780033_INSPECTIONS_20171231

IYI --I
'Division of Water Resources
=HNmber$ - © Division of Soil and Water Conservation
®Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: �/p Arrival Time: LJ Departure Time: ®' County: �✓ Region:Ajo-a
Farm Name: 14'N_4'A/Py �`V'4_me Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: i—// � �!/L�-�t/s Title: gwiVe;e Phone: ,9'1P' &,
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator,
Certification Number: 1 �'"rj119
Certification Number:
Longitude:
Design Current
Design
Current_
Design Current
Swine '
Capacity Pop. -
Wet Poultry
Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
D , P�oult . `
Casa '
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
;t
,1
51
Other
Turkey Poults
E
Other
Other
Discharges and Stream Impacts 16
I. Is any discharge observed from any part of the operation? ❑ Yes P No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
A No
❑ NA
❑ NE
b- Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
9 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
ER No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
r"7'l' 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?
T
Page I of 3 21412015 Continued

Facili Number: jDate of Inspection: 3v Jt%OU ZD/
v
Waste Collection & Treatment
4. 11 storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 19 No
a. If yes, is waste level into the structural freeboard? ❑ Yes 0 No
Structure i
Structure 2
Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): f
Observed Freeboard (in):
_�
5. Are there any immediate threats to the integrity of any of the
structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ NA ❑ NE
❑NA ❑NE
Structure 5 Structure 6
❑Yes 0No ❑NA ❑NE
❑Yes r No ❑NA ❑NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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 T
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): ,J v,4 e24AX SCe"D y/ k2,pt _
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
IT 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.
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[f No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[:]Yes
b No
❑ NA
❑ NE
❑ Yes
1P No
❑ NA
❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes [Q No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
[] NA ❑ NE
21412015 Continued

[Facility_Number: Q7 -_33 Ds ection: ,jp 1VV
U Zpl
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
[] NA ❑ NE
the appropriate box(es) below.
�T
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
�] No
❑ 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 CAW MP?
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 D1 No ❑ NA ❑ NE
❑ Yes]
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
❑Yes No ❑NA ❑NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Sv2 u �S/� ��! O — z. $, do= s, v
c.4,L►Z It
1
Reviewer/inspector Name: /L45_::�ia_ "rn�r
Phone: }`lO,
Reviewer/Inspector Signature:
Page 3 of 3
Date: ZD AA2 Z0/
21412015

rM
ype of Visit: 0-Copliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
m
eason for Visit: &I routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:/ Arrival Time: ' p Departure Time: 7 County:
Farm Name: / f Owner Email:
Owner Name: - � a_ Phone:
Mailing Address:
Physical Address:
�— Region:
Facility Contact: L; pj Title: QCUPhone:
Onsite Representative: �'cy �i'S Integrator:
Certified Operator: _ �' �`u�s Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine'-
Design
Capacity°
Current
Pop.
Wet Poultry
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pap.
Wean to Finish
La er
Da' Cow
Wean to Feeder
Non -La er
Da' Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
3
Q
D , P,oul
Design
Ca aci
Current
I;o
Da' Heifer
D Cow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
Gilts
Boars
O#her,
Other
NNon-Layers
NHPullets
Beef Brood Cow
Turke s
T-ujkey Poults
10ther
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)
❑ Yes ELNo ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ 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 .4 No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes RNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: - Date of Inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: % (,
Spillway?:
Designed Freeboard (in): / 9
Observed Freeboard (in): �L
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5
allo ❑ NA ❑ NE
[:]No ❑ NA ❑ NE
Structure 6
❑ Yes �SNo ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes CR—No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes fR�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 allo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
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 �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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
ENo
❑ NA
❑ NE
❑ Yes
Z No
❑ NA
❑ NE
❑ Yes
Z�No
❑ NA
❑ NE
❑ Yes Q No ❑ NA ❑ NE
❑ Yes [}�No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes [allo ❑ NA ❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements [3 Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes QNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes JE4 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [2 No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 2141,2015 Continued

9
Facili Number: - Date of Inspection: /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EJ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [B_No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [3 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [] Yes [2 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i_e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below. ❑ Yes 21 No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW? ❑ Yes Eg No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes '='l No ❑ NA CD NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 5No ❑ NA ❑ NE
Reviewer/InspectorNarne: fit✓ B"---- Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412015

SI
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0-fro—utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: (, _ L
Arrival Time: Q.'
Departure Time: D9 County:r_
Farm Name: �'�yt�y
�l/Ccn
f / /�
Owner Email:
Owner Name: s-r�r�y1��
Phone:
Mailing Address:
Physical Address:
Region: iA V
Facility Contact: Z'-ato�aTitle: eei(.cll'!Phone:
Onsite Representative: f �.-�� /S.wy�y �!/v Integrator:�rf
Certified Operator: �l +xd� liast5 Certification Number: 7 ��
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
-
Design Current
Swine =_ Capacity Pop.
Wean to Finish
Wet Pouitry
La er
Design
Capacity
C►urrent
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish L7lD
Daig Heifer
Farrow to Wean
Design
Gurrent
Dry Cow
Farrow to Feeder
D . P.oW
@a aci
Pao -
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
M
Other`
Turkey Poults
Other
FlOther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
CNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[] No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
[] No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
EQ No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
12-No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412014 Continued

Facili Number: - Ds ection:
Waste Collection & Treatment
�. 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2-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: /— 41 Z_/0 //_/ i"
Spillway?:
Designed Freeboard (in): Z
Observed Freeboard (in): 33 13-3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes KNo
[DNA
❑ 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 RNo
❑ 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 q'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes MI 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 allo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ;S�No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes 54No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Ycs
J-No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
FM No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
1EINo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
"No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
O No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
JA_No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[EINo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes 00 ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I ° Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �-No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

' acili Number: 7 Y- Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ®,No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ®No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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 �No ❑ NA ❑ NE
❑ Yes gNo ❑ NA ❑ NE
❑ Yes E.No ❑ NA ❑ NE
❑ Yes ®-No ❑ NA ❑ NE
❑ Yes Dj]-No
❑ Yes [RNo
❑ Yes ja No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (referto gnestttiir#): Explain any YES answers and/or any additional recommendation- s;o*anytther commentii
Use drawin s of.:faciii to better a Isis situations (use: additional.., pages as necessa =
Reviewer/Inspector Name: j 7-e- c,�
Reviewer/inspector Signature:
Page 3 of 3
Phone:
Date:
21412014

-o` -i ;z- 1-6-
Type of Visit: CMom nce Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: —/ / Arrival Time: / ; D Departure Time: County: �� Region: f�
Farm Name: Owner Email:
Owner Name: Sd,r,�y C��� S Phone:
Mailing Address:
Physical Address:
Facility Contact: ���� �`�+� Title: fy Wn 1_ Phone:
Onsite Representative: . Integrator: /r1 0
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Design Current
Capacity Pap.
Wet Poultry
La er
lNon-Layer
Design
Capacity
Current...:.
- Pop. _
- -
Design •nrrent
Cattle Capacity Pop.
Wean to Finish
D Cow
Wean to Feeder
I
Dairy Calf
Dairy Heifer
Feeder to Finish j a
Design Current
D . Poult Ca aci
Farrow to Wean
Cow
Farrow to Feeder
Non -Dairy
Beef Stocker
Farrow to Finish
Layers
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turkeys
Turkey Poults
10ther
Beef Brood Cow
Other
Other 7=11
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes TNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [allo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

.IFaeflity Number: - 3 Date of Inspection: &v , G
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
® No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): -3-7
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
MNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
eg No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Eallo
❑ 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
EqNo
❑ NA
❑ NE
maintenance or improvement?
I. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes allo ❑ NA ❑ NE
❑ Excessive Ponding 0 Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs_ ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): oe-'- yl"_.1O.-/ rY,/
13. Soil Type(s): ,,l 10/C 3 1HaA
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EkNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes PkNo ❑ 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 )ZjNo ❑ NA ❑ NE
❑ Yes EB-No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes KNo ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �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 J-No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes allo [] NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes 12No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: 7,K - Date of Inspection:
e
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes fnNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [a- 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 a No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes El No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
M 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
(54,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
MNo
❑ 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
MNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�gNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
INo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
0.No
❑ NA
❑ NE
Comments (referta'question ft Explain any YES answers°and/or any additional recommendations or any other comments
Use drawings of facility to'better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: f r y _ r — Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412011

-� At z
Type of Visit: (D Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: &<O-Utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: L Arrival Time: Departure Time: ► County LD&;O.�
Farm Name: T "'7 VAS . - r �� Owner Email:
Owner Name: b_z "r `l Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: L-.� - P_S Title: Phone:
Onsite Representative: { Integrator:
Certified Operator: SIZ4 Certification Number: 70t.
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swiioe Ca aci Po
P h' P•
, D ign Current Design Current
Weft Poult Cam aci . Po Cattle Ca aci Po
r5P h P• P h' P•
Wean to Finish
La er Dairy Cow
Wean to Feeder
Non -La er Dairy Calf
Q - Dairy Heifer
Feeder to Finish
Farrow to Wean
-Design Current Dry Cow
Farrow to Feeder
D ,P,oui Ca .aci P,O Non -Dairy
Farrow to Finish
Layers Beef Stocker
Non -Layers Beef Feeder
Gilts
Boars
Pullets Beef Brood Cow
Turke s
Other
Turke Poults
10ther
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ff No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes
[:]No
ET<A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[] No
Q NA
❑ NE
C. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
eNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E�r No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
dNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

r
Facili Number: —t - I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[° Jo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
F3,K'
© NA_
[] NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
EJ'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
0 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
E3f '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
ENo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Ef No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below_
❑ Yes
ZNo
❑ 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 ❑7A�pplication Outside of Approved Area
12. Crop Type(s): �tJvw "SG vkc (,1
13. Soil Type(s): 06CQ 0 4 AXICI ES
14. Do the receiving crops differ from those designated in the CAWMP?
❑Yes
N
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
dNo
❑ NA
❑ NE
18_ Is there a lack of properly operating waste application equipment?
❑ Yes
dNo
❑ NA
❑ NE
Reauired Records & Documents
19_ Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
gI1"o
' ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
2?01�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
EKo
❑ 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
❑ 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 to application equipment,as required by the permit?
7
❑ Yes
C] N ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check
❑ Yes
[j>d'�­❑ 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
Q,No ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
V:�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 Fo ❑ NA ❑ NE
❑ Yes [P. kio ❑ NA ❑ NE
❑ Yes �e` ❑ NA ❑ NE
❑ Yes R5,Ntr ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
Coinments � ty:. P ( - pages ._ -.. ry) .:' any�,ottier,.comments.
Use drawin r of facdiu�to;be#ter. eition pl$ n's tdahons ase dditin allain any YES answers and/or pyas mecessaecammen bans orP r COJ: t-3
sue'' "
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: `1 0 -333
7 �] I
Date: 7 — I— f
21412011

Type of visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
[lesson for Visit: (94outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: e, Region:
Farm Name_y1/�., 5 �� l Owner Email:
Owner Name: S'�L��_ a v, s Phone:
Mailing Address:
Physical Address:
Facility Contact: '��et Title: Q�jl�,s� Phone:
Onsite Representative: �`y� Integrator: g7e,., --2
Certified Operator: �� �� ,4- Mlle y Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet�Poultry _
Capacity
Pop.
-attle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
jNon-Laer
I
Dairy Calf
Feeder to Finish
t7
.,;. ...:..
�,
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D P,oul
Ca aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
113eef Brood Cow
Turkeys
Other
Turkey Poults
Other I f
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes ❑ No ❑ NA ❑ NE
[:]Yes [D No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[:]Yes
[2fo
❑ 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
[ij,-IQo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Eyl<o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

T_+1
Facili Number: - jDate of Inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [—]Yes DE(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:! f
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3's
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
D No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[ R o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[DXo
❑ 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
`gXo
❑ NA
❑ NE
maintenance or improvement?
Waste Aaalication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
QXo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [l"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):
13. Soil Type(s): 22-1-
14. Do the receiving crops differ from those designated in the CAWMP? [:)Yes [! No D NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �To ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [R-'l 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 �No
❑ Yes . "No
❑ NA ❑ NE
[]NA ❑NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes GJ'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes 03'1Io ❑ 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 EE'No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 03 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes Q4 ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

