780034_INSPECTIONS_20171231

NORTH CAROLINA .�
Department of Environmental Qua

16
m9I®
Type of Visit: eTompliance Inspection U Operation Review O Structure Evaluation p Technical Assistance I
Reason for Visit: tr routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: , 3 t""� Departure Time: County: p%- Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: J. Title: Phone:
Onsite Representative: p +Its Fry D� r y0/1 ,-L c Integrator:
Certified Operator:
Back-up Operator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design Current
wineCapacity
Pap.
We#Poultry
Caacity
Pop. "'
Cattle Capaciinish
La er
Dai Cow
rMF7arrowtoFinish
eder
-
Non -La er
Dai Calf
inish
Dai Heifer
ean
Design
Current
D Cow
eeder
D . �Poultr.
Ca act
P,o
Non-Dairyinish
Layers
Beef Stocker
Non-Layers
Beef Feeder
s
Pullets
Beef Brood Cow
100th
uIts
r
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: `
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (Ifyes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes WNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
No
❑NA
❑NE
❑Yes
No
❑NA
❑NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[RNo
❑ NA
❑ NE
Page I of 3 21412015 Continued

• Facili Number: - J 1 Date of Ins ection:
Waste Collection & Treatment
No
4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[] Yes
[G3
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier;
Spillway?:
Designed Freeboard (in): /
Observed Freeboard (in):
5_ Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Fallo
❑ 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
10 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
SLNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
0 Yes
R No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
fo No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
allo
❑ 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): f �C
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Pg<o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E3 qo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[Zees
❑ NA
❑ NE
acresdetermination? f+^a
17. Does the facility lack adequate acreage for land application? 1 t< ❑ Yes [D No ❑ NA ❑ NE
18. is there a lack of properly operating waste application equipment? LP _&
y ❑ Yes [o ❑ NA ❑ NE
Required_ Records & Documents
be _r
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �Io ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? Ifyes, check 0 Yes [TNo ❑ 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 [ ,v
El Waste Application ❑ Weekly Freeboard [:]Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall O Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Erfo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes [JNo
o ❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - 3y Date of Ins ection: �Y
/
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? Ifyes, check
[:]Yes
[Z 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
Ej No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[]"C�lo
❑ NA [] NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
E2-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
[allo
❑ 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
EJ 110
❑ 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
31�o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [31�o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [E`No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes �No ❑ NA ❑ NE
.5,- 'y �u�-' s / 7 y jur ���rls[u�a� / 'r_�d,
Reviewer/Inspector Name:
ReviewerAnspector Signatui
Phone:
Date:=�!—�bl�
21412015
Page 3 of 3

�„ _ _ ivision of Water Resources
Facility Nutnber l - Division of Soil Fanfi"Gonservation
_ - Q Other Agency
Type of Visit: mpliance Inspection 0 Operation Review O Structure Evaluation p Technical Assistance
Reason for Visit: routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ; 3 Departure Time: County: �� Region:
Farm Name: 4L, Z),z�vj5 -Fie pry-- Owner Email:
Owner Name: %%%�Ll�ircJ�! Phone:
Mailing Address:
Physical Address:
Facility Contact: /7% Title: �c�y, Y _ Phone:
Onsite Representative: i i rx. i ,-7 al 1 ►- Integrator:
Certified Operator: Gum Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
F"�Z O
�b Design Current Design Current Design Current
Swine y; Capacity Pop. _-- Wet Poultry Capacity Pop. Cattle Capacity Pop.
— .....
Wean to Finish La er Dairy Cow
>qwean
to Feeder
27QCD
on -Layer
Dairy Calf
Dairy Heifer
Feeder to Finish
_
-D ,Poul# , Ca aei P.o
La ers
Farrow to Wean
Farrow to Feeder
Dry Cow
Non -Dairy
Farrow to Finish
Beef Stocker
Beef Feeder
Gilts
on -Layers
Boars
Pullets
Beef Brood Cow
-
Other
l Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
I _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3_ Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
❑ Yes [] No
❑ Yes JR No
[:]Yes 23.No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

FaciliNumber: jDate of Inspection: -- �—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ®-No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
allo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[:]Yes
allo
[DNA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
[:]Yes
® No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® 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 [Z_No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �rrrz d IDU`r�Sr"rl e v r^n /ZO t°�
13. Soil Type(s): _ Li2 - f f f� /
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes allo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes allo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 6�[ 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 JRLNo ❑ NA ❑ NE
[:]Yes 0 No ❑ NA ❑ NE
Required_ Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [—]Yes [allo [DNA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes q No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: _ Date or Inspection: �l
. 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes fB 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 C. No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
®No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
'74 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
Cj�_No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31 _ Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Q No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
C!-No
❑ NA
❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Phone:
Date: 6''�:�
21412015
Page 3 of 3

