780023_INSPECTIONS_20171231

Type of Visit: O'Compliance Inspection U Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral O Emergency O Other 0 Denied Access
Date of Visit: �y %� Arrival Time: 1171 IS Departure Time: 'Uv County:lzel s on Region: � cc
Farm Name: Ole, '5iir. )CWS � Owner Email:
Owner Name: �01r4-
;EcySG Phone:
Mailing Address:
Physical Address:
Facility Contact: a r / tf 136,'t-' ` r Title: r sf� Phone:
Onsite Representative: of
Certified Operator: `
Back-up Operator:
Location of Farm:
Latitude:
Integrator: --.s `
Certification Number: G �C7 [ s
Certification Number: too J 3 1f
Longitude:
Design Current
Design
Current
Design Current
5wtne
o p -, 'ty Pop.
Ca act
Wet Poultry
Capacity
Pap.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
7— . � q,;t
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr Pout
Ca aci
Po
Non -Da'
Farrow to Finish
JLayers
Beef Stocker
Gilts
Nan -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream ImD$cts
I _ Is any discharge observed from any part of the operation?
❑ Yes
D N-
❑ NA
0 NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
E]�W_A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[B 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 DWR)
❑ Yes
❑ No
[ -16A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[ o
❑ 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 21412015 Continued

Facili Number: jDate of Inspection:
Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
_ f
[j[-Na ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 'Z_r
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 property addressed and/or managed through a
❑ Yes'
ED,?°
❑ 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
[g Pd'b
❑ NA
❑ NE
S. 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
®_Ne-
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[;],Nm
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below, ❑ Yes [51q_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): C /3 " � I a- y s & 0
13. Soil Type(s): wo
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 1 =1 "o ❑ 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
ff 'No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
0--No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
EJNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
CyNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
21 Did the facility fail to install and maintain a rain gauge? ❑ Yes El-*N4o ❑ 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

FaciliNumber: -7 - Z-3 jDate of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0-W ❑ NA ❑ NE
25.'Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑-hdo � ❑ 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
❑,Nu- ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
D,1Vo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
U_NQ�- ❑ 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
E]-M° ❑ 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
Q-1%ro_ 0 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
[D-NV- ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q"No ❑ NA ❑ NE
33. Did the Reviewer/Fnspector fail to discuss review/inspection with an on -site representative?
0 Yes
No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[D- o ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
Phone:gia+ q33-333 L1
Date: b � l
214120I

51 �'t j X 7
w�ston of Water Resources
Facility Number '] _ ®°Division In
oil and Water Conservation
Other y
Type of Visit: 05compliance Inspection 0 Operation Review p Structure Evaluation O Technical Assistance
Reason for Visit: (fr outine Q Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: ' J Arrival Time: FA 3 Departure Time: / o County:
Farm Name: L(�� sc.Z4 PUF( L( Owner Email:
Owner Name: L �jGt �dvr'e— Phone:
Mailing Address:
Physical Address:
Facility Contact: C"'AS Title:
Onsite Representative:
Certified Operator: Ucofid _ goer -
Back -up Operator:
Location of Farm:
Latitude:
Phone:
Region:'n—
Integrator: Irl g ---,S'— 1,
Certification Number: QD 31 1
Certification Number:
Longitude:
l)esignCurrent
DesignCurrent
Design
Current
Cap CaityPop.
WetPo.ultry Capacity _Pop.
Cattle Capacity
Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Layer
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
57L0 o���O
;, "'
Design Current
D Poultry= Ca acity Po
Dairy Heifer
Dry Cow
Non -Daily
Farrow to Finish
La ers
Beef Stocker
Gilts -Layers
Beef Feeder
Boars
Pullets
jBeef Brood Cow
Other Elk
=
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made`?
b. Did the discharge reach waters of the State? (If yes, notify 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 [SrNo— ❑ NA ❑ NE
❑ Yes
❑ No
[E]­NA
❑ NE
❑ Yes
❑ No
E3'_iA
❑ NE
❑ Yes Q No
❑ Yes �o
❑ Yes [i]No
dNA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 21412015 Continued

Facili ° lumber: jDate of Inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [fl NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑`T\ A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Zs
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes--[jTNo
❑ NA
❑ NE
(i.e., large trees, severe`erosion, seepage, etc.)
6. Are there structures onI 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 DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
.r No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
EJ'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
ETNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [TNo ❑ 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 "i-vu..u.. A t5'G D
13. Soil Type(s): U eL LO
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes LJ '"" ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [24io ❑ 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 Ea<o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes [_, o E] 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 do ❑ 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 E3<o
❑ 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ONo
❑ Yes Cj"No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

f
[Facility Number: - 2 Date of Inspection:
i
14. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [' oo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No B-KA D NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey Ej Failure to develop a POA for sludge Ievels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [2"go ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes D-No ❑ NA ❑ NE
❑ Yes [],?i6 ❑ NA ❑ NE
❑ Yes Eatt5 ❑ NA ❑ NE
❑ Yes ❑ o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
EaNa-
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
E3-Mo-
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
�6
❑ NA
❑ NE
as
S l u+- cJ[i / — ! V J 1 & r I Cf -zf, —'� ' 0
7{ LJ -0,tik eeVe- - -11 s. D p- Y-J - Y7 v
J
(t - '7(0 - '30�-- 6k-S 1
Reviewer/lnspector Name: I i i! Lt _ _^� Phone: �iU.'�') . l
Reviewer/Inspector Signature: I Date:
Page 3 of 3 21412015

,�,-Z - l j, se4�---
�s
Division of Water Resources
Facility Number 71/ - Division of Soil and Water Eonservation
•Q Other Agency
Type of Visit: omptiance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 015 routine O Complaint O FoHow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 15�--3-14 Arrival Time: Departure Time: fop County: RD Region:
Farm Name S Owner Email:
Owner Name: �.y 1,UCc y_�}-�X 9 Phone:
Mailing Address:
Physical Address:
Facility Contact: 1?Ga.0 j 7 U Title: �,.t, �' Phone:
Onsite Representative: ! «, Integrator: Slyr,�d�
--
Certified Operator: A.--- Certification Number: / Dr'? / sz?
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
esign Current
pacity Pop.
m
Wet Poultry Capacity Pop.
Cattle Capacity Pop.
Wean to Finish
I jLayeT IDairy
Cow
Wean to Feeder
Non -La er
I
a Calf
Feeder to Finish by74hy
a' Heifer
Farrow to Wean
Design l±urrcut
Dry Cow
Farrow to Feeder
D . P,oul Ca aci P,o
Non -Doi
Farrow to Finish
I Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
1pullets
Beef Brood Cow
Turkeys
Othe
ITurkey Poults
Other
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
E No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
'6. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
P�J-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 21412014 Continued

Facili Number: jDate of Inspection:
!
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
S—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): / 2- ��
Observed Freeboard (in): 33 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
M"No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
U' 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
jTNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[K No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E[No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Leo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑'BAN ❑ PAN > i 0% 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): �iYytac r
13. Soil Type(s): Q
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 Imo, No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [g No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes allo ❑ NA ❑ NE
❑ Yes [allo ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Q No ❑ NA D NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes 2 No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
I
21. Does record keeping need improvement? If yes, check the appropriate box below. aYes EgrNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard E!J-Waste Analysis ❑ Soil Analysis ❑ Waste Transfers Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield Ja120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
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?
[:]Yes ® No ❑ NA ❑ NE
❑ Yes [allo ❑ NA ❑ NE
Page 2 of 3
21412014 Continued

Facili Number: 2e - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes k],No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes c] 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 [NNo ❑ 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
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 [2'No ❑ NA ❑ NE
❑ Yes -0 No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes ,M No ❑ NA ❑ NE
❑ Yes ZNo
❑ Yes ELNo
❑ Yes Colo
❑ NA ❑ NE
❑ NA ❑ NE .
❑ NA ❑ NE
lComments (refer to question #) Explain any:;YES answers::and/or;any addrhonal recommendations or any oche tnents:�r
UsedrawinasoffaciHtvtobette�.-.etulsdmSitU2tion§;(6se additional:vaQes as necessaMv ;.�`„ LL..
P 6 0 ':j a a- r
r-"
Reviewer/Inspector Name: ��4� & nPhone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412014

t ype of visit: c(�,'om fiance inspection u operation Keview V structure Evaluation V t ecniucat Assistance
Reason for Visit:toutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ! 'a Departure Time: County: �a h
Farm Name: d L� S ,ey C2 1 Owner Email:
Owner Name: r t , —5rn- F C'-{ Phone:
Mailing Address:
Physical Address:
Facility Contact; _ ���t �C {'-�C'-� Title:
Onsite Representative: 1
Certified Operator: }
Back-up Operator: L40, <
Location of Farm:
Latitude:
Phone:
Region:F_E_�
Integrator:
Certification Number: h l7 B JU
Certification Number: 4 00 1. 5`D O
Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
I ILayer
IDai
Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
{a t)6
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D . Pout
Ca act
Pao
Non -Dairy
Farrow to Finish
Layers
I
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Otherl
Turkey Poults
Other
g _.:., __
i'_.::e.wY':',.�:...:....
Other
- � 'M'1riA1TAYllm ::....,—.....:
�Y'L:'�%€i•ii
Discharees 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
j2r<�k
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
[] Yes
❑ No
El 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
dNA
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
allo
❑ 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 I of 3 21412014 Continued