' Facility Number: 7 - Y-1-71 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C9 No
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes 0No
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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ER 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 the 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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[]Yes [R]No ❑ NA ❑ NE
❑ Yes Vo ❑ NA ❑ NE
❑ Yes [J<o ❑ NA ❑ NE
]'es ❑ No ❑ NA ❑ NE
❑ Yes
[R o
[] NA
❑ NE
❑ Yes
[I No
❑ NA
❑ NE
❑ Yes
Io
❑ NA
❑ NE
Phone: 22!Z 35L
' 3
Date: f _ — AP ;RJ/3
21412011

ype or visit. �7t=ompitance inspection LJ uperanon Keview u �truciurc Lvatuation u i ecnnicat Assistance
Reason for Visit: (DRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: Q plri County:
Farm Name: Zwx" E V P►r6 Owner Email:
Owner Name: ac%n+0"s eVAAS Phone:
Mailing Address:
Physical Address:
k7bESOA) Region: FG
Facility Contact: hT-R O n k U4A►JS Title: Co. 0 wow Phone:
Onsite Representative: /ANDUA/LS Integrator:
Certified Operator: 34n04 ''uJAa Certification Number: 17 $a 9
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Shine Capacity Pop.
�.
Design Current
Wet Poultry Capacity Pop.
Destgu Current
C+attle C+apacity Pop.
Wean to Finish
[Layer
Dairy Cow
Dairy Calf
Wean to Feeder
Non -La er
Feeder to Finish
0 9;0
kX UD
Dairy Heifer
Farrow to Wean
Design Current
D , P.oul Ca achy P,o
La ers
Dry Cow
Non -Dairy
Farrow to Feeder
Farrow to Finish
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Other
r Other
IPUIlets
Beef Brood Cow
Turkeys
Turkey Poults
Other
.. ..%w:YFI'ISerJYIBI'.YGY.IPol.°Ira.Ra�s:�9YlAtiAueRl"�;:�" .. ..-. "
Dischar es and Stream Impact
oe
'MNo
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
Cq'VA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
EErNA
❑ 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
EglA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[q No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
d] No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3
21412011 Continued

V
[Facility Number: '-1 - d3 Date of Inspection: ',Ak 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes dNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No WNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [✓"No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [3rlo ❑ 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 [ErNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ffNo ❑ 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 dNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes dNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E(No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): _Z L` RMvp4 (, AZE� M 411 R A4T^3 C ea.$)
13. Soil Type(s): pp A k o N CB , a A k LJ K Q>
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes M 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 dNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
dNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
dNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[if No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ff 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 dNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes gNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
[DNA ❑ NE
M NA ❑ NE
Page 2 of 3
21412011 Continued

[Facility Number: "1$ - U 3 Date of Inspection: (Q t
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ff No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes Ef No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Ef No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to property dispose of dead animals with 24 hours and/or document ❑ Yes [fNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
g 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
[+TNo
❑ 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
0 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
dNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[fNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
F1 No'
❑ NA
❑ NE
Comments (refer to question #f): Explain any YES answers and/or any additional recommendations or any other comments. - -�
Use drawings of facility to better explain situations (use additional pages as necessary).
tAo 4!? V 0.RA 'S RRSg PAmo1 -N-4 0t,4 ,_ Z t A ',D.dl a.
w qo1
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 3 of 3
�0z_ \ 4�4 ,S�Vy _ \ E6
Phone: q 10-309-69Sf
Date:
21412011

a ype or visit: 4W i.ompuance inspection v uperanon mevtew V structure Evaivataon tJ t ecnmcai Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 7 !$ I / Arrival Time: $ AM Departure Time: �� A County: R Region: FR49
Farm Name: ..Ll` Q EVAfS
Owner Name: d A rAQ y E V AAS
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: 4t "O A E V OAS Title: Co - p tJHFR Phone:
Onsite Representative: H ry h7 VQ AA Integrator: _PASS-hft e LAACM.S
Certified Operator: d A r4!2V E V A +y S Certification Number: [% A 9
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
HWean to Finish
Design Current Design Gurrent Design Current
Ca aci Puy Wet Poul Ca aci Po Catt le C►a aci Po
P typ �Y P h P! P n' P•
Layer Da' Cow
Wean to Feeder
]Nog -Layer
Da Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
12,230
11 750
IJesign Current
D . louit . Ca aci P,o
Da Heifer
D Cow
Non -Dairy
Beef Stocker
Layers
Gilts
Non -Layers
Beef Feeder
Soars
Qther
Other
Pullets
Beef Brood Cow
Turkeys
Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Qio ❑ NA ❑ NE
[:]Yes
[:]No
[1 rNA
❑ NE
❑ Yes
❑ No
❑'NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes [�No
❑ Yes allo
[v(NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facili Number: - 113 Date of Inspection: '7 is I I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [g 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: l- 15k
Spillway?:
Designed Freeboard (in): �V 1 r44tRQc>A rleL+
r
Observed Freeboard (in): 3 �L y3 °
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E No ❑ NA [3 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 dNo ❑ 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 gNo ❑ 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 C�No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes ESI'/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
A
13. Soil Type(s): D&I Q N 1 co t 1 CD A l m
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [5No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [fNo ❑ 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 [vrNo ❑ NA ❑ NE
❑ Yes &I No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes 2 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [::]Yes j(No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E3"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
jj/NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - O 3.3 1 Date of Inspection: 7 1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [Y(No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 9No
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 [TNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [�14Vo
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 ❑ No ❑ NA ❑ NE
❑ Yes [31No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
[]Yes dNo ❑ NA ❑ NE
❑ Yes
[v]�No
❑ Yes
[9No
❑ Yes
[Ef No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature: e5k _ Date: 7 I f,SJI 1
Page 3 of 3 21412011

S-o3'(-Z0i0
Type of Visit eriffompliance 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: �' /� Arrival Time: /%SG Departure Time: S�•�y0 iy County: �rre.✓ Region:.F��
Farm Name: Sa �d F!/a.vS I -/ T Owner Email:
Owner Name: e51'A_.vs Phone:
Mailing Address:
Physical Address:
Facility Contact: 4 Nda, Eyol. s Title: 0Ujrje-r Phone No:
Onsite Representative: Integrator: /°r-r cle
I
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = p =' [=] « Longitude: = o [=]' = u
Design Curren#
Design Current
Design •nrrent
Shine Capacity Population
Wet Poultry Capacity Population
e Capacity Population
❑ Wean to Finish
❑ La er
❑Dairy Cow
❑ Wean to Feeder
❑Non -La er
❑Dairy Calf
Feeder to Finish
airy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
El Beef Feeder
❑ Boars
❑ 1'ulleis
❑ Beef Brood Cowl
❑ Turke s
Other
❑ Other
El Turke Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No L1, NA
[I NE
❑ Yes
No NA
El[S
❑ NE
❑ No 01ZC
❑ NE
❑ Yes
❑ Yes
❑-Tq-o— ❑ NA
[INE
❑ Yes
D<,)---❑ NA
❑ NE
Page I of 3
12128104 Continued

Fact y Number: '7 — p—:0 I Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ErNo ❑ 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: /—/4 //-19 /
Spillway?:
Designed Freeboard (in): 1' 6 i 7 — /O //� ✓r�N�✓c���
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.) ��
6. Are there structures on -site which are not properly addressed and/or managed El Yes [? 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
oo
❑ NA
El NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
,[3
L�'No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9_ Does any part of the waste management system other than the waste structures require
ElYes
D-<.
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
El Yes
/
[;J
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes LSNo ❑ 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) akv":l e/0. SJ
13. Soil type(s) Dn 6 QAj C-es .. r o-A , M
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 2&o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes e<o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes PNo___E:11
N—o El NA ❑ NE
17. Does the facility lack adequate acreage for land application? El Yes o NA El NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes NA ❑ NE
Reviewer/Inspector Name i e�� S Phone: �f 10. 3 3 . 33i�
C 'IG
Reviewer/Inspector Signature: Date: %S ZO/D
Page 2 of 3 12128104 Continued

Facility Dumber: -% B —Q Date of Inspection
Required Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
ElE Yes
�
No ❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
L'7 No ❑ NA
❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
ErNo ❑ 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
ErNo ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
D NEl NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
/o No ❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No ElNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
ElYes
_
o ❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
OT<o ❑ 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
DNo ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 L
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No NA
[INE
General Permit? (ie/ discharge, freeboard problems, over application)
32_
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA
❑ NE
33_
Does facility require a follow-up visit by same agency?
❑ Yes
2<0 ❑ NA
❑ NE
Page 3 of 3
12128104
n

.L Yw S S "r S - ZC (:'rf f=t�'-- - - -
Type of Visit QMompliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit (?1outine 0 Complaint 0 Follow up 0 Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: ; DO Departure Time: �i•�3s County: /Qad �o^� Region:
Farm Name: 511AIC1 Owner Email:
Owner Name: SCin/� ti �i/Q�vS Phone:
Mailing Address:
Physical Address:
Facility Contact: AS 4;vQ&1& N-5 Title: D64fP-4," Phone No:
Onsite Representative: �kNd .CLaNS Integrator: Irez
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o =' = « Longitude: [=] o =
iSDesi;g@----._
'
ICDest n Current Dest nSwtne
�I
purrent`' WetPoultry
Po ulat�on
Capagity P,opul honttle Capa Population
❑ Layer
El Dairy Cow
❑ Non -Layer
E= ElDai Calf
-
❑Dai Heifer
Dry Poultry
❑ D Cow
❑ ry
tT;l❑ Layers
❑ Beef Stocker
x ❑ Non -Layers
❑Beef Feeder
P{ ❑Pullets
❑Beef Brood Co
Other
❑ Turke s
❑ TurkeyPoults
❑ Other
❑Other
Humber of Structures:
❑ Wean to Finish
El Wean to Feeder
® Feeder to Finish
�323
5F O
El Farrow to Wean
El Farrow to Feeder
O
Discharges &Stream Impacts
1- Is any discharge observed from any part of the operation?
El Yes
,�/
L] No
❑ NA
❑ NE
Discharge originated at: ❑ Structure El Application Field El Other
a. Was the conveyance man-made?
El Yes
El No
,��
ETNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yes
❑ No
ETNA
❑ 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
EJ<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
❑ NA
El NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
�.,�lo
L'i '4Vo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
I2/28/04
Continued

• Facility Number: -7 $ -- Date of Inspection -29-09
Waste Collection & Treatment
�,/
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes L7 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes Q'�10
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 7-lO I -Co f
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .- 6 Z 2-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes l_`_fNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes E 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 [}5o'
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑T ❑ 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 015r ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 91 ❑ NA ❑ NE
maintenance/improvement?
11, is there evidence of incorrect application? if yes, check the appropriate box below, ❑ Yes 9N'o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [_-IPAN > 10% or ] O lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14_ Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
D o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[}-71o'
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
B'�lo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[1o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
B o
❑ NA
❑ NE
Comments vefegto,1gnestxon,#}- yplatn any YES4answers andlortany recommends ons or any other comments.
=Use drawmgs of,factltty twbetter eaplam situatEon�„(use,addtttonal,pages as necessary)
1
- _.'1..{._4--•-'-fi 3.. f"`",..
Reviewer/Inspector Name �G l�[.V { ! Phone: 9i0. �33. 33W
I
Reviewer/Inspector Signature: Date: �(-29- 2,00"?
Page 2 of 3 12128104 Continued

Facility Number: 7 —j3 Date of Inspection 9-Z9- 49
_Required Records & Documents ��//
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes ETNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes B o ❑ NA ❑ NE
the appropriate box. WUP ❑ Checklists
El❑Design (I Maps El Other �,
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ E Yes o ❑ 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 fait to install and maintain a rain gauge?
❑ Yes
LSN�❑
NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
41.
Elko—
BINA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
D o
❑ NA
❑ NE
25_ Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
El o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
E3o
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0-<o—
❑ 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
Yes
[I,
,E,,lv�o
I 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
��
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
B<o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El,-
Yes
-,��
tSNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
EM
❑ NA
❑ NE
Page 3 of 3 12128104

13ylus 9_oq_00 A
Division of Water Quality
Faci)ity Number—� 0 Division of Soil and Water Conservation
1�
— 0 Other Agency
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 17-2Z-,081 Arrival Time: Departure 'rime: County:
Farm Name: SX v S — I g Owner Email:
Owner Name: .5[LMd 6g L- t/q_" S Phone: _
.01
Mailing Address:
Physical Address:
/LSD.✓ Region:
Facility Contact: da'rJ4 Title: Phone No:
Onsite Representative: Srif-Ah '�_ LriaQ EyaNS _ Integrator: _ i"G, '�`aS L ha F wt 5
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = c = ` ="
Longitude: = ° = I = u
i in
Design Current
Design Current
Design Current
Swine
Cap�c�ty Poulation
Wet Poultry tCapacity Population
La er
FC1 Non -La er
Cattle Capacity Population
❑ DairyCow
❑ DairyCalf
❑ DairyHeifer
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
l3 2 30
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Non -Dairy
❑ Beef Stocker
❑Beef Feeder
❑ Beef Brood Co
❑ Farrow to Finish
❑ Gilts
❑ Boars
- -
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures: U1
Discharges & 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
N
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
❑ No
�NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
��
D o
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
E3<0
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
EI No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

t
Facility Number: 7g 33 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: g /"Z Alf 7—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): z _ z�3.3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes CTNo. ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ETNo ❑ 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 threa notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 9< ❑ 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 ErNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑' o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
[:]Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Area
�G
12. Crop type(s) ywada, t`A-, >; 6 rn :. _� sal am L l c0,.5 �
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
17_ Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
D No
E N�o
Er -
No
No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NI?
❑NA ❑NE
❑NA ❑NE
;._
ferjo ecommendations or any other comments.
( f q-� _ �, �..�
�� uestton #) Explain any YES,answers and�eajle
Use drawna of acrL'
�,s as necessammen re.xgp�sruse�addthv.,•r.
Reviewer/Inspector Name i*G Phone: gIQ, 413 , 3330
Reviewer/Inspector Signature: Date: -7— ZZ— ZDO $
Page 2 of 3 12/28/04 Continued

Facility Number: 7 — Date of Inspection TZZ-O
Required Records & Documents _�
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes L'J No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes BIN. ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑Design ❑Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
O No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections ❑ Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
El oo
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
EKo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26_
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
EfNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[!J No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
2 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
ONo
❑ 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
ETNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
1-11,
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Cotnments-and/or Drawings.: '" � _ *c Efi ; X
Page 3 of 3 12128104

1W��A� A
-z- L -7—D c/c/
Facility Number %g
® Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit ® Compliance inspection Q Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up 0 Referral O Emergency Q Other ❑ Denied Access
Date of visit: Arrival Time: �/ i 00 Departure Time: Z: County: /peLe,r roA.1 Region: �
Farm Name: `%g Owner Email: cy
Owner Name: -S�-N —V,:,a Phone: ' �Z$� 6�/ go
oe
Mailing Address:
Phvsical Address:
Facility Contact: SaAjd ! ,t<!/G S Title: er%4. A/er Phone No:
Onsite Representative: So Ar rl u_24' ZA;Vi-f ,6=escS Integrator: Pe-5 Z4K e— y*fS
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o ❑ d = « Longitude: ❑ ° = I ❑ "
Swine
Design Current; Design Current
Capacity Population Wet Poultry Capacity Population
ElLa er
❑ Non -La ei
❑ Wean to Fin
❑ Wean to Fee
Feeder to Finish
/ Z30
g8
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
El Gilts
[I Boars
Other
❑ Other
Dry Poultry
Non-L,
Pullets
JJ Turkc Poults
❑ Other
Discharp_es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
Design Current .`
Cattle Capacity ;Population'
❑
Dai Cow
❑
Dai Calf
❑
Dai Heifei
❑
D Cow
DNon-Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Co
Number of Structures: 3
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. 1s there evidence of a past discharge from any pan 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 [9No ❑ NA ❑ NE
❑ Yes
ND No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: 7 - 33
Date of Inspection 5- 7-O
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: LKS 1-6 La -7 -/O
❑ Yes [�No ❑ NA ❑ NE
❑ Yes �fl No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in): [q _ 19
Observed Freeboard (in): ZA 30 3
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
P No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
�Q No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
te 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
[A No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[n No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes `P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑/Evidencce of `Wind Dllrifl ❑ Application Outside of Area
//
12. Crop type(s) a �s.�� G.Acl /V.. P� s'�.�-e J S�10 ��,✓ / UWS�u��
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes f] No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'? ❑ Yes 05 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes P No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes [)6 No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 0 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):
/
AL
Reviewer/Inspector Name; ICt�/G.� S Phone: 9tb.�3.3330
Reviewer/Inspector Signature: Date: S d 7 _ ZOO 7
12128104 Continued

r
Facility Number: 7 $ -_Kj Date of Inspection .S-o 7-d7
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes W No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes � No El NA ❑ NE
the appropriate box. ❑ WDP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and i" main Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [P No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[A No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
(2 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
OjNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ YesLP
} No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
6
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
Page 3 of 3 12128104

1
Type of Visit 411 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: llArrival Time: Departure Time: Q; 3p County: Region:
Farm Name: —5,2 '67 [/a-vS Owner Email:
Owner Name: /L�d� A4 ` Phone:
Mailing Address:
Physical Address:
Facility Contact: sgdz a, �Y�tis — Title: Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator: reSA
16.2� .
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ❑ e ❑ ' ED « Longitude: ❑ ° ❑ I ❑ "
Design Current
Swine C*apacity Population
Wet Poultry
Design Currett
Capacity Population
Design Current
C►attle Capacity Population
❑ can to Finish
La er
aowean
to Feeder
EFIEEINon-Layer
❑Dai Calf
Feeder to Finish Z a
F "
airyHeifer
❑ Farrow to Wean
Dry Poultry
`""``
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Col i
❑ Turkeys
Otber
El Turkey Points
❑ Other
❑Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
Ej No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
❑ Yes
EpNo
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
9FNo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (Ifyes.. notify DWQ)
❑ Yes
[PNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes
[;WNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
VNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number:Date of Inspection `Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 99 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes t? No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 7
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): - S
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes CgNo ❑ 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 El NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [ No El NA El NE
maintenance/improvement? r
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 [3Evidenceof Wind Drift ❑ Application Outside of Area
12. Crop type(s) /�G!is. 'r' aIr ems! L � �i+t.c�l � .��✓
r_ a/ p
13. Soil type(s) ,« z _ J o wXy'o 1 Na C
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1XNo
❑ 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
0 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[;VNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
07No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations o anyother comments°
.Use drawings of facility to better explain situations.(use additional pages as necessary):t, ,
Reviewer/inspector Name ec, cI Phone:
/Q 33-3300
Reviewerllnspector Signature: Date:
7 2p_
Page 2 of 3 12128104 Continued

Facility Number: g —331 Date of Inspection / O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [fNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [A No ❑ NA ❑ NE
the appropriate box.
❑ WUP []Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes (ANo ❑ 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 DI No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ja No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
25_ Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
14 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
qNo
❑ 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
EgNo
❑ 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
[;tNo
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31 _
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
VNo
❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[PNo
❑ NA ❑ NE
Page 3 of 3 12128104

of Visit f8'Eompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: � Arrival Time: t7 t7 Departure Time: /al OO County: �"� Region:
Farm Name: JE�_en 7 Owner Email:
Owner Name: s �da�ls _ Phone: � �.2fs" L/I
;Mailing Address: / /l %%7it.r t C�� : /"%�O -_-__ --�• d3yD -
Physical Address:
Facility° Contact: Title:
Onsite Representative: _ Siti-ir r -
Certified Operator: S
Back-up Operator:
Phone No:
Integrator:'I ate -ems
AII
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = I = u Longitude: = o = f = «
urrent
wl
Design CurrenSwine
pulatton t Wet Poultry
❑ La er
Opacity Pap l t►on
Ca[tle Capacity Population
Dairy
❑ Wean to Finish
❑
Cow
Heifer
❑
❑ Dai Calf
D Caw
❑ Non-Dai
El Beef Stocker
El Beef Feeder
❑ Beef Brood Co
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? El Yes MNo El NA ❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made? El Yes 0 No El NA El NE
b. Did the discharge reach waters of the State? (if yes. notify DWQ) [I Yes ,QNo El NA El 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 DI ❑ Yes [,"No ❑ NA El NE
2. Is there evidence of a past discharge from any part of the operation? [-IYes(ZNo ❑ NA El NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State El Yes 5INo ❑ NA El NE
other than from a discharge?
12128104 Continued
Type
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? El Yes MNo El NA ❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made? El Yes 0 No El NA El NE
b. Did the discharge reach waters of the State? (if yes. notify DWQ) [I Yes ,QNo El NA El 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 DI ❑ Yes [,"No ❑ NA El NE
2. Is there evidence of a past discharge from any part of the operation? [-IYes(ZNo ❑ NA El NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State El Yes 5INo ❑ NA El NE
other than from a discharge?
12128104 Continued
Type
Type

{
Facility Number: , J3
Date of Inspection `%;q,5-
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:
Spillway?:
Designed Freeboard (in): - .,
19
Observed Freeboard (in): a 4 a27 y
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 No
❑ Yes No
Structure 5
El NA El NE
❑ NA ❑ NE
Structure 6
❑ Yes MNo ❑ NA ❑ NE
❑ Yes [9 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? �d Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes FNJNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ,KNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ yes NNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes KNo ❑ 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) G/l _rLe5 rA2_e /_�;Sir�dG! 6rGt� 4a% l- r�,
-
t3.
//r'�'rn��
L—
Soil type(s) ,a 3/4(la � �ZZ2 �&/^ 3 /;22P
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Q No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
RI 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
RNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
F§-No
❑ NA
❑ NE
Reviewer/inspector Name Phone: gjl7
Reviewer/Inspector Signature: Date:
12128104 Continued

r
Facility Number: �—_3_3 Date of Inspection — D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Z-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 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 I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
J0 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[ZNo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[2 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
RNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
UJ-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
j[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
P 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
EKNo
❑ 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
[LNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[.No
❑ NA
❑ NE
12128104

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine Q Complaint O Follow up O Emergency Notification O Other ❑Denied Access
F: l 0 Zacility Number 3 late of visitZ o Tune- �
O Not Operational C Below Threshold
® Permitted ®[Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: W t S - County: �o Sv-v►- _ . _ . .. _ ..... .
Owner Name: ... �._yQt.� s Phone No: `710 - (v 2 5 ei? iJ
1LLading Address: 30 -� L �r i -- � .� e"' } _. �- - --_ a yQ
Facility Contact: Tide:
Onsite Represen e: i --
Certified Operator: ...._.. __ .._ .... va..�., 5
Location of Farm:
Phone No:
Integrator. RMS ima -e-
Operator Certification Number: , _ I _1 000
la Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude <
i Cnr3t eat s r DeQgn Car�reid�t':t3T .
Swine - _Po - on
. Po' . `:Cattle
Wean to Feeder.
Layer
Feeder to Finish
3 L 3a
23
Non -Layer
Farrow to Wean
= r - _ -
Faaow to Feeder
Other.
Farrow to Finish
Tow Desk
r f _ = -
„� _ .3
Gilts
Boars
IIM
Number cr!'L-agoons'. ;� .
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated au ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes IM No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes KNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes GLNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes &No
Structure l Structure 2 Structure
3 Structure 4 Structure 5 Structure 6
Identifier: _ _L. _ _. -+, to _._...._ _ If.`�
Freeboard (inches): 3 3
12112103 Congnued

Facility Number: — 3 Date of Inspection A 2x
5: Are there any immediate threats to the integrity of any of the structures observed? Cie/ trees, severe erosion,
❑ Yes
;2FNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
A No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
C1 No
8. Does any part of the waste management system other than waste structures require maintenancehmprovement?
❑ Yes
t,No
9. Do any stucmres lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
JqNo
elevation markings?
Waste Application
10. Are there any buffers that need maintenaneeJimprovement?
❑ Yes
a No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
ELNo
❑ Excessive Pondmg ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12- Crop We Rar-wtuds sw-Arm taA,ii;mcak�Atrx—n', a is" , Sw. . ara._e, ottr-Scej
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Ilan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
RNo
b) Does the facility need a wettable acre determination?
❑ Yes
R No
c) This facility is pended for a wettable acre determination?
❑ Yes
X,No
15. Does the receiving crop need improvement?
❑ Yes
1.No
16. Is there a lack of adequate waste application equipment?
❑ Yes
A No
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �No
I9. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes %No
Air Quality representative immediately.
Reviewer/Inspector Name
❑ Final Notes
Reviewer/hupector Signature:
rzn7ml
Date: 1017,
Cnntkuad

Facility Number: — 33 Date of Inspection D t L
Reyuired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP�checklisg,-desiVr, -map.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Applicatim"_0 Freeboard/ ❑ Waste Analysls'O Soil Samp]inf,-,-
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by Genera€ Permit?
Oe/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Fatalities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record k=90�LCrap
r NPDES required forms need
_ improvement? If yes, check the appropriate box below
❑ Stocking FYield Form ❑ Rainfall ❑ Inspection After 1" RairL/
❑ 120 Minute Inspe=oW/O Annual Certification Forst'
❑ Yes
Wo
❑ Yes
,B No
❑ Yes
,!KNo
❑ Yes
KNo
❑ Yes
RNo
❑ Yes ;&No
❑ Yes MNO
❑ Yes 9 No
❑ Yes 19 No
® Yes ❑ No
❑ Yes 4No
❑ Yes J4 No
❑ Yes IgNo
❑ Yes RNo
10 Yes ❑ No
12112103

0
Type of Visit (D Compliance Inspection 0 Operation Review (] Lagoon Evaluation
Reason for Visit ® Routine O Complaint 0 Follow up O Emergency Notification Other ❑ Denied Access
Faciliri• Number 7 3.i Date of visit: /6 of Time:rO
Not Operational 0 Below Threshold
Permitted ® Certified /O Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: S-i Countv:o����
Owner Name: „ -sR^�� �.�.✓� Phone No: (!� d
0 os=� �.��d�
Mailing Address: NC
� � /
Facility Contact: �.sr'�✓6•st/�✓� Title: ��Phone��No:
Onsite Representative: ��✓/s .��✓� _ Integrator- //V' /`�.e.•�
Certified Operator: SA' ,�l/9�✓1 Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' " Longitude 0
:Skitie
Design':: 'Curren# ;.. Design Csirrent ;Des
`Catiacity Poaulation ., !Poiil&r i Raseity Pasiulatian Cattle .' =Can:
❑ Wean to Feeder
fO Feeder to Finish
I /,7;:Z30
I / g30
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Numbec'olLagoons` . ;,
Holding POndS / Saud Traps
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3_ Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes N No
❑ Yes X No
[:1 Yes �&No
❑ Yes P'No
❑ Yes ;K No
❑ Yes ]PNo
❑ Yes No
Structure
Continued

Facility Number: 7 — 13
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, notifi, 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?
«'ante Application
❑ Yes 121 No
❑ Yes � No
❑ Yes No
❑ Yes ISINo
❑ Yes JRNo
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
'%No
11.
Is there evidence over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
)Q No
12.
`of
Crop type f�C�iru�.d . Si����.4i.✓
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
WNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
IRNo
b) Does the facility need a wettable acre determination?
❑ Yes
P No
c) This facility is pended for a wettable acre determination?
❑ Yes
�a"No
I 5-
Does the receiving crop need improvement?
❑ Yes
'F&No
16. Is there a lack of adequate waste application equipment? ❑ Yes KNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes A 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 03No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes tg No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes XNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ANo
23. Did Reviewer/lnspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified ANVMP? ❑ Yes No
[] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
C.ommeats (refei to question #1) Lip" any YlE ansssers and/or'_any remmmendattonS or ariv;otlter camme
- - _ -- _ c
ilse drawtrigs of laedttvto.better ei[plam srtusttnas: (nse addtnottsl pages as necessary) Field Con, ❑Final Notes Rk:.
,.
(�t��!✓�rFoe�
r
Reviewer/Inspector Name
Reviewer/Inspector Signature: _ �...t� Date: Z
05103101
Continued

a
Facility Number. -7,7 — �U Date of inspection
Odor issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
® Yes ❑ No
❑ Yes fR\o
❑ Yes R qo
❑ Yes 04 No
❑ Yes P No
❑ Yes CRr,•Vo
❑ Yes ;N No
Additior€a) Comments;andiar Drawings
05103101

r
Type of Visit ID Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit (DRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 1 05 Time: @ d�
Facility Number
• a10 Not Operational 0 Below Threshold
® Permitted ® Certified [] Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: _ Sc.x'SA!, C4Qn5: Count.•: [Zn (ae Can 2.0 -
Owner Name: Sc,, d C Phone No: 0 G zS
Mailing Address: - 1 3 0 5- M rt t? 4-lLC, i2ou.& (:::C.ii e- I� C. • 2g 3.4-0
c
Facility Contact: S 4�,F- Lc sd_4' Title: Phone No: /
Onsite Representative: 3 Integrator: _r e
Certified Operator: C{_ eA c� �_ 4j11 r+ _ Operator Certification Number: L- LC AS
Location of Farm: —�
IRSwine ❑ Pouttry ❑ Cattle ❑Horse Latitude a ° 0` Longitude ' �• �•
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca acitF• Population Cattle Capacity Population
El Wean to Feeder ❑ Laver ❑ Dairy
® Feeder to Finish ILI Non -Laver ❑Non-Dair
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons
Holding Ponds / Solid Traps
IL-1 Subsurface Drains Present llLl Lagoon Area I" Spray Field area I
Waste
Discharges & Stream Impacts
1. Is anv discharge observed from any pan of the operation? ❑Yes IUi No
Discharge ori_*inated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed was the conveyance man-made? Yes No
❑ No
b. If discharge is obser-ed, did it reach Water of the State? (if yes, notify DWQ) ❑yes ❑ No
c. If discharge is observed, what is the estimated flow in sal/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ) ❑ Yes �&No
2. Is there evidence of past discharge from any pan 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 P No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [RNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier._ -
Freeboard (inches): 310.,
05103101 Continued

Facility Number: Date of Inspection I V
5. Are there any immediate threats to the integrity of any of the structures observed? (mid trees, severe erosion, ❑ Yes � No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes 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 (3 No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes [13 No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes INo
12. Crop type Q L' i 4,nrs &-z,- 4- ( Cyr,-,, ^ 0, S i
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Reouired Records & Documents
IT Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25_ Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
❑ Yes No
❑ Yes W1 No
❑ Yes �} No
❑ Yes fjj No
❑ Yes _V] No
❑ Yes ® No
❑ Yes No
❑ Yes f No
ElYes 57yyNo
❑ Yes EP No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (�efir to q eshoi #)Eapiainua v�YES answers and/orany recommeQdahloIIs?O oy other c mmeets��
iUse drawings of faeihty to better explain sttuatenns (use addttional'.pages 'as necessary) ❑ Field Col ❑Final Notes
TL
rt
Reviewer/Inspector Name i `'
ri
= ,' x ,.
Reviewer/Inspector Signature:
Date: 03
05103101 ':!�T Continued

rt Facility Number:T-ff
-
Date of Inspection () at O
Printed on: 5/4/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i_c. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes [3 No
❑ Yes ® No
❑ Yes ® No
❑ Yes No
❑ Yes ® No
❑ Yes ❑ No
05103101

1
Facility Number Date of Visit: Time: ILE �i
Q Not Operational 0 Below Threshold
Permitted 0 Certified ❑ Conditionally Certified ❑ Registered Date Last Operated or
` Above Treshold•
Farm a.�...County:
`CSQ�......................._.
Owner Name: ..�-01d.... .................................... Phone No:...........(tt
Facility Contact: ............!2.&P-1'.................................. Title:................................................... Phone No:
Mailing Address: �, ... rl ¢ 4. ` Al e 2FI
Onsite Representative .............. ....w. r -. Integrator:
Certified Operator:................................................................................................................ Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry
❑ Cattle ❑ Horse Latitude
Longitude �• �� ��
-
- .. ;
Design : Current ` Design
: Current" . Des Carreat
Sat.
Svviae - _
Capacity Population Patltcy Capacity
Population. . Cattle'Capacity's.,Po
-
Wean to Feeder
JEJ Layer
❑ Dairy 2 `I
Feeder to Finish
1 ❑ Non -Layer
❑ Non -Dairy
Farrow to Wean
Farrow to Feeder
Other
r
Farrow to Finish
Total Design Caliadty Z s
Gilts
Boars
TOW SSLW-
DischarpM & 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?
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 gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
IdcntiEier: 0 � ......I ......................
.1-.(................... - �.......................�....
Freeboard (inches): 3
5/00
❑ Yes KNo
❑ Yes 9R:No
❑ Yes
No
❑ Yes
�o
❑ Yes
Wo
❑ Yes No
Structure 6
Continued on back

u Facility Number:? —.3_3 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/dr 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 Aaulication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidencegf over application? ❑ Excessive Ponding RIPAN ❑ Hydraulic Overload
12. Crop type eL
13. Do the receiving crops differ with those desig ated in the Ce�
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?
imdl Waste Management P19fi (CAWMP)?
Required Records & Documents
17. Fail to have Certificate of Coverage &c 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?
yiola�ign�s;off dgfc�e>3cte wire pQte�i dtrttig t�tlls:v�s�t! Yoh wii� �eitye trio fu�t�tr
... • corresi aridence: ab;DUA this'
:..... . ....:.......:::..::........ .
i3e1r-%4dq -Ce-UrIt* !- Uzry q a`c .
9� rer-645.1 i J
�eU w4e Cowr
Cgre of oke,&, Caws 406-r e- ,moo ✓ed .
f ri9 / f lily:/•
r
❑ Yes KNo
❑ Yes P(No
❑ Yes o
❑ Yes Fo
❑ Yes pfm—
Yes 1'No
❑ Yes C No
❑ Yes o
❑ Yes No
❑ Yes Wwo
❑ Yes�No
❑ Yes [$No
❑ Yes VNo
❑ Yes 1KNo
❑ Yes gro
❑ Yes PZNO
❑ Yes RNo
❑ Yes k "No
❑ Yes J�No
❑ Yes JNo
❑ Yes eNo
❑ Yes 2�N0
Acts, Sdw%&- P; 9cjcAd 4to,�t t,rX be TXIt—
a
Reviewer/Inspector Name _...
Reviewer/Inspector Signature: Date: 5/00

rI Facility Number: —33 Date of Inspection —Q 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 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 permanenthemporary cover?
lAdditional'Comments andlotUratv�ngs•
Ayes ❑ No
❑ Yes ro
❑ Yeso
❑ Yes o
❑ Yes *1140
❑ Yes e�
❑ Yes ❑ No
5100

Facility Number Date of Inspection I 6 /;iZ,--d
Time of Inspection 2' 3"Z) J 24 hr. (hh:mm)
Permitted ® Certified E] Conditionally Certified ❑ Registered 113 Not Operational Date Last Operated: ..........................
........... ,S,�,✓ `/ �� /—/ ob -r?,,
Farm Name!.`✓ ............................. County: p-.......
Owner Name:.............. �/ ..--.. rli{! ...... .. .. Phone No: � �L....`G�p ..................
Facility Contact: ....��^.� . ... Title:................................................ ................ . Phone No: ...................................................
Mailin Address egal•r....,,W4..%&I .l��Fr`C.'....,l�f��.��!a /...Y.-..-c..... �� ���.................... ...........
g ... .._._- ...............
Onsite Representative:.,..- .:.. ........ .... ............................... Integrator 15..................................................
Certified Operator :......... A' .`.. e--- ............................... Operator Certification Number: ..........................................
Location of Farm:
Latitude • ° Longitude ` ° "
Design Current Design 'Current Design Current
SwnCapacity Population'CattlCapcacity Population_.
❑ Wean to Feeder
Feeder to Finish
zre)
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer ❑ Dairy
4 ❑ Non -Layer I I❑Non-Dairy
- Other
Total Design-Capadty
(Number of Lagoons = ❑ Subsurface Drains Present ❑ I agnon Area ❑Spray Field Area
r74-
p µHolding"P - ds / Solid Traps ❑ No Liquid Waste Management System
_... _r
Discharges & Stream Impacts
Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon [I Spray Field ❑ Other
a. If discharge is observed, was the convevance than -made?
b. If discharge is observed, did it reach Water of the State'? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/tnin'?
d. Does discharge bypass a lagoon system'? (Il' yes, notify DWQ)
❑ Yes 6rNo
❑ Yes No
❑ Yes No
❑ Yes [:No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes W No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 1PNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Freeboard (inches): .... ....... 1/ 3/
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
3/23/99 Continued on back

Facirty Number: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pan of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? []Excessive Ponding ❑ PAN
12. Crop type
13. Do the receiving crops differ with those designated in 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?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation(freeboard, waste analysis & soil sample reports)
20- Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23- Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
�; N.6-yiolatioris;oi- &ficienU' ' •were hO(ed• during this visit:- Y:ou. Will-ieeeiye iio #wither -; -;
correspondence. abatif this visit_ _ ..
❑ Yes )q No
❑ Yes ❑ No
❑ Yes D�-No
❑ Yes KNo
❑ Yes J!&o
❑ Yes ANo
❑ Yes ANo
❑ Yes 19No
❑ Yes I No
❑ Yes P.No
❑ Yes ❑ No
❑ Yes R No
❑ Yes CKNo
❑ Yes N No
AYes ❑ No
❑ Yes] No
❑ Yes KNo
❑ Yes k!fNo
❑ Yes No
❑ Yes No
❑ Yes InNo
- — - INF _ -z4.
Comments refer to question #j -Explain :any E answers and/or any recoinmendahons or any other eoinments -
- _
Use drawtngs of facrltty to better atplaun sttua>oias(use addtbonal pages as necessaiy)` _
- --R- --
XA
24
07
Reviewer/Inspector Name s _ w
Reviewer/Inspector Signature:
Date:
3/23/99

Facllity Number: 74r — Date of.Iixspection /3
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ,0 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 X.No
28, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes Eg-No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) [:]Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
Addihona omments an or',.'awings:;._.. -��
_ _ _ _ -. - . s,}..
AL

. Division of Soil and,:,. ater Conservation Uperation Review z=
_D-Division of Soil and Wa#er Conservation �Complianee
Division of Water Qual�ty� Compliance fnspechon
Other Agency Opera#ion Review.-
10 Routine Q Complaint Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection
Time of Inspection L 124 hr. (bh:mm)
Permitted 13 Certified [3 Conditionally Certified © Registered 3 Not Operational Date Last Operated:
Farm Name: __.. .............. " - �li "••`'s• ._....L....... .1...................... Count)':......_..lm5l_3?)�,............ I---.. .......................
Owner Name:...............................I......... Z [1C._.wS Phone No: ........._.._ ..z ....6........ `l itr ..........................
Facility Contact: .... :.....- Ai
......... Title: ............. ................................................... Phone No: .............. ::7 .:...........
............ ..............................
Address: 116 �-..I a rr.I- i .. (. '! �. ?'L: L..`.. ............. -2-
Mailing T�
Onsite Representative...............D............................................ Integrator:........... II Qr ..........................
ye-
Certified Operator:.....:.......................................................................................................... Operator Certification Number:..........................................
Location of Farm:
i
.............................................................. :..........................................................................................................................................................................................................
Latitude 00 �° •4 Longitude • L 14
'Design Current " ,
Swine _ Ca' pacity Population-,.,,
❑ Wean to Feeder
Feeder to Finish
Z
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
of -Lagoons- -•-
ijs./ 5614,4;-aps
Design Current =
Design; Current
ultry _.. Ca . acio. Population --, Cattle.
Capacity Population
Layer ❑ Dairy
Non -Layer ❑ Non -Dairy
I-
Other
-
Total Design Capacity
/ 3 Z 3 '
-_ Total `SSLW
- :;.:i
❑ Subsurface Drains Present
❑ Lagoon Area ❑ Spray Field Area
❑ No Liquid Waste Management System
= _
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
h. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Docs discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard(inches):....fJ..............................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
❑ Yes ❑ No
Continued on back
' 3/23/99

Facility Number: ]f 3 3 Date ol• laspection Z5/`
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
[]No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenarice/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? []Excessive Ponding ❑ PAN
❑ Yes
❑ No
12_ Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
-❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & 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
❑ 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
❑ 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 ❑ Np
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
0: �Vci-yioiaii¢ns'or deficiencies •*ere noted during this:visiL • Y:OI} Wwi�l•re"eeiye 0a fuftWe -:
corres� ont#ence. about_ this visit .. ....... .
Comments (iefer toWgeresf,on #) Explaui anyYES answers and/or any recommendat,ons or -an other commenfs.
y --�
Use diawrngs of facrirty to:better explatnsttuatrons {use additional pages -as necessary)
� EA
))Iel Was S 6 a.�S, - aer nS ec '�'�t e-T
de. � ���e� �aUJ o;r�(. Ilse leoe- a �'s - 'note Wo5
l l o►ti�_ . i � e 1 E�e� t�a5 n�T b1e�-1 o�� ,t G��1e S CA%S wd��S�e ✓ ea�d w
+o ram± - IEci'e C
Pr
S=i(� is S"G� raj r
Reviewer/Inspector Name
Reviewer/Inspector Signature: T Dater
3/23/99

2 [�'D�vision of Soil and Wa#er Conseevation Qpe;ahoni Revsew
�u �-
-_ Q Division of Soil and Water Conseryahon , Compliance Inspection �--r ,r T
4
-Drvision of Water Qieahty Compliance InspectiopCU
0 Uther A enc ' O eration Review _ - _r {
Routine 0 Com taint 0 Follow-up of DWQ inspection 0 Follow-u of DSWC review 0 Other
Facility Number `] 33 Date of Inspection F!n
Time of Inspection 24 hr. (hh:mm)
Permitted [3Certified [3 Conditionally Certified [3Registered JE3 Not Operational Date Last Operated:
Farm Name: VG.yt 5 1 ' ... County:......../ o U eSa-Yt•
- .......__..-.......................... I..........
Owner Name: sG 41.Gt,'^...5......................................... Phone No: ....................1'Q.z. ....... ...................... u E.... .. .. .............
Facility Contact: ............l�W 11n e r �J
.......................................... Title:.............._...........................----....._ ...._..... Phone No: ...................................................
Mailing Address: ..... .1305....mQr!.c.......1�Pj ............................. .....a�rn�eov�+�. N�-�...................... Zr-.a.�u...
Onsite Representative: . n..... Integrator:....... .Pr 5 ...............................
.............................................ss.........................................................................................
Certified Operator:.,. ...................... ..C.......a..!.....5................................. Operator Certification Number: .........................................
Location of Farm:
AL
.......................................................................................................................................................................................................................................................................... T
Latitude a ° Longitude • 9 1&
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 No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (II' ves, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
e
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway Xyes o
Structure 1 Structure 2 Structure 3 Structure 4 Stntcture 5 Structure 6
Identifier: / v to % -1 d
.
Freeboard (inches)_ nn IIO
............................. ......-................. ...... ..................................................................................
5. Are there any immediate threats t the integrity of anyA of the structures observed? (ie/ trees, severe erosion, {(Yes ❑ No
jfxinsli seepage, etc.)
3/23/99 Q r� / ! " PT, 0
t -5 ZU 9q� Continued on back

Facility Number: % — Date of Inspection -ZO�
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
)�No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
\No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
UM No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
No
12. Crop type _f 0._ raze &1a
13. Do the receiving crops differ with those designated in the Cer ' ded Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
(�(No
15. Does the receiving crop need improvement?
❑ Yes
O No
16. Is there a lack of adequate waste application equipment?
❑ Yes
RNo
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
gNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
0 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
AfNo
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge? 1
❑ Yes
No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes No
(ieJ discharge, freeboard problems, over application) ❑
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 'gNo
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 PNo
❑; Rio yialatigris;o cief eieacies were noted durirtg his; . .. You wiil reeeip .Rio. Further
corres� 6 ideirce: about this visit. : ` : ::: :: :::: :
Cote inents (refer to=quesenn'#) E'M anp,YFS as sewers and/or any recomimendat,ons or any other eo> rnents` -
17 _
4D 6 e-
zz• Dwa
le-vel.
�s LQy�
-9,-
Jl
Xy&4'yeS f 1lp !S a e f tO a
ro U9 k+ IIpf�6 u�,� a'4 )&t ed /� 1 (' 1
g i ✓�ll� ;o-), Q�c e t vq s AW Ii01 ed d-i k'fq r � lr' Q
>/ o rS / A -Ae y- 4 c4irQd 4eeboa1V
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 7 --Z10-- 99
3/23/99

Facility Number:733 Date of.Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes VNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes Ko
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? [`Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes MNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
Mclitional -onnmefi att or rawtngs•:
3/23/99

1f
[a Division of Soil and Water Conservation 13 Other Agency
a Division of Water Quality
10 Routine O Complaint O Follow-up of DWO inspection O Fallow -up of DSWC review O Other
S�
Facility Number Bate of Inspection r�� ,
Time of Inspection I z4 hr. (hh:mm)
Registered Xcertified [3 Applied for Peermit Permitted 0 Not O erational Date Last
Operated:
Farm Name: ...... ��• YaLI .............r.. f9 Countv:.................. .R4r,5a ?..........
................................................... cog
Owner Name:......................... ................JFV4..n..�L........................................ Phone No: 59/b. — �.a. - [z'V- ..�..........
... ............ ............ .....I..
FacilityContact: ............ fps .,.�.. . Title................................................................. Phone No: ...................................................
Mailing Address:.......... Q. ��?......... �4 r,."en ........ �I Ir!!'�4 ? C` o1S3 f" ��......
q...................... .....•-----.....,f....................._.........
Onsi#e Representative: ...................Integrator•..............�r. - - P.........,� ,,�r�.....u�................................... ---
Certified Operator:.......... -SSE t�......................FY. 1,165................_................ Operator Certification Number:.......... a .......
Location of Farm: J
Latitude • 6 66 Longitude 0• �' r_�66
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
gNo
2. Is any discharge observed from any part of the operation?
❑ Yes
PjNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
KNo
b. If discharge is observed, did it reach Surface Water? (If yes. notify DWQ)
❑ Yes
U(No
c. If discharge is observed, what is the estimated flow in gal/min?
r[
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
KNo
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
A No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
XNo
5. Does any part of the waste management system (other than lagoonstholding ponds) require
❑ Yes
,-No
maintenance/improvement?
b. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes No
7125197
Continued on back

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes XNo
Structures (l,aLoons,liolding Ponds, Flush Pits,ete.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes No
�Stru lure E Structure ucture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ] 1 `"1h it —1 1?-
..................................................................................................................................................................................................................
_ Q t
freeboard (ft): ...............j..I .� R . . .X.................. ��.............
10. Is seepage observed from any of the structures'? U Yes XNo
11. Is erosion, or any other threats to the integrity of anv of the structures observed'? ❑ Yes No
12.. Do any of the structures need maintenance/improvement? ❑ Yes No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13, Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
Of No
Waste :application
14. Is there physical evidence of over application'?
❑ yes
ANo
(If in excess of WMP, or runoff entering waters of the State, n tifv DWQ)
((-''•.�-•��
15.
Crop type ........... . ....... . ..... - .. ---- --...........................................................................-I............I..........
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)'?
ElYes
XNo
17. Does the facility have a lack of adequate acreage for land application"
❑ Yes
No
18: Does the receiving crop need improvement?
❑ Yes
A Nio
19. Is there a lack of available waste application equipment?
❑ Yes
XNo
20. Does facility require a follow-up visit by same agency?
❑ Yes
KNo
21. Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑ Yes
;K No
22. Does record keeping need improvement?
❑ Yes
A No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste 'Management Plan readily available"
Yes
X\o
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
JXI\lo
25. Were any additional problems noted which cause noncompliance of the Permit"
Yes
❑ No
0 No.violations or deficien' de's were- noted- during' this visit.-.You,wil,l receive no further
correspondence ahout this.visit.
C `ointments={refer to question #): Explaidany YES'answers and/or any reconnnendattons-or any:other comnnen' s
Usedrawings:of facility to better explain situations. (use additional"pages as necessary),G
_y- l� Seivice
��ltiYY1 ion _''�c"i a•�,,� Ai+gz��''`s
q4epn 0�;,
�Ote = .�v . fir` 0r
rMd �D �b
A - - -J, L r
4kVW
a4 Sort ao
1, 1 A
7/25/97
N
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: .S d-

171 Routine O Complaint O Follow-up of DWQ ins ection O Follow-up of DSWC review O Other
Facility Number
Date of Inspection zr 7
78 �
Time of inspection rap Use 24 hr, time
Farm Status: ���z�r��d Total 11me (in hours) Spent onReview /
or Inspection (includes fraud and processing)
FarmName: .J��'^'dy l/,9ir� S / — Z _ _ County
Owuer Name: -s •.��•¢•�.� Phone No:.,,. J �• 00-1YT�
Mailing Address•
Onsite Representative: Sis'' f Integrator.
Certified Operator. �^'� ��-� Operator Certification Number:
Location of Farm:
t// C✓,� i ,c.,� �s,� z 2 Sri a v> Z r:./,Es
Latitude ' • C� K Longitude • Q' Q"
113 Not Operational Date Last Operated:
Type of Operation and Design Capacity
f "�- atgs,,l z � a�� �� ,� ad?` ;'`�.f'H� ' �. ^` ;t��' i .,+'`�.,,..=";,��s :,�.i--��;s� '. �tt;��"�,w"£�.�r,�•y+�> �,
SwiaeNumber� �� Pgultry �, x'*Nuwnber u Csttie ,�.:. _umber
T0 Wean to FeederM. Dairy
Z ❑
® Feeder to Finish J 7 O Non- Beef
Farrow to Feeder
Farrow to Finish ❑ Other Type of Livestock• R7
2M
-y Cx .� a;,�i".Fi .3�Y.,.-..i.�.,q,,, -.r* {rr '2 :. �" •�a....e.s v: ,r.Y�e.>..... `?_-:
{Number of Lagoons /,.Holding Ponds Z Subsurface Drains Present
Lagoon Area?. Spray Field Area
Genera!
1. Are them any buffers that need mainteuancermprov=cut?
I Is any discharge observed from any part of the operadon? �
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (1f yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Was 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?
❑ Yes
IN No
❑ Yes
® No
❑ Yes
0 No
❑ Yes
allo
❑ Yes P No
❑ Yes P No
❑ Yes P No
❑ Yes ® No
Continued on back

6. Is facility not in compliance with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/l/97)?
S. Are there lagoons or storage ponds on site which need to be properly closed?
Structures [Lagoons and/or Holding Ponds)
9. Is structural freeboard less than adequate?
Freeboard (li): Lagoon 1 Lagoon 2
ley 2y�
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 maintenancelimprovement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
Lagoon 3
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
Waste Auulication
14. Is there physical evidence of over application?
.(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15- Crop type aws
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?
IS. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For Certified Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Play in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes
0 No •
❑ Yes
0 No
❑ Yes
rgNo
❑ Yes
4 No
Lagoon 4
❑ Yes
® No
EMrYes
❑ No
0 Yes ❑ No
❑ Yes 22 No
❑ Yes ;9 No
❑ Yes ® No
❑ Yes INNo
❑ Yes P No
❑ Yes M No
❑ Yes ® No
❑ Yes 0 No
Fj Yes ❑ No
❑ Yes ® No
❑ Yes I@ No
Comments (refer to question # ° Fa�lain any YES answers and/or any recotbmendaixons or any other counzssnts .
w.
r,. - 2.JF6t rrx .. w (" ...� �.� �� r�,�.y�,�•...q i
Elise drawrags of facilnty ra beacrLcVIain smuatioas �unse addtfiaaa],PaSes � Y� � �v
/�. 7ZI
Cz
r�r�o.3,. /Z',c . ,Erir✓s NAC
Reviewer/inspector Name
Revivu,er/Inspeetor Signature:
_ _ Date:
T/ 2 r/f %
or Division of Water Quality, Water Quality Section, FacilityAssessment Unit 11/14/96

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Sandy Evans
1305 Marietta Road
Fairmont, NC 28340
Dear Mr. Evans:
Ala
1DEHNR
DIVISION OF WATER QUALIFY
April 3, 1997
SUBJECT: Annual Compliance Inspection
Sandy Evans Swine Farms
Registration No. 78-1, 78-33, 78-80,78-45
Robeson County
On March 25, 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.
1f You have any questions concerning this matter, please call Robert Heath at (910) 4W
1541.
Sincerely,
Robert F. Heath
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine - FRO DSW
Ed Holland - Robeson Co. MRCS
Wachovia Building, Sulte 714, Fayetteville FAX [phone]
North Carolina 28301-5043 N%q
fr C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

Roldtin; 0 Complaint 0 Follow -up -of DWQ Inspectiou 0 Follow-up of DSWC review 0 Odwr
F FaEwe eflurmcdon 7 vdilty NazOw I
lbut of I 107=0 use 24 hr. time
Furs TOM 71m (in boors) Spent oldtgvkw
or Laqwdion (Includes trravd and processing)
Farm N=w.
4i4-
Ow= Name:
Mailing Address:
Gnslte Representatim
Camedopentm M?mtw CatUkadm Number.
Location of Fwm-.
L&*Ude 0 Longitude [=301
83 Not Operational Date List OpemtmL-
Type of Opemflon mod Design Capacfty
Wean to feeder
Feeder to Finish
Emw— to wean
Famw to Fceftr
Farrow to Finisb
Other Type Of Livesw* -
I. An there; any buffers that need maintenancarnpavement? El Yes 0 No
I Is any discharge observed fim any part of the opc=d=? 0 Yes 0 NO
a. Udischarge is observed, was the c=vriance uam4mdc?
b. If discharge is observed, did it mach Surface Water? (If yes~ mik* DWQ)
c. If discharge is observed, what is the estimated flow in gal min?
d. Does discharge bypass a lagoon syrum? (if M No* DWQ) _ ---
3. Is lhere avide= ofpw discharge from any part of the operation?
4. Was there any adverse impacts to the waters of the State other dm fimn a discharge?
S. Does any pan of the waste management sym= (other than IngoomAmIding pomds)
-13yes-ENo
E3 yes MNo
E3 Yes 3 No
13 Yes IN No
D Yes P No
D Yes 13 No

6 b salty WC in Mft My grumme adw* asM Yes IM No
7. Did *9 fi=Tq bg to have a ea dfied operaw in nqmek dwV (if knecticm s&r 1AffM 13Yes OM
- 8. Astdwt lagooas air swrage p=& on dw wbicb =W to be populy Chme Myes ®No
Lt.r—Odgm JLBZNAB Raft MONIPJJALN
9. h scrucbmal f! PxI n v 4 Ica d= adequft? Oyu MNo
Fzeebowd(ftY. _LqPwI L%Vo*2 LagY Loom
91
10. h seepage observed fiom any of the sbuckwai?
E) Yes
13 No
11. bm)siou. army otbcr threats t*the miry ofday ofthe strucwmabswftV
1:1 Yes
0 No
12. Do any of the Anwans need mlir q ' WUVCMCW?
R Yes
E) No
(If any of quesdow 0-12 Was answeredM and the situation Posts an
immediate public health or environmental threats notify DWQ)
23. Do any of the sftchm lack adquW marken to Men* On and stop pumping k%VW
13 Yes
13 No
.B:aste UgM111--on
14. Is drat Vbysical vvideace of ova applicatim?
13 Yes
M No -
wan ofthe State, voWyDWQ)
�
is. CMP type
I& Do the active crop differ with dK= designated in the Animal Waft Management P1=?
13 Yes
0 No
17. Does the beffity have a Lack of sdaxpmoe acreage for bnd applics*m?
E3 Yes
MNb
IS. Does the cova crop and improvtocat?
13 Yes
M No
19. b there a lack ofavaWle irrigations equivss:era?
13 Yes
It No
ft CeWfied FacUfflo—QUIV.
20. Does the fieflity fail to have a copy of the Aral Waste M=4mumt PL= nadUy wal'Imble?
13 Yes
M No
21. Does the fi=MV fig to comply with the Animal Waste Mzmagenwwt PI= in my way?
E3 Yes
10 No
27- Dues new bepiqg wed imprwv==t?.
10 Yes
M No
23. Daft hdUW require a Mow-V visit by same sgwq?
13yes
13No
24. Did Rcvkvevinq)mw fill to discus: stvia w/nespection with owner ear apen.ftT in
13 Yes
MNo
Explain', day TU answers anyTwomrhm''dad
Ca
Use drams of.faciiitjr.co batter w .
C
,Name
Signature: 9 7
Division of Water ONON&. Water OArawy section. Fecilim A-- — "-,-

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Sandy Evans
1305 Marietta Road
Fairmont, NC 28340
Dear Mr. Evans:
A ��
IDEEHNF;Z
DIVISION OF WATER QUALITY
April 3, 1997
SUBJECT: Annual Compliance boa
Sandy Evans Swine Farms
Registration No. 78-1, 7&33, 78-80,78-45
Robeson County
On March 0, 19W, 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 MRCS 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 Robert Heath at (910) 486r
1541.
Sincerely,
94-r-V1*1W
Robert F. Heath
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine - FRO DSW
Ed Holland - Robeson Co. MRCS
Wachovia Building, Suite 714, FayetteAe N, C FAX 91048&0707
North Carolina 28301-5043 An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 5096 recycled/10% post -consumer paper

19 Rodtine O Complaint O Follow-up of PM Inspection O Follow-up of DSWC review O Other
Date of Inspection z f 7
Facility Number 7 Time of Inspection f 1 o Use 24 hr. time
Farm Status: .,.,_._{ "A04C Total Time (in hours) Spent onReview L
or Inspection (includes travel and processing)
Farm Name: County:
Owner Name:-s-A-''� ,�•`�.� PhoneNO: 4/� �•Z�—<Y��
Mailing Address: -- �-- --
Onsite Representative: S.v-�4s� /. '� fir. , _ 2 36 L/�� ---
Certified Operator:-S��''�y - r/A�! Operator Certm ation Number.
Location of Farm:
n
u
�irr� U
Latitude Longitude 1.__._J • ��
rE3 Not Operational Date Last Operated:
Type of Operation and Design Capacity
Y.rlwfnl�p `a�Nllmber�oliltly .rye lljnmber�`.:�.r'Nnmberia�w a.
Wean to Feeder ..f�'Lava
Feeder to Finish 1 Z. 7 D . Non- Beef
Farrow to Wean
r?
FUr
arrow to ceder
F w to Finish 0 Other Type of Livestock v". Y
Number of Lagoons /. Holding Ponds': tx Subsurface Denies Present
�-„ . Lagoon Area Spray Field Area
� t
Gencre
I. Are then any buffers that need mainteaaacelunprovemeat? ❑ Yes GNo
2. Is nay discharge observed from nay part of the operation? ❑ Yes 19 No
a. If discharge is observed, was the conveyance man-made? ❑ Yes im No
b. If discharge is observed, did it reach Surface water? (If yes, notify DWQ) ❑ Yes el No
c. If discharge is observed, what is the estimated now in gal/min?
d. Does discharge bypass a lagoon system? Of yes, tro* DWQ) E3 yes P No
3. Is there evidence of past discharge from any part of the operation? I] Yes ONO
ti
4. Was then any adverse uapacts to the waters of the State other than from a discharge? ❑ Yes P No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ® No
maintenanoeirmprovemeat?
Jrwwohruod An AIMrk

fi » fidlity not in compliaooe with any applicable setback pia?
7. Did the facility fail to have a certified operator in tesporudble urge (if inspection after I/1197)?
S. Are tbere lagoons or storage ponds on site which need to be properly closed?
S§vctures fLaeoons and/or Ifloldial Pond
9. h Ammunal ficeboard less than adequate?
Froeboard (ft): .Lagoon 1 Lagoon 2 Lagoon 3
/ 4 * 2 /'v
10. is seepage observed from any of the structuzes?
11. Is erosion, or any other threats to the integrity of any of the structuuxs observed?
12. Do any of the structures need
(if any of question: 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
Waste Ayolication
14. Is there physical evidence of over application?
.(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type 01 ,
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acmage for land application?
18. Does the cover crop need improvemieat?
19. Is there a lack of available irrigation equipment?
For Qertifeed 1±acilities Only
20. Does the facility fail to have a copy of the AminW Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
22. Does retard keeping need improvement?
23. Does facility require a follow up visit by same agency?
24. Did Revieweranspector fail to discuss reviewrmspectkm with owner or operator in charge?
E3 Yes
01 ho `
❑ Yes
IM No
© Yes
ISNo
Yes
Q No
Lagoon 4
❑ Yes ® No
$Yes ❑ No
13 Yes ❑ No
❑ Yes ® No
❑ Yea 10 No
❑ Yes ® No
❑ Yes ISNo
E3 Yea %3 No
❑ Yes IM No
❑ Yes ® No
❑ Yea ONo
0 Yes 13 No
0 Yes ® No
❑ Yes 13 No
Camm� (refer.to qutstron #) F.xplazn arty l'ES answers and/or nay recomiiLetiBations or arry othbr oairmmeatS' t
ilse`dra�ymgs of fasrlity to better artuatioms (tut addrticxnat pa8es or
T �..� �� frf</k� � /�+E ca..,.«-�'� /�.0 • �r/9+rif GoN�<''��
AA''''�J� C� S � co„rr�d�R ,2,t,.1a ✓��/�-f �o�os�p' ,i� CH-��j' • -
xi^` 1� �r`O CJ�Q.lLsf Cdi� .!� �O �S ,Su✓•r "
rho �,c�.no.� ,. /�1.c . ,tr r�,r✓r !�'�� �a �s�/�;,C ,� y.�.�sr � o �,� e,.�
Reviewer/Inspector Name
"k
.-.'.."' yr-•+ire
ReviwerAkspector Signature:
L7 Lf %
"Wafine of Wrier Oneily. Warr O"&VV .C"%q n .r_ P.

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Sandy Evans
1305 Marietta Road
Fairmont, NC 28340
Dear Mr. Evans:
e��
1DEEHNFZ
DIVISION OF WATER QUALITY
April 3, 1997
SUBJECT:. Annual Compliance Inspection
Sandy Evans Swine Farms
Registration No. 78-1, 78-33, 78-80, 78-45
Robeson County
On March 25, 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 aff 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 Robert Heath at (910) 486-
1541.
Sincerely,
Robert F. Heath
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine - FRO DSW
Ed Holland - Robeson Co. MRCS
Wachovia BulEding, Suite 714, Fayetteville 1683�3 Niv,
FAX 910-48�0707
North Carolina 201An Equal Opportunity Afftmxffive Action Employer
Voice 91GAW1541 50% recycled/ 10M post -consumer paper

RoddM -0 Compbklnt 0 FoUow-up of DW Follow-ag of DSWC ndw D Otber
Q is L
Date of llqpediaa
FacMty Number
Thos Use U br. d=
Farm Ste TOW MW (in h"n) Spot sawvww
arlopeeftoondadesfraud and procnshj=
Farm Nam
Owserftme:
MWIlag Ad&m:
Oadft RepresenCdvv
CArdBed Operator; Number.
Lamdon of Farm:
r3 Not OpIrsdonal Daft ust Opastom
Type of Opention and Design Capsetty
06a7�WOM"MIM& -..
iei-of Sobswfact Dadw Present
7
1. An that say buffen that nwd =6nte==lmvvv=cut? El Yes IN No
2. h my &=haw obs=vW from my put of the %WM*M? Q Yes 18 No
if &Schur is *MrV4 Was the =V"C* MM-w*? A3Yes 'Mb&
b. If discharge is Ona%-4 did it read Suftce Wattr? (lfM oil* DWQ) E3 Yes MNo
c. lf&=hap is observed, what is the CUWnwd flow in PMU&?
d. Dow discharge bypass a Ingoca M=? (If yes, me* IDWQ)
13 Yes 99 No
I h dM= rMcm ofpM a Some my put of %wnfim? 13 Yes M No
4. Was tW= any adverse impacts to the won of the Soo other shwa from a &scbwp? 13 Yes ;M No
.5 D= =Y Put of the waste mxnagamM system (other than Iagooaslboldiag Pam&) 13 Yes NO

IL b eeft not m campbam+e mm any owmabb sd60* abwk? 13 Yes $! w
% Did do fi=Rky SB b bave a oml ied op oftr in tapoasible cbwp (if im wdm sAw 1/1ArM 13 Yn ®No
ii. An tine hgm= or smsage p=& an abe wdtiob sad io be propaiy cloned? 13 Yes ® No
&troetnrle: fLaeoon: andfor Holding lo�atlsl - c.
4 L fteebaard ka: tbam adegrmae? C] Yes 21 No
P'aeeboatd (i!) ' C omm l ow
2 Isg 3 tagooa 4
2 7 -
1Q Is seepage observed f m any of dw ablock ?
I I. L aoikm, or gay otba daub to du bt*ity of gay of the i observed?
12. _
(If any of qondotrs 9-12 was answer d ya, and the satiation pass to
immediate public health or ew&onmestd threat, no" DWQ)
13. Do any of the Ammum h ck to iden* atut gad stop pvm&g kvcb?
Waste Atloiication
K 1s there pbygW avidam of over gphcxdm?
.(if ineaves of Vae.orrmffenterins won of the Sb cc nm* DWQ)
Is. Cwp type .o 0
Id. Do the active alop differ with dwae designated m tbs Anima] Waste Manageman PW .
27. Dog the facffity have a lack of adegmw acn age fa Ind application?
Is. Dog the cover emp new hoprovem nt?
19 Is then a lade of available irrigation equipment?
EM Clg&jed F'aciftties t]nly
2D Dog the fecdit3r fail to have a oopy of the Animml maser Managaneos Plan toddy uvaa'lable?
21. Dag die filailety fad to =Vp y with tbs Animal Waste Mkt Pl a ion say. yi
22. Does rre m bmpiag need itopraveraem ?
23. Dog Smility require a IbMm.op visit by same lacy'!'
24. Did Revievvaltasp xIor fail to discr+evicwfmspectian with ovn= or opersmr in '1
DYn ON*
Ya ® w
11 Yea 13 No
E] Yes ImNn
E3 Yes ® No
13 Yn IN No
13 Ya MNo
13 Yes ® No
D Ya It No
CI Ya ®No
n Yes 10 No
M Yes © No
©Yes IMNo
El Yes 13 No
Cats: (t+afer lb Eapinm.amy YES aka aad�oi �amgr miicadanons or `
useUmw of fatEity;tc betEa explain a at gat:
*dial = s
r]L / 7�� N�.� Imo'
�r,L i•3 ,vaP.0 �A�€�S
Rsvkwetflnspector Name,
Reviwe &wpector Signature:
A ��� 1 1 I IYr irr
sr: Divisio a of Mew Quality, Water Qua fey Secdon, Fed y AlommmsR! Unit

0
FN Rodtine 0 Complaint 0 Follow-up of D**V2 inspection 0 Follow-up of DSNVC review 0 Other
F
Date of section
Facility Number _EM9fIJuspectiamL ./o rJo . Use Uhr. time
Farm Status: Total llme (in hours) Spent onRen*ew
or Inspection (hicludes travel and processing)
A0 -- -- -----------
Farm Nam:
Owner Name:
Mailing Address: 41 10.r A710ewX74
Onsite Represents
Certified Operator.
Z
Location of Farm:
Latitude Longitude
UE3 Not Operational Date Last Operated:
Type of Operation and Design Capacity
T
D-rater Certification Number.
Wean to feeder ❑ Layer
IE1
I �77
Feeder to Finish I is, 2.3 Z' ❑ Non -Laver U
E3 Other Tyne of Uvexw&�` V
�e. Subsurface Dzains Present
Utgoon Area
Spray
1. Am there any buffers that need maintenancelimprovernent?
0 Yes
No
I Is any discharge observed from any pan of the operation?
[3 Yes
53 No
a. If discharge is observed, was the conveyance mm"na&7
El Yes
M No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
El Yes
JUNo
c. If discharge is observed, what is the estimated flow in gal/min?
dL Does discharge bypass a lagoon system? (If yes, notify DWQ)
[I Yes
®No
3. Is there evidence of past discharge from any part of the operation?
E3 Yes
MNo
4. Was there any adverse impacts to the waters of the State other than from a discharge?
0 Yes
No
5. Does any pan of the waste management system (other than lagoons/holding ponds) require
0 Yes
No
maintcnancermVrovement?
Continued on back

6. Is facility not in compliance with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/l/97)?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures {Lagoons and/or HoldingPonds]
9. Is structural freeboard less than adequate?
Freeboard (ft): Lagoon I Lagoon 2 Lagoon 3
❑ Yes
0 No
❑ Yes
IM No
❑ Yes
® No
❑ Yes 13 No
Lagoon 4
10. Is seepage observed from any of the structures? ❑ Yes ® No
11. is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes ® No
12. Do any of the structures need rnaintenance/nnprovement? ® Yes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels? ❑ Yes ® No
Waste Application
14. Is there physical evidence of over application? ❑ Yes ® No -
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
I5. Crop type
16. Do the active crops differ with those designated in the Animal Waste Management Plan? ❑ Yes ® No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes [RNo
18. Does the cover crop need improvement? ❑ Yes ® No
19. Is there a lack of available irrigation equipment? ❑ Yes IN No
For Certified FacElities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes ®No
21. Does the facility fail to comply with the Animal Waste Management Plan in any way? ❑ Yes ®No
22. Does record keeping need improvement? 19 Yes ❑ No
23. Does facility require a follow-up visit by same agency? ❑ Yes W No
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge? ❑ Yes ONO
Corfu t6 '(refer to questi6n #)Txglaxn fang YES answers and/or ty rtcommenrla xarrs ar nay other c rents ,µ j �. "
s r%z 4
Use drawings of facility to better explain srtuatsons (use adih+QnaR l pages asectssar3+��=
- .. -•,
4
8
Reviewer/Inspector Name { W.
Reviwer/Inspector Signature: a�» 7� _ Date: y ,z - } 7
cc. Division of Water Quality, Water Quality Section, Facility Assessment Unit 11/14/96

State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt, Jr., Governor
Jonathan B, Howes. Secretary
November 13, 1996
Sandy Evans
Sandy Evans
Rt 1 Box 306
Fairmont NC 28340
SUBJECT: Operator In Charge Designation
Facility: Sandy Evans
Facility ID#: 78-1
Robeson County
Dear Mr. Evans:
a
t � e
®FNFZ
.r.
FVC�:��I
,
NOV 19 f396
ENV. MANAGEMENT
FAYETTEVILLE REG. OFFICE
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form must be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our office.
Examinations have been offered on an on -going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this requirement please
call Beth Buffington or Barry Huneycutt of our staff at 919n33-0026.
Sincere ,
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
Enclosure
cc: Fayetteville Regional Office
Water Quality Files
P.O. Box 27687, 4
Raleigh, North Carolina 2761 1-7687 fC An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 - 50% recycled/100% post -consumer paper

Site Requires Immediate Attention:
Facility No. _
DIVISION OF ENVIRONMENTAL MANAGEMT`EN79 r 325
/ ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: T4 Z-, 1995
Time:
Farm Name/Owner: n —i d) (5-13A., _W 3q
Mailing Address:' c ZOO 3 ,i
County: RIA.•--I
Integrator:_ _ Phone:
On Site Representative: Ord �1��.. Phone:
Physical Address/Location: �d� _
Type of Operation: Swine � Poultry _ Cattle
Design Capacity: Number of Animals on Site: A—­o
DEM Certification Number: ACE DEM Certification Number: AC
Latitude: Longitude: '
Circle Yes or No
Does the Animal Waste Lagoon sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) s
or No A ff Freeboard:sp ,! t. Inches
Was any seepage observed from the la n(s)? Yes or "gas any erosion observed? Yes or No
Is adequate land available for spra ? Ve or No Is the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelli Ye r No
100 Feet from Wells? Q or o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or J0
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or Na
Is animal waste discharged into water of Ae state by man-made ditch, flushing system, or other
similar man-made devices? Yes or 0 If Yes, Please Explain.
Does the facility maintain adequate waste management s (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Y or No
Additional rnmmentc-
'�4L
Inspector NadW
. _.
Signature "
cc: Facility Assessment Unit Use Attachments if Needed.

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Sandy Evans
1305 Marietta Road
Fairmont, NC 28340
Dear W. Evans:
AvlawkA
EDEHNR
DIVISION OF WATER QUALITY
April 3, 1997
SUBJECT:. Annual Compliance Inspection
Sandy Evans Swine Farms
Registration No. 78-1, 78-33, 78-80,78-45
Robeson County
On March 25, 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 m
compliance with 15A NCAC 2H, Part.0217 at the time of the inspection. Please r� 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.
I€ You have any questions concerning this matter, please call Robert Heath at (910) 486r
1541.
Sincerely,
Robert F. Heath
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine - FRO DSW
Ed Holland - Robeson Co. NRCS
Wachovia Building, Suite 714, Fayetteville y� FAX [phone]
North Carolina 28301-5= N%q C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/ 10% post -consumer paper

Routine O Complaint O Follow-up of DWQ Intoon O Fol!=M ofDSWC mAew O Other
Dot! otlatpQctba
Facility Nttneber 7 � � 1''ime auTLspatia� �v rJo Drt =4 iv Um!
Farm Statw. cxazl road i�me (id hours) spent a mmewiew
ler Lopecdoa (includes travel and procenho
O t
Firm Nam, .Sim � S s � 61-'. a It -CAP :A so.*.
-
ensue ReprewMative: s,�"i�1 �/•••r•! ; - S/ /E
Cfttw OpaamR;.:.17k-2 9
Location of Farm
u
Lmt#taade Longitude [:Da I 31
Not Operational Date Last Operated:
Type of Operation and Design Ca arhY
......--
,�c s�3•.".'ry-- -.� « Y� ,�I.:.s'x %::':.'' x t a A�»«.>,r" - --�.r�.Y +{ Z, i.t `._ �t� � . t x F
4a �- r 11�[. umbmiF.1[s
EFw
o feeder �' tRiC w. t?
to Finish 13 "- N '' Beyaf
to WCdr1_�Y�.,rw Tw,'r
"�yS:a r. �a Y�fi r �.yyaa
rim
F w to Einish '-� i Othrr Type onivema
`° .3.�-'�,.%�-a:,��:': '^''�,"+;•:�;''""',r?`, ,+s.,k<« Y' +Y....: w.�,J:i �����e�''��r�".,"'�"uy:�„z �.y„ •'-'..•�.:'• :.z. .< _ ..� �.�... t.�r �� .� � ,V� ��'
1. Are there any buffers that need mainUmanm/umprovemed? ❑ Yes 99 No
3. IS my &charge obsernd f m any part of the w=Sm?
a. if discharge is observed, was the oonveyance ntaa-enade?
b. Ifdiscbarge is observcct, did it reach Sw&ce Wale l Of yits. adtify DWO
e. If discharge is observed, what is the estimate3 flow in SdAmia?
d. Does discharge bypass a lagoon system? (Ifm xdfy DWi) _ -
I It there evidence of past discharge from any pact of the opaatiao?
t] Yes ® No
fl Yes No
E3 Yes 2[No
13 Yes ® No
D Yes Is No
4. Was there Jay adverse impacts to the wa m of the slat= odW tbam fsnm a &wb wp?
S. Does any part of the waste umsgernent system (other than Iagooaslbolding ponds) require
Q Yes P No
13 Yes P9 No

fi b bca ty not is M-1-1 w;r z2Y opplicabe Qimb? F
7. Did titre heft fit m have a M-Med opcftr in =90=0& dbwp Cif baron aft Wro?
L Are there lagoons or sknp pan& an site which need to be ptgaty dome
Structures (Latroon3 anchor Holding P
9. Is swx*n l fitebowd loss film adegple?
Freeboard ($j: 1 Lagooir Lagoon 3
20. L seepage observed from any of the smx*vW
I L Is erosion, or say other &V is to the iategrily of my of the abnwtina
12. Do nay of the Mractures need '
(If any of questions 9-12 was answered yes, aaad the situation pose: act
Immediate public health or environmental t,hr=4 notify DWQ)
13. Do any of the sanctum lack adquaft markers to identify cart and stop pumping kvels?
Waste AIDQlication
X h there pbysical evideace ofover application?
.(If in excess of WMp, or runoff entering waters of the Stacie. notify DWQ)
23. drop type
16. Do the scdn crops difFer with those designated in the Animal Waste Matsag mad Ran?
17_ Does the facility have a lack of adequate acreage for Tared application?
IS. Does the oom crop need improvement?
19. Is there a lark of available irrigation equ4ment?
Forte sed FeeUities nnly
20. Does the facility fail to have a copy of the Animal Waste Managemeat Plan ruaadiny available?
$l. Does the 5e0ity faun to cartrply with the Animal Waste Management Plea in nay ways!
22. Does record keeping need improveamcat?
23. Doss sty require a follow-up vhdt by same apnrfl
24. Did RrvirwerQespcdw fail to dire m rrvdcwrb poWon with owner at operator in urge?
D Yes ® No `
D Yee $g Na
S..
D Yee ON*
13 Yes ® No
lagoon
D Yes is No
© Yea ® No
8 Yes DNo
D Yea ® No
D Yes ® No-
D Yea ®Na
D Yes MNo
D Yes ®No
❑ Yes M No
13 yes ®No
D Yee JONo
im Yea ONO
D Yes a No
D Yes ENO
Commcnts (refer to gucsnon #): , Explain any YES answers'andlorasry=ommctidstiona
Vsedra<wings,of.facilitytdbetterrxplain_:ituatians;�nsead3itio�a3pagesas,�ecp�'x:•.` ��> - `-. ,i��t�.
R
.,..4 ,.a 44.E .cgs. Q
eviewer/iaspeetar Name -" T7;':'_`
erllaspwtor Signature: e.,e,; A Dates Al -A — F 7
.� it r� r r r�. �.r� .r
ol,wo a of wiser oualirs: Water 0ga w seedan. Permit-

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Sandy Evans
Sandy Evans 1-18
1305 Marietta Rd.
Fairmont NC 28340
Dear Sandy Evans:
A&141 07.
�EHNR
July 16, 1997
%iljt 18 1997
FNYi; r TEViLLE
REG. OFRCE
Subject: Certificate of Coverage No. AWS780033
Sandy Evans 1-18
Swine Waste Collection, Treatment, Storage
and Application System
Robeson County
In accordance with your application received on May 30, 1997, we are forwarding this Certificate
of Coverage (COC) to Farm No. 78-33, authorizing the operation of an animal waste collection, treatment,
storage and land application system in accordance with the State's General Permit (attached). This
approval shall consist of the operation of this system including, but not limited to, the management of
animal waste from the Sandy Evans 1-18 Farm, located in Robeson County, with an animal capacity of no
greater than 13230 Feeder to Finish and the application to a minimum of 105.3 acres of land as specified
in the Certified Animal Waste Management Plan (CAWMP).
The COC shall be effective from the date of issuance until December 31, 2001. Pursuant to this
COC, you are authorized and required to operate the system in conformity with the conditions and
limitations as specified in the General Permit, the facility's CAWMP, and this COC, with no discharge of
wastes to surface waters. An adequate system for collecting and maintaining the required monitoring data
and operational information must be established for this farm. Any increase in waste production greater
than the certified design capacity or increase in number of stocked animals above the number authorized by
this COC will require a modification to the CAWMP and this COC and shall be completed prior to actual
increase in either wastewater flow or number of animals.
In accordance with General Statue 143-215.10C, Animal Waste Management Plans shall include
the following components:
- A checklist of odor sources and best management practices to minimize these sources.
- A checklist of insect sources and best management practices to minimize these sources.
- Provisions set forth for acceptable methods of disposing of mortalities.
- Provisions regarding emergency action plans.
Your existing Certified Animal Waste Management Plan must include the above elements, by
December 31, 1998. Documentation of the certification must be available to inspectors onsite. Submittal
of the amended certification statement shall be required upon renewal of your permit coverage in 2001.
Please be advised that any violation of the terms and conditions specified in this COC, the General
Permit or the CAWMP may result in the revocation of this COC.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Upon notification by the Division of this COC's expiration, you shall apply for its renewal. This
request shall be made within 30 days of notification by the Division.
This COC is not automatically transferable. - A name/ownership change application must be
submitted to the DWQ prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the
right to apply for an individual non -discharge permit by contacting the engineer listed below for
information on this process. Unless such a request is made within 30 days, this COC shall be final and
binding.
The subject farm is located in the Fayetteville Regional Office. The Regional Office Water Quality
Staff may be reached at [phone]. If you need additional information concerning this COC or the
General Permit, please contact J R Joshi at [phone] ext. 363.
Sincerely, %
ZA
A. Preston Howard, Jr., P.E.
cc: (Certificate of Coverage only for all cc's)
Robeson County Health Department
Fayetteville Regional Office, Water Quality Section
Robeson County Soil and Water Conservation District
Permit File

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
CERTIFIED MAIL
RETURN_RECEIPX REQUESTED
Sandy Evans
Sandy Evans 5-10
1305 Marietta Rd.
Fairmont NC 28340
Farm Number: 78-33
Dear Sandy Evans:
A IT4
FAIL
�EHNR
April 9, 1997 RECEIVED
APR 0 9 1997$
FAYE rEVi LLE
REG. OFFICE
You are hereby notified that Sandy Evans 5-10, in accordance with G.S. 143-215.1OC, must
apply for coverage under an Animal Waste Operation General Permit. Upon receipt of this letter, your
farm has thirty .QZdM to submit the attached application and all supporting documentation_ In
accordance with Chapter - 626 of 1995 Session Laws (Regular Session 1996), Section
19(c)(2), any owner or operator who fails to submit an application by the date specified
by the Department SHALL NOT OPERATE the animal waste system after the specified
date. Your application must be returned within thirty (30) days of receipt of this letter. Failure to submit
the application as required may also subject your facility to a civil penalty and other enforcement actions
for each day the facility is operated following the due date of the application.
The attached application has been partially completed using information listed in your Animal
Waste Management Plan Certification Form. If any of the general or operation information listed is
incorrect please make corrections as noted on the application before returning the application package. The
signed original application, one copy of the signed application, two copies of a general location map, and
two copies of the Certified Animal Waste Management Plan must be returned to complete the application
package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Permits and Engineering Unit
Post Office Box 29535
Raleigh, NC 27626-0535
If you have any question concerning this letter, please call Mike Lewandowski at [phone]
extension 362 or Ed Buchan with the Fayetteville Regional Office at [phone]
Sincerely,
f-r A. Preston Howard, Jr., P.E.
cc: Permit File (w/o encl.)
Fayetteville Regional Office (w/o encl.)
P.0+�9535, Raleigh, 144i R arolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10%post-consumer paper

State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
November 13, 1996
Sandy Evans
Sandy Evans 5-10
RR 1 Box 306
Fairmont NC 28340
SUBJECT: Operator In Charge Designation
Facility: Sandy Evans 5-10
Facility ID#: 78-33
Robeson County
Dear Mr. Evans:
A4
O Q
r)j
00ft"
QE�HNFZ
'4l°'
NOV 19 1� S
ENV. MANACj ?e-� i E
FAYETTEVILLE REG. OF- iCE
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form must be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our office.
Examinations have been offered on an on -going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this equirement please
call Beth Buffington or Barry Huneycutt of our staff at 919M3-0026.
Sincerely,
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
Enclosure
cc: Fayetteville Regional Office
Water Quality Files
P.O. Box 27687. Nf
1W4CRaleigh, North Carolina 27611-7687 An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 50% recycled/10% post -consumer paper

!- Site Requires Immediate Attention: w
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT 79 _ 3:5
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time:
Farm Name/Owner: ) �51gv 1 `t
Mailing Address: P.t / f , �-�30K- c3mmnz�Zz C yo _
County:
Integrator: *�_ �gentative_ Phone:
On Site Representative: jg-.o Phone:
Physical Address/Location:_
mp
Type of Operation: Swine Poultry Cattle
Design Capacity: 6;g rr� Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: AC
Latitude: Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon h sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) JY;eor No Actual Freeboard4sA_,..,jFt. Inches
Was any seepage observed from the la n(s)? Yes or Owas any erosion observed? Yes or No
Is adequate land available for spry ? Ye or No Is the cover crop adequate? Yes or No
Crop(s) being utilized: -y
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelli Ye r No
100 Feet from Wells? or o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or a
Is animal waste discharged into water ofA state by man-made ditch, flushing system, or other
similar man-made devices? Yes or W if Yes, Please Explain.
Does the facility maintain adequate waste management recp4s (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? A0 or No
Ariditinnal Cnmmente-
Inspector NwIW
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Vito 'Jr-0 0
C d t a l ro 1
A)
0 o1
to
al u N 11
0
04 QI u
1.1 l
0 (J
rrI
i i t ai
U0.1
fit
U at 1; a l u
u�aa
al�'U,'.i..#
;
rvd,1
az
r.l U
m ,I;
do
lei
it
u
it tn
ro a ?.
a V, r' 14 11
I +
rr;
VI dl 11 ry i 111 IL
V C
.,1nl
UtI1 WrIut
�Ipl
�1:t;1a
11°ct,�!���t
` If
dl , [� r11
'In
f 1 'l l at
cf ro
47 1 a) :1
`'
�.
C7 to
fit ."I �x
t1+ 1; VI
N Ate
MI
1., ,�.� •.I
''
dl ,� u, y,
I.) IV vl 01
r r' U
1�1 0
V I [
IV
"I
3 dt do
sn ;t dl ,-r 1.I
UP
v?
r a dj
U
N11 vl ri rr
in
r'� ! 1
• IqJ :s Or �r
• • U
KI,
11'
"t ro
.:I d)
al r: v! •] [I 'to
l r
z [1
11, 1+ alto, y al
I,
1
vl " -.1 QI
IA v .0 '
1U . a'U
no oil
lei >,
v
z
a�
1.
0
n,
�Z ..
at
z�
Vt tI
11 U1 N
Grout
r: c; tit
3 nt N
0
II
:n '
V4
r
a1
-t
n' C
tit .1
11, H
N
411
at
.r,
al
11
1J
ro
G
tn
In
tl
a
O
,

ML
w
r ry.
-w
U
LLIJ
Law..
IM
IMLI
I -
Lw UIVART
LU
Am
im
ti
Uft
4
tm
JUL
JUL
ft.IffU
Z 7
AM
an
Am
SIM
4 A
AM
Am
� Abm

;_"'
E� �
■

� l
I�I�I
.i1 f

ETA

0
'M

►1'
I

A�

r
1
6-

. r»
ti
�..
�� -! 5
Ste.- � �� - �� � ..
•' T� � .
.� ��;
A. .1 +'��
_7�[ r�'1 _ �_ ..
�14.rLtic.�F, 1