I
Type of Visit: ®'Compliance Inspection O Operation Review p Structure Evaluation Q Technical Assistance
Reason for Visit: all routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: r Departure Time: County: D Region:
Farm Name: W ' ) C ; .-- 12..1. S r -t ., w`. - Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ,-/1�,�,w:s Title: �y �� Phone:
Onsite Representative: ,i ; n :- _ Integrator: RSjy�`
Certified Operator: o+co-�� _ Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
R'et Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
if
Non -Layer
Dairy Calf
Feeder to Finish
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
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
10ther
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes J -No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [] No
❑ Yes [] No
❑ Yes f.No
[:]Yes Cj�-No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3
21412014 Continued

Facili Number: - Ds ection: — 6
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes allo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a2Z-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [3 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 allo
[] NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify 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 U�. 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 Avolication
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes 0 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 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 ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):,&2nif&v rt r / rri
,, 1 ! -
13. Soil Type{s}: �V %C
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes allo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes EqNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 15& 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 [KNo ❑ NA ❑ NE
❑ Yes [3,No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [&No ❑ NA [] NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P�,No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes �No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [::]Yes E]-No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes CE�No
❑NA ❑NE
❑ Weather Code
[:]Sludge Survey
DNA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facifi Number: jDate of Inspection:
+ 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes CEI.No ❑ NA ❑ NE
? 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes CE�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 O No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
allo
❑ 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
[allo
❑ 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
Callo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31 _ Do subsurface file drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
®-.No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or GAWMP?
❑ Yes
O No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[allo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
allo
❑ NA
❑ NE
s of fac ity to better eaplaia;sit11*06. :_(nse;addrtional pages:assnecessary) ,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Date: rZa2t2t&
21412014
Page 3 of

Type of Visit: JOTompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 'D a Departure Time: I Z2/3a I County:
Farm Name ; Ll„r �.�.��y�� Owner Email:
Owner Name: Phone:
Mailing Address:
Region:
Physical Address:
Facility Contact: m � ; .. Title: 6 ,;P1 Phone:
Onsite Representative: �lG,a.��r Integrator:
Certified Operator: �_ Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Poultry Capacity Pop.
Layer
Design
Catiie Capacity
airy Cow
Current
Pop.
Wean to Feeder
3S
©
Non -La er
Da Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
sign Current
Dewon
D , P,oul @a aci P,o ,
Layers
airy Heifer
Cow
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
s
Poults
#Oth
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
fQ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2, Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
[] NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

y Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ZLNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 1 g"
Observed Freeboard (in): 3 C')
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ®. 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 Q, No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes W 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 [E No ❑ 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 N 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): vn d` -
13. Soil Type(s): Lp
14. Do the receiving crops differ from those designated in the CAWMP? Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes ® No NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ®No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
� No
NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
}❑ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
® No
❑ NA
❑ NE
20. Does the facility fai) to have all components of the CAWMP readily available? If yes, check
❑ Yes
JR] 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. 01Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard aste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stacking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
❑ Weather Code
.Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facili Number: IDate of Inspection: 1,_ -3- iS
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes O 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 S No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ® No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ® 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 Z 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
JS 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
21 No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
®,No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Callo
❑ NA
❑ NE
74�7�c
46, cc c t u u7
___/��`
rar 7 0 ct,S et car
r
by
r /
I C ce U pi '�- —ro 4 r %n r '4 o
4-Io— 303— 016­1 Cr!I 0,.J'r
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 9-& --!, j -5 3— 3DCIU
Date: `I— t3-20/3-
21412011
Page 3 of 3

Type of Visit: (D Cam fiance Inspection O Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: Routine O Complaint 0 Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: W QL1Arrival Time: Departure Time: V0 1110.6 ounty&i�n_ Region
Farm Name: A +/Uf ,� �� u t _ Owner Email:
Owner Name: �QVI j Phone:
Mailing Address:
Physical Address:
Facility Contact: tik-N "� v� _ Title:
�r
Onsite Representative:
Certified Operator:
Back-up Operator:
v(
Phone: .
Integrator: & '76 [ � 7
Certification Number: lf;76-3
Certification Number:
Location of Farm: Latitude: Longitude:
esi gn Eurrent
Dn.. esig
Current
Design Current
Swine
Capacity Pop.
Wet Poultr3'
Capacity
Pop.
Cattle
Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
b
Non -La er I
-
Dairy Calf
Dairy Heifer
Feeder to Finish
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D , P,oul
Ca aci
Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
�-
Turke s
ey Poults
Other
Other
Dischar¢es and Stream Imnacts
1. is any discharge observed from any part of the operation?
❑ Yes
[� oo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
E 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
LJ N
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