Facility Number: -7 - IDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
KINl'e-0 NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[:]Yes
[-]No [4-NA
D 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
❑ 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
[;� �o ❑ 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
Ej oo ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
; "o ❑ NA
D 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 Apolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Q'No ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Q'No ❑ 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): �. tr r '5 C' a
13. Soil Type(s): - o
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes <o ❑ NA ❑ NE
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?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes [�o ❑ NA ❑ NE
❑ Yes [3- o' ❑ NA ❑ NE
❑ Yes
Egl<o
[] NA
❑ NE
❑ Yes
[B'Ko
❑ NA
❑ NE
❑ Yes
Ea o
❑ NA
❑ NE
[:]Yes
/ No
❑ NA
❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Ff-No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes B No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [� No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of Inspection: _ o S
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes G],W ❑ 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 ]"'o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [,1Go ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes O 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 No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes EfNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes LLkKo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
[]Yes �To
[DNA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes F3/No
❑ NA
❑ NE
Comments (refer to question #) Explain any YES answers and/or any. -;,additional recommendations or an other cowmen"t1:, ^
Use drawings of facility to tietter=exl 1 in situations (use additional pages-M.-necessary
S('�� , _g.' 1117
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
C
Phone: j
Date: G
21412014

1A. .. 1 Z N N .i r
ion of Water Resources
Facility Number - Division of Soil and Water Conservation
OQ Other rAgency
Type of Visit: q)Xbmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 04 outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival T�` 0-6 Departure Time: County: RegionFAo—
Farm Name: Q (A-Z - _� Owner Email:
Owner Name: ;Roo Sr-- �� Phone:
Mailing Address:
Physical Address:
Facility Contact: ;�t )Se'4q'6^ Title: Phone:
Onsite Representative: u Integrator: 1,1113
Certified Operator: 11.3 �✓ U it 10 0
i
Back-up Operator:
Location of Farm:
Certification Number: 1 d l
Certification Number:
Latitude: Longitude:
_ Design Current
Design
Current
Design Current
Swine - - Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
ETLayer
Dairy Cow
Wean to Feeder
I iNon-Layer
Dairy Calf
Feeder to Finish O
Dairy Heifer
Farrow to Wean
e
Dry Cow
Farrow to Feed
Non-Da'
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qther __,_-
_
TurkeyPoults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes M<[—] NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No �A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E5�No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
6/No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facili Number: - Date of Inspection: QU
go 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
G-14T-0
NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
D-l-k'
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
25-I+l'6'
❑ 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?
0 Yes
Q 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
[�3-Vo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
[no
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ OEvidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): ilk
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes V2-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?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ENINo ❑ NA ❑ NE
[:]Yes El -No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [!�r<o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [Pl<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 lk< ❑ 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 ZNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes eNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - ate of Ins ection:
34-
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes B o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes [� ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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 E�Xo ❑ NA ❑ NE
Other Issues
28, Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31, Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewerlinspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes 2"'o ❑ NA ❑ NE
❑ Yes �To ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
[:]Yes M No ❑ NA ❑ NE
❑ Yes kfNo
[:]Yes 01<o
❑ Yes C3 No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to.que0ioW-#) ".Explain any YES answers and/or any addttional., recommendations or any otteer comments
U e drawin s offacili to better explain situations use additional. a es�"ecessa"
JD<c, 31
IL
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Lh3 ` 3-U q
Date: U
21412014

Facility Number ®- .;7 3 ® Division of Soil and Water Conservation
topOther Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Fallow -up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: /3 Arrival Time: 'd a Departure Time: Q' County:
Farm Name: Qr' Owner Email:
Owner Name: - t �� ��M %� r„v Phone:
Mailing Address:
Physical Address:
Facility Contact: �✓'� Title:
Onsite Representative: 51; Iz-, e—
Certified Operator:
Phone:
Region:(
Integrator: xaf G[.V
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
.�ggo
Des] Design Current
RCapacity
Swine Pop. Wet Poultry, aC sty Pap. Cattle C►►specify Pap.
Wean to Finish La er iry Cow
to Feeder
on -Layer
Dai Calf
Dairy Heifer
kdWean
Feeder to Finish
"'
Farrow to Wean
t
Design Current
Dry Cow
Farrow to Feeder
D , Poiiit . ,'Ca
La ers
ace P,oP.
Non -Dal
Farrow to Finish
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Turkeys
Beef Brood Cow
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 DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2" Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes J&No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes [-]No
❑ Yes FKJ No
❑ Yes Q�_No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0 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 y
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
M No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
ta No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[, No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
[Z No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes RNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 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):�fn,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 ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes (g No ❑ NA ❑ NE
❑ Yes 2 No ❑ NA ❑ NE
Rece aired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes I] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [4 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 R No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

-[Facility Number: - Date of Inspection: !3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [R No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes to 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 D4 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Cg No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes C@ 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 CKNo ❑ NA 0 NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
® No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M No
[DNA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
E& No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
g-No
❑ NA
❑ NE
Comments (refer.to question #): Explain any YES,answers and/or any additional recommendations or any other eonnments
a Use "drawings of facility to better explain situations (use additional paees as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone:Iy.�-3"-�-$�
Date:
21412011
Page 3 of 3

Type of Visit: 041_ompliance Inspection 0 Operation Review O Structure Evaluation p Technical Assistance
Reason for Visit: Ly`xoutine Q Complaint 0 Follow-up C) Referral O Emergency 0 Other O Denied Access
Date of Visit: I� Arrival Time: ri : Dr?c Departure Time: : 3 p County: o %__ Region: j20
Farm Name: ZgCc.r>e_ d Owner Email:
Owner Name: '6 —, 11 m Phone:
Mailing Address:
Physical Address:
Facility Contact: ; + Title: Phone:
Onsite Representative: �4—d" Integrator: f�
Certified Operator: IT)- /'y p u S Certification Number: �7
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity P,op.
Design Current
�?Vet�Poultry , Capacity Pop. Castle
Design Garreat
Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
IT
Non -La er
Dairy Calf
Feeder to Finish
Farrow to Wean
1 �_
Design Gurrent
D , P,oul Ca aci P.o
Layers
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Othe
Other
Pullets
Beef Brood Cow
Turke s
ey Poults
Other
Discharees and Stream Impacts
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
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated voltune that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
[] Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
Pg No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: 7r - Date of Inspection:
Waste Collection & Treatment
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes O�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): IT t
Observed Freeboard (in): 3 K
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
[51 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
VI No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
0 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® 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). r- fFSz•�
13. Soil Type(s): 13,����
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes KNo ❑ 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?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [Z No ❑ NA ❑ NE
[::]Yes [allo ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
®. No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
FSZ No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists El Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
(a No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[::]Yes
JKJ No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: �-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes ® No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface 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 RA No ❑ NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ff�No ❑ NA ❑ NE
❑ Yes
;4 No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
Use drawings of facility to better ezplaui situations {rise additional pages as neri_cessary), T' y
Comments refer to question Explain! an YES.answers and/or au additional recommendations or an otlii&i&ifimehN.:
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: /2�
21412011

Type of Visit: C,,_omMpliance Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: (g Koutine 0 Complaint Q Follow-up Q Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: ; 0_ County: 7�0�����'�— Region:
Farm Name: . /�.�! G S 41 Owner Email:
Owner Name: r y W Qy/1 /�i9LCS Phone:
Mailing Address:
Physical Address:
Facility Contact: /` ep,-_ Title: ]j,oe e, Phone:
Onsite Representative: Shy Integrator: l -el—
ii
Certified Operator:` I�r {� n uCertification Number:'
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
`' Design Current Design ...�: Curren#
Design Current
Swine Capacity Pop. We# Poultry C&apacity Pop.
Cattle Capacity Pop.
Wean to Finish La er
Dairy Cow
Wean to Feeder Non -Layer
DairyCalf
Feeder to Finish
t7
Daia Heifer
- Dest °n""Current
Cow
Farrow to Wean
D , P,oitl Ca c
r . �o ,
Farrow to Feeder
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other - -
Turkey Poults
Other
Other
Discharnes 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
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[] No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

F'acili Number: - Date of Inspection: `^ —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes M No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): f 2-
Observed Freeboard (in): J- 0 !
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes 0 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ 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
J&No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
KNo
❑ NA
❑ NE
maintenance or improvement?
1 1. 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): 'S"V "WW/sue zaVcz �z-rJ
13. Soil Type(s): Aj& F f &Z fC Fj p' f
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes J&No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes P0 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes RI No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes IR No ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[g No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
JXLNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
®No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
M No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permii conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ Yes ® No
❑ Yes � No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes R] No ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ® No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [—]Yes No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No
34_ Does the facility require a follow-up visit by the same agency? ❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or, any additional recommendations or anyA,gtlier comments
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 9J'D`4�`33DO
Date: !6� /�
21412011
Page 3 of 3

