
❑ Pullets
El Beef Feeder
❑ Boars
❑ Beef Brood Co
= ❑ Turke s s
-
Other
❑ Other
❑ TurkeyPoults
❑Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
L7 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[]-No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
Ij No
❑ NA
❑ NE
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
El Yes
,�,�
2� o
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
O o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

s -n
Facility Number: 7 - jg Date of inspection -08
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
B'go'
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
91�o`_
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2. 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
L7 go
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
0-N-o-
❑ 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
3-lq—o
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
R7qo-.
❑ 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
alga
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 3No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Et o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 1 O 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) I;,> � Ha. ) SV"'V arc �'ni
13.
Soil type(s) W &-I?> No A r'�n A
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E"j,N
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
BZ
[vo
❑ 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
814o­
❑ NA
❑ NE
18.
is there a lack of properly operating waste application equipment?
❑ Yes
0-l7o -
❑ NA
❑ NE
Reviewer/Inspector Name FR 'L P.t/5.. - Phone: 910 • !/l.'7 •333®
Reviewer/Inspector Signature: Date: w-Z7-Z01!9$
Page 2 of 3 12128104 Continued

-.16 6 - z 7-08
Facility Number: g — /Ij7 Date of Inspection �7 O
Required Records & Documents ��
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ 17,Yes go ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes al;�❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0lro ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24- Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems 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 Reviewerlinspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
BVo
❑ NA
❑ NE
❑ Yes
075o
❑ NA
❑ NE
❑ Yes
Ll'o
❑ NA
❑ NE
❑ Yes
EfNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
0'go
❑ NA
❑ NE
❑ Yes
3 l�o
❑ NA
❑ NE
❑ Yes
0116
❑ NA
❑ NE
❑ Yes
[a l�o
❑ NA
❑ NE
❑ Yes
Elgo_
❑ NA
❑ NE
❑ Yes
DITo
❑ NA
❑ NE
❑ Yes
O' o
❑ NA
❑ NE
Additiional'Gomm nts,and%or°Drawtngs:, > :�� ', , ..h , �. —
A.
Page 3 of 3 12128104

® Division of Water Quality
Facility Number ] $ 1 $ 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: /0:30 / Departure Time: \oZ: 3d c
County: AO So� Region: FieO
Farm Name: J, I� SPA � 1=avw�Zt2 Ci WOAJ Owner Email:
Owner Name: LP • Phone_
Mailing Address:
Physical Address:
Facility Contact: w►� p4`S Title: Phone No:
Onsite Representative: ; GI�� �g '�i Pcl sue../ Integrator: ` LXIV4:`'
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = 0 0' = « Longitude: = ° =' = "
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
o Finish ❑ La er
o Feeder ❑ Non -La ei
❑ Wean t
❑ Wean t
Vj Feeder to Finish
1 Zb
El Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
El Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
ElNon-Layers
El pullets.
ElTurkeys
El Turkey Poults
El Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
.Design �� Current;'
Cattle Capacity Population "
El Dairy Cow
El Dairy Calf
❑ Dai Heifef
El Da Cow
ElNon-Dairy
❑ Beef Stocket
❑ Beef Feeder
El Beef Brood Cowl
Number of Structures: �; I
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 [� No ❑ NA ❑ NE
❑ Yes
10 No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
Ey No
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �]] No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: d #
Spillway?: A10
Designed Freeboard (in):
Observed Freeboard {in}:
3"
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 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 C 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 [ 4 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [d 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 Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
M No
El NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes
P No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ElEvidence of Wind//Drift El Application Outside of Area
12.
Crop type(s) r{�_e'rt ku d ate- ! �y Swa4 d Cs rwi Pj (p V ov5e e d
13.
Soil type(s) LQ $ Alo A (7 0 A
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
[ No
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
[ No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
to No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
P No
❑ NA ❑ NE
IComments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Q j L�`h ✓e e-y �_ _ Phone: Q/D . 413j, 333 0
ReviewerAnspector Signature: Date: 0 7
12128104 Continued

Facility Number: "] — f Q Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ CheckIists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [P 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
[i No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M No
ElNA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[1 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[6 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes]
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[ 1 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
�9 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
V2 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
EX No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
R No
❑ NA
❑ NE
Comments and/or Drawings:
u
12128104

Divisian of Water Quality
j=F=aeifityNuMUrjj-- 8 S O Division of Soil and Water Conservation
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: i - /2 - O(a Arrival Time: Departure Time: County: �50�- Region:
Farm Name: 1+10 VP- SPA P-, Favw. 't Z. -pia-roar 5"2 "kwner Email:
Owner Name: R Hoge— Start raFt.,S LP Phone:
Mailing Address:
Physical Address:
Facility Contact: MIteaI.1 PO i S-�o IJ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator: MuG 2Z,.. �►�Di,.1N
Operator Certification Number:
Back-up Certification Number:
F&O
Location of Farm: Latitude: ❑ e ❑ , [ Longitude: ❑ ° = I ❑ "
DesigBIJIL66rrent
Design Current
Design Current
Swine Capacity Population
Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ DairyCow
El Wean to Feeder
-Laver
❑ DairyCalf
Feeder to Finish -7QZp
DairyHeifer
El Farrow to Wean
Po�ury.
El Dry Cow
El Farrow to Feeder
ElNon-Dairy
El Farrow to Finish
❑ La ers
❑ Beef Stocker
Gilts
Non -La ers
❑Pullets Beef Feeder
EBoars
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turkey Pouits
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any pan of the operation?
❑ Yes
(A No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[79 No
❑ NA
❑ NE
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
❑ Yes
[A No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
1A No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
� No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[A No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
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 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes M No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
El Yes
� No
El NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[7No
❑ 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
[X 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
[A 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 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Croptype(s) Beymq da 14a u Sma(f CYAiN
13. Soil type(s) Wo-E , No A . Go R
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[A No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
El Yes
� No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA ❑ NE
Comments (refer t&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): R
Reviewer/Inspector Name fGK Re.Ve. is
Phone: /O) 433 -3330
Reviewer/Inspector Signature: R'Z"t�
Date: 0}-I2-20o6-
Page 2 of 3 12128104 Continued