X�l 9�__ U ,
[Facifity Number: jDate of Inspection: [f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No lf= LJ NE
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): �T
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Structure 5 Structure 6
❑ Yes g ""' ❑ NA ❑ NE
6_ Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[E] 1"o ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[g-i'ttr ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[ ❑ 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
C3>I' ❑ NA
❑ NE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ED_NQ- [DNA
❑ -NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes/❑ 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,`D.�riiift ❑ Application Outside of Approved Area
12. Crop Type(s): &,A VA, V_tk
13. Soil Type(s):
r[
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
❑ Yes
©-1"do
❑ NA
❑ NE
❑ Yes
[�o
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes [y5 N ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Blo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [G]ilo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis D 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 eNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E2'NTo [DNA ❑ NE
Page 2 of 3 21412011 Continued

lFaciNty Number: - Date oiIns ection: �-kC..
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EE[ ❑ NA ❑ NE
41
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q--bio ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes �o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E2- <o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes [� io ❑ NA ❑ NE
❑ Yes U].X6 ❑ NA ❑ NE
❑ Yes ffNo ❑ NA ❑ NE
❑ Yes [!]<o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑�- -i�o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [e3-go ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes G214o ❑ NA ❑ NE
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
21412011

Type of Visit: (0Compliance Inspection U Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: ("outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
US , C 6 2V6
Date of Visit: IV Arrival Time: L._J Departure Time: L � County: 1r _ Region
Farm Name: mt 1 4v, DOwner Email:
Owner Name: 2{ 8 Qxy;_S Phone:
Mailing Address:
Physical Address:
Facility Contact: 3 <<wt 0 &WI le:
Onsite Representative: u
Certified Operator: a
Back-up Operator:
Integrator:
Phone:
a
Certification Number: La ( U V
Certification Number:
Location of Farm: Latitude: Longitude:
f Design Curry Design Current Design Current
Swine Capacity Pop , 'Wet Poultry Capacity Pop = Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder °,S Non -La er
Feeder to Finish " r
Farrow to Wean
Farrow to Feeder D , ,.Po,1
Farrow to Finish La ers
Gilts Non -Layers
Boars' Pullets
Turkeys
Other } £ Turke Points
Other. Other
Design Current
Ca aci P.o P.
�
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes 10 ❑ NA ❑ NE
❑ Yes
[:]No
R;�-NA
❑ NE
[—]Yes
[:]No
C5'1�A
❑ NE
❑ Yes
❑ No -
[n NA
❑ NE
[—]Yes
[dNa-
❑ NA
❑ NE
[:]Yes
M40
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

acili Number:. - Date of Inspection:
or V
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Zl ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
<o
❑ NA
[] NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
to
❑ 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
04o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[jk o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P/No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
��
E11°
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes 2<0 ❑ 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): �lJ <4'A ja_ C__ c ilk U
13. Soil J
-
Type(s): --'Q �.c
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[E] lTo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
g-N-o_
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
lfl <o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Q'1Qo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[a-Nn
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
v 1qo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
to
❑. 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 [<o ❑ 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 dNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0 No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: jDate of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes glvo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L.LJ�"� ❑ 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 lass assessments (PLAT) certification? ❑ Yes EaAo [] NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [BNo ❑ 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 C3 N ❑ 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
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 [jrNo ❑ NA ❑ NE
❑ Yes [ENo ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
' No
VNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question:: Explain any YES.answers and/or any additional recommendations or any other, comments,_ F
Use drawings.of.facility to better explain situations (use_ additional pages as necessary).
0 - I)-- - 0 -� /P
ts aV4-� to - �- I f
Reviewer/Inspector Name:
Reviewer/lnspector Signature:
Page 3 of 3
u
Pholl
Date: 7z 0 (,
21412011

JaJ6r //J_
8 10139
IType.of Visit: Q Compliance Inspection Q Operation Review p Structure Evaluation O Technical Assistance I
Reason for Visit: "outine 0 Complaint Q Follow-up O Referral O Emereency O Other O Denied Access
Date of Visit: p t I Arrival Time: ; I Departure Time: IV`�5o County: c n Region: rM
Farm Name: 1. /71,TAM & , fz fARM Owner Email:
Owner Name: M AR v . DAur5 Phone:
Mailing Address:
Physical Address:
Facility Contact: ��r.,.� [°�}[�� r Title: 9 Phone:
Onsite Representative: JA M 1_ Integrator: li> 1..� 39OLVA)
Certified Operator: �P Certification Number: 160763
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
_
Design Current _
Swine . Capacity Pop. Wet PiAdt y
'
Wean to Finish La er
Wean to Feeder ] Non -Layer
Feeder to Finish - `' _' "'
Farrow to Wean
Farrow to Feeder P,aul
Farrow to Finish Layers
Gilts Non -Layers
Boars Pullets
Turkeys
Other. Turke Poults
Other Other
-
Design Current
Capacity Pop.
Design Current
Cattle Capacity Pop.
_
Da' Cow
DairyCalf
Design Current
Ca aci P,o
Da' Heifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes E�fNo ❑ NA ❑ NE
a. Was the conveyance man-made?
❑ Yes
❑ No
[] NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
�] No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[—]Yes
[►� No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