& n s 10A.T11 o 77/_
vision of Water Quality
Facility N1Imber �� �O ZJ Division of Soil and Water Conservation
Q Other Agency
Type of Visit @roc^ompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit M Routine 0 Complaint 0 Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 2 C Arrival Time: O i w De a im�O�'1 e: � Q County: Region:
Farm Name:£ // Owner Email:
Owner Name: _ ��G�Gdti//fiat" Phone:
Mailing Address:
Physical Address: D
Facility Contact: L% &Ar- - Title: �,. , ;� Phone No:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 0' [:�] Longitude: = ° 0 , = w
Design
Swine Capacity
Current Design
Population Wet Poultry Capacity
ut Design
Crren
Population CattleI Capacity
Current
Population
❑ Wean to Finish
❑ La er
E]Dairy Cow
❑ Wean to Feeder
❑ Non --Layer
I
❑ Dairy Calf
® Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑Turke Poults
❑ Other
❑ Dairy Heifer
E]Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑Beef Feeder
❑ Gilts
❑ Boars
❑ Beef Brood Co
Number of Stnuetures:
Utlter
❑ 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 Iallo ❑ NA ❑ NE
❑ Yes
❑ No
0"NA
❑ NE
❑ Yes
❑ No
ETI iA
❑ NE
2lA
❑ NE
❑ Yes
❑ No
❑ Yes
P-i` o
❑ NA
❑ NE
❑ Yes
B-7Qo
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility NuTber:.y — Q,?S I Date of Inspection /
Waste Collection & Treatment
,��,,�
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[I NA [I NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
,L,t_d,-Ko
Cf No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:yo/ �.
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E3,5'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'1 o ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
&X ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
;.Ko ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste managemett system other than the waste structures require
❑ Yes
E[-D o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
El Yes
,�._,, �/
L?'l;o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below.
❑ Yes
gavo--❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Hare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
aj
SM A-/1 -1 AqY J
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
t❑<o ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
P<o ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
93--go ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
L�<o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
®?IZ5- ❑ NA
❑ NE
Comments (refer to geteshon #) EzplaEn any YES..answers and/or any=recommendations or any other comments.
Use.draw�ngs of facility to better captain situations. (use --additional pages, gas necessary.)
p ia-
Reviewer/Ins ector Name r. Phone:
Reviewer/Inspector Sig tare: Date: O 52
Page 2 of 3 l2 8/04 Continued

Facility Ndmber: Date of Inspection !1 D
Required Records & Documents /
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes B No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWIvIP readily available? if yes, check ❑ Yes fflf,To ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other ,�,�
21: Does record keeping need improvement? If yes, check the appropriate box below. El Yes MNo ❑ 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
E1,1�o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
&116
❑ 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
EkW
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
2 Flo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
2Fo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
El NA
El NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
,Q—Ko
b No
❑ NA
[:1 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
E]--Ko
❑ 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
P-mb'
❑ 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
UKo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency'?
❑ Yes
ELWo
❑ NA
❑ NE
Additional' Comments and/or` DravFing `- -
AL
Page 3 of 3 12128104

a
�J l/lvision of Water Quality
Facility Number M
Z
O Division of Soil and Water Conservation
Other Agencv
Type of Visit
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
,,c�ompliance
C-froutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: SF07" L) Arrival Time: I 11 2V Aw+ Departure Time: /2: j n ., County.
Farm Name: �� / a 1=ar"^S f ram- _ _ Owner Email:
0wnpr Nnmp: W i G y �u✓ Phone:
Mailing Address:
Physical Address:
Region: F'e o
Facility Contact: X44,�14 Dgaci n1 Title: I G SPA Phone No:
OnsiteRepresentative: K,44:1 Scirk�11 +SkiIt'� Integrator: ur�1t. Oi'�✓�
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: F-1 o ❑' 0" Longitude: = ° =1 I ❑ "
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
_ - - ❑ Non-Layet
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges &Stream lmpeCts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance roan -made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity 1 oopulatio'
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: EZI
c. What is the estimated volume that reached waters of the State (gallons)?
10
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?
s
❑ Yes ONo ❑ NA ❑ NE
❑ Yes
❑ No
E NA
❑ NE
❑ Yes
❑ No
�lA
❑ NE
❑ Yes
❑ No
Lr NA
❑ NE
❑ Yes
E No
❑ NA
❑ NE
❑ Yes
?No
❑ NA
❑ NE
12128104
Continued

l Facility Number: 78-23 Date of Inspection -d7-09
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
L�No El NA
El'
El NE
a. If yes, is waste level into the structural freeboard?
El Yes
E� No ❑ NA
❑ NE
Structure Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: It i 0 Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .2 r! 31 l
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
EE 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
ONo Cl 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 NNo ❑ NA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? ElYes B No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drin ❑ Application Outside of Area
12. Crop type(s) R c.r1-1, 11 !`H 4 ) S"'k I'd 6r'1 i.J (0 - s%
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
B No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
ETNo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
[�NoNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
[� <
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
T
ReviewerllnspectorName k;Je_ R<C.VtJs ,Phone: �li0.`oL33.3335%
Reviewer/Inspector Signature: 14,44, Date: S `D'r -2-00 %
12129104 Continued

3
Facility Number: 7 $ Date of Inspection S-a7-09
Reuuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes do ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
dNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Ej No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
YN o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
Ll No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
E No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
7No
❑ 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
E No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[I NA
El NE
dNo
33. Does facility require a follow-up visit by same agency?
El Yes
L/ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

•
EJWS F 4 ­, d WO Z /a $
U Division of Water Quality
Facility Number 7S z 3 0 Division of Soil and Water Conservation
- 0 Other Agency
Type of Visit _Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit &Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 3'O % -O$ Arrival Time: 08: /S Departure Time: County: /7'o 6e S4 Al Region: t'i—O
Farm Name: _. /J . �'ij' �.. Z Owner Email:
Owner Name: wade- a; loe Phone:
Mailing Address:
Physical Address:
Facility Contact: �`4 5 _f�tl�i ��/ Title: 5��,Q�s 7 Phone No:
Onsite Representative: I Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: =o [=]' [=]" Longitude: Qe E:]' =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
Design Current ''
Capacity Populations
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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 M No ❑ NA ❑ NE
❑ Yes
❑ No
[A NA
❑ NE
❑ Yes
❑ No
VNA
❑ NE
[9NA
❑ NE
❑ Yes
❑ No
❑ Yes
EgNo
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
12128104 Continued

Facility Number: _7— Z,3 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
L'I No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No [ 'NA ❑ NE
Structure Structurgo Structure 3 Structure 4
Structure
5 Structure 6
Identifier: Z _
Spillway?:
Designed Freeboard (in): / 9 9
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
L7 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
O No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit?
ElYes
,21
LT No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Apytication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
ElL"J Yes
���
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) 6CJ_W 14 d a- CA12 J _ S. (
13. Soil type(s) WA,�
14. Do the receiving crops differ from those designated in the CAWMP?
ElYes
B No
ElNA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
B'�o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:]Yes
ETNNo
❑ NA
El NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
DIN o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
i
Reviewer/inspector Name '� I�etfp�.5 Phone: 910,e-33.3360
Reviewer/Inspector Signature: Date: .3 - O 7 -ZDO�
12128104 Continued

Facility Number: 7 g — Date of inspection 3-07- D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [Y No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes LS No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [3 o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
[]Rainfall []Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[9 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[fNA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ETNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0'Ro
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[] No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
E AA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
��
5o
❑ NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�LJI
U 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
,��
V 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
ETRo
❑ 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
❑ NA
El NE
33. Does facility require a follow-up visit by same agency?
El Yes
��No
L' 1vo
❑ NA
❑ NE
Additional -Comments and/or Dravnn gs:'
-
Page 3 of 3 12128104

. . _ ► BM 9410)
0 Division of Water Quality
Facility Number z j 0 Division of Soil and Water Conservation
- 0 Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ®Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: .3 Z3 -07 Arrival Time: %/� JrDi¢s.. Departure Time: z ; S10 County: SDI[/ Region: `�v
Farm Name: �/ Owner Email:
Owner Name: Ale a c- TN Ao rRai,B/� _ Phone:
Mailing Address:
Physical Address: ��//
Facility Contact: __ICa4z v bu,20,cl Title: ___ GGPhone No:
Onsite Representative: Integrator: /��krO�i-, �YOLeIi✓
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 e = I = 11 Longitude: E_—] ° =, I=] "
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish Z (�
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non-Layet
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkex Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design ..CorrenP ;:
Capacity Population ..
�A
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy lieifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
41
Number of Structures: ILIr L.
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 [P No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[jNo
❑ NA
❑ NE
❑ Yes
[�g No
❑ NA
❑ NE
❑ Yes
JZ No
❑ NA
❑ NE
12128104 Continued

Facility Number: 7S-Z
Date of Inspection 3-23�D7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): 19,7 19
Observed Freeboard (in): Z 7 " Z &
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed
through a waste management or closure plan?
❑ Yes A No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes �j No ❑ NA ❑ NE
❑ Yes T No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes R No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [�No ElNA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes V3 No ❑ NA ❑ NE
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
FNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift El Application OutsideofArea
12.
Crop type(s) &.ic y S;�e-c ! a--V"'N t1D ✓GYSee_Z ✓
13.
/
Soil type(s)
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
;Z 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
10 No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name RQ e. v e- Phone: (910) '�=33 :3,'330
Reviewer/inspector Signature: Date: 3 - Z 3 -ZOO 7-
12128104 Continued