Facility Number: g— 1 $ Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [N No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P No ❑ NA ❑ NE
the appropriate box. ❑ WLp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes [� No El NA El 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 El 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
(A No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Q9 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively. certified operator in charge?
❑ Yes
[§No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
EdNo
❑ NA
Cl NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�M No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
73 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
(A 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 fotlow-up visit by same agency?
❑ Yes
WNo
❑ NA
❑ NE
Additional Comments anc#Ior."Drawings:
Page 3 of 3 12128104

Type of Visit
ompliance Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
O Routine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: Arrival Time: r7 a Departure Time: County
Farm Name: rrra'i Zia L!/�Owner Email:
Owner Name: y f� ,r �/79ilin,j 4. Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: _- Integrator:
Operator Certification Number: 20 --
Certified Operator: _-+.■-�-C�
Back-up Operator:
Location of Farm:
Region:2
Back-up Certification Number:
Latitude: = o = I = q Longitude: ❑ ° = 0
Des g CurrentDestgn �Currept Design Current
Swine Capacity 'Popula ono Wet Poyltry Capac�f3 Population Cattle ' "�C.pigIty Population
❑ Wean to Finish ❑ La er ❑ Dairy Cow
❑ Wean to Feeder ❑Non -La et ❑ Dairy Calf
Feeder to Finish dx ❑ Dairy Heifej
❑ Farrow to Wean a ❑ Dry Cow
Dry Poultry, w
❑ Farrow to Feeder x:_ ❑ Non -Dairy
❑ Farrow to Finish ❑ La ers
El Beef Stocker
❑ Gilts ❑Non -La ers ❑ Beef Feeder
❑ Boars ❑ Pullets
❑ Turke s El Beef Brood Co
-
Other_ ❑ Turkey Pouits :
❑ Other El Other j�Nu�berof Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
kj No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
&No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
No
❑ NA
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
(�No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
QNo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number:
Date of Inspection 1IR9
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:
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
4 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?
E9 Yes
o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
0 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[KNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
RNo ❑ 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 l0 lbs ❑ 'Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
rQ No
El NA
El 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
W 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
P No
❑ NA
❑ NE
Reviewerllnspectar Name>�""� u zQ Phone:
Reviewer/Inspector Signature: Date:
12128104 Continued

'w
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ElNA ❑ NE
LN
the appropirate box. ❑ WUP ❑ Checklists ❑ Design
g El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 9 Yes ❑ No ❑ NA ❑ NE
14 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
El Yes
� No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Wo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ER No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
W No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
19No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
A 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
ZNo
❑ 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
WNo
❑ NA
❑ NE
General Permit'? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
Additional Comments and/or Drawings ., ., r _ .' ,; ` i p �'° q
p�� %t%B� Pk•►�i ri '�rrD/� �l>�m-- D� ��a� G rc�: �- ,��+c�C �v
12128104

i.
(Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
!j Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility lumber `7 Date of Visit: Time: I Q ?oa E=
_7 _070P era tie nal 0 Below Threshold
Permitted Q Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Dame: H*Ae 5..,,}ft Fr,r. W2 - d..A County: Aob Snit
Owner Name: �. Hoke__ -A Fs�r L Phone No:
Mailing Address: 14O? C r Road)5 r /VC �83 ','o
Facility Contact:
Onsite Representative:
Title:
Phone No:
Integrator: C a reo 1tt
Certified Operator: M,f-,A GGI W ejO15Td 17 Operator Certification Number:
Location of Farm:
[wine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 04 0" Longitude ' �• ��
Design Current
Swine Ca aeity Po ulatioi
❑ Wean to Feeder
�eederto Finish
O
❑ Farrow to ",Vean
❑ Farrow to Feeder
±=
❑ Farrow to Finish
❑ Gilts
❑ Boats
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver ❑ Dairy
❑ Non -Laver I JE1 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
No Liouid Waste
Discharges 8- Stream Impacts
1. Is anv discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Svrav Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes ©'IVo
❑ Yes DNo
b, if discharge is observed, did it reach Water of the Stare? (If yes, notif}' DWQ) ❑ yes 2-go
c. If discharge is observed. what is the estimated flow in eal/min? ��-
d. Does discharge bypass a lagoon system? (If yes. notif}, DWQ) ❑ Yes Ehl;"o
2. Is there evidence of past discharge from any part of the operation? ❑ Yes CEIRo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes D- oo'
Waste Collection R Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes D'1<
Structure I Structure 2 Structure 3 Structure 4 Structure ; Structure 6
Identifier:
Freeboard (inches): 3,p el
03/03101 Continued