r
Facility Number: 'l - 344 Date of Inspection: 16Ol 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
[�No ❑ NA ❑ NE
[ rNo ❑ NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in): IQ
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Q No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify
DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
CEJ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
m 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
0 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E� No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. [—]Yes E?�No DNA ❑ 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): QP_P'M DA Gikw-.51 / VtN uA
13. Soil Type(s): 1AC', Aj A N90
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes [;�`No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [�yNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists [:]Design [:]maps ❑ Lease Agreements
❑ Yes
[]'No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes 8 No ❑ NA ❑ NE
❑ Yes [dNo [DNA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [A 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 E�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
E2f NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 06 jDate of Inspection: U t-, !
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [� No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [`� No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes d No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [—]Yes C!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 ENo ❑ 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 0 Yes [Ef No ❑ NA
0 NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes d 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 E� No ❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ff No ❑ NA
0 NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [f No ❑ NA
❑ NE
Gamnients (refer to guestioa #): mendationsor au}othr eomments
ExpainnYEnweis ai/?h!d'ditanal reco)m.
in itatnadi
obeterexplsedrawings of fclty s dtdnl pages as necesaryU
i
ao�7-
�
sis"-� Ag 5m PSG � A �£ckc��Q�a b
Q� SN"C\ kN5=f'�> S�nC� 1t an :r3 c to'5z_ *0
vol.W'&- x,.,CAV,�W-1>- " V-%CW' . 10 -aoi�
r ,
� R�co� v�ea� Kerr.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: CZVOU
Date: I a
21412011

Type of Visit: Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: outine O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: /a ' � County: Region: / /2,fJ
Farm Name: (�c/�ff/rye �J�/`/,S�LJI�, Owner Email:
Owner Name: fCJ Phone:
Mailing Address:
Physical Address: , /�
Facility Contact: Title: �(�,itQ,[� Phone:
OnsiteRepresentative: �n7i17[/ [/��PJ Integrator: !vI g
Certified Operator: 40X-e 46AIl4_ Certification Number: /X20
Sack -up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
g �
Design Current
'.. -
Design
Current
Design Current
Swine
Capacity
Pap.
WetzPoultry .Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
_
La er
Dairy Cow
Wean to Feeder
er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D .1?oult
Ca aci
P,o .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Seef Brood Cow
=_..
Turkeys
Other
TurkeyPouets
Other
;.®e'vrrwaes
Other
-
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
[—]Yes
[[? o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
E<
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
VA
❑ 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
/
Q'<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[ ` o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
['No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Dumber: ZE - Date of Ins ection: Q !
Waste Collection & 'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes E No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Q NA ❑ NE
Structure
Identifier:
Spillway?:
Designed Freeboard (in): Z1—
Observed Freeboard (in): 136
Structure 2
Structure 3 Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes
[glo
❑ NA
❑ NE
❑ Yes
1 No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
R<o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
U� o
❑ NA
❑ NE
maintenance or improvement?
Waste Aaptication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[E j o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
1EKo
❑ 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): i� >
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[ENo
❑ NA
❑ NE
15_ Does the receiving crop and/or land application site need improvement?
❑ Yes
[Ej"No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[] No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
2<o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
aKo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
to
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ['Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard 2<ste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking 0 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 [2s ❑ NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No E3< ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 171Y - Date of Inspection: 4
24.,Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
No ❑ NA 0 NE
BNO ❑NA ❑NE
[:]Yes
�10
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
[216
❑ Yes
Q'Vo
❑ NA
❑ NE
❑ Yes t, To ❑ NA ❑ NE
[:]Yes L'g'No ❑ NA ❑ NE
❑ Yes E3 o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes �io ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes FEJ�o❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use'drawiings of facility to better explain situations (use additional pages as necessary).
1,9-1,31 /
l - �3/ Z-o
Reviewer/Inspector Name:
ReviewerAnspector Signature:
Page 3 of 3
"'L, ,,, &-., '-'� e-ep'� 642,A-a-
Phone: 16) ~ 4.- 431
Date: ldlx
20lI
If f
21412011