Facility Number: -7$ -Z Date of Inspection -?,3'0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes La No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 06 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VJ No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
R No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
(9 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0 No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
'O No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
EdNo
❑ 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
53 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
;M No
❑ 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
0 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
Put
WNo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit & Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Q Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other El Denied Access
Date of Visit: g-O i —061 Arrival Time. %D; 00 Departure Time: %0 + 3d 1 County: )E70z1Cxp1/
Farm Name: e s Z Owner Email:
Owner Name: _ -GJ464G ZZt /eY Rac, (Jr.i _ Phone:
Mailing Address:
Region:
Physical Address:
Facility Contact: �s � l i ga g Z Title: Phone No:/�
Onsite Representative: / _ _ J, uac.�1 Integrator: �.�-d�._ L5 V i✓
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =I a 01 El" Longitude: = ° ❑ ' E__1 "
�_U_urrent
�_U_Current
Design Current
Swine
apacity opulation
Wet Poultry apacity opulation
Cattle Capacity Population
❑ Wean to Finish
❑ DairyHeifer
Dry Poultry
❑ D Cow
❑ Non-Dai
❑ Layers
❑ Beef Stocker
❑ Non -Layers
El Beef Feeder
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ TurkeyPoults
❑ Other
Number of 5truetures:
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
❑ Boars
Discharees &Stream Impacts
❑ Layer El Dairy Cow
❑ Non -Layer El Dairy Calf
1. Is any discharge observed from any part of the operation?
❑Yes
[� No
❑ NA
❑ NE
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance man-made?
❑Yes
[�1No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
� Na
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)`?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑Yes
� No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
� No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
� No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: %g— 23
Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3
Identifier: L4 / Gam 7—
Spillway?: IWO o
it
Designed Freeboard (in): Z71 7 19
Observed Freeboard (in): 2 f`O. 32 �r
Structure 4
❑ Yes WNo
❑ Yes 69 No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes EWNo ❑ 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 M No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ 1 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 10 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes 0 No ❑ NA ❑ NE
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes V No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [--IPAN a 10% or ] 0 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) gu-�ru1�a. Si�aG� �sur`✓ (b✓crSer�
13. Soil type(s) Ala AZLE PO-g
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
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment'? ❑ Yes
{A No ❑ NA ❑ NE
LX No ❑ NA ❑ NE
Q2No ❑ NA ❑ NE
P4 No ❑ NA ❑ NE
Comments (refer to question ,#) ,Explain any YES answers and/or any recommendatr n or any other comments
Use drawings of facility to better egplain situations. {use additional pages:as necessary)
Reviewer/Inspector Name � Kli e- .b K!& ijdS _ a'`` I Phone: [9IOJ V-1-31 —30470
Reviewer/Inspector Signature: Date: 9�— p5 - 200 Z.
Page 2 of 3
12128104 Continued

Facility Number: 79 -2 Date of Inspection g`O9—Aly
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 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 appropriate box.
❑ WUP ❑Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Z 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
CR No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
CgNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
N No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
D9 No
❑ NA
Cl NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
%No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
WNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�? No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
M 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
5 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 E
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
CgNo
❑ 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
Q4 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[3allo
❑ NA
❑ NE
r
Additional'Comments andlar.Drawings:
t
Page 3 of 3 12128104

F1
Type of Visit 0 Compliance Inspection O Operation Review U Structure Evaluation O Technical Assistance
Reason for Visit Q Routine O Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: j Q Arrival Time: Q S Departure Time: County: eUbg�Sjn�- Region: �eci_00
Farm Name: �n1 0 4 z 1 Owner Email:
Owner Name: (,kad e� nrz i fI - Phone: ` r
Mailing Address: _ S� �9 � L Q C [ a �euC _ O rr u rvt /v L 2 $ .34&
Physical Address:
Facility Contact: 'Title: Phone No:
Onsite Representative: 4-If q 6 ; Integrator: I CbCp �,�.. - � rip.&_
Certified Operator: a cA P_ gf-i"17 Operator Certification Number: 023
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 e = 1 Longitude: = ° = 6 =
it
Destgn Current
tgnCurrent
Design t!nrrent
Swine M ;Capacity Population
Wet PaulttyFD06�
apacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dai Cow
❑ Wean to Feeder
❑Non -Laves
❑Dai Calf
Feeder to Finish (p
_ y
❑Dai Heifer
ElFarrow to Wean
f' '
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocket
❑ Gilts
❑ Non -Layers
❑Beef Fe eder
❑ Boars
El Pullets
❑Beef Brood Cowl I
❑Turke s
Other
Turkey Poults ❑
❑ Other
❑Other
�
Number"of $t[uctures: Z
d
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Z No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[RNA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
W NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ}
❑ Yes
❑ No
(NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
KNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
5�No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: — 23
Date of Inspection 1
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 I Structure 2 Structure 3 Structure 4
Identifier: *_ I j at Z
Spillway?: KO KZ
Designed Freeboard (in): M .1 -10(
Observed Freeboard (in): 21T 3y
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes RNo ❑ NA ❑ NE
❑ Yes ❑ No [O NA ❑ NE
Structure 5 Structure 6
❑ Yes [�o'No ❑ NA ❑ NE
❑ Yes VgNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes U 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 ❑ Yes qNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [)Z 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 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) get"wt &AAA' — izo�l � 3 2S f 3a0 r ZSO� 5 wee�.U� ek t r4, � � S-0, .. _
13. Soil type(s) tl�h g W j[.g I?O 6 -
14. Do the receiving crops differ from those designated in the CAWMP? []Yes 5dNo ❑ 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
P4 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
a No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
9No
❑ NA
❑ NE
_ Phone•Reviewer/Inspector Name %(v ?
Reviewer/Inspector Signature: ���_,.,f�C{ �� �n Date: _ / f/I y
12/2&04 Continued

Faeili#y Number: -- Z2! Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes RLNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9 No ❑ NA ❑ NE
the appropirate box. ❑ WUr ❑ Checklists ❑ Design- ❑Maps- El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [9No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
HINo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[ANo
❑ NA
❑ NE
24_ Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
91 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
(9 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[RNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [Z No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[RNo
❑ 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
G6No
❑ 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
LKNo
❑ 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
[9No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
W-No
❑ NA
❑ NE
Adt�onal Comments and/o"r.Drawings:`
-7,(. CCl+i ri �.: k; a (; ,•� `mac. 1 " ra + �+re.�`f` v. s Pe ��f -� c-�S a� u.�
12128104

Type of visit • Compliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: /OZT/ T T-une:
0 Not Operational Q Below Threshold
13 Permitted ®_Certified 13 Conditionally Cerdfied 13 Registered DateJast Operated or Above Thresshold•
Farm Name: __. _ _ �-a—cir m. County: - _�Q I�K�
Owner Name: 1_, ,I�r� a_,. TN_ [5r,i Phone No:
Mailing Address:
Facility Contact: _ �-- 4.,e - - &/ Title: Phone No: w�
Onsite Representative: ! afn. _ _ _ _ Integrator:
Certified Operator: ... ��+ , . , r /'f Operator Certification Number.
Location of Farm:
•
0 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �4 �f.6 Longitude • �0"
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 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? )VIA4
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [ No
Waste Collection & Treatnnent
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes J] No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: . - /_ . a - w _. -
i�
Freeboard (inches): 0904 a
12/12/03 Continued

Facility Number: 7S: — ar j Date of Inspection OTZ /o
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or [] Yes j] No
closure plan?
(If any of questions 4-6 was answered yes, and the situation posers an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelunprovement? [[]Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancerunprovement? ❑ Yes dNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Js there evidence of over application? If yes, check the appropriate box below. ❑ Yes tZ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type �c'r rss ✓.�� lfk N S w. a � i G r e s x.i
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes P'No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ( No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes ® No
16. Is there a lack of adequate waste application equipment? ❑ Yes E jNo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attar below ❑ Yes JM No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes RI No
19, is there any evidence of wind drift during land application? (i.e_ residue on neighboring vegetation, asphalt, ❑ Yes 09 No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ,) No
Air Quality representative immediately.

Facility Number: Date of Inspection 1G '
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(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
q No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iet discharge, freeboard problems, over application)
❑ Yes
(j No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
28. Does facility require a follow-up visit by same agency?
❑ Yes
No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
P No
NPDES Permitted Facilities
30. Is the facility covered under a NPDErS Permit? (If no, skip questions 31-35)
® Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbr Bakers on irrigation equipment?
❑ Yes
Ep No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
EM 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
[RI No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
M No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
I2112/03

Type of Visit ® Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit Q Routine O Complaint Q Follow up O Emergency Notification 0 Other ❑ Denied Access
j Faciliry \umber ' 1 Date of Visit: ( ZI b Time: ` b �1
i — •--rO Not O erationai 0 Below Threshold
® Permitted ® Certified ❑ Conditionally Certified [3Registered Date Last Operated or Above Threshold:
Farm Dame: T 4" 6 i—Ci.S`,nn f f- 2 Count\: _��'s + eS� f=�? 1
Owner Name: lrn c, t`+ Phone No:. f
� l �
Mailing Address: der �' � i� � r �e (1c ��� its . � ,F c,4— lf6 r �.s� -74-a
J
Facility Contact: ii r Title:
c
Onsite Representative:
Certified Operator:
Location of Farm:
Phone No:
Integrator: r "
Operator Certification Number: l
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �0 C u Longitude ` •
Design Current Design Current Design Current
Swine Capacity Population Pouhry Ca acitV• Po ulation Cattle Capacity Po ulation
❑ Wean to Feeder ❑ Laver ❑ Da'
® Feeder to Finish a 10 Non -Laver I 1 10 Non -Dairy
❑ Fasow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons I I
Holding Ponds I Solid Traps II
Discharges S Stream Impacts
I. Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in sat/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ANo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes `1Z No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus stoi storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4. Structure 5 Structure 6
Identifier: '' //, I 7—
Freeboard (inches): `T 14, 34
05103101 Conrnrued

Facility Number: 8 — � Date of Inspection ! C
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes M No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes [N No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
It. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes m No
12. Crop type 13 cr "v ut, -1 r - !n G S
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes (Q 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
e) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
U1 No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20,
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
9 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ® No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ® No
24. Does facility require a follow-up visit by same agency? ❑ Yes O No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Gomments,(refer to_0&ttdn #): Explain any AES A.sW6iRnd/or?any recommendations. or any: other comments.
iUie drdWii gs of facilityd'.better explain situations: (use additio al pages as necessary)
Field Copy ❑Final Notes
777
I ' L E,.S �- S - i l I G- yAc w " 4-e,1,,r. 11,3103
P4P"'r work, At+ b cdx- �-,
f a 0l-d- >-f�""4 ,
Reviewer/Inspector Name K! th,2
Reviewer/Inspector Signature: , ^
05103101
Date: G
�r.n.rr• .n. i ir�i�i�
Continued

-01-71
Facility Number: — 3 Date of inspection (1 1717
dor 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 permanentitemporary cover?
05103101
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes W No
❑ Yes [9 No
❑ Yes ❑ No

orAb
Date of Visit: rime: /-'o Q
Facility Number 2•
Not Operational 0 Below Threshold
0 Permitted [3 Certified 0 Conditionally Certified [3 Registered Date Lao Operated or Above Threshold:
Farm Name: / -+� �� �/} Z _ County:
,iJ /axe �9/a� G2 �' — 927,7
Owner Name:�1 %T Phone�No:
Mailing Address: T %,� % ��'7. /"a-"�' �D•J / ��r�'o^",r /1 / C yd'
Facility Contact: Z�&Title: Phone No: _
Onsite Representative: �� �` Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
[]Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �• �" Longitude �•
._ _ a" Cr- - chy'CuDesapGarrent rnt- tu�gn
�Si4ne" Pottrt_Po nrouPouacCa ae "Po ulatmn
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish 7 e ❑ Non -Layer ❑ Non -Dairy 1.=
❑ Farrow to Wean
ElFarrow to Feeder ❑Other
❑ Farrow to Finish :Total Design CapaC�ty
-;', ❑Gilts _ _• - -
- ❑Boars :.TotaISSLW
Number of Lagoons IQ Subsurface Drains Preseet ❑ Lagoon aoo Area 10 S ray Field Area
':Hotdteg`Ponds 1^Sated Traps ;. ❑ No Liquid Waste Management Svstem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Water of the State? (If yes. notify DWQ) ❑ yes RNo
c. if discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ) ❑ Yes )zNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ONo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [rNo
Waste Collection 8- Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ElYes �No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): -Z
05103101 Continued

Facility Number: % — 29 1 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 Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding [I PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes X] No
❑ Yes )KI No
❑ Yes )0 No
❑ Yes ED No
❑ Yes KNo
❑ Yes ONo
❑ Yes XNo
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
;R No
b) Does the facility need a wettable acre determination?
❑ Yes
r9 No
c) This facility is pended for a wettable acre determination?
❑ Yes
;9 No
15. Does the receiving crop need improvement?
❑ Yes
PNo
16. is there a lack of adequate waste application equipment?
❑ Yes
E[No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
e&No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(lei Illy, ch5Psts, des�gpn,maw etc.) I'llc/ _'
❑Yes
No
—'
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
Q No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
O No
21. Did the facility fail to have a actively certified operator in charge?
El Yes
5�No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
A No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24. Does facility require a follow-up visit by same agency?
❑ Yes
yuNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
El Yes
� No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Commeats {infer46;question #) Exphtan airy YES answers andlvr an) recommendations ar nay. uMer cottaasehts.
Use`drawiags of farBrty to hatter a 'loin-s�tastioiss (use additional pages ills aecessaiy)
. _ [] Field Conv ❑Final Notes
_ _
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: 7F — 23 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 [Z No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ,® No
29, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes n No
roads, building structure. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes O No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters. etc.) ❑ Yes 2S No
31 _ Do the animals feed storage bins fail to have appropriate cover? ❑ Yes � No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? P-Yes ❑ No
O5103101

:= Division of Water Qu airty
Q: ivis on - t i of Soil and Water Conservations
M
r 0 Oth r Agency -
Type of Visit Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit Koutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number jDateorvisit: �I Time: a 1 Printed on: 10/26/2000
Q Not Operational Q Below Threshold
Permitted D Certified 0 Conditionally Certified [j Registered Date Last Operated or Above Threshold: ............... .
Farm Name: .....f...d"........1r'!... ...1....71~ Counh:......./C�... .....................................
Ar...e,
Owner Name:...t'%V e.. � ....rt. Phone No 4(?'z ^ 1.. 7 ..........................
Facility Contact:.....fn........................................Title:................... Phone No: r1
................ ..............................
11'
...........................................
Pi
'gBr�., ,_y�.G.6..0
Mailing Address: .5127.... `—QCnp.gd... ........r
Onsite Representative:...... /Integrator:...................r..................................._.............. .
Certified Operator:... !..... &.* Operator CertificationNumber:..................... ........................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �' �•° Longitude �• �' �"
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder JE1 Layer I ❑ Dairy
Feeder to Finish D ❑ Non -Layer I I[] Non -Dairy
❑ Farrow to Wean
El Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity 7 p
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance titan -made?
b- I discharge is observed. did it reach Water or the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in galhnin?
d. Does discharge bypass a lagoon system'? (If )es, 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
StRICtUre I Structure 2 Structure 3 Structure 4 Structure 5
Identificr: .................................... .................................... ................................... ........................ ............ ............... ..............
Freeboard (inches): 31 3r
5100
❑ Yes k"o
❑ Yes No
[]Yes o
❑ Yes
RIM
❑ Yes
KNo
❑ Yes
Tio
❑ Yes o
Structure 6
Continued on back

Facility Number: — Z3 Date of Inspection s— � Printed on: 10/26/2000
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 g, over application?
12. Crop type 2e ctu t, c4 a
13. Do the receiving crops differ with those
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
r C�+
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'?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ 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?
yiolailiq, . . .deficiencies v� . . noted diNi . g th... Sit. Yoo ..........................
correspondence: abauti this :visit :::::::::.::. .......:::::::::. :
question #) Ezplau>I,any YES' answers and/or any recomm
lity-toib tier ex_aplain-situations."(iLw-additional pages as nec
949194_/ A"J&' 6tsr cNac/s
N 1 C. C
nns or.;:any other comment
❑ Yes �No
❑ Yes r
0
❑ Yes No
El Yes o
❑ Yes Arlo
❑ Yes ANO
❑ Yes )�(No
❑ Yes A. No
❑ Yes No
❑ Yes �"io
❑ Yes )No
�`
❑ Yes No
❑ Yes A1110
❑ Yes *0
❑ Yes f
Yes o
ElYes No
El Yes No
❑ Yes ANo
❑ Yes ' No
❑ Yes No
❑ Yes KNo
AL
Reviewer/Inspector Name —10 p
Reviewer/Inspector Signature: Date: .r
5100

Facility Number: —�3 Date of Inspection Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below ❑ Yes o
liquid level of lagoon or storage pond with no agitation? Ir
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 1�No
28, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes T
0
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 AO
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes o
31. Do the animals feed storage bins fail to have appropriate cover? El o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes
hon omments,an ar rawin
4& 1
J
5/00

Wermitted ©Certifjieed 11 Conditionally Certified
Farm Name: ......{.�....r W?..�.�.....1...'...Z
Owner Name:
Facility Contact:
Mailing Address:
Onsite Representative:
Certified Operator:
Location of Farm:
[] Registered
113 Not rational Date Last Operated: ........
... County:....... / 41�1.�rC��`'................ ......... ----------
Phone No: .Z 77
.........../.... z- ..........-............. .........
............................. rnone n4o: _....................
.... ....... . ................
Ca..
//_
Integrator: ......5�... a. Crl,?.1....... s...... .
Operator Certification Number:
T
Latitude • ° " Longitude • ' r.�66
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 9j No
Discharge originated at: El Lagoon ❑ Spray Field ❑ Other k
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 jNo
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (II' vcs, notity DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes RNo
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 92rNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Effio
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: It
Freeboard (inches): ........ 3.iD............. -.....................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes OdNo
seepage, etc.)
3/23t99 Continued on back

1 �
Facility Number: 9— z I):ite a#' Inspeetinn
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
�eo
(If any of questions 4-6 was answered yes, and the situation poses an
�� 11
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
No
8.
Does any part of the waste management system other than waste structures require maintenarice/improvement?
❑ Yes
No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
tNo
Waste application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
XNo
H.
Is there evidence ofover application? ❑ Exce ive Ponding ❑ PAN
Yes
El1111
�No
12.
Crop type 8 Pr silt. ` ,,,
�`�`
13.
Do the receiving crops differ with those desi_n led in the Certified Animal Waste Management Plan (CAWMP)?
El Yes
VNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
POO
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?
El Yes
ONO
16.
Is there a lack of adequate waste application equipment?
❑ Yes
RNo
Required
Reenrds & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
�No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
ALM
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
VNo
15gNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
El Yes
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
XrNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
ONO
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
PNo
�'�Io violafiQns or clef eiencies were noted d(rrtng this:visit: Moir :will reeeiye Riou>�thgr
corresporinence:ahout:thus'v t::::.•:,','':•:,.•.-.-:::::: :::-.-:.::•:•:,:'.* .,"-
00

� L
Facility Number:Date of Inspection 7�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes []No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �No
28. Is there any evidence of wind drift during land application? (i.e..residue on neighboring vegetation, asphalt, ❑ Yes VrNo
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 RNo
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? ❑ Yes O - -
32, Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Wade / Ray Taylor / Britt
T&B Farms #1 & #2
5199 Tobacco Road
Or►vm NC 28369
Dear Wade / Ray Taylor / Britt:
IT
•
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
December 30, 1999
. 1 5 2000
FAYETTEVILLE
REG. OFFICE
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 78-23
Robeson County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. IRR1, IRR2, DRY], DRY2, DRY3, SLUR1, SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections.' Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincere]
Kerr T. Stevens, Director
Division of Water Quality
cc: Fayetteville Regional Office
Robeson County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

Division of Soiland Water;Conservation=`Operafion Review
-E _Division of Soil and Water Conservation -,Compliance Inspection -
'Dwision of Water Quai�ty =Compliance InspectionTf
Other Agency - Operation Review= '
Routine 0 Complaint 0 Follow-up of DWQ ins ection 0 Follow-up of DSNVC review 0 Other
Facility Number Date of Inspection
Time of inspection ET�24 hr. (hh:mm)
Permitted l] Certified E3 Conditionally Certified © Registered 0 Not O crational Date Last Operated:
Farm Name: rt EM 5 ' /� County F�e 54Y`J
.................
. -.... .......................................................I.......
OwnerName: ..... r t.1...................................... Phone No:...........f�. L ..'..L.. Z.. .. ..............................
Facility Contact : ..... :........... 45 t 4 a f ........ Title:....-............ Phone No:
........................................................ .................. .
I'lailin = Address .... .... s✓+ crtti
�a ��..-.....1...7.........................................r..�...............-..-.....'VL'....... 2�3 0
Onsite Representative: r��^........ Integrator: ...............................
........ ............. ............... ....... ' .. . ..J.... I,� ......... .
1.C.. P� ..:..........!,1 p
Certified Operator-_ - , �? V' �'t ;•••„ „"„ ..•••. Operator Certification Number:
Location of Farm:
I............... .......... ....... .......................................................... ................................................... ...................................................------- ........... ...........................................•-....-....-.L T
Latitude ' 4 0.4 Longitude 9 ic
Swine Capacity Population
❑ Wean to Feeder
Feeder to Finish
S7(o
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity j ()
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area
Holding Ponds / Solid Traps ❑ Na Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance ntan-made?
h. If disclarge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. If discharle is observed. what is the estimated flow in cal/min?
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
IdentiFier: _[( �J
Freeboard (inches): ....................... .`�.-r'............................. .......------ ........... .....................
.
❑ Yes 9No
❑ Yes KNO
❑ Yes No
❑ Yes No
❑ Yes %No
❑ Yes D�No
❑ Yes KNo
Structure h
1 [b[99 Continued on back

Facility Number: Date of Inspection 2 Z
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.) Y[
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8_ Does any pact of the waste management system other than waste structures require maintenancelimprovement? ❑Yes No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? ❑ Yes �<No
Waste Application
10. Are there any buffers that need maintenance/improve men t? ❑Yes �NO
11. Is there evidence of over application? ❑ Pondin-g 10
Nitrogen/ ❑ Yes (No
12. Crop type ��J.r.w! � LZ......./. 4 l..!.....a6? r.�...............................................................................................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yeslo
14. Does the facility lack wettable acreage for land application? (footprint) ❑ Yes 9 No
15.
Does the receiving crop need improvement'?
❑ Yes
gNo
16.
Is there a lack of adequate waste application equipment'?
❑ Yes
ANo
Required
Records & Documents
IT
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
WNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19,
Does record keeping need improvement'? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
o
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
RrNo
21.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
At No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
*No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency'?
❑ Yes
No
Xo:vialations:or def cienues -were nofed. dtu•ing :tiiis_visii.' Y_ou wiil:re�ceivie it6 ftirilier : _ :: :
eorrespooclehee: at iAH' this Visit.'.'.'-* :::::.::.:.:: ::. : .: ::::.::::: . .
Commments (refei to question #): Explain any YES answers and/or any. recommendations or any outer comments. _ _ r
Useljrawtngs°of facility to better explain situations. (use additional pages as necessary).:—,!—,—
Q��}y 1 I
e9od lho f'A •Arm5/ Ue-r1 `t(fcc� d- well g4ab.(L �1r4CJ A6
{9�vGi! fr�Co� S 0�4-,j rrGceA/' ,1q C ro�S_
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 2— "Z�(-QQ 11/6/99

1
4
0 Division of Soil and Water Conservation ❑ Other Agency
IX Division of Water Quality
Routine O Cam laint G Follow-up of DWQ inspection O Follow-u of DSWC review 0 Other
Date of Inspection
Facility Number
Time of Inspection 24 hr. (hh:mm)
© Registered XCertified *Applied for Permit © Permitted 113 Not Operational Date Last Operated:
FarmName: .............................g.........F.�. .n._ #..1.... ....#' Countv:...................... .......... �?7p.....--- .......................
Owner Name:................ "` 'C._... L.�k.L.?..............�.......M........... Phone No:.. �/6oW �oZ- L�....
....... ..... ....... .....o ............................. •-----.-
Facility Contact:-----.--7irr.y..........:.J -ail4` . 5.---.--- Title: ..........................
. ...!.?��...`..$
Mailing Address: ............1�-.......... ............. ............................
Onsite Representative: .................... . .... ..... .......... ............ i.1/'L. -------- ------ _-
Certified Operator; .............. Ki4................. ..........................
Location of Farm:
Phone No:
Cl rf-Rf...... N G....... .......�........... .... a.�r3q
Integrator :_.......... '�s"!'.k.f......... -
Operator Certification Number :. ................ ............... .._....
Latitude 0.0° 0" Longitude ' ` "
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of pact discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes 1Z No
❑ Yes Pff No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 01 No
❑ Yes XNo
❑ Yes %No
❑ Yes fig No
Continued on back

Facilityi\umhrr V-70I
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (La oonr-,Iloldi S Ponds, Flush I"its, ete.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I . Structure ? Structure 3
I �
Identifier: �E ...�Y........ I.....h.......��.............................
Freeboard (ft): ..................... « ....................r�
10, Is seepage observed from any of the structures'?
❑ Yes XNo
❑ Yes OKNo
Structure 4 Structure 5 Structure 6
11. Is erosion, or any uthcr threats to the integrity of any of the structures observed?
12.1 Do any of the structures need ntaintenance/improvement?
(if any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application r
14. Is there physical evidence of over application'? ,
(If in excess of WHIP, or runoff entering waters of the State, notjfQ)
I5. Crop type ...... IZf !Gt j..... 5.........�
16.Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW.MP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Js there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative"
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste :Management Plan readily available?
24, Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any'additional problems noted which cause noncompliance of the Permit?
D Yes XNO
❑ Yes
9 No
❑ Yes
JKNo
❑ Yes
No
❑ Yes
F
No
❑ Yes
No
[] Yes
No
❑ Yes
go No
Cl Yes'
FU
❑ Yes
06 No
Yes
06 No
4k El Yes
toNo
0 No.violations or deficiencies were- noted- during' this visit..You.will receive no further
correspondence about this.visit:
omments, gs ('refer to question #).;, Explain anyA-FS answers and/or any recommendatrions or any oflie
lse drawinof facility to better explain situations. (use additiinal pages as neeessar} } ,
❑ Yes KNo
❑ Yes JKNo
❑ Yes ❑ No
7/25/97
0
Reviewer/Inspector Name :..
�U_e ,,i BrawN
Reviewer/Inspector Signature: ( _CfV7_1y71" Date
•c«fi'

of
Facility Number 23
Farm Status:
ollow-up of DSWC review O Other
Date of Inspection
Time of inspection 3 Use24 hr. time
Total Time (in hours) Spent onReview Z
or Inspection (includes travel and processing)
Farm Name: -- } t` ) J County: &Agslls a_
Owner Name: L7 (`r phone No&A-(A g - 9Z-1 71
Mailing Address: ,- Si L9 rD Lma ICE - - Q r r Iw w%. - - �e- .-
Onsite Representative: Integrator: , , C rr r -6 1j
Certified operator: , itz— Operator Certification Number.
Location of Farm:
„Z
Latitude Longitude �' 0` �•
113 Not Operational Date Last operated: -
Type of Operation and Design Capacity
�
�SWine
�"=Nnmber _ _ . _. Number CattleX ,1Tamber
Wean to Feeder
y Feeder to Finish Non- V5,Had
Farrow to Wean �=��
��.��.�'y��r�
Farrow t0 Feedff
Farrow to Finish© Other Z�pe ofliv+estock -
x .�. -� � � ' r tax c> -� ��;•` _-�;- " i�'�.rr �'�+� �'
Number of Lagoons 1 Holding PonSubsurface Drains Present WE,
Lagoon Mea
Y" iE-va
General
1. Are there any buffers that need maintenancdin4memeat? ❑ Yes [ No
2. Is airy discharge observed from any part of the opeaation? ❑ Yes �No
a. If discharge is observed, was the conveyance man-made? ❑ Yes P`No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes JC(No
e. If discharge is observed, what is the estimated flow in pVmin?
d Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes qNo
3. Is there evidence of past discharge from any part of the operation? ❑ Yes WN0
a. Was there any adverse impacts to the waters of the State other than from a discharge?, ❑ Yes RNo
S. Does any part of the waste management system (other than lagoons4holding ponds) require Yes RNo
main ten - a impro'vemeat?
Condnrred an buck

6. 1s taclity not in bompliemce with any applicable setback criteria? _
7. Did the facility fail to have a certified operator in tespouss'ble charge (if inspection after IIIPM?
S. Are there lagoons or atorage ponds on site which need to be property closed?
Structures (Lagoons and/or Holdip Pondsl
9. Is structural feeboard less thaw adequate?
Freeboard (fi): - / n 1
nYes 0
(3 Yes �No
❑ Yes ,10
❑ YesTo
Lagoon 3 Lagoon 4 / `
10. Is seepage observed from any of the strucum? ❑ Yes J(No
11. Is erosion, or any other threats to the integrity of any of the swacturts observed? ❑ Yes No
12. Do any of the des need ? ❑ Yes No
(if any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWG
13. Do any of the structures lack adquate markers to identify start and stop pumping levels? ❑ Yes
Waste ADollcationYINo
14. Is there physical evidence of over application? = El Yes KNO
of in excess of WMP, or runoff entering wagers of the Statz, notify DWQ)
is. Crop type r rK utcfo _.
16. Do the active crops differ with those designated in the Animal Waste Management Plan? ❑ Yes (No
17. Does the futility have a lack of adequate acreage for land application? ❑ Yes No
18. Does the cover crop need improvement? ❑ Yes )(No'
19. Is there a lack of available irrigation equipment? ElYes ONo
For Certified Fac04ties Qn
20. Does the facility fail to have a copy of the Anima] Waste Management Plan readily available? El Yes o
21. Does the facility fail to comply with the Animal Waste Management Plan in any way? ❑ Yes No
22. Does record keeping need improvement? ❑ Yes WNo
23. Does facility require a follow-up visit by same agency? 0 Yes No
24. Did Reviewcdlnspector fail to discuss review/inspection with owner or operator in dwp? 13 Yes No
Cammenks (refer torestiori # Fatplain siry;YFS answers aad/arany recomamrndsttons ar gay btbsr counneukgs r
Use�drsw�ags offaclrty-to better cxpiain" situatxuns ;{use$ddi#inma3 DBm�'�.,
t e- xce Hen+S�•a�e.
a
RevirwerQnspeetor Name
ReviwerADupector Signature:
cc: DVisWon of Mater Quality,015iter Quality Section, Faei&y Aasmment Unit
Dam , j 23 - 5-7
11/14/96

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional office
James B. Hunt, Jr., Govemor
Jonathan B. Howes, Secretary
Mr. Ray Britt
5199 Tobacco Rd.
Orrum, NC 28369
IDF.=HMF:;z
DIVISION OF WATER QUALITY
June 2, 1997
SUBJECT: Annual Compliance Inspection
T&.B#1 Fanm& T&B#2Farm
Registration Nos. 78-23 8t 78-79
Robeson County
On May 23 , 1997, suff from the Fayetteville Regional Office of the Division of Water Quality
inspected the subject swine facility. Please find enclosed a copy of our Compliance Inspection
Report for your information. It is the opinion of this office based on the information provided and
observations made during the inspection that the facility was in compliance with 15A NCAC 2H,
Part.0217 at the time of the inspection. Please refer to the comments section on the rear of the
inspection form for information regarding your facility.
Please be aware that all swine facilities with a liquid waste collection system designed for a
minimum of 250 hogs must have a certified waste management plan on or before December 31,
1997. The district NRCS office, Agriculture Extension office, or the Division of Soil and Water
have specialist available to assist you with upgrading of existing facilities and certification.
If You have any questions concerning this matter, please call John Hasty at [phone] _
Sincerely,
I4
ohn C. Hasty, Jr.
Environmental Specialist
oc'. Operations Branch
Central Files
Audry Oxendine - FRO DSW
Ed Holland - Robeson Co. MRCS
Wachovia Building, Suite 714, Fayetteville * FAX 91a-486-0707
North Carolina 28301-5043 Nit 14 C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/ 10% post -consumer paper

.NL�
R
i
L athade ��]• �]• �" Laagitnde �► �� �
E3 Not rstioaa! Date Last Operated:
Type of Operations and
Type ofLiveawk
' 1+1s�mbtr of LMrrans 1S*)d ng Paads 9 bsssrface Drai¢s PremM
,,[aY . ru. ,rt'�w•a�►.�:a :` ► Wit' �'�
3 La oDa Ara ti � Spray Are*
I. Are dbsre my buffers disc aeed
2 h aay dkcharge observed hvm any►put of the opmadm?
a. If &schup is observed, was the aomveyam msn4w&?
b. If dis lwp is observed, did it reach Sm'h= Waw? (If m y VWiy
a. If d w2wge is observed► what is the estimated flaw in gafmia?
d. Does dircbarge bypass a Ugoon system? (If Yet. mdfy DWiy
3. is &M evidence of pan d: Whwv %any part of the opmmoa?
4. Was *= aay adverse mVacts to the won of the State od w tbwn fim a Enebarge?
J. Does any part of the waste ma upmeat sym= (odw d m iagoon6oldwg pom&�) aquim�
13 Yes
t3 Yts No
0 Yu ArIlb
❑ Yes
Yrt *o
13 Yes ONO
13 Yes JRNo
.j7YaNa

a h 1S amy not in o"liaooe with any ndm* tares? � � � m Ya �tO
7. Did the 6mlity fig eo bm a o mfwd vpasmr is tespmsRge dwe (WoVeam afiv tnff ? 13 Ya Na
4 An these 1gom or smw ponds as she whieb nood to be p mp oty 13 Yes �Jo
&ndans nAtmas ■u ftr Ao)Aiaa Pond
P. h st moual f cdxwd kas dean a&gnft? - D Yes To
FseebLm om 2 Low= 3 Za;000 4
1Q 1s same obs: Vod i= my of the suuctu=7
11. L aysim a my adw doras5i ao tie imp of affy of the savama obsavc+d?
• r - e.
It Do say of the yes need
(if any of questions 9-12 wss answered M and the dewtioa poses an
immediate public haft or coviroomeaW dwem4 notify DWQ)
M. Do smy of the orucb= lad s4mte market to identify start and stop pumpin levds?
wage As g1mgon
14. L them pbysical evidence of ova appliati=7
.of in excess of'AW, or rumff catering ws*
of the State, notify DWI)
15. Cmp type V ^K
1 d. Do the active crops differ with those designated in the Aaimsl Waste Managemmt Plan?
17. Does the Sctiity bave a lad; of adsgsn: somw for land spplicadw?
18. Dees the cover crop need kqmnvmftV
19. h tbaY a lack of avallable irrigation equipment?
Fir Csrtif ed Faegkies Quin
sa. Does dw hci* Sail to have a cM of the Animal Waste Mmwmment Fin radtiy available?
21. Does the 5cdity fad to comply w►itb the Animal Waste Management Plan in any way'!
2L Does te=d keeping need hoprovemoull
23. Dons fimhty require a follow-wp visit byname a
24. Did Ravk vaftspector 5g to discus reviewimapaotion wU vwner or opwom in rlsame
13 Yes �No
D Yes No
13 Yes No
II Yes �No
13 Yea Kwo-
E3 Yes �No ,
(3 Yes
13 Yet ;No'
D Yes P(No
1] Yes o
p Yes No
Yes gNo
(� Yes tNo
13 Yes
Conirae�(refier, m question #i}: ;Explain airy�ES answeisand/orimyrec�neadationa�sa�%otbsic+baaa�ttt •�,� „�-�: r �-
SUM di4irb s bf fac�ity to better ex�kia.nt�wian : iiie' dditiaa�ilpages as neon x : a t
��.� M i s � r► a �cee I ie+►'�' Slime .
Rtvkwer4ospector Name
Reviwedlnspector Signature:
ee D pWon of Warm Qualiry,OK&ttr Quaft SceskM Feggkv.ea---, ,t..:.
Datm . 13 -T7

Site Requires Immediate Attention: NO
Facility No. 7 S - Z 3
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: Auvas � 2- 5 , 1995
Time: / S : / 5
Farm Name/Owner: % ''l 13 FQ-
tMailing Address: 9f / 1S2 .9 Q rru w. XC z 736 9 _ --
County: Robcsoey
Integrator: Ca rro 11s Fo,.ds 'I"c_ . _ Phone:
On Site Representative: RaS, *6r++1- _ Phone: «) G? F - 9Z 7-7
Physical AddresslLocation: 'Vwy df/s yOpe' zk"" 1'ly o. 5bx
a r1 vc
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: 57&0 Number of Animals on Site: 576 o
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: 0 '
Circle Yes or No
Does the Animal Waste Lagoon have sufficient
(approximately 1 Foot + 7 inches) ® or No
Was any seepage observed from the IN
n(s)? Y
Is adequate land available for spray? or No
Crop(s) being utilized: C'oas f4 / _
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin 0 Yes r No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or NR
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes o No
.Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Qor No
-Additional Comments:
" 3 4*k6 , S%c.v o.,rle ,
Inspector ame
freeboard of I Foot + 25 year 24 hour storm event
Actual Freeboard: 3 Ft. & Inches
es or(&Was any erosion observed? Yes or&
Is the cover crop adequate? (G)or No
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

1
State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Ray Britt
5199 Tobacco Rd.
Orrum, NC 28369
Dear Mr. Britt:
A4;je
IDEHNR
DIVISION OF WATER QUALITY
June 2, 1997
SUBJECT: Annual Compliance inspection
T&B#1Farm&T&B#2Farm
Registration Nos. 79-23 & 78-79
Robeson County
On May 23 , 1997, staff from the Fayetteville Regional Office of the Division of Water Quality
inspected the subject swine facility. Please find enclosed a copy of our Compliance Inspection
Report for your information. It is the opinion of this office based on the information provided and
observations made during the inspection that the facility was in compliance with 15A NCAC 2H,
Part.0217 at the time of the inspection. Please refer to the comments section on the rear of the
inspection form for information regarding your facility.
Please be aware that all swine facilities with a liquid waste collection system designed for a
minimum of 250 hogs must have a certified waste management plan on or before December 31,
1997. The district NRCS office, Agriculture Extension office, or the Division of Soil and Water
have specialist available to assist you with upgrading of existing facilities and certification.
If You have any questions concerning this matter, please call John Hasty at [phone].
cc: Operations Branch
Central Files
Audry Oxendine - FRO DSW
Ed Holland - Robeson Co. NRCS
Sincerely,
�1
/t4
ohn C. Hasty, Jr.
Environmental Specialist
Wachovia Building, Suite 714, Fayetteville FAX[phone]North Carolina 28301-5043 N%0V C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/ 10% post -consumer paper

I FjicMy Ni=bw !
Data of I S-MMWArl
Time of Inspectlnn Use u dr. dam
Iwo Time (in boars) Spent "Review
or Iospedion (indades bov and procasing) L—=--J
e �......_
Farm CoaatY:
Owiw Name: Fiona No: 1'%a) '7 7
Mwuag Addrm: Sl q %off cga C�-_ 219
ChWte
certified Opm da .8r OpemW cwemaKton N=Ma:
f3!7«i�L'N"RtTl'��*�C:!f1Tt3:i'iT!f:�'�`tT.t
L.
.Latitndc a•0= a« Londe p• p= p�
03 Not rational Date Last Operste&
Type of Operation and Design Gpsclty
IE3 law Dairy
Feeder to Finish 2 N Beef
.:
F w wean-�"'`:..►�:: '�." '.,,
w...,��rr��
�-.w I
Otht+r Type of Livestock
'�y�-..ri":+'�".+,.e+!!'1'z;a r....,�. •'�; s'»�5-Yw.Y:,"vt'-.5;�:� 1 '�' ,ems:.Y..,.�.-..-F.:+{:�
illnmbi* �rI-ag an:l.Holding Psnds, i s ;3 r Subsurface Drains Prtstnt x z
S
1. An d=t any Wfiers that need
2 h my discharge observed from any part of the opmatiad?
a. Ifdischa ge is observed, wa the cmwcym= ?
L If discharge is observed, did it reach S-fac0 Wma? {I!'yer, notify DWQ)
e. If discharge is observed, who is the cai matod flow in pVndc?
d Does discharge bypass a lagoon system? (Ifyes, notify DWQ)
3. h 6ete evideaa of Pav &wbwv from any pm of the opastion?
4. Was there any adverse to the waters oftbe Some other d m 5m a discharge?
S. Does any part of the waste management system (otber d m l+goon0wJdWg ponds) require
j] Yea PNo
Q Yes
Q Ya lNo
Q Yes
Q Yea No
Q Yes No
D Yes �CNo
V Yes ';(No

6. $ Sriiity not in compUmm with any applicable whack vittaia? - _] Ye
7. Did the bcMy fsii b bmt a earti5ed apmwin teap=M& charge {if man dyer lfiWfl ©Yes KNo
& Azt them lsgoaas or soorage Von& an site Wbicb need b be pQopoiy aiowd? Q Yes XfNo
trnetures fLseoaQs a r a _ Toedsl
9. D WucMW fin dxwd leas than adeqmft? Q Yea o
Freeboard _ Jsgooa lap= 2 i[agoan-3 2.ad = 4
10. L seepage owed from MW offt sQ Yes XNO
I I. 3s aosims, is my odw 6=4 e Ae imoegritSr ipf say of the muwu cbsarved? Q Yes 040
12. Do day of the :tnxema med~ Q Yes qfNo
(it any of questions 9-12 was answered yes, and the situation pore an
immediate public bed& or uvb'ot►meaW dumtk sotlfj► DWQ)
.13. Do any of the sww wet lack adgrtate markers to idaa* tout sad stop pumpwS levels? ❑ Yes �Nk
Waste Aooliradoo
u. Is that pbysicsl evidence of aver app ? Q Yes gNff
.(Ifm Cause of VW, or runoff waters of the Stag notify DWQ)
2s. cm type . _6",rOlin 7 4e - - -
A Do the active crops c8ffer with dwse "pated is the Atr= Waste Managcz=l Plea?
17. Does the fw ity have a lack of mbgw a aerege for lead apphad m?
28. Does the cover emp need izapr
19. L time a lack of available irrigation cgWpsaml?
F =Certified FatiAN �nh+
20. Doe the bcdity h U to have a copy of for Animal Waste Mamgp=cat Pl= tudily svaii'Me?
21. Does the beflity 62 to ee®ply W tb the Animal Waste Msaagemeat PLn in any way?
22. Does icew beeping need imprvv ?
23. Doe fatuity mq=e a folba-ap visit by wade ageecy?
24. Did Revkw►erftgcrtor fail to ditcrrss =vicw&qpecdw with uwmr or ape:atcr i o da ge?
Q Yes �No
Q Yea JNo
t7 Yes AN6
Q Yes PNo
Q Yes :Nb
o
ElYes
Q Yes �(Na
Q Yea KNa
Q Yea PNO
CKmeati (reitr to gam►F): ;F.laia airy YES aassys: siadiory iecttdations cr other
Use_drsw o�'facity q better e=plaia ,ose:additamal pages is=,,,.;�., T "
rc.rm 'ts ; n eW I e,,+-6hpr
Revhrw 4nspemr Name
Revfwerllnspector Sipature:
Diraion of Muter OuelftAPamr Dadity Srador,. Feetlim -A— ----- " .
Do E 23 -9 -7

Farm Status: t
Farm Name: To IS ji Z county: ....!k �e-- ._..,�_...
Owner Name: L10je. 2&4,Q,ile-,,x,4rPhone No: &/ ) 4P 2 $--!2 2- 7 7
Mailing Address: �� Iq 1 ot7R. e- W a r r uy►�1 r I:i 'L 2� 3 bq
Onsite Representative: -- '—_. kOa T. Integrator: , (1Q f f'D
T Q -
C ff" operator; r+ Operator Certification Number. _. r 3------
u
Latitude �• 0• �« Longitude �• Q� �«
Not Operational Date Last Operated:
Type of Operation and Design Capacity
,r�rX..�ix''" .� .+.�.
o Swine �x �' Nnniber .:X ~PtsZtry=rTaml:er;
��+v Y'
. �'LC.
wean to Feeder _ �w�
9'
Feeder to Finish 2 M Non- �` BeeDa f
Farrow to Wean K's r :.r�� at. xrtg:` q s
Farrow to Feeder
Farrow to Finish r [] Other Type of Livestock
�3.X.,�p.,a—� r �?,..' r�;� a��S :y1s..- ".+hy«� ?�i,�'�: ',R,.- .i' ,,..:`-r ���'i�!', ..3 �'�;'.j..' d .; dc.•..'".��'.�� 3: � }
,� §Number ofisgooas'/ Holding Ponds• ( Subsurface Drains Present
�'. •�....�..-+�, � `°"�� -�� � _ = zK Lagoon Area �.= Spray Fuld Area
natal
I. Any there any buffers that need maintenancelimprovemeet? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes *o
a. If discharge is observed, was the conveymme man-made? ❑ Yes'
dNo
b. If discharge is observed, did it reach Surface Water? (If yes. notify DWQ) ❑ Yes ,fNo
c. If discharge is observed, what is the estimated flow in gal/min?
d Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes No
3. Is there evidence ofpast discharge from any part of the operation? ❑ Yes No
4. Was there any adverse impacts to the waters of the State other then from a discharge? ❑ Yes ANo
S. Does any part of the waste managernent system (other than lagoonsftlding ponds) require 10 Yes XNo
nmintmiaacefmigrov=eat?
Continued an back

6. h f ci ity not in compliance with Amy applicable setback criteria?
7. Did the facility fag to have a certified operator in responsible charge (if inspection after 1/1/97)?
8. Are there lagoons or storage ponds on site which need to be properly closeffl
tm res (Lagoons aq!j/gr Holdtllg Pods
9. b struchiral freeboard less than adequate?
Freeboard (ft): .Lagoon 1 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
(If any of questions 9-12 was answered yes, and the duration poses an
Immediate public health or environmental threat, notify DWQ)
.13. Do any of the structures lack adgttate marim to identify start and stop pumping levels?
Waste Application
14. h there physical evidence of over application?
(If in excess of VW, or runoff enterin waters of the State, notify DWQ)
is. Crop type
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?
19. h there a lack of available irrigation equipment?
For Certified Facilities Only
20. Does the fac0ity fail to have a can of the Animal Waste Management Plan ready 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 Reviewer/htspector fail to discuss reviewfnspection with owner or %11=tw in charge?
0 Yes P4'o •
t] Yes JZ(No
0 Yes )KfNo
❑ Yes `4io
Lagoon 4
13 Yes gNo
❑ Yes �No
❑ Yes �No
❑ Yes �No
❑ Yes �No.
0 Yes No
0 Yes XNo
❑ Yes �No
❑ Yes OINo
❑ Yes P fo
❑ Yes ONo
❑ Yes 0,No
❑ Yes PtNo
❑ Yes PNo
Cortiraeat4 fi (rt:r to question #I):gF�cplam arty YES answers andfaratsy reecommmmdanons of btht"t caam�ea�. ,� .
rs� - -
:Use drsavmgS of fact? tty ab bettei exp�latn,�s>iu�uons° �ursc addit�amal pages,as�seces_,,.saaY]� ��'�,�"� , � `
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8
Reviewer4uspector Name
Reviweranspector Signature:
Date: — 2 3 --�l
ce- Division of ifater Quality,41Vater Quality Secoion, Fact* Asseument Unit 111141106