780020_INSPECTIONS_20171231

M
Type of Visit: 19 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I tv / H_71 Arrival Time: ys Departure Time: %�-, .3 a County: ��6 �` Region: �0
Farm Name: �j� p Qq ,e /%i P I�rr�✓iS Fq trvk, Owner Email:
Owner Name: ; f�,�� jJ'%c /ra , Phone:
Mailing Address:
Physical Address:
Facility Contact: 17De'aTitle: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design
Curren#
Design Current
Swine
Capacity Pop. ;
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
DairyCow
PKWean
to Feeder
/o
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D , I;oulY .
Ca ac'
P.o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Broad Cow
Turkeys
O#her
Turke Poults
Other
-
Y;�w.�.R9m,�Wi:�kitt
Other
��au���:�uu�t_0imaon�4v,a9W:_'
Discharmes and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ET -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 past discharge from any part of the operation?
❑ Yes
B No
❑ NA
❑ NE
3_ Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
E] No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Number: 77 - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [�!rNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 12
Observed Freeboard (in): 1_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No [] NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes❑'�Io ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes I_ T <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 E No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
i0. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes EfNo ❑ 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): ,/ l�hu�ar /fynr _3 "W
13. Soil TYPe(s): ) i" /1v/1C / W`V-2—
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
O No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[JNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[/� No
❑ NA
❑ NE
18. 1s there a lack of properly operating waste application equipment?
❑ Yes
ET<o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [::]Yes ONo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes DNo ❑ 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 I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �o ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

• Facili Number: - ©ate of Ins action:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C3 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q-<o
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 2-114-o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31 _ Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
❑ Yes 2'�4o ❑ NA D NE
❑ Yes [iJ o ❑ NA ❑ NE
❑ Yes E No ❑ NA ❑ NE
es
❑ No
❑ NA
❑ NE
[] Yes
�o
❑ NA
❑ NE
❑ Yes
B<o
[] NA
❑ NE
Comments (refer,49 echo© #) tErxpllam any YES,iinswe s;aad/i r;any addrt�oual;recommendations or any other conunents:' 1
:ElUse drawiugs of tac�lity'tfl better explamrsitaadons (use°additionial pages as 10
Reviewer/Inspector Name: v'-C_.i�y� Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412015

Type of Visit: C7Compliance Inspection U Operation Review U Structure Evaluation p Technical Assistance
Reason for Visit: routine O Complaint Q Follow-up O Referral 0 Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: i 7 Departure Time: ,'p0 County: � Region: ]�
Farm Name: O� � f a rm, Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: T a X— xe A_�� lx__ Title: &P c.0 n sP� _ Phone:
Onsite Representative:
Certified Operator: ! ,' .' ­_
Back-up Operator:
Integrator:'
Certification Number: "Z.. y /,3 ;;-
Certification Number:
Location of Farm: Latitude: Longitude:
- Destgn Current Design Current
Swine Capa PPIN VVet Poultry Capacity Pop.
Design Current
Cattle Capacity Pap.
Dai Cow
Wean to Finish
La er
Wean to Feeder
/0!
I Non -Layer
DairyCalf
Feeder to Finish
Design Current
Dr. I;oul Ca aci P,o
Dai Heifer
Farrow to Wean
Farrow to Feeder
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Farrow to Finish
tLavers
Gilts
Non -Layers
Boars
Pullets
Beef Brood Cow
5 i�... W'YSF. Ali ixVTurkeys
NO .... --
Other
Turkey Poults
Other
Dischar es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 qNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [] No
❑ Yes No
❑ Yes allo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: - Date of inspection: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): /^^^Vyy91
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.)
Structure 5
D�]_No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
❑ Yes allo ❑ NA ❑ NE
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 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
(DNA
❑ 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 EDNo ❑ 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): i? G la
13. Soil Type(s): )Jyl� /
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
Reauired 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
Lallo
❑ 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
RNo
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
allo
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facifi Number: IDate of Inspection: —/
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C�-No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Ca No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
je2eNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑Yes _PNo ❑NA ❑NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes &�No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
0 No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
[allo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
[] No
❑ NA
❑ NE
Reviewer/Inspector Name: J�TI%U`� (�7*yPhone:
00,
Reviewer/Inspector Signature: ,� Date:
Page 3 of 3 21412015

U
11
Type of Visit: (JCompliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: online O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: g'! Departure Time: County: r�B� Region: FI? 0
Farm Name: ill C r-0— FGt /'in- _ Owner Email:
Owner Name: meI Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone: /
Onsite Representative: Srk.' Integrator:
Certified Operator: Certification Number: V u'?
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity 'Pap:
Wet Ponitry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
ILayer
Dairy Cow
Wean to Feeder
iNon-La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Desi
Dry Cow
Farrow to Feeder
D . PoW
Ca aci
.P,o ,
Non -Dairy
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?
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)?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
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 [KNo [DNA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facili Number: 2,57 - 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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 9-
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [allo ❑ 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 Z No [DNA ❑ 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 [ELNo ❑ 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 [RNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes allo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ®, No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)ter,/1'l�t
13. Soil Type(s): jva r"'a I K / "/e"
14. Do the receiving crops differ from those designated in the CAWMP?
[—]Yes
0 No
[] NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
allo
❑ 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
[3 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[RNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
KNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
CE�No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [4 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [MNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - Date of Inspection: = / 7 %lf/
t 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes B No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
[:]Yes
2,No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[a No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
a No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional.problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[jCj No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[gNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
CKNo
❑ NA
❑ NE
Comments (refer twquestion:#):,Explain any YES answers andlor,any,additional recommendations or any,,"other4comments. :
Use drawings of facility to better explain situations (use =additional;:pages as`necessary).'
Reviewer/Inspector Name:
Phone: �,� �3� 330a
Reviewer/Inspector Signature:
Page 3 of 3
Date: ,
2/4/2014

Type of Visit: ©'Compliance Inspection CV Operation Review O Structure Evaluation Q Technical Assistance I
Reason for Visit: G1 outine O Complaint O Follow-up O Referral O Emereencv O Other O Denied Access
Date of Visit:
�-N— IS
Arrival Time: 1 Departure Time: / p County: Region: Fg-D
Farm Name: -fir p /k,!E_ 177C_Le e� FOeryu
Owner Name: ; r In
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: 12z-2r... — l'}�G I�-�..�. Title: Phone:
Onsite Representative:�l'a5r't1_ Integrator:
Certified Operator: S�..�1 Certification Number: 2 N / 37
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design �nrrent
ne Capacity Pop.
Wet Poultry :..
__.;Capacity
Pap.
Cattle Capacity Pop.
an to Finish
Layer
Dai Cow
an to Feeder
/ o11
S
Non -Layer
Dai Calf
to Finish
Dai Heifer
ow to Wean
y'
Design
Current
Cow
ow to Feeder
Dr l;oul
Ca acit
to .
Non -Dairy
!ZFeeder
ow to Finish
Layers
Beef Stocker
s
Non -La ers
Beef Feeder
rs
Pullets
Beef Brood Cow
- -
Twtc s
=
ke Poultser
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 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 DW R) []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)
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
❑ Yes KNo
[:]Yes WNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412014 Continued

• Facility Number: -I Date of Inspection: --
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
R No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): f �}
Observed Freeboard (in): 36
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Wo
❑ 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
[allo
❑ 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
MNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
5?-No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
EaNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[5-No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes &Z�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): 1V2V-- KJ0_ / 0yrrsr-Y�
13. Soil Type(s): "Allb
14. Do the receiving crops differ from those dcIrsignated in the CAWMP?
0 Yes
E2=No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�o
❑ NA
❑ NE
acres determination?
IT Does the facility lack adequate acreage for land application?
❑ Yes
F4 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[54No
❑ NA
❑ NE
_Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
allo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[allo
❑ 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 PNo
❑ 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 Ljj No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes O_No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

IFacHity Number: 0- - Date of Inspection:
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 ® 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 [S 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)
3 1. 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 ❑ NE
❑NA ONE
❑NA ❑NE
(DNA ❑NE
❑ Yes [a No ❑ NA ❑ NE
❑ Yes [2�No ❑ NA ❑ NE
❑ Yes Callo ❑ NA ❑ NE
❑ Yes C,No [] NA ❑ NE
❑ Yes [�LNo
❑ Yes ® No
[:]Yes [ 3,No
❑ NA ❑ NE
❑ NA ❑ NE
[DNA ❑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 fuse additional pages as necessary).:
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 91� — JO.3-33 coo
Date: _� y � 1_
21412011