Facility Number: 7
Date of Inspection JD �v-
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
❑ No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancerunprovement?
❑ 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 maintenancerimpmvement?
❑ Yes
❑ No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attar below ❑ yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ❑ No
Air Quality representative immediately.
[Meld Copy ❑ Final Notes
Please
Jri0"'4' fAt
,a 3
tr�opn /4•7
9ra5S
stgot 4-0
esr�6l.'s!,
yoaO/
�euss Go✓er,
44"'4iaf
5 9o,`�g A0
wrl�r�
�n hGr
I,,, - /c/S
Reviewer/Inspector Name
Reviewer/Inspector Signature:
A 40 We 1-1 S'l s'
Date:
12/12/03 Coked

Faty Number: —/ Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application)
❑Yes
❑ No
27. Did Reviewer/Inspector fail to discuss reviewimspection with on -site representative?
❑ Yes
❑ No
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

t It
1
L
Type of Visit ® Compliance inspection Q Operation Review O Lagoon Evaluation
Reason for Visit * Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
FaciliyNumber
Date of %-isit: r1 0 Time: 0
S
Nat O erational OBelowThreshold
0 Permitted 0 Certified O Conditionally Certified ❑ Registered bate Last Operated or above Threshold:
Farm Name: Sw Count': O-C
Owner Name: . 14, ♦J ..0 S,en-LFe.I , Phone No: Za to 2 q-T I L: 3
Alailinc address: , �ko 2q Zn nc_ CLL,.rd, &ce -- ---- �� i I rv, s�,1.� 1J�29,340
Facilit- Contact: 0L.5"e- Title:
OnsiteRepresentative: eg LP&A
Certified Operator: 1h (rl c,e i
Location of Farm:
Phone No:
Integrator: CC-M I S
Operator Certification number: �tdo 39 O
iffi Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ` Longitude ' �
Design Current Design Current Design Current
Swine Ca acity Population Poultry Capacity Population Cattle Ca aci v Population
❑ Wean to Feeder ❑ Laver 1 1 10 Dairy
® Feeder to Finish Cj 2-0 ILI Non -Laver I I ILI Non -Dairy
❑ Farrow to Wean
El Farrow to Feeder 10Other
❑ Farrow- to Finish Total Design Capacity
❑ Gilts
❑ goy Total SSLW
Number of Lagoons I ILI Subsurface Drains Present JLJ Lagoon Area IL Spray Field.Area
Holding Ponds / Solid Traps ❑ No Liquid waste Management System
Discharges 8 Stream Impacts
1. is any discharge observed from any part of the operation? El 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 ❑ No
c. If discharge is observed. what is the estimated flow in eal/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ) ❑ Yes ❑ No
?. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Wa a rolleeflon & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): 3$
OSIV3101 Continued

i
Facility Number: — Ig Date of Inspection �a
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] Yes [ No
seepage, etc.) v
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ 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 [N No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [RNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes [BNo
Waste Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes M No
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [9 No
12. Crop type elm t . r%_ -4- S nn . I"�� n 0 - S . _
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes P No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ffl�,lo ro
b) Does the facility need a wettable acre determination? ❑ Yes p Nm t46
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No "LA
15. Does the receiving crop need improvement? ❑ Yes [N No
16. Is there a lack of adequate waste application equipment? ❑ Yes [2j No
Renuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[1) No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
M No
19.
Does record keeping need improvement? (icl irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
[St 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 9INo
24. Does facility require a follow-up visit by same agency? ❑ Yes MNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer toquesttnn #): Explain any YES.answers andlarany recommendations or any other comments Tamar
Use drawrngs of f24 g b'b6tter explain situations. (use additional pages'as`isecessary): ❑Field Copy ❑Final Notes
` V,e C-- rdo 4- [ C ym,
&�' V t4' J_ ek C_ U'.4 -`.
Reviewer/Inspector Name
ReviewerAnspector Signature: Date:
05103101
Continued

I
Facility Number: — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor 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?
05103101
E4 Yes ❑ No
❑ Yes [2 No
❑ Yes [9 No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes P No
❑ Yes ❑ No

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine Q Complaint () Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number r Date of Visit- �6 AZ Time:
rG
Not ODerational Q Below Threshold
® Permitted ® Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: ., County-
Owner Name: � � ,�,,., fisrt�s� L, /� Phone No: 10 �P— 71�3___„
/ / d
Mailing Address: �/o2 % �U�✓� �! u.�r� Di1d fi¢i��•�r��. /VC- .z� y
Facility Contact: _ .���+ s'� / Title: Phone No:
OnsiteRepresentative: %%' /�N Integrator:
Certified Operator: /�!'�� / p/�!'' Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude 0' �• u Longitude 0• 0. 0�
w per, °Current_ ' Des" -Current. D - Cnrreot
- - - _ _ _
'Swine-` _ = Ca acit�-..population Potiitiv _- :-"_ Ca Tacity. Po ulatioh - Cattle._ --` - :Ca_1111cttr, a-ullation
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish %92U z0 " ❑ Non -Layer Non -Dairy'
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other -_ h
-
❑ Farrow to Finish Total! Design Ci�acity
❑ Gilts - -
❑ Boars = - .0tal SSLW_ {'
- Number of Lagoons ❑Subsurface Drains Present ❑ Lagoon Area ❑
S my Field Area
-_ Holdiftiji ands !'Soitd`T -aps T V ❑ No Li uid Waste Management System `
Discharges & 5tream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ,® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If diseharge 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 /El 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 RjNo
2. Is there evidence of past discharge from any part of the operation?
❑ Yes allo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes A5 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes ,Q No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard (inches): 3
0510310-1
Continued

Facility Number:
Date of Inspection
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 maintenancelimprovement?
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?
❑ Yes - ® No
❑ Yes ,® No
❑ Yes 0 No
❑ Yes JRNo
❑ Yes 0 No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ,N No
11. Is there evidence of over application? ❑ Excessive1 Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [RINo
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes JR No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes LKNo
b) Does the facility need a wettable acre determination? ❑ Yes ffNo
c) This facility is pended for a wettable acre determination? ❑ Yes ZNo
15.
Does the receiving crop need improvement?
❑ Yes
N No
16.
is there a lack of adequate waste application equipment?
;@-Yes
❑ No
Required
Records & Documents
17_
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�EjNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP checklists, design, maetc.)
`_
❑Yes
� No
19.
f 4-
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
/M No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
fRNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
�ZNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
ALNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
allo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
RNo
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Conts (refer to quesgort #) E><p mmelatn y YES:a ers andlor:any recommendattons.or anv atlt:er:caatmerz s.�= N
Use drawrngs of facdtty t ii better ezpla n stdaatrons: (eta addidonal pages as accessary) ❑ Final
Field Conv Notes
_
d/.
�s ,cam
-1_e�jQ�GD�:
Reviewerllnspector Name
Reviewer/Inspector Signature: Date: /D o Z
05103101 Continued

Facility Number:Date of Inspection 6/0 lid
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below 29 Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. are there anv dead animals not disposed of properly within 24 hours`' ❑ Yes RNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 4 No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any mayor maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc-) ❑ Yes K No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes (� No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes allo
Additional Gomments,andlcr-Drawings.
05103101

y D1V4SlOn Df Water Qnahty Y _
Dry 6iii of Soil and Water CDnservatron
- Q Other=Agency_
Type of Visit Of Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit a Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Ifatr of visit: Timr: If do I Punted (in: 10/26/2000
%
Q Not Operational Q Below Threshold
APermitted [3 Certified © Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
Farm Name: .. G� nOK- 5 � t•...... County: ....Aolo'cx `.................... ...............
Owner Name: �� T• Q ... l�..e......M. L Phone ;�`o:....... ,�p �� 7 f� S�
...................................................................
Facility Contact: 1�--"`'� r GIs !'itle:...... Qr.'.................................. Phone No:.....................-..........................
........................... `..........., / ��
.r
Mailing Address: ..... ADZ 9...Itl.- ... ._.. �� ....................... ZG t ... ry1.�.. J, .. 1� ...................... 28
Onsite Representative: /'• ............. .-......... Integrator rq ri^�11/�f............................
l.•-•-�- ..................... ..-.
Certified Operator:- ,)j%I4e f Ld......... . ....... Operator Certification Number: ...................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 6 11 Longitude • 6 44
Design Current
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity 7 ZO
Total SSLW
Number of Lagoons I Fag ubsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps I ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discbarge 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 o
c. II -discharge is observed• what is the estimated flow in gal/min?
d- Imes discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? El Yes o
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 OX0
Structure I 5tructurc 2 Structure i Structure, 4 Structure 5 Structure 6
Identi ficr:................................................................. ....
Frechoard (inches): 36
5100 Continued on back

Facility Number:? -- f Date of Inspection Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes <N0
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes Aallo
(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
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ YesO
Zo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
MNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
PTIqo
11. Is there evidence of over application? ❑ Excessive Ponding❑ PAN ❑ Hydraulic Overload
❑ Yes
Al No
12. Crop type h:4.4J5A1. C7 /7ioaerjeej
13. Do the receiving crops differ with those designat d in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
o
TNO
14. a) Does the facility lack adequate acreage for land application?
ElYes
b) Does the facility need a wettable acre determination?
❑ Yes
jkrNo
c) This facility is pended for a wettable acre determination?
❑ Yes
o
15. Does the receiving crop need improvement?
❑ Yes
No
16. is there a lack of adequate waste application equipment?
❑ Yes
kNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
2(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
JKNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design'?
❑ Yes
No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
0,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
kNo
24. Does facility require a follow-up visit by same agency?
❑ Yes
No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
IQ Yiolations ar deee�c�rnotesdrr�his:visitYoi� wiliceye ,futrt#�er
corres• o dense'. a�ouf this :visit:
Comments:(refer.to:question #) Explaiin.any YES:answers andlor any recommendations or any other comments n _­ff
_
Use di:awtngs of facility to better explain situations: (use additional, pages as necessary): _
S rr r�Ue /ka n - I�a— AL
Tu rs -
tee= S�� I w=ed
�-!r pr
Oond Loki h-e ri,u�� tifc�s
9
Reviewer/Inspector Name Missq,
Reviewer/Inspector Signature: Date: —7-11 Al 5100

Facility Number: 7f _ T Date of Inspection —a
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 permanent/temporary cover?
Printed on: 1/4/2001
❑ Yes No
❑ Yes ko
❑ Yes No
❑ Yes
❑ Yes 4 'Y"
© No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Reviewer/Inspector Name w
Reviewer/Inspector Signature:
Date:
01/01/01

Division of Water Quality
0 Division of Soil and Wager Conservation
0 Other Agency
Type of Visit fAcompliance Inspection O Operation Review O Lagoon Evaluation
for Visit O Routine Womplaint O Follow up Q Emergency Notification O Other © Denied Access
Facility Number EZEDDate or Visit: � Time: Z ' Printed tin: 7/21/2000
Q Not O erational 0 Below Threshold
Permitted 0 ertified [3Conditionaliv Certified j] Registered Date Last Operate r Lbove Threshold:
Farm Name: .... 6WO.n'..-5..... County: ........................... .......................
Owner Name:........ sit ............................... Phone 1\To:... ,tr .G�l.. 7r-......................................
..... ... ............
FacilityContact: .. l ....................... 'Title: ...... .......- ./—c............. .............. Phone No:...................................................
Mailing Address: <
Qz .... ar af.�=................................................... rftul.�.... AT........•&yx
Onsite Representative: Integrator: rr
..................................... ............... rr'Ol ... .............................
Certified Operator:.....0,CAae/... Al.. .... ..e "Ve . ......................... Operator Certification Number:.............. ..................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �* �� �=� Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle _ Capacity Population
Wean to Feeder JE1 Layer I ❑ Dairy
Feeder to Finish ❑ Non -Layer I 1E] Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder JEI Other
❑ Farrow to Finish Total Design Capacity �v
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 110 Lag—n Area ID Spray Field Area
Holding 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'? (Ifyes, notify DWQ)
c. If dischar«e is obticrved. what is the estiinated Ilow in galhnin•?
d. Does discharge bypass a lagoon system'? (li" 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 S
[Yes ❑ No
❑ Yes R No
❑ Yes WNo
❑ Yes ;5,No
❑ Yes RNo
❑ Yes j�Io
❑ Yes )9 No
Structure 6
Identifier:
Freeboard (inches):
S/00
Continued on back

)Facility Number: — 1 Date of lrrspection Printed on, 7/21/2000
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? ❑ 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 Ievel
elevation markings?
❑ Yes
❑ No
Waste Application
10, Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over applicati n? Excessive Ponding ❑PAN ❑Hydraulic Overload
El Yes
❑ No
12. Crop type
13- Do the receiving crops differ with those design ed in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15- Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & DocumenLti
17. Fail to have Certificate of Coverage & General 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
❑ No
19. Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ElYes ❑ No
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge? Yes ❑ No
22, Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) es ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'? es ❑ No
24- Does facility require a follow-up visit by same agency? es ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
:: q yiolatioris:ot. deficiencies were 'noted- dtWing Ithwv. sit., - Y04 ►vial-ti &-6, i6. fiat t e
-,.,cones' oiidence:aboutthisvisit.':•::':'::'::'::::':':::':':':':::':::':'::':::'::: :
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):
rcclei Vej. a ca-9 44 owS � J ! e
/h relay ed -/a n� -�a.e l e � k s �`I Q.14 AZJ iuri-1-
;,-
Coles nu.W,der- �{�s�•-Ca- �11e� edVZkol.
c 3
Tk
l-�-q , � 11 k�t�IK // -�
Il e_ a_4LI Sed TuCL r cu Jrr hail c.4.l 1 � Atk K � k;d - - W47aS jjg5
►`"u-h n i i� QCrnSS .�►�- ��Dc�-a[ � a�-�as �-�r
Reviewer/Inspector Name )Oka= reml
Reviewer/Inspector Signature: Date: q" I Z —dD 5/00

Facility Number: — Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or hclow ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ❑ No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Aaaltionornments an or
.1 ✓ rs f�l r. wau.(d yy 4 lie-rr-rn.ca-ti._.. �4 ;+ •
oul-. boa -lied �o ye�w�� [e r`ti a4j A.e
::4rv. s;4e o �e roJ Was d'a �[ad 6 no ran.
7Xe t i�rr'q a>ti. �. eras p t4,I/ ed o u r t% +-1 Le g-eld ok-+ke ".-k s r
of rri .�-- 1`e 4u>a- �p t l
4"ke' Uer�)l %lu? Pe�eJ beside `{'fie d ri411
a+,d- Where 5omeoxe- W uq-,d 4. S' kove/ a-md
4r!e-� i-o 6 6-- P -Ae- --AtA)' OP yas-(, - 1 41,, eW
ro Q -J um
n ene uj�s a tse e 1 Jo, ,a 44-+ rc.? nazi -tra�� 4Cr�sS '�'�
roaj � acv n_ CL I ci� iT 4h - e, 1`i
S 1 ' 4� 4h-- r b1�LS
f P ` Ate- e WQr
0 reLt.G/Lec(� r-
on- Pie fQpaah we's A4nj
ot-AAd na- Brea-cX ed as re deed , % e q�;sera w,5 ,
lv Al e Ylt ert= Aa' o
ba6"L no 7fi
-9-r -e 'tc" O.,t
y 9
bq G- 4r� � rSP�/ as a! /D9 :6,D a',LcJe d ces-O(Q
P
9 4Jde y
L A&waw—
"-fA-CU'OO-r C-4-t-,4e- W scl+a e CtS 4e 11�aw
beet--- CLWaAl
5, Ike lrr; �a4- aJJlSed Kr )f061f4v
C`J .ke W re5-64ed i7",wf aro(Jr,O
e5d auPT
We fSay' - 4,Ae u.,-- r P� eli-`r`o`� e4r av� u)as /�a 1 I�auA5
W Y1 � rA - k e r�-e..trit ed, 1e A� 1 e %I 4tA e o r4.�ack l
sioo berrA 4 S,�>p bie wo s+-,

f® Routine Q Complaint 0 Follow-up of DWQ inspection Q Follow-up of DSWC review O Other
Facility Number /
Date of Inspection z
Time of Inspection pK) 24 hr. (hh:mm)
® Permitted © Certified [] Conditionally Certified 13 Registered 13 Not erational Date Last Operated:
Farm Name : ...........: �.P.r .. .....�,lr ,r�� �.......��i J ... County......... .... ......................_.................. ...
Owner Name: ..............���n7kPhone No...r
Z ..T.... 7 % ...- --..
Facility Contact: /��� c. l-� .. ... Title: ................................................................ Phone No:..... ........................ ........... ...
Mailing Address: �v�. /. Cr..a re emu.... !`.. 4,%� �..�.� ...�i�..�l ..� ...
�� /� .J Integrator: d
Onsite Representative:.•-.......a�.! :.�.1....� ............... ............ eg .... �•��..��-� ...�ctn.... .............
Certified Operator:........ ....... ....1_. ............................ Operator Certification Number: .....................................
Location of Farm:
Latitude =• =' 44 Longitude =0 =' ="
Design Curren
. t Xiii
Pacr aatyn cy Cw.Po-Matron..;
_. .
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
t F.
.�
❑ Other
x._
Total Design, Capacity
-
TOW SSLW
Number of Lagoons %
IQ Subsurface Drains Present ❑ Lagoan Area ❑ Spray Field Area sr
Holdrn Ponds'/ So1rd:Tra =
. _ : =_• - g:-,� _ W 4 . -W-�_ • ^ ps .
t
, �_ ; ❑ No Liquid Waste Management System
❑ Wean to Feeder
eeder to Finish
79Zd
Zd
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes TNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes M 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 ycs, notify DWQ) ❑ Yes [X No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes M 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 0 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure fi
Identifier:
Freeboard (inches): .................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes -[- [No
seepage, etc.)
3/23/99 Continued on back

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? . ❑ 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 El No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 01 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
12 No
_Waste Application
10.
Are there any buffers that need maintenancerimprovement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
® No
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
F!� No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
Q No
c) This facility is pended for a wettable acre determination? �,•
❑ Yes
R No
15'.
Does the receiving crop need improvement?
❑ Yes
Q No
16.
Is there'a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
IT.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
(3(No
18.
'Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ielWilP, checklists, design, maps, etc.)
❑ Yes
IgNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
JS No
20:
Is facility not in compliance with any applicable setback criteria in effect at the time.of design?
❑ Yes
P No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
10 No
22,
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
M No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
&No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
bjqo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
gkNo
vigia>�igris oar d f eie'nctes v re npte� d4rritig thjs:v�s}. •Yolk wig �eet'iy.......�. • ..: .
eorr46fide' ' e: aN f this visit::.. .
o.✓ �.�s%/�..- � 'mil �
Reviewer/Inspector Name01
Reviewer/Inspector Signature ��� Date: /z�

Facility Number: %Y'— 14 Date of Inspection Z6
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes e Rio
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 9No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes JgNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes &No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes UNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 4 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes 2 No

U Division of:So�l and -Water Conservattoit = Operatton"Review Y ¢`
x:
Dtytston of Sod and_Water r
0 Coriservatton - Compliance Inspection
Dlvtstoer Quality'- Compliance inspection _ _
4 then: gefic Operation' Review
Routine O Com taint O Follow-u of DW ins ection O Follow-u or DSWC review O Other
Facility Number Date or Inspection E�9
Time of inspection 24 hr. (hh:mm)
Permitted 13 Certified E3 Conditionally Certified © Registered [] Not Operational Date Last Operated:
Farm Name: (1( ir[� Lev County:..... D U� $-..-......_....
.......................................................................................
Owner Name:.... I.n .l..wr..l.. 07...... Phone No:... t 1.............................................7!
kac►lity Contact.• t.G Q� f ..... ... Title:...... � Phone No:
Mailing Address:......"'n�- 0 • dO L(j//
C�
........ ................�............................�.c............................. �..
Onsite Representative: ......... M%`Integrator: ..................................................
Certified Operator:...A.1..`, G1..4:.!�!./... ....... Q S. „ ................. ............ Operator Certification Number: ..... 2d.3-JqC� ., „..,,,,,,,
Location of Farm:
a
............ ......... .... ........................... ........ ..... ...I.-.......... ............. .............. .................... ................ ..... T
Latitude a 4 &° Longitude C� 0 4 "
Design Current
Swine Capacity Population
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Poultry Capacity Population Cattle Capacity Population
❑ Layer I 1 10 Dairy t
❑ Non -Layer. ❑ Non -Dairy
❑ Other
Total Design Capacity 1 7 9 2-
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 11EILagoonArea 10 Spray Field Area
Holding Ponds I Solid Traps 1E1 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 roan -made'?
h. If discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the State
c. !f 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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard(inches): .......... -....Z ........................................................................................................-- .............................
❑ Yes
4NO
❑ Yes
No
❑ Yes
No
❑ Yes RNo
❑ Yes No
El Yes K[�No
❑ Yes *0
Structure 6
93
1/6/99 Continued on back

Facility Number: -- Date of tnspcction
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion, ❑Yes KNO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan'? []Yes ;(No
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 pact of the waste management system other than.waste structures require maintenance/improvement? ❑ Yes KNo
9.
Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
❑ Yes
gNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
No
11.
Is there evidence of over application? Ponding ❑ Nitrogen
❑Yes
XNo
12.
Crop type ........ ..C4.1 ...%.....................................................................................................................
13_
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?.
❑ Yes
V0
14_
Does the facility lack wettable acreage for land application? (footprint)
❑ Yes
No
15.
Does the receiving crop need improvement?
❑ Yes
kfNo
16,
Is there a lack of adequate waste application equipment?
❑ Yes
gNo
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
gNo
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
gNo
19.
Does record keeping need improvement? (icl irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
'No
21.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
9No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
❑ Yes
4No
23.
Did Reviewernnspector fail to discuss review/inspection with on -site representative?
❑ Yes
9�No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
UNo
No.violations:or detieiencies .were noted cinring .ibis: vWi:. Y.ou w' Afretceive no further .
; • ; • correspondence: $boot: this :visit.: • :.. •. • . •. •. •. •. -. •. -... •... •. •. •. •. •. •. -... •. •. •... •. •. •. •. •... •. •....
Comments (refer to question #): Explain any YES answers and/or"any recommendations or any- other: comnieiits:_ = 7;___
Use -a' of facility. to better explain situations. use additional pages as necessary) ,
we4 .hle Alcre.a e � /-,��a*— l,,.., 41,ee e. .e avk-L
5 v erl i , j J "k-r %god a4
d oo,J r e c,,V 5 .
Reviewer/Inspector Name
Reviewer/Inspector Signature: 5 I _ _ Date: 2--' Z— lr j I !/6/99

3 Division of Soil and Water Conservation [3 Other Agency
�[ Division of Water Quality'
_.
",`�r � „'�p kv'�* 2>x< �"ace'�k s'�4sx., ""'°x� �.'j' �'�rh..: �v �n � "- �ni• a3 �d w'�'
10 Routine O Complaint 0 Follow-un cif DWO inspection 0 Follow-up of DSW C review 0 Other
Date of inspection
Facility Number
Time of Inspection 24 hr. (hh:mm)
Registered %Certified © Applied for Permit Permitted 0 Not Operational Date Last Operated:
# c7 A �t. r ov1 County pal p
Farm Name. Fr_W_V1............... • ............. A .... ...
Owner Name: i#%A.le.. Of fT*� - mi, 1. J, Phone No: 60?(� —...r2 /Jr3..... t....................... . r....................
FacilityContact: ...........!...!..1..g.-.........i..O.f,itle:.................................... ... Phone No:.....:............... ......................... ..........................
Mailing Address: 7" �f C .....ti iv 1 G1/.r.�!?°✓e..,�........N .......... .Q(%.............( .................. ....... ... ......
Onsite Representative: ......... 1.:.1J.C./., a. a...L....... ...1 Q_/..��n.......................... Integrator:........�r�0 � ,�.......!` si....��1G• .................... .....
Certified Operator, ............ .(,!.!_t.Clf31 4•....................80..!-5. ................... Operator Certification Number, .......... 03 ! a
Location of Farm:
C
G
Latitude Longitude �• 0` �"
� F Denign Current Design Current Design Current
<Ca act Pa ulation Cattle Ca ty, $Po aci uia
omtran, Sme p
Wean
Dairy..
4_1❑Layer
❑ 1\'on7-Layer E Non -Dairy
M-'
^ .....ww.. 'Y Y, ;^..%#", - kr, n-„+Jx .YS .L'w cC•+e
❑ Other^ mI
Total Design Capacity
pr Rh '79ao
`...
4 Tote ssLw
Numlaer,of Lagoons ! Holding Ponds
�, ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Feld Area
............ .� . .
w ❑ Na Li uid Waste Management System
to Feeder
Feeder to Finish
93FJ
Farrow to Wean
R Farrow to Feeder
[,] Farrow_ to Finish
❑Gilts
El Boars
Hera!
r
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 flaw in gaUmin?
d. Does discharge bypass a lagoon system? ([f 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 KNo
❑ Yes ANo
❑ Yes XNa
❑ Yes EfNo
❑ Yes P(No
❑ Yes QfNo
❑ Yes XNo
❑ Yes ANo
❑ Yes ANo
❑ Yes XNo
Continued on back

Facility number:
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (l.agoons,Ilolding Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I
Identifier:
Freeboard (ft):....... ...........
❑ Yes KNo
❑ Yes XNo
Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(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 tnaximunt liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, noUl DWQ)
15. Crop type ....t......................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilitio Qnly
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25, Were any additional problems noted which cause noncompliance of the Permit?
0 No.violations or deficiencies wre-noted-dur.ing this:visit. You will ree_eive no ftirther
: correspondence about this:visit:-
❑ Yes ON,,
W'es ❑ No
Ryes ❑ No
❑ Yes KNo
XYes ❑ No
❑ Yes 0j No
❑ Yes ANo
❑ Yes ANo
❑ Yes ZNo
❑ Yes 9No
❑ Yes No
XYes ❑ No
❑ Yes XNo
❑ Yes No
❑ Yes No
Comments (i eferto question,#): Explain any YES answers and/or any recommendations or any other.'comitments.
Use drawingsif 6etlitv46 better.explain situations. "(use additional pages as necessary}
CD? rhs `
Gu CtSr� l -IRUII °v1lS�tp- n _�lo�r�i -
Crn
& -
Tj
7I25197 J
Reviewer/inspector Name
Reviewer/Inspector Signature:
Date: _5 %a VS
c

IC3,Roatine O Comnlaint O Follow-up of DWO inspection O Follow-un of DSNVC review O Other I
I Facility Number f g I
Date of Inspections
Tirane of Inspection D;dZ7 24 hr. (hh:mm)
Total Time (in fraction of hours
Fares Status: ❑ Registered q Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review
❑ certified 121 Permitted I or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:....... _ ......�...r........... .... �. ..
Farm Name: .....e k..... Si�?0.1�. _.. __.... ... �............. County:........�._�.. .._.
�o
Land Owner Name: ....... ...... �.. L Ll� .....__............... Phone No:. 3 �.P . _....... _....._...
Facility Conctact:.-N— i.ii._ 4..... ................... Title: � �La Cam. !�� Phone No:.��! ._ .....
Mailing Address: ........ . ..... — ----- .... 64n� ��t 7- t2M ...
OnsiteRepresentative: ... �!�1......._ . _ .. r............. ....._ Integrator:.0—trrnl.l.:-5._ .._........ .
Certified Operator: _.......... Operator Certification Number: q
Location of Farm:
Latitude ' 6 �.J u Longitude ' 6 0"
Type of Operation and Design Capacity
.�,.i�-
$aaw '`' DES1gIiN C)Irre�t a �� ''De51gI1 CU17 ent , ' s r; x pesft CU CIIt
z Wiz.,.
$vi iae�_ z Poul Catfle
t?7'•, °, ,w,N Ca aci '`" Pv alation3.. ... Ca aci �4�'Po ul$tion
El Wean to Feeder `ry La ❑ Dairy
Feeder to Finish 2D ❑Nan -La er ❑Non
a° Farrow to Wean `�." wt'3, --:: n xe ,x , ;, r+bp'.! z; �;,,;�,'�;..ys, �-ry
,�. -="rc' ass- to r �h `wax. r'� *°`
Farrow to Feeder Total#Destgn�Capacttyr `79 ZO
Farrow to Finish"
_..A� otal SSLW4R
❑ Qther T t
K.
s_. ^st5- s?N__�:.� .s, �,....,:,•��s-.e°t€ds,.r�ir ... ":ux.x _..s.�"�..-'' :.' '<':z:5 *.�r't��::.
Numtier of L oons�% Holdm Ponds ❑ Subsurface Drams Present
,��� n •, �f ❑ Lagoon Area -x f ❑ Spray Field Area
General
1. Are there any buffer; that need maintenance/improvement? ❑ Yes KNo
2. Is any discharge observed from any part of the operation? ❑ Yes AZ40
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance marl -made? ❑ Yes MNo
b. If discharge is observed, did it reach Surface Water? (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 KNo
3. Is there evidence of past discharge from any part of the operation? ❑ Yes KNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes WNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes KNo
4/30/97 maintenance/improvement? Continued on back

—I
Facility Number: _%
p 6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
5QP 7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes �No
Structures (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes �No
Freeboard (fl): Structure Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
10. Is seepage observed from any of the strictures? ❑ Yes KNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes kNo
12. Do any of the structures need maintenance/improvement? XYes XNo
(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 ANo
Waste Application
14. Is there physical evidence of over application? ❑ Yes KNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ) ,
15.
Crop type ....... ` U. _.... ...._—...........—... ..... __.. —._ ...._
16.
T�..►.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes PI.No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes XNo
18.
Does the receiving crop need improvement?
❑ YesXNo
19.
Is there a lack of available waste application equipment?
❑ Yes No
20.
Does facility require a follow-up visit by same agency?
❑ Yes O.No
21_
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
[:]Yes 0,No
For
Certified—F—acilities Qjj1v
22_
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
AYes ❑ No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes �10
'`�N\o
24.
Does record keeping need improvement?
[I Yes
Comments '(refer to`queshon # Explain a_ }" YES answers`and/or any reconunendahons r any:other comments.
Use drawings. of facility} to better,explatn situattons (use additional pagesf as necessary)4.
b
j* IZ, L,&jcm#-- b-L,-k ACeak w+owf`r5
ea pI o�-{-I•e W mP w Ls na+ atl4Imble- c-+i &4-i,,.te &� irupeao►N_
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 7 Z-9- 7
cc. Division of Water Ouality. FKater Ouality Section. Facility Assessment Unit 4130/97