Type of Visit ;Routine
m liance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit:-7C}-///o Arrival Time: /: � Departure Time: 'l i �O �- County: A Region:
Farm Name: �1.1�I1 qKf i t'k Owner Email:
Owner Name: iq�Phone:
Mailing Address:
Physical Address:
Facility Contact: /A)-Lt +►✓dUiS Title: O�^-)e-r_ Phone No:
Onsite Representative: lqjrj 'e-r°IV 1 integrator:u�'�W�
Certified Operator: 64 Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ 0 0 = = u Longitude: ❑ o = 6 ❑ «
Design Current
Swine Capacity Population
Wet Poultry
Design Current
Capacity Population
Design Current
C►attle Capacity Population
❑ Wean to Finish
I
1E] Layer
❑ Dairy Cow
Wean to Feeder
j
7 -
❑ Non -Layer I
❑ Dairy Calf
❑ Feeder to Finish
Dry Poultry
El Layers
❑Non -La Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Dairy Heifer
❑ Dry Cow
ElNon-Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
El Beef Stocker
❑ Gilts
❑ Beef Feeder
❑ Boars
❑ Beef Brood Co
Other
Number of Structures:
❑ Other
❑ Other
Disci & 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 To ❑ NA ❑ NE
❑ Yes
❑ No
L' 1 A.
❑ NE
❑ Yes
❑ No
EY&A
❑ NE
❑ Yes
❑ No
3 A
❑ NE
❑ Yes
N"o
ElNA
❑ NE
Yes
ElLS
E,
No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: %g— 03 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ETNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? []Yes C3 o ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
is
Observed Freeboard (in): .7-7
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ffNo ❑ 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 environmentalnotify
DWQ
7. Do any of the structures need maintenance or improvement? El Yes ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ONo ❑ 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 2rNo ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) a e-A l r: da, (-t S� �Gf �Orar N (O. S� Wig! �el/ �jV/V[IG�S . SO1.1/6
iiLLs
13_ Soil type(s)
r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ON"
El
[I NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
E No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
21No
❑ NA
ElNE
18. Is there a lack of properly operating waste application equipment?
ElYes
'Co
❑ NA
❑ NE
..:....
ItComments (refer to question #1) Exptamxany YES answers and/or any recommendations nr any other comments.
=sedraTvV"ng1 of factl,ty to better explain situations. {use additional�pages as necessaryI:
Ai
ReviewerlInspector Name tE -I&N-e,�/��Phone: V33 ` 33-3
1Q`l0,
ReviewerlInspector Signature: Date: T 'ZO — eo/Q
Page 2 of 3 12128104 Continued

Facility Number: 7Date of Inspection - ZO /O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E` rgo ❑ NA [I NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes I—TNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design ❑Maps ❑Other �,�
21. Does record keeping need improvement? if yes, check the appropriate box below. El Yes t"f 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 E] Weather Code
22- Did the facility fail to install and maintain a rain gauge? ❑ Yes ,[ N//o [I NA El NE
E"1
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes
Ld No
ElNA
ElNE
Yes
ElB
'No
❑ NA
❑ NE
❑ Yes
Io
❑ NA
❑ NE
❑ Yes
io
❑ NA
❑ NE
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29, Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
ElNA
❑ NE
El
Yes o ❑ NA ❑ NE
❑ Yes ffN. ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
❑ Yes Zo�
NA ElNE
❑ Yes ❑ NA ❑ NE
Additional Co wits and/or Dr ivi g
.J-
Page 3 of 3 12128104

ArmS er�Lw�cl- 5 —� S = z 00`I
- vision of Water Quality
!Facility Number 7 ®3; f Q Division of Soil and Water aunservation
0 Other Agency
Type of Visit GrIcompliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit O Routine Q Complaint O Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: !RObeSO-1 Region: �'�
Farm Name: A.1i llio w+ ba L : 5 YuYwt Owner Email:
Owner Name: _ w i %lirt sre b a U!'_5 Phone:
Mailing Address:
Physical Address:
Facility Contact: ��' ""sir Oxe^rd; ^j Title: Lt""' �aNa 9t Phone No:
Onsite Representative: J �wM f�" znfdi rr Integrator: /iJ�u�,Pu„� fat'd•'`�
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: [= o Q L = 4i Longitude: = ° ❑ A = {l
IN I
- Design Current
Swine - C•apacity Population WetiPooltry
Design
Capacity
Current Design
Population CattleEl''Emap ,YAPopulation
Current
❑ Wean to Finish
❑ La er
❑ Dairy Cow
Off Wean to Feeder
552-
❑Non-La er
❑ Dairy Calf
❑ Feeder to Finish
Dry Poultry
❑ Dairy Heifer
El Dry Cow
El Farrow to Wean
El Farrow
to Feeder
❑ La ers ElNon-Dairy
❑ Farrow to Finish
El Beef Stocker
❑ Non -Layers
❑ Pullets ❑Beef Feeder
Boars
El Beef Brood Co
❑ Turkeys
Other _ El Turkey Poults
❑J Other El Other
Number of Structures:
Gilts
❑
Discharges &Stream Impacts
Discharges &Stream Impacts
�
1. Is any discharge observed from any part of the operation?
❑Yes
�
L� No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field ❑Other
a. Was the conveyance man-made?
❑Yes
❑ No
ERI�A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
❑ No
�lA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
El Yes
No
L7NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
,❑
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
,L�_TNo
LS No
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facilitv Number- .7 L 3q Date of Inspection 9 —2- 7 -09
Waste Collection & Treatment /
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0NNoo El NA ❑ NE
a. If yes, is waste level into the structural freeboard? ElE� No Yes ❑ NA ❑ NE
Stn,cture I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2.$
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
' No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
O<lo ❑ 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
E[ o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
2 o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El2 Yes
r-,�
o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes
�
0 o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. [IE Yes
,�
o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) SCr-M Lkd e, (/I&., ) W r •J' ,, A"wu
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
C too
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
3.T'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
❑ NA
El NE
17. Does the facility lack adequate acreage for land application?
El yes
B�o
LTl No
[I NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
LJ No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone: W 0, yL33. 33.3AI
Reviewer/Inspector Signature: &ZA AZZ-t� Date: 'K-21-260
11/18104 Continued