17 � MU, I LlJ?
Type of Visit: IErCompliance Inspection U Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Qfouiine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
r
Date of Visit: �Arrival Time: Departure Time: cy County: Region:
Farm Name: mcbla., Owner Email:
Owner Name: t `-yL eo­L Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Title:
Onsite Representative: j
Certified Operator: `t
Back-up Operator:
Phone:
Integrator: N17 � -?'�' 6 t/
Certification Number: ra[ Y 13 7
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design Current
Design Current
Swine Capacity Pop.
Wet Poultry Capacity Pop. Cattle
Capacity Pap.
Finish
La er Dai Cow
Feeder
O
Non -La er Dai Calf
"' Dai Heifer
o Finish
o Wean
U
Design Current D Cow
o Feeder
Dr 1',oult . Ca aci P,o , Non -Dairy
o Finish
La ers Beef Stocker
Non -La ers Beef Feeder
Boars
Pullets Beef Brood Cow
Turke s
Inj
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? [:]Yes ❑e .Na— ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No E]'T]A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No E3"5-A ❑ 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 ET`N­A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ©''Ke_ ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [ o ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility umber: 7X- Z( Date of Inspection:
Wfiste 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
Identifier:
Zia❑ NA ❑ NE
❑ No [ A ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
QV4 GqXo-"E] NA ❑ NE
WYes �6i""" ❑ NA 0 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 E o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes EJ N ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes C No ❑ NA ❑ NE
maintenance or improvement?
Waste ADnlieatiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [�Vo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [t33No ❑ NA ❑ NE
❑ Excessive Pending ❑ 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)4
1
13. Soil Type(s): (h
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
C2 1w
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
L2,156
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[2,Vb
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[!jNo
❑ 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 C3 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 Ej�`No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �rNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility umber: - Date of Inspection:
24.'Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑-KE ❑ 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 D 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 Q<o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [ r o [] NA ❑ NE
Other Issues �-�,,�
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes []'No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? [:]Yes ' No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the [:]Yes Vo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes, 2: No ❑ NA ❑ NE
❑ Application field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑Yes [�] No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ' �o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes PNo ❑ NA ❑ NE
Comments (refer to goestion ft Explain any YES:answers and/or any additional recommendatrons,or any other commeuits
Use drawings of facility tobetter explain situations: {use: additional pages as necessary).:.
cat 16 V1J C all_ 0-
S Wst K� -� 3
�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Molt— q I �_ _M V
Date: tz-1LAgN
21412011

• �U I �''�ts '7 a G
6
Type of Visit: (U Compliance inspection O Operation Review p Structure Evaluation O Technical Assistance J
Reason for Visit: eRoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access 11
Date of Visit: Arrival Time: t !� Departure Time: CountylL G
Farm Name: �j r�,� Owner Email:
L
Owner Name: b c�C.f J �; ��it(1 Phone:
Mailing Address:
Physical Address:
Facility Contact: D ek,VI Title: OJAZ6 l Phone:
Onsite Representative: ( Integrator: 94 4
Certified Operator:De
a'F LI-Gat j
Certification Number: lzllf 7
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current - Design Current . Design Current
Swine Capacity PopW�, W,etP,oultry Capacrty Paps x, Cattle Capacity Pop.
UFd
inish Layer Dai Cow
eeder 6 O ° Non -Layer Dai Calf
Finish DairyHeifer
Wean Design Curent D Cow
Feeder m D . Point , Ca aeY pNon-DaFinish; La ers Beef Stocker
Non -La ers Beef Feeder
}s Pullets Beef Brood Cow
TurkeysW
Other WI� Turkey Points
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 [ o ❑ NA ❑ NE
[:]Yes [] No ENA ❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
[] No
[-NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
ffNA
❑ 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
�o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

r
Facili Number: - Date of Ins ection: '
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E'Ao ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes El No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5 Structure 6
❑ Yes f. Io ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
EZ '
❑ 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
�1Gb
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E3,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
EDK°
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[DXo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes 04 ❑ 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): S 0
13. Soil Type(s): %VOA
14. Do the receiving crops differ from those designated M the CAWMP?
❑ Yes
[�Ko
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[]�<o
❑ NA
❑ NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
CRIZ
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
a�r<o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[!]O'No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E2" o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
EgXo
❑ 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
5rNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[g'No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
�rNo
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facili Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [? No ❑ NA ONE
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 to provide documentation of an actively certified operator in charge? ❑ Yes ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes []J o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes [gl1`io ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[g,'6o
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[11 o
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
�Io
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[SNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�' No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments -
Use drawings of facility to better explain situations (use additional pages as necessary).
ca('0 " s L
G I U+' !3 U"'U�
e
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
.1D-1b-1d,
9-7- 13 -
PhonjW 'M— ?&
Date:
21412011

Type of Visit: WCompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Q'houtine 0 Complaint 0 Follow-up 0 Referral 0 Emergency O Other Q Denied Access
Date of Visit: Arrival Time: Departure Time: Q9' County:
Farm Name: r��r, e Me It At) Owner Email:
Owner Name: d . i`nC� Ei3� Phone:
Mailing Address:
Region: ri)0
Physical Address:
Facility Contact: OuL to Title: Gt.,.a C\f- Phone:
Onsite Representative: Integrator: MoRRA4( 8I2OW N
Certified Operator: �2k TAA hot,,•t DE p N m e 1 LA A) Certification Number:
—1
Back-up Operator:
Location of Farm:
Latitude:
Certification Dumber:
Longitude:
Design C►urrent
�D ign
Current
Design Current
Swine Capacity Pop.
Wet Pouttry'Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
I ILayer I
w
X an to Feeder "1%04 55
I INon-LaXer IDai
Calf
Feeder to Finish
I "-
Dai Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
mom;
D , P,oul Ciiaci
P,o .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream Imnacts
1. Is any discharge observed from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[D NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
[] Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ENNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[]� No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: a. - a..3 jDate of Inspection: 1ks Xa
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ['v]�No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? 0 Yes ❑ No ['NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 Q
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes EgIL ❑ 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 [3/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 [3No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes []Ao ❑ 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 E !Vo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [g No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [I. 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): t Nl (� v� GR Azi_ 1 l S. n , a
' J '
13. Soil Type(s): 1i U A U v,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 2No ❑ 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 [D"No ❑ NA ❑ NE
acres determination? .
IT Does the facility lack adequate acreage for land application? ❑ Yes [;3 No ❑ NA ❑ NE
18. is there a lack of properly operating waste application equipment? ❑ Yes dNo ❑ 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 dNo [] 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 [2"'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 Eqi /No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No []KNA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: +-1 - Date of Ins ection: :
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [2No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes dNo ❑ 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 [tf No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
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 (2 No ❑ NA ❑ NE
❑ Yes [ZNo ❑ NA ❑ NE
❑ Yes [v]"No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes &No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes C3'No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes [TNo ❑ NA ❑ NE
Comments (refer to -question #): Explain any YES answers and/or any additional recommendations.or any other comments:'
Use drawings.of facility.0better explain situations (use additional pages as necessary
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
_faY]S Phone:�aN
Date:
21412011

Type of Visit: (Lrtompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (P4o-utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: . &J Departure Time:�� County: �'1 Region: F%L4
Farm Name: ke— E 1,) Owner Email:
:
Owner Name: :1ZLt16" Phone:
Mailing Address:
Physical Address:
Facility Contact: KC. ,C,5 Title: li e LU .ems Phone:
Onsite Representative: t Y Integrator: 1 ^�
Certified Operator: u�Gc,-� 5 Certification Number: O� 3 0 1
Backup Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design C
Design
Current- '
Current
Capacity P p
Wet Poul#ry
Caacety
ppacity
WDign
Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
_
Non -La er
I I
Dairy Calf
F eeder to Finish
.'
,� k�a
I
I
k �" ,
Dairy Heifer
Farrow to Wean
Design
Current, _
Dry Cow
Farrow to Feeder
�h*
D , P�oult
Ga act
Rap
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Y v "
10
Pullets
Turke s
Beef Brood Cow
Other
'"
Turkey Poults
other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
<
❑ 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
61NA
❑ 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
A
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
[g-<o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Ej,?do
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Faciliq Number: - Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2<o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:]Yes ❑ No 2'9iA ❑ 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 [Z]- o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
Q'No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
U] rw
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E4-14
❑ 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
I_Y`'' O ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
O<o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [-]Yes H 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
to
[—]Yes
�o
[—]Yes
ll 40
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes []jo ❑ NA ❑ NE
❑ Yes 11 ,?ro ❑ NA ❑ NE
[:]Yes L=J 1Yo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [—]Yes L_ PK-o ❑ NA ❑ NE
the appropriate box.
❑WUP [:]Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E?<o___ ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No R<A ❑ NE
Page 2 of 3 21412011 Continued

Facie Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes El"go
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 1 o
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 [5] No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes [:]No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA Eg Nt'
❑ Yes E3<o []NA ❑ NE
❑ Yes E3'No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes E]'K ❑ NA ❑ NE
❑ Yes
�fo
❑ Yes
[3-<o
❑ Yes
E5<0
❑ NA ❑ NE
❑ NA ❑ NE
0 NA ❑ NE
-. _ ..
Comments (refer to question• m ap aany YES answers and/or any.:additional recommendations or any ot. er cowmen
.�
Use drawings oifacitity to better;explain situations (use additional pales as:n-
ecessary
2"Oe', A>4
Reviewer/Inspector Name:
Reviewer/Inspector
Page 3 of 3
Phone: 7Al
w'� Date:
21412011

Type of Visit: Q Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: '1 1 t l Arrival Time: t 11 Otl Departure Time: 11:45 CountyAbMA) Region: ERQ
Farm Name: MCI EQAJ VfMfy'k Owner Email:
Owner Name: . ����\�.� rn L P A 0-' Phone:
Mailing Address:
Physical Address:
Facility Contact: zP_Pgn C\P-AN Title: QWrk ? (z Phone: qt0- -134- O ILI
Onsite Representative: AMQ_ Integrator: V \uRDh.l GRoLjN
Certified Operator: A"Ay'm\�-j (JFa4�' M^- 1. tfko _ _ _ Certification Number: 0 413 1
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
Layer
Dairy Cow
Wean to Feeder
Ito-' UAIAO
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Design
i
@urrent
P,o
Dry Cow
Non -Dairy
Farrow to Finish
Gilts
La ers
Non -La ers
Beef Stocker '
Beef Feeder
Boars
Pullets
Turkeys
Beef Brood Cow
Other
Turkey Poults
NJ
Other
Other
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
❑ Yes
M 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 the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
Lai NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: jDate 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 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Rio ,❑��NAA ❑ NE
❑ No Ivy A ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):_
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes OQ-Ko ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[v]'1Go
❑ 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
fo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[� "Nbo
❑ 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
E3156
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10, Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E2-K'b"
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below.
❑ Yes
[]'No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Appl' ation 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
E2-<o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Ea o
❑ 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
21�o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ o
❑ 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
E?No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists [—]Design ❑ Maps [] Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [-]Yes [(No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
[dNA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: :ZIJIhA
24. Did the facility fail to calibrate waste application equipment as required by the permit? C] Yes E?fNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes dNo
the appropriate box(es) below. -
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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 d No
❑ Yes ❑ No
❑ NA
❑ NA
[] NA
0. NA
❑ NE
❑ NE
❑ NE
2'NE
❑ Yes dNo ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes EA No ❑ NA ❑ NE
❑ Yes [�No ❑ NA ❑ NE
❑ Yes
E f No
❑ Yes
gNo
❑ Yes
gNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to'question-#).-Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility46-'better explain situations (use additional pages as necessary)';
Ca-�c� �jrr►a}-cuv� A[m-, 1 *0 z-1 I .
Reviewer/Inspector Name-
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �f� `A3r
Date: f
4/2O

.s s o y 20/0
02-0
Type of Visit (Ytompliance 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: Arrival Time: 9 00,k- I Departure Time: . SO County: 00(f"Se-a , Region:
Farm Name: Owner Email:
Owner Name- Mani-!
Mailing Address:
,rzv
Physical Address:
Facility Contact: Title: Title: �" [''� "" 5�-+'� Phone No:
Onsite Representative: Integrator: — &rs''jlu
Certified Operator: ' b',e%'^1 Operator Certification Number: Z`t /3 7
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o = d = 6i Longitude: = o = I = "
Swine
Design
Capacity
Current Design
Population Wet Poultry Capacity
C*urrent Design Current
Population Cattle Capacity Population
❑ Wean to Finish
10 Layer
❑ Dairy Cow
Wean to Feeder
1710 q
1 6300 1 10 Non -Layer I
1 ❑ Dairy Calf
❑ Feeder to Finish
Dry Poultry
❑ Dairy Heifer
❑Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood CoAj
Number of Structures
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Layers
Non -Layers
❑ Boars
Pullets
❑ Pullets
❑ Turkeys
❑ Turkey Poults
Other
❑ Other
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑Yes
[I No
EKA
El NE
❑ Yes
❑ No
0'�IA
❑ NE
L-f 1vA
❑ NE
❑ Yes
❑ No
❑ Yes
B<o
ElNA
ElNE
ElYes
ET'5-
❑ NA
❑ NE
12128104 Continued

4
Facility Number: 79 — QDate 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 ErNo ❑ NA [-I NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 �"
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ETNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
L] No
❑ NA ❑ NE
8_ Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
20
❑ 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
��
L7 No
[I NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
ElE Yes
,/
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) ' w..,� �:.� Sw.t
ilge'"'"e-
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Reviewer/inspector Name Phone:
-
Reviewer/inspector Signature: Date: —Zy — 2-010
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection `PZ `7 D
Required Records & Documents
19. Did the facility fail to have 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 No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design El Maps El Other
21.
Does record keeping need improvement? if yes, check the appropriate box below.
[]Yes
G o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
[:]Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l"
Rain InspectionsWeather
Code
22.
Did the facility fail to install and maintain a rain gauge?
[:]Yes
/❑
No
per,
El NA
NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
,/
L� No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[1 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
01 o
❑ 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
NNoo
El NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
T
E o
❑ 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
�//
ETtoo
❑ 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
ElD Yes
o
❑ 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
ErNo
❑ NA
❑ NE
Page 3 of 3 12128104

I 9-1/'WS t.NTr✓�� !__'
�T11�vision of Water Quality
Facility Number 7 $ Z Q Division of Soil and Water Conservation
i
0 Other Agency
Type of Visit ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0"Wo—utine 0 complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: S'06 -O Arrival Time: Departure Time: a0 i4 County: 070 k e Sa1'v Region:
Farm Name: G��tie-- Mc'l e44g Owner Email:
Owner Name: +r mC i e4 ^= Phone:
Mailing Address:
Physical Address:
Facility Contact: be—dr�j Title: DWJJW I A44" "ate Phone No•
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 p = 4 = Longitude: ❑ ° = d
.. Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish
Wean to Feeder f 4 _5 00
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Im acts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
may,.
Design Current
Cattle Capacity Population.
❑ Daia Cow
❑ Daia Calf
❑ Daia Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
E ivA
❑ NE
❑ Yes
❑ No
[jl<A
❑ NE
E3 A
[INE
❑ Yes
❑ No
ElYes
B'Igoo
❑ NA
[INE
ElB Yes
o
❑ NA
❑ NE
12128104 Continued

Facility Number: —2Q Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ETNo❑
NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
E3 A
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 39
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2io
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
ElYes
PVNo
El NA
El NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental) threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
B o
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
21 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
�--,,��
3 o
❑ 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 E3 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 types) ��YM� G �Gr�-'�f�� , 5.C:wz; % �OVisr ,ezJ )
13. Soil type(s) Nt7B (Jl�cLg ,_,,i/
14_ Do the receiving crops differ from those designated in the CAWMP? ❑ Yes LNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
Q No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
&To
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
[ o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
E3f4o
❑ NA
❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
T
Reviewer/Inspector Name ✓CJS Phone: 00. 333 y
Reviewer/Inspector Signature: Date: $-'06 - .2007
12128104 Continued

Facility Number: %$ - ;a Date of Inspection '467
Reguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropiate box. ❑ WUp ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other
❑ Yes
D Noo
❑ NA
❑ NE
❑ Yes
D No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ETNo ❑ 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?
Otherlssues
29. 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
3 L Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
❑ Yes
B<o
❑ NA
❑ NE
❑ Yes
ErNo
❑ NA
❑ NE
❑ Yes
['1'Vo
❑ NA
❑ NE
❑ Yes
EfNo
❑ NA
❑ NE
❑ Yes
Q No
❑ NA
❑ NE
❑ Yes
0"q-o
❑ NA
❑ NE
❑ Yes
21go
❑ NA
❑ NE
❑ Yes
�o
❑ NA
❑ NE
❑ Yes
ET'No
❑ NA
❑ NE
❑ Yes
9-go
❑ NA
❑ NE
❑ Yes
E J1No
❑ NA
❑ NE
❑ Yes
Elmo-
❑ NA
❑ NE
12/28/04

3�i s 9-0q-09 P_� --
-- �- `Division of Water Quality
===are_it1iLtyumber % 0 Division of Soil a4d Water Conservation
— -_ -- - - Q Other Agency
Type of Visit 01compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Crkoutine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: %�S� „yI Departure Time: County: A'ZArse^"' Region: A-p-a
Farm Name: G eoY e- C e4.✓ Owner Email:
Owner Name: (S Go ►rEt�tw-� Phone:
Mailing Address:
Physical Address:
Facility Contact: hCft Al Title: Phone No:
Onsite Representative: N-FAl- Integrator: �f�l l�i5 &Za.//✓ _
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = 0 = . = u Longitude: 0 e 0 I = u
Design Currey# k:Destgn Current sl Design Current
Swine Capacity Population WetgPoullry�r Capacrtys_P�npulatron Cattlei -' Capacity Population
inish
ow
Feeder
alf
&Stream Impacts
i. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure [I Application Field ❑Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
Page 1 of 3
❑ Yes LTNo ❑ NA ❑ NE
❑ Yes
No I3NA ❑ NE
❑ Yes
❑ NoLTNA
❑ NE
NA El NE
❑ Yes
[]No
❑ Yes
,❑,,
El NA ❑ NE
❑ Yes
,L'fNo
LT No
❑ NA ❑ NE
11/28/04 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E NNoo [I NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes L�#'No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3%
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
,�,{
B r�o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
B< ❑ 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
o [I�B NA [:3 NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[3 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
�,
L.�j'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
W. 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
L-f %o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ FAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �t /dtt (�'v� C_ of c// a rol�i✓ �S•
13. Soil type(s) (,�� g
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ETNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:) Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�No❑
NA
❑ NE
Reviewer/inspector Name Phone: 91A ie33, 33349
Reviewer/Inspector Signature: Date: —
Page 2 of 3 12128104 Continued

Facility Number: 7 Date of Inspection
Re wired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Q No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [llo ❑ NA ❑ NE
the appropirate box. [] WUP ❑ Checklists ❑ Design ❑ Maps ❑ other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
D'Igo
❑ 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
B<o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
L <o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
019'o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[T No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[31ro-
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes G�No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[3"1Qo
❑ 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
Eallo
❑ 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
D-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
B<o
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
9-No
❑ NA
❑ NE
Additional,Comnients an-d/6ijIDrawings: ,�±s
. '
A.
Page 3 of 3 12128104

'Bj�u 4610-) TVs
0 Division of Water Quality
Facility Number j jb n v 0 Division of Soil and Water Conservation k
0 Other Agency
Type of Visit ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 3-29- 07 Arrival Time: Departure Time: /2:30 County: IPO645o.y Region: —5A90
Farm Name: _ Geonag. /uc/ .v r,,.r Owner Email:
Owner Name: G r E Ica.✓ Phone:
Mailing Address:
Physical Address:
Facility Contact:
p t 0'.'.1 "C-i Gct wJ Title:
Onsite Representative: b G0.N mGt ez—ki
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
f /
Phone No: �9/0. loZ�. 491i i�
Integrator• Af"!.Pdr k , I-v�✓�
Operator Certification Number:
Back-up Certification Number:
Latitude: = o Longitude: c
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
11oY 15900 10 Non -La er
Dry Poultry
Pullets
Turke
Other
Discharges & Stream pacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current:
Cattle Capacity. Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Da Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
Number of Structures: �!
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [4 No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[)9 No
❑ Yes
1A No
❑ NA
❑ NE
❑ Yes
ER No
❑ NA
❑ NE
12128104 Continued

Facility Number: ]g— 2 01 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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 �
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
LN No
❑ NA ❑ NE
(icl large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[I 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
[j No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El yes
Me
[I NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
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 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. Croptype(s) &,_,a4gda. Kfl 'E l��S�u�-e.� smell (r'rkrii✓ 66uw5e
13. Soil type(s) O g W 0.
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
[XNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
R No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
( ota i= a VUA I,
Reviewer/inspector Name —Ri� KeJe _S Phone: 910. µ33 . q33 D
Reviewer/Inspector Signature: I;?4" ll¢f Date: 3 r%
12128104 Continued

Facility Number: '7 $ — ZD Date of Inspection 3-28-07
Re uired 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 M No ❑ NA ❑ NE
the appropirate box. ❑ WuP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes CO 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
D9 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[A No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[A No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[9 No
❑ NA
❑ 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 property dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
IN No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12129104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: %— it? '� Arrival Time: ;Cep Departure Time: ��.'�S' County: 46eS&-L Region: DLO
Farm Name: 6t1Dt-e, e AtcA aAj Owner Email:
Owner Name: G G6Yc ,rL _ _AA G_ L ��N _ —Phone:
Mailing Address:
Physical Address: I
Facility Contact: AkC-(-t'a i✓ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No: Integrator: .6-6 cJAI
Operator Certification Number:
Bach -up Certification Number:
Location of Farm: Latitude: = o ET = u Longitude:
Design Current
Design Current Design Current
Swine Capacity Popation Wet Poultry
Capacity Population Cattle Capacity Population
❑ Wean to Finish
Layer
❑Dai Cow
❑Dai Calf
Wean to Feeder 0
UJOINon-Layer
❑ Feeder to Finish I
Heifer
❑ Farrow to Wean Dry Poultry
❑ Dry Cow
❑ Non -Dairy
❑ Farrow to Feeder
❑ Farrow to Finish ❑ Layers
❑ Beef Stocker
❑ Gilts ❑ Non -Layers
El Beef Feeder
❑ Pullets
❑ Boars
❑ Beef Brood Cowl
-7: ❑ Turkeys
-
Other ❑ Turkey Poults
t�umberof�Structures:
❑ Other El Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Of No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[2q No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ
❑ Yes
99 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
1� No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Q@ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
P No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: -7
Date of Inspection 7 -/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 ) Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes [ No
❑ Yes E2690
Structure 5
El NA ❑NE
El NA El NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 7 �f
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PIo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes Mo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[$No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
I No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
Cl Yes
M No
El NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[A No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [A No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop/ Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Grose 4 a PQ S�rc L Sifts Ll �ra.`.v t�D V �vS� t �J
13. Soil type(s) Alh jA.JQ,B
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [I No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
r„
Comments (reier`to question #): Explain any YES answers and/or any recoi
Use drawings of:facility to better explain'. situations. (use additional pages as
ienµdationsTor`a
❑ Yes
❑ Yes
other cam
® No ❑ NA ❑ NE
V1 No ❑ NA ❑ NE
[9 No ❑ NA ❑ NE
[$?No ❑ NA ❑ NE
Reviewer/inspector Name t~ Ke.t/er`S - --- - - 1 Phone: (9/0) 1%3j-3300
Reviewer/Inspector Signature: 2• e1:,__- Date: 7 — / i - Zyd ee
Page 2 of 3 12/28104 Continued

J
Facility Number: 7 — 20 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ \VUP ❑ Checklists ❑ Design
g El Maps El Other
❑ Yes [ANo ❑ NA ❑ NE
El Yes ®No El NA El NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 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 Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
[)5 NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
ym No
❑ NA
❑ NE
❑ Yes
O No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
%No
[]NA
❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes
V No
❑ NA
❑ NE
❑ Yes
qNo
❑ NA
❑ NE
Additional.Commeiits and/or Drawings:
AL
Page 3 of 3 12129104

4 . �,
Type of Visit compliance 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: �Arrn'al Time: r Departure Time: &9'30 County: V+ Region: eA
Farm Name: G c Poona %�C_ _LL+i//►'�— Owner Email:
Owner Name: -,p C nr Phone:
Mailing Address:
Physical Address:
Facility Contact: ;%ft— Title: Phone No:
Onsite Representative: Integrator:
Certified Operator: ����a.�-- _ Operator Certification Number -
Back -up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o =,
0 41 Longitude: = 0 = I = W
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boar.
Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
7/j%y 1 2zioy 10 Non -Layer
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Puults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes allo ❑ NA ❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
rM No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[QNo
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
K No
❑ NA
❑ NE
12128104 Continued

.t
Facility Number: D Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ 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
PQ 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
rO No
❑ NA
El NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
Q No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
MNo
❑ 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
Q Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
JQ No
❑ NA
❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
10 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[I Application Outside of Area
12.
�
Crop type(s) s1.�.>•Ct�el.e�� / -!P _
13.
Soil type(s) _12�22i fJa:5
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
4 No
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
[J4 No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[] Yes
No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
No
❑ NA ❑ NE
IS.
Is there a lack of properly operating waste application equipment? ❑ Yes
K.No
❑ NA ❑ NE
/= 4Z SirJ.c lea 4 S K- 5 i ol, DF_ You-sr�'d: 7.
Reviewer/inspector Name �' y e�A '.` Phone:
Reviewer/Inspector Signature: Date: aLf !'__ _
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [j No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes 1KNo ❑ 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. CZ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking P Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes R No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes KNo ❑ NA ❑ NE
24_ Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
E�LNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
Z NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Lq No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
R No
❑ NA
ElNE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
54 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
rVINo
❑ 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
RNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
UkNo
❑ NA
❑ NE
y
12128104

Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
IReason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
D to of Visit: i0 1c e f Tune: � : /"
Facility Number � .:?
Q Not Operational C Below Threshold
® Permitted ® Certified [3 Conditionally Certified 13 Registered Date -Last Operated or Above Threshold:
Farm Name: _.. �0ee
��o� - �-fir.; N_ � rw+ County: /fa ,�cxo�,�
Owner Name: _ _ _ , _ Phone No:. _
3f
Mailing Address: 26
Facility Contact:
Title:
Phone No:
Onsite Representative: �i v :T r %�7 L c: __ integrator.
Certified Operator: e-<<-.-e _�_.. 1� _� .. Operator Certification Number:
Location of Farm:
0 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • �' �" Longitude •
R`� 'QLliL{it ,�� y Curet - - _ 7.L.4CiLbL,
Swine `:. Po lion . s_ m Po 'on. Cattle f fron s
Wean to Feeder /py Layer Dairy
Feeder to Finish x. Non -Layer I on -Dairy
E��
Farrow to Wean
Other
Farrow to Feeder
Farrow to Finish Total.Desigu'.0 ty '
Gilts = _
Boars TaW'SSLW
Number 6fL�oo :
Discharges 8 Steeam ts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? /ylA
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes P No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes jA No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Idendfier
Freeboard (inches): 37
I2/I2M3 Confirmed

l'a2WiNumber: Zf — :2 '0 1 Date of Inspection ie oY'
5_ Are there any immediate threats to the integrity of any of the structures observed? Cie/ 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 maintenaneeftmprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste_AmAication
10. Are there any buffers that need maintenancerm4 rovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type .0 ] ij9� n? u t iti r• r �t 2� c.0 % r" . I I r c�
❑ Yes 19 No
❑ Yes ER No
❑ Yes ®No
❑ Yes [ No
❑ Yes m No
❑ Yes No
❑ Yes ® No
13. Do the receiving crops differ with those &esignated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14, a) Does the facility lack adequate acreage for land application? ❑ Yes [51 No
b) Does the facility need a wettable acre determination? ❑ Yes [P No
c) This facility is pended for a wettable acre determination? ❑ Yes 0 No
15. Does the receiving crop need improvement?
16_ Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality representative immediately.
❑ Yes P No
❑ Yes ® No
❑ Yes [M No
❑ Yes 0 No
❑ Yes 31 No
❑ Yes fla No

FaciliSy Number: %,' -. 2,0 1 Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
1% No
22. 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
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?
(ie/ discharge, freeboard problems, over application)
❑ Yes
Qj No
27. Did ReviewerAnspector fail to discuss reviewlinspection with on -site representative?
❑ Yes
(] No
28. Does facility require a follow-up visit by same agency?
❑ Yes
M No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
NPDES Permitted Fac ities
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 retard 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
❑ No violations or deficiencies were noted during this visit You wM receive no further correspondence about this visit.
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I2/I2/03

} it
Type of Visit ® Compliance Inspection 0 Operation Review O Lagoon Evaluation
Reason for Visit ®Routine O Complaint O Follow up Q Emergency Notification Q Other ❑ Denied Access
Darr of Visit: b Time:
Facility lumber t
10 Not O erational Q Below Threshold
® Permitted ® Certified 0 Conditionally Certified [] Registered Date Last Operated or above Threshold:
Farm Natne: Cie_'D I`Gp 1Mr 4.n f ,n County:
Owner Name: r. Le-6-y\ _ Phone No: 11 to — O
Mailing Address: 3 l a i , �iJ (�� � - _ j-�,... '_k,
Faciiih- Contact: L4 r, Title: i_jnn�oJ Phone No:
Onsite Representative: Ir-re , x4f, Integrator: CC, r rro S _
Certified Operator: C2rr..2 VAC- " e~ Operator Certification Number: i 2,0 [
Location of Farm:
,o Swine ❑ Poultry ❑ Cattle ❑ I•lorse Latitude Longitude �' �• ��
Design Current
Design Current Design Current
Swine Ca acitti Population
Poultry
Capacity Population Cattle Ca acitr Population
® Wean to Feeder
p
❑ Laver
I
1
10 Dairy
❑ Feeder to Finish
JE1 Non -Laver
I
I
JE1 Non -Dairy
❑ Farrow to Wean
Farrow
❑Farrow to Feeder
Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon area JEI Spray Field Area
Holding Ponds I Solid Traps f ] 1Co Li yid Waste Management Svstem
Discharees S Stream Imnaets
1. Is anv discharge observed from any part of the operation?
Discharge originated at: ❑ Laeoon ❑ Spray Field ❑ Other
a. If dischare: is observed was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in salinim9
d. Does discharge bypass a lagoon system? (If ves. 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 I Structure 2 Structure 3 Structure 4 Structure
Identifier
Freeboard (inches):
05103101
❑ Yes [A No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes p No
❑ Yes K) No
Structure 6
Continued

r
Facility Number: — Date of Inspection L
5_ Are there anv 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 [E No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
® No
9. Do anv stuctures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
allo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
b6 No
IL Is there evidence of over application? ❑ Excessive Ponding❑ PAN, ElHydraulic Overload
ElYes
1P No
2 12. Crop type i ] lP r rVtti. j__- +4 - Klnn - l �`/_ L n V , _? .
3. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
19No
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 wenable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
Rj No
16. Is there a lack of adequate waste application equipment?
❑ Yes
[R No
Reouired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes � No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps. etc.) ❑ Yes W No
19_ Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes No
20. 1s 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 cenified operator in charge? ❑ Yes No
22. Fail to notify- regional DIVQ of emergency situations as required by General Permit?
(ie' discharge. freeboard problems. over application) ❑ Yes No
23_ Did Reviewer/lnspector fail to discuss review•iinspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes W No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ONo
0 No violations or deficiencies were noted during this visit You will receive no farther correspondence about this visit.
'�..i±-_—Y . _. •; s:,-p.�+...� .�.•msa-^..sxe:x"tia.Mi''"`2eG� cs• .V
Comings:{refer to"gnesiiorii'Eiplaiie anyYE5-answers aadlaranY recomutendatiians ar say atlter eommessis. -
Use drawings of facEfty, to better explain situations.'('use adtiittonai pages as nettssaryj ❑ Field Copy ❑ Final Notes
w�— .
��'m� � C1a 1'� -� �� [S7� t•O b ►�-GAL
d'
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 6
`1
O5103101 r Candn"ed

4 . %
IFacility Number: -f 8 - -W Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
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?
F1 Yes E3 No
0 Yes P No
EJ Yes No
El Yes 1� No
[:1 Yes N No
El Yes [JJ No
E3Yes [:3 No
Additional Cornments'2ndf6r- Drawings:,
A.
05103101

-
VA
n �� d ����4�i'. Diu rs•��+.���ryx �}�����'4w+ �f ��
i-
Type of Visit Q Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification Q Other
V
t x A4_
❑ Denied Access
Facility Number 78 ZO Date of Visit: 10-23-2003 Time: 3:3Qpm
ro Not —operational O Below Threshold
Permitted ® Certified [] Conditionally Certified D Registered Date Last Operated or Above "Threshold:
Farm Name: �i�c►x .lYa Mitt. F;dXx[t.................. ............... County: RQb. sQM........__.................................. FRO .............
OwnerName: Gcox.................................... McLean ...................................................... Phone No:(Q�Q�.b28:9..f!)X................ ....._._................................
MailingAddress: 312Q.d.?'.1!..Rd........................................................................................ i sirmantAC....................................................... 2.3.0.............
FacilityContact: ..............................................................................'1'Me:...__._....__........__...-----..-................_........._... Phone No:
Onsite Representative. Integrator: CArrolj'• SoQda,. ac ......................
Certified Operator: Gggrgg.E ............................... IYacLuix........................................... Operator Certification Number: ,.82g1,.............................
Location of Farm:
In the southwest side of SR 2481 approx. 1.4 miles south southwest of Gaddysville, NC.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 • 25 48 Longitude 79 • 13 ` 00 u
©esign Current
Swipe, Ciipacity 'Population
® Wean to Feeder
7104
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Carrent Design _; Current ='
Poultry Ca acitti' Po elation . Cattttle Capacity, Population,.-.
❑ Layer I ❑ Dairy
❑ Non -Layer I I ❑ Non -Dairy
❑ Other f
TotahDesign Capacity F 7,104
Total SSLW r 213,120
Number of Lagoons 1 ❑ Subsurface Drains Present ❑Lagoon Area ❑ Spra} Pield Area
Holdin Ponds /_S
g. Sohd Traps ❑ No Liquid Waste Management System
Dischar,;es & 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 obsmed, did it reach Water of the State`' (If yes, notify DWQ)
c. If discharge is observed. what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier I
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
Structure b
Freeboard(inches) ............... 32............... ...... .................... .._............ ................................... .......... .................... _....
0S/03/01 Can inupd

Facility Number: 78-2Q Date of Inspection 10-23-2003
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ® Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Coastal Bermuda (Graze) Small Grain Overseed
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14_ a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
No violations or deficiencies were noted during this visit_ You will receive no further correspondence about this visit.
j'% 1 '.. 1.� {-• '.Y,�k c .� .., �. 1 "; �C
ComrnetltS (refer ttti quesdoo #) Ezilaln aiily YES"answers and/or an}'r`ecommendattuns or any other comments y
Use drawings of ficihtj to better explain situations.: (use additional pages'as necessary).
4 :, ® Field Copy ❑ Final Notes_
y
Visited the farm as the result of referral from Danny Edwards, SWCS, about water and waste standing in a low grass waterway andAL
channeling material flow to one comer of the field that abutts a head of woods. There was waste ponded in ruts in this corner and it had
he potential to exit the field if a signifigant rain event took place. Spoke with Mr. McLean about irrigation procedures which included
hutting off the spray gun in the waterway area of the field. Pulling across the channel and then resuming irrigation unless conditions
were extremely dry and the pull in this area was at a rapid rate. Records were not checked at this time as SWCS was checking this farm
that day and said they were ok.
Reviewer/Inspector Name Larry Bailey': Paul Sherman' DannyEdwards
Reviewer/Inspector Signature: Date:

Type of Visit 4 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint 0 Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: �6 9 �� Time: � i � �
10 Facility Number 7 I�
Not O erationa! 0 Below Threshold
® Permitted ID Certified E3Conditionally Certified O Registered ate Last Operated or Above Threshold:
Farm ?dame: Gf��4EGG�- County:
Owner Name: Gz � G��'� Phone No:
Mailing Address: `7C`1' �d ��/��"�'^'� _2Y�Y�
Facility Contact: �Fo/,c�i� �G��.�i+o Title: Phone No:
Onsite Representative: _ Integrator: _,,,t�•�e�%r ��� �-L`�
Certified Operator: �i�4,� �C� is'9� Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' u" Longitude +
"
-Des" Current. = Des' n'iCarrent
- -�"Des orient
:5wene
Ca scity.-Pa uhttron . Poultry = Ca achy
:Pa tilatiori - Cattle - . Ca achy_ Pts'nfstioa,
Wean to Feeder
7/D
/O
;
❑Laver
❑ Dairy
[] Feeder to Finish
;.`
❑ Non -Layer
I
Non -Dairy
❑ Farrow to Wean
=
Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Defti Cips- '
Gilts
❑ Boars
Total_ SSLW a
DischaEges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes Pallo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conyevance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure Z Structure 3 Structure 4 Structure 3
Identifier:
Freeboard (inches):
05103101
Oyes O No
❑ Yes �@ No
❑ Yes
® No
❑ Yes
to No
❑ Yes
❑ No
❑ Yes
93 No
Structure 6
Continued

Facility Number: 7? — Za
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 maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Aoolication
❑ Yes X No
❑ Yes IX No
❑ Yes RNo
❑ Yes )RNo
❑ Yes DWNo
10. Are there any buffers that need maintenance/improvement? ❑ Yes ;&No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 10
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 KNo
b) Does the facility need a wettable acre determination? ❑ Yes KNo
c) This facility is pended for a wettable acre determination? ❑ Yes PTNo
I5. Does the receiving crop need improvement? ❑ Yes [;rNo
16. Is there a lack of adequate waste application equipment? ❑ Yes o
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
U No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP. checklists, desp, mps, etc.)
❑ Yes
Aio
19.
✓ J
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
q No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
to
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
f No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
P!fNo
(] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Comments:(referto'.questioii`t#) Eiplsut any ad/ar any recommendatwns;or anv atlter oosAments:
Use drawings of faeility to;bettxr ezplatn s�tEiattons: (ase addti�orial pages -as, necesssrv)Id C -
❑ Fie ❑Final Notes`
N a = ryN pry
Re-viewer/Inspector Name 7.- -77
Reviewer/Inspector Signature: Date:
05103101 Continuer!

I Facility Number: 7X — -00 Date of Inspection
Odor Issues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes N 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, El Yes JONo
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.) El Yes No
31. Do the animals feed storage bins fail to have appropriate cover? El Yes A No
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? 0 Yes /N No
Additional Communts,andioe.Drawing
05103101

f i
Type of Visit Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number Date or visit: 2�Tirne: Printed on: 10/26/2000
Q Not O erational Q Below Threshold
Permitted 0 Certified [3 Conditionally Certified [3 Registered Date Last Operated
PKore Threshold : ..................
Farm Name: ......... ��5zG xl..........:.... .P -l%� ..... County:......./... e. �f.....................................
Owner Name: ....... �.7L(�G} ..tom ........ Lem. ... Phone No:. CQ <..C.1 d.�........................
Facility Contact: ........4Q K..La.. ... Title: Phone No �1„•
............
Mailing Address:......... 1 z.A..... J.e_.�................................................. ... ,(.f....N G7[ 7...... A" .v........ ................ ..�
2
Onsite Representative:. 4�.�rs..r�rn..— ..... .... ......... integrator:...............grt�(i.�G1....................
.._.. .............
Certified Operator:... �,,,,,,,,,,,,, r CL
...................................I.....�� _.............. Operator Certification Number:................ .
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �� Longitude
Design Current
awitic
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design CapacityQ
Total SSLW
Number of Lagoons I J❑ Subsurface Drains Present JJLJ Lagoon Area ❑ 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? ❑ Yes )S�No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If disc:har«e is observed. what is the estimated flow in gal/min''
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier. ..... ...................................
Freeboard (inches): 3 f
5100
❑ Yes No
❑ Yes ArNo
❑ Yes No
❑ Yes No
❑ Yes o
❑ Yes
f' Structure 6
Continued on back

Facility Number: —Z� Date of Inspection % �d Printed on 10/26/2D00
g
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? „ ❑ Excess iverPonding ❑ PAN ❑ Hydraulic Overload
12. Crop type OerrkudcL OmisL
13. Do the receiving crops differ with those designate n the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment'?
Re uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
19. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
❑ Yes No
❑ Yes tNo
❑ Yes❑ Yes
❑ Yes to
o
❑ Yes
❑ Yes INNo
o
❑ Yeso
❑ Yeso
❑ Yes
❑ Yes J�No
❑ Yes Po
❑ Yes Qk No
❑ Yes No
❑ Yes No
❑ Yes K.No
❑ Yes F '
❑ Yes jNo
o
❑ Yeso
❑ Yes
QM61ati#Os'oi- defci ndiC ,s -mere noted• during �his:visit; • Yo4 wit! -receive iio fufth& -
cories� deuce: about; this visit ..... • • .
Conimemts (re%r taiquestion #)c Explain any YES answers and/or any-i-ecommi!ridations-or any otli;er conimeuts - -
Use;drawingsof f&cility to better explain situations. -(use additioaal:pages as necessary) r-
r-t I&aks' 9ve­ u)e/
�-�►ye-� � n, �r a�- Sf7Lc.
r
F
er/Inspector Nameer/inspector Signature: - Date: "Q 5/00

• Facility Number: -- 2-0 Date of Inspection
Printed on: 1/4/2001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e, broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes o
© No violations or deficiencies were noted during this visit_ You will receive no further correspondence about this visit_
ector Name '= 4e `-_ r k s w Reviewer/Ins .= !> r p � •v _�. -
Reviewer/Inspector Signature: Date:
01/01/01

Routine Q Complaint 0 Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other -
Facility Number 2 p Date of Inspection
Time of Inspection 124 hr. (hh:mm)
Permitted [3 Certified 13 Conditionally Certified 0 Registered 0 Not O erational Date Last Operated:
Farm Name: .......(2.,�Q1' .�.....1.:.(..L-4p".f....`� rOK........................ Couuty:..........� Jx................... .......................
Owner Name: ....... L1..tQ..........
.... L.'._! .... Phone No: .....,.I
Facility Contact: .......................... ................. Title: .................... ................ Phone No:.......... .
.............. ...............
Mailing Address: ........ 3L1.0 ...... ............................................ ...... r,y.. A. . ....... .3..7...LG
Onsite Representative:......... ?.LSa,nL, r.....................I........................................ Integrator:...............C�..�:R. r D.....5.................................
Certified Operator. ,,,,�,�O �r-,-, _,„L.:..t- C L eds�� Operator Certification Number:
......................................................................... ...........................
Location of Farm:
Latitude 0 �° ��� Longitude
Design , _ .:Current -
C acr ty = a P.'' ulation ; P
aoultry
.:
Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
ti
Farrow to Finish
❑ Gilts
❑ Boars
❑ Non -La
❑ Other
Design Current gn s _Current
Des,
Ca aciity :Population ... Cattle _
_ ;Caliaci Po uladon
❑ Dairy
er ❑ Non -Dairy
- sr
�
-- ° Total Desx Ca ac>It Y.P .
-_ •Total-SSLW-= _
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other ANO
a. If discharge is observed, was the conveyance man-made? ❑ Yes
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 gaUrnin'?
d. Does discharge bypass a lagoon system'? (If yes, notify.DWQ) ❑ Yes JNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes;NoNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes �No
Structure I Structure ? Structure 3 Structure 4 Structure 5 Structure 6
Identifier: j /I
Freeboard(inches): .........L.. O...... ....................... I. .................................... ................................ .... ...... I— ............. .............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes )��
seepage, etc.)
3/23/99 . Continued on back

F
rk
Facility Number: — 27j 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 maintenancelimprovement?
❑ Yes
8. Does any part of the waste management system other than waste structures require maintenancetimprovement?
❑ Yes
PO
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
kNo
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
KNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
ANo
12. Crop type
13. Do the receiving crops differ with those designa e n the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
XNo
14. a) Does the facility lack adequate acreage for Ian application?
❑ Yes
0No
b) Does the facility need a wettable acre determination?
❑ Yes
1qNo
c) This facility is pended for a wettable acre determination?
❑ Yes
j'No
15. Does the receiving crop need improvement?
[:]Yes
gNo
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
e(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
W No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
eNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
KNo
21-
Did the facility fail to have a actively certified operator in charge?
❑ Yes
9INo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
discharge, freeboard
❑ Yes
ONO
(ie/ problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ONO
24.
Does facility require a follow-up visit by same agency?
❑ Yes
*0
25,
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
PNo
Reviewer/Inspector Name WtilY1y-
. --�-�
Reviewer/Inspector Signature: c Date: bj 22 -OD

Facility Number: 7f v Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes PRo
❑ Yes o
❑ Yes WNo
❑ Yes c,6No
❑ Yes dNo
❑ Yes ❑ No

s. 1
n Dw4sion of Soil and Water Gortservadon Operation Revie
} [3 Division of Sdil and%Water Conservation -Compliance lnsj
Dwision of Water Quality Compliaiieeinspection
0 Othi Agency Operation Review = ry
Routine Q Com taint O Follow -tip of DWQ inspection Q Follow-up of DS% C review Q Other
Facility Number Date of Inspection
Ig
Time. of Inspection 0 24 hr. (hh:mm)
Permitted © Certified [] Conditionally Certified © Registered JE3 Not Operational Date Last Operated:
Farm Name: a�elnry­
ef........ .... .r`Wl........................... County: ------- b�....... ............ ..I....................
Owner Name:.. ;L!eo..�.. f .t° ....................... (C Lee..•':..-...............-•----.... Phone No:....... t'C! z�..../..YLQ.l------......................................
Facility Contact:e,l✓... Title:._........ Phone N .
...................................... ............................. ... jam+ .........................
Mailing .�ciclress:...... % z �!.. j.t........................ ... ........1--. r..fl-.!1!l..t't.Yk f ...1.. . ............. 2a5/
................ .
Onsite Representative: ...... ej /L&-..................................................... Integrator:............. at r6-0.//S...................................
Certified Operator: ...... Oe 4,r, L° .... 1�C . ...................... Operator Certification Number:.......... ....................
Location of Farm:
..........................................•---•-...... -------... --------..................................._.....---... -... .........................---- ----- ..........--- ..... .................... --------------- .............__...-------- .................
Latitude ' 4 It Longitude ` 4 94
Design Current
Swine Capacity Population
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑Dairy
❑ Non -Layer I ❑ Non -Dairy
❑ Other
Total Design Capacity -7/ p
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds / SoEid Traps ❑ No Liquid Waste Management System .
Discharizes & Stream Imnacks
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
h_ If discharge is observed. did it reach: ❑ Surface Waters []Waters of the State
c. If discharge is observed. what is the estimated ]lo%v in galhmn?
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?
❑ Yes JqNo
❑ Yes KNo
❑ Yes UjNo
❑ Yes ONo
❑ Yes No
❑ Yes No
❑ Yes P(No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ................................................................................................................................
.....Z�....................................................................
1/6199 Continued on back

Facility Number: 7r- 2-D Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc_)
6- Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? � El Yes �j 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 main ten ance/improvement? ❑ Yes PNo
8. Does any pail of the waste management system other than waste structures require maintenance/improvement? ❑ Yes o
6
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? ❑ Yes I TNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 1] No
11. Is there evidence of over application? ❑ Ponding ❑ Nitrogen ❑ Yes No
Ptype 12. Crop t e ['i!! ti ..........a-...................................................................... ................. .............. ( �..
13. Do the receiving crops differ with those desionated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. Does the facility lack wettable acreage for land application'? (footprint) El Yes KNo
15. Does the receiving crop need improvement'? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes �No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes K No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.) ❑ Yes '40
19. Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports) El Yes ®�N0
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes V,No
21. Did the facility fail to have a certified operator in responsible charge? ❑ Yes j�rNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application) ❑ Yes XNo
23, Did Reviewerlinspector fail to discuss review/inspection with on -site representative? ❑ Yes 0,
No
24. Does facility require a follow-up visit by same agency'? ❑ Yes No
N.O.Viobtions -or. del-kierieies .we're n' o.tied during O' is, visit:. Yoti w'ilfretweive'na furihei- . _
corresb6fidence: abbot• this 'visit.; ; ; ... _ .... .... ...... .
Gotnments.(refeir to question #):' Explain any YES answers and/or any "recommendations or any.6ther comments
`oU __4awsof facilit}blain�situations. (use additional a es as necess'aetker`ex ry}Yl -
A
�ery �fce n &j .
�f
do� recor�S• j �j
C v�-�-� w e Qoot I o r !�
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: 11/6/99

0 Division of Soil and Water Conservation ❑ Other Agency
23 Division of Water Quality
10 Routine O Complaint O Follow-ou of DWO inspection O Follow-up of DSWC review O Other
rDateof Inspection 6 TFacility Number o2� of Inspection I// :q5 124 hr. (hh:mm)
D Registered Certified 13 Applied for Permit JAPermitted 113 Not Operational I Date Last Operated:
Farm Name G. a r6..�....... f'Ltei4. 1� ..............................................County : .............fCD ., Q....................-----.------.....
Owner Name:............ ra .1P.......... .... .1.." l.Erre-14 J................I... Phone No: .Q l.�P .................
9�......6 o.
Facility Contact: ....... ..[.... „inx� 5............ Title ... Phone No:
MailingAddress:..........R....... I ................ &Q.x.......... :51/..................................... ......F .... V.C.................... ..
G��q
Onsite Representative:.............•---- ....-•--....I f G_L_......................................... Integrator:........L._ r'o.�'......... ..{ S
Certified Operatorz......... .. O erator Certification Number:.........
Location of Farm:
Latitude • 4 « Longitude • 4 49
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes JU No
2. Is any discharge observed from any part of the operation? ❑ Yes IM No
Discharge originated at: [I Lagoon [I Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/impiovement?
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
IM No
❑ Yes
0 No
AlA
❑ Yes
W No
❑ Yes
Eallo
❑ Yes
;M No
❑ Yes
X No
❑ Yes
f$ No
❑ Yes
Pff No
Continued on back

1
Facility Number: q $— CIO
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes (d No
Structures fLa oons lioldin Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes J4 No
Structure 1 Structure 2 Structure 3 Structure 4 Structure,5
Structure 6
Identifier_
Freeboard (fty .......... a
10. Is seepage observed from any of the structures?
1.7 Yes
No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
No
12.. Do any of the structures need maintenancelimprovement?
❑ Yes
No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or tnaximunt liquid level markers?
❑ Yes
X No
.waste Application
14. Is there physical evidence of over application?
❑ Yes
f No
(if in excess of WMP, or runoff entering waters of the State. notify DWQ) M1
,
15. Crop type ................cam. i... ,5.... ._.
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW,MP)?
❑ Yes
M No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18. Does the receiving crop need improvement?
❑ Yes
I@ No
19. Js there a lack of available waste,application equipment?
❑ Yes
GK No
20. Does facility require a follow-up visit by same agency?
❑ Yes
X No
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative'?
❑ Yes
fid No
22. Does record keeping need improvement?
❑ Yes
No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
j${ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
PjNo
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
® No
0 No:violations or deficiencies. were ntited-during this visit.- You.wili receive no further
correspbndence about this.visit:.. :.
0
x;,sD r
Comments;(refer to.question #):..Explain any".Y`E S answers and/or any recotiunendations or anyot}ter corsunents
-u g9gr
Use diawun s of facility to better explain situafirins. (use additional p4&s as necessary}
to 6L v4ff #V� AC44r
ayt 4,0 sty-.44A,;,�
C4 �U
dt.2tsta cn�r�Q,t,� �2
7125/97
Reviewer/inspector Name
u
Reviewer/Inspector Signature: � ,, y1 Date:

D$ �lII1i A
D. Z-
Routine C Complaint Q Follow-up of DW
Fadiity Number
Farm Status: 0 ee t-k,-�- e•j
of DSNVC review O Other
Date of Inspection I S W-931
Time of Inspection 1 Use 24 hr. time
Total Time (in hours) Spent onReview I
or Inspection (includes travel and processing)
Farm Name.•i� C ecc-►�i4'p i% County:
owner Name: re
3eeMe- Mc Lem►. Phone No:� ..o)
rung Address: o� 5 I !a i r,,.. Q �T•C' Z. Sri b
Onsite Representative: n 6 b Integrator;
Certified Operator. Gc L +^-- Operator Certification Number.
Location of Farm:
.'.TTr�T,�
Latitude 0 6 Longitude Q• Q'
(3 Not Operational 1 Date Last Operated:
Type of Operation and Design Capacity
ty Sr'raL iF Re3< >e
c�e:°.�1k ?b' +af
Latitude 0 6 Longitude Q• Q'
(3 Not Operational 1 Date Last Operated:
Type of Operation and Design Capacity
ty Sr'raL iF Re3< >e
c�e:°.�1k ?b' +af
�i! C�6 :K.- yip�mY beL.ra;�• .,oa'`""1Thi5o, EY. SA_ e fi£e
Numb�.`p
�r. �!`a�
ee
a=.'j Mtl
KY
. >M;KPY
s��=
Wean to Feeder
Feeder to Finish
D `'iff �90
❑Non Reef
-
Farrow to Wean
-M 44
Farrow to Feeder
Farrow to Finish
❑ Other Type of Livestock
S:'�3�^ . T���AZIi`�L` � -.,H14 d6-✓':x' .�'.�Cx ".. .�" i. �ti. .i�"V ):� ..6P.E.:. iG� z ZiW'.
WE'N5��".."
0Number of Lagoons l Holding Ponds Subsurface Drains Present
1;ml spray Field
1. Are these any buffers that need maintenancelimprw ment?
❑ Yes No
2 Is say discharge observed from any part of the operation?
❑ Yes No
a. If discharge is observed, was the conveyance man-made?
❑ Yes No
b. If discharge is observed, aid it reach surface water?? (If yes, notify DWQ)
❑ Yes No
c. If discharge is observed, what is the estimated flow in gWhnin?
1A
a. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes No
3. Is there evidence of past discharge firm any part of the operation?
❑ Yes �No
4. Was thew any adverse impacts to the waters of the State other thaw f mm a discharge?
❑ Yes /E(No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes qNo
maintenanerJunprovementR
Continued on bark

6. is facility not in coke with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after I/l/97)?
8. Are there lagoons or storage ponds on site which need to be properly closed?
§tructures (Lagoons and/or Holding Ponds)
9. Is structural freeboard less than adequate?
Freeboard (ft): I Agoon
I Lagoon 2 Lagoon 3
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) mprovement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
WasteApplication
14. 1s there physical evidence of over application?
(if in excess of , or runoff entering waters of the State, notify DWQ)
15- Crop type F. 7&r- rv% Lok
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the cover crop need improvement?
I9. Is there a lack of available irrigation equipment?
For Certified FacUities Onl
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did ReviewevInspector fail to discuss review/inspection with owner or operator in charge?
0 Yes 1 fo •
❑ Yes No
Yes No
❑ Yes �No
Lagoon 4
❑ Yes ONo
❑ Yes jj�No
❑ Yes )I(No
❑ Yes YNo
❑ Yes �No-
7 ❑ Yes Pl�o
❑ Yes Plo
❑ Yes KNo
© Yes kNo
OYes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
AYes No
Comments (refer to questron #) �F.xplaur arty YL5 answers arrdlorarry,recommendat<ons or any other COIImrents..' "'
F
.Use draw�ag5�offacr�tty�to betttitatplain srtuatrons fuse additional�pagesas�a_ecessa�r) '� ��'�� �° ���,,e,, Fah
lee re-m
needs '4-v Dyed,
t?
#t 20 d � 2� �' rV o ewe cans pwov t ' �-�- �'ti e rN+ . _G15 f e e'{� a h1 wa S
,7 ] - 41 GCS Gd lw3�S�E f Sep, 0.na fySiS a r�dl trt'ic�a•CiOh. CGcorclS tot f cd�e�
did iwsPez+loft Cer.c!ems;a�
t�
Reviewer/InspecWrNome � rv�.. w� g��, • � <��. �3X w . ;w� rZ>
Reviwer/inspector Signature:Y-20LL
Y ( zs Date: jrZO - 7
cc. Division of Water Ounfity. ale, Ouality Screen. Facility Assessment Unit 11/14/96