A "_
Facility Number: `7g —3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
❑ Yes O No ❑ NA ❑ NE
❑ Yes LJ No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections El Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
ElYes
L"J No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
NNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
El,
NNoo
❑ NA
�
25.
Did the facility fail to conduct a sludge survey as required by the permit?
Yes
,L'�J,
& o
❑ NA
,❑1NE
I�#'Nl
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[I NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El" Yes
��No
No
❑ NA
❑ NE
Other issues
�
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
ElYes
M No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
ETNo
❑ 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
B 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 No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
El NA
El NE
33.
Does facility require a follow-up visit by same agency?
ElL_f Yes
.._
No
❑ NA
❑ NE
Additional Comments and/or Drawings: w ;�
Z,� MU S� � / ...:a /1.i ZnY � S {. I✓� G4.N � �Q G Z'„ F 4J M (J 4�7iiJNOF
Page 3 of 3 12128104

BLiIlS e,v��:-G�f 7-03-08
G-Irrivision of Water Quality
Facility Number j 0 Division of Soil and Water Conservation
0 Other Agency
Type of VisitC)"15o'mpliance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit a Koutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: �'�3: Q Arrival Time: /Q.00 Departure 'rime: %�, Op County: ��s�� Region:
Farm Name: U[��/t//f tG/YI ot V1 %S 4r� Owner Email:
Owner Name: A11 46 a hn L J 1 �C Phone:
Mailing Address:
Physical Address:
Facility Contact: WEwiuw=_ OZeatj (� Title: Phone No:
Onsite Representative: J Integrator:! all Z4
Certified Operator: �IMOW4��✓dtn/ Operator Certification Number: ir70_3
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = 1 = [{ Longitude: = ° 0 d 0
it
Swine
Wean to Finish
can to Feeder
Feeder to Finish
Farrow to Wean
U Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
;552 1 3000 I JE1 Non -La et
Discharges & Stream Impacts
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Design Current
Cattle Capacity 1?opalation
❑ Dairy Cow
❑ Dairy Calf
I
I-
[] Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Ca
Number of Structures:
1. Is any discharge observed from any part of the operation?
❑ Yes
L✓J No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
El Yes
J
ElNA
ElNE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
ElYes
�[JNNo
L1 No
❑ NA
❑ NE
e. 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
BNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
O<o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: -71-3 51Date of Inspection Z3-D
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
0 o
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
rI
Observed Freeboard (in): Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Bl o
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
BNo
❑ 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
E NNoo
❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
2<o
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
E No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
Qiqo-
❑ 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 Drifi ❑ Application Outside
of Area
/
d-,,— kl'N A— AVA-1�4,1
!/�,
12. Crop type(s) fZ id
13.
Soil type(s) *DAdox
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
LI No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
ENo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
ff 'No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
L7 No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name wrdk FLt/Gf,S I
Phone: 9i0,s133, 331d 0
Reviewer/Inspector Signature: Date: 4p - Z.3

A- t
Facility Number: 7 Date of Inspection Z3-D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [hNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ETgo- ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes F5 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ONo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
ff NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
El NA
El NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
,[.TN
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
El Yes
�Li�No
L7 No
El NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
B NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? .
❑ Yes
ETNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
315o
❑ 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
El No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[J No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
2 o
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Wd
Facility Number �$ 3-Z]
0 Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 07'f07 Arrival Time: Z: SO Departure Time: i� ��S County:S�✓
FarmName: aw+ a J i S t. Owner Email:
Owner Name: _LAJi,l�t�, r+.��rtiili _ Phone:
Mailing Address:
Region:
Physical Address:
Facility Contact: x, -.-s i�,�f e � i N L Title: aa1Ace.f Phone No:
. Onsite Representative: ���w•.. KCW c rJe. Integrator: /'�+tt_L p � Dp­b W pi
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: [—] e [—]' [--] Longitude: [� ° [� G 0"
Design Current Design Current
Swine Capacity . Population Wet Poultry Capacity Population
❑ Wean to Finish
Wean to Feeder Z 13100
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -Layer
Dry Poultry
Pullets
Turke\
Poults
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Currenl
Cattle Capacity .Populatio
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes $ No ❑ NA ❑ NE
❑ Yes
Q4 No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[F No
❑ Yes
[9 No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
12128104 Continued

.' Facility Number: '7 3 ' Date of Inspection -07--D
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
`1" No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
El Yes
Q] No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: Z46 /
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ,3J4
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[0 No
❑ NA
❑ NE
(ic/ 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?
111
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement`? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [� No El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ii
9. Does any part of the waste management system other than the waste structures require ❑ Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes [p No ❑ NA ❑ NE
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 ] 0 ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s) ?C 1 ficul /A.1 QI e-1— I 1J1jJ4W
N
S
13.
Soil type(s)
'
14.
T
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
[A No
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
[P No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
1� No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector flame �'> i c R ev t.l Phone: 9/0. V..33. _V330
ReviewerAnspector Signature: Date: .S- d 7- 2-Q07
12128104 Continued

Facility Number: -)'3 - 3 Date of Inspection 5-47 -07
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps El Other
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
10 No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes q No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other issues
2& Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
i No
❑ NA
❑ NE
❑ Yes
EP 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
❑ Yes
CA No
❑ NA
❑ NE
El Yes
'No
El NA
❑NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
Additional Comments.and/or Drawings:
i
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit a Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: _� —Q Arrival Time: 7r Departure Time: i d 0 County:
Farm Name: Owner Email:
Owner Name: �/S Phone:
Mailing Address: 73 JVCL�b g��
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: PAjpnr4l,yC.,.
Back-up Operator: $I '?-ka C-t 1_)a til
5'0 IV Region: 1549
Phone No: �?
Integrator: /GfL[IplL� � w/
Operator Certification Number: _19703
Back-up Certification Number: L T6 V
Location of Farm: Latitude: = o = I = u Longitude: 0 ° ='
=
Design Current Design Current�Design.Current
Swine Capacity Population Wet Poultry C►►opacity Population Cattlapacity Population
❑ Wean to Finish 10 Layer 1 ❑ Dairy Cow
Wean to Feeder
110 Non -Layer I
❑ Dairy Calf
El Feeder to Finish
Dry Poultry a
❑ Dairy Heifer
❑ Farrow to Wean
❑ Dry Cow
ElNon-Dairy
❑ Farrow to Feeder
❑ Farrow to Finish El Layers
❑ Gilts ❑Non -La Non -Layers
❑ Pullets
❑ Boars
❑ Turkeys
Other ❑ Turkey Poults
❑ Other ❑ Other
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes
Ow
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
�FNo
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[ PNo
❑ 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
lXNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
KNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
M No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

•s
Facility Number: 'T - Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[8)No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
KNo
❑ 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
[)YNo
❑ 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
[WVo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [:]Yes QjNo ❑ 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 [VNo ❑ 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 7No ❑ 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/ ❑ Applications Outside of Area
12. Crop type(s) L.�Ct/�u u aq I
Z
13_
Soil type(s) _ _4�_
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1� No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
ElYes
�) 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
RNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
[ANo
❑ NA
❑ NE
Comments (refer to question #t}: Explain any YES answers and/or any recommendations or any other4comm' e�
U01se drawings of facility'to better explain situations. (use additional pages as necessary): •�d
z �W
Reviewer/Inspector Name t/ Phone: /O �-
33aa
Reviewer/Inspector Signature: Date:- / %—ZMtl� -
ruge Z of J 1.4iZaiv4 u0nnnueu

Facility Number: % g— Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes JNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ yes MNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes V 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
[;PNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
WNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[ &o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�OFNo
❑ NA
❑ NE
Other lssues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
V No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
%No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
KTo
❑ 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
QPNo
❑ 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
PffNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PrNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

riv 4fe W`j 8'-//—DS
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
O Routine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: a—Q,S Arrival Time: Departure Time: County: Region: PM
Farm Name: 'LWS *;ikm Owner Email:
Owner Name: � �1bh► A • s • Phone /- ZZ 35N
Mailing Address: 731 KCGE—M Dn. "R101"D me,
Physical Address:. S tzl
Facility Contact: ti3�M t'� Title:
Onsite Representative:�� fN�
Certified Operator:
Back-up Operator: tor- zL
Location of Farm:
.�A Phone No:
Integrator: t�6tj
Operator Certification Number: _II&W3
Back-up Certification Number: Ix r?_I
Latitude: = 0 0 I= �s Longitude: 00
0 6 0
Ld
Y7, 11tr t1ly _11+ X, &4- 1:�D AA� ISR It Z�Z_.
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
$Z Z I ❑ Non -La et
❑
Wen to Finish
D�Wean
to Feeder
El
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
Dry Poultry
Non-L
Pullets
Poults
Design . Current.
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
DEY Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Co
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? (it -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)
Z. 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 2 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA
❑ NE
❑ Yes ❑ No ❑ NA
❑ NE
El Yes El NA
El NE
�1Vo
El Yes IJ No ❑ NA
❑ NE
❑ Yes �`No❑ NA
❑ NE
12128104 Continued

. Facility Number: — 3
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: A27'
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ldNo ❑ NA ❑ NE
❑ Yes 2rNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental) threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 9 1�, No ❑ [INA NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes lQ 3No ❑ 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 2<o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ONo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ZeNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop t ype(s) ��ilfS A'1ej�
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination' El Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
jZ No ❑ NA
No ❑ NA
MIN ❑NA
No ❑ NA
No ❑ NA
Reviewer/Inspector Name
Phone: q04
ReviewerlInspector Signature: Date: - /0 -�
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE

Facility Number: *1 — -341 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? es No ❑ NA ❑ NE
20.
Does the facility fail to havgwi componAV of the CA P readily a ble? If yes, check
the appropriate box. Up Checklists A r5esign VI ps El Other
e
RrNo
❑ NA
❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Bl�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 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
ETNA
0 NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
25.
Did the facility fail to conduct a sludge survey as required by the permit`?
❑ Yes
Q o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
2' E
Other Issues
29. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ONo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
9 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
2 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
2No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
NA
❑ NE
33. Does facility require a follow-up visit by same agency'?
❑ Yes
No
❑ NA
❑ NE
12128104

Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other © Denied Access
Date of Visit: �e / I ` Tune: .�: �`�'
Facility Number '%3'
. .�� O Not Operational O Below Threshold
M Permitted ® Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Naive: L✓i 41W be v , r . County:
Owner Nam E: _. / ).'//i cti-, .!JS. ! .. .._ _. Phone No:
Mailing Address: __ 7.3 y
Facility Contact: Phone No: _
Onsite Representative: �„}, w-, a �E cn ; ��� Integrator. Yea. -12r u ram.
r
Certified Operator: D. XPi_Ik1: w+e Operator Certification Number:...
Location of Farm:
® Shrine ❑ Poultry ❑ Cattle ❑ Horse Latitude
Longitude
��p -.
Sw�ii�
.•. t ign. Vu Lei tt �"6
Current
S.:
-Po onP9.;..-T--Capacity 7popolation_
~
- ', Den
Cattle
Wean to Feeder a
! fr':: a Layer
Dairy
Feeder to Finish,
Non -Layer
Non -Dairy
Farrow to Wean
Farrow to Fender
Other
Ot
"
Farrow to Finish
Total D!_
� Catty
Gilts
Boars
-
' Total `SSLw .71
Number o[I�gooas
�'� �
ti
Discharges & Stream
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) El Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? /y1p
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes M No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes EZ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure S Structure 6
Identifier:
Freeboard (inches):
12112103 Conl&uwd

Facility Number: '7 g — Date of inspection a
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
closure plan?
(If any of questions"was answered yes, and the situation poses au
immediate public health or environmental thereat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes '� No
elevation markings?
Waste Aanlication
I0. Are there any buffers that need maintenancehmprovement? ❑ Yes ER No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes E4 No
❑ Excessive P�ndinar ❑PAN ❑ Hydrap Overload [] Frozen Ground ❑Copper and/or Zinc
1057 '*"t
12. Crop type lSe..., Ala . k/: _ I.. An ., �a / co
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes M 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 deterurination? ❑ Yes ED No
15. Does the receiving crop need improvement? ❑ Yes [J No
16. Is there a lack of adequate waste application equipment? ❑ Yes ES No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes It 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 M 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.
(tefcrta_ga n. r E a Y$Saaswas� ormty ySEWbthercommentk.
=MR-
b�ter� .'(a9e`addi@aasl psasr veld C Final Notes
FRe=viewerAnspector
er/inspector Name L4 Q i -; %!irr.1G _Y3faK7li� _ �y
Signature: Date: 10-
1 frlf.IV✓ wrr�-�..r

Facility Number: 79 — 3 Date of Inspection
Reuuired Records & Documents.
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
BT40
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
{iel ehecklisu, , maps etc.)
❑ Yes
2fio
23. Does record keeping need improvement? If yes, check the appropriate box below.
[t 1es
❑ No
❑ Waste Application ❑mod- Waste Analysis ❑4mi-�g-
V'�0�7J.3�
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
214o
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
O'fio
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
El Yes
,�,,C
(ie/ discharge, freeboard problems, over application)
1� �o
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
lido
28_ Does facility require a follow-up visit by same agency?
❑ Yes
Q o
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[- "No
NPDES Permitted Faei4ides
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
B14o
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35_ Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute inspections ❑ Annual Certification Form
12/12(03

n
Date of Visit: `'js` D3 Time: 2: DO rcr
Facility Number 3
J Not Operational Below Threshold
Permitted Certiiified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: uJiWil,A. County: P—o6---50 AJ
Owner Name: oi,fl E" A. Phone No: 9JC)--#-22— 3515
MailingAddress: 73* Mcleod. DViJP- P,at.JJantti , niC.. 2g383
Facility Contact: --N I KAYA4 OKe4CLI W G Title:
OnsiteRepresentative: :�ii �e—
Certified Operator:
Location of Farm:
Phone No: 0-Y22- 3515
Integrator: 414 ��' 13r0a:14S F�rM
a
Operator Certification Number: A1AJ I g703
cov +Zt wcs 3;" e-- or 5t2 itzz ripayw. r44,, v F ;-IS ;A''� rStC4.arj wii-t, //"rs 46DP/30
aAfd I✓SY4t_ of t4j4_jS Vi j( e- V
wine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 6 Du Longitude °
Design Current
Swi c Ca acity Po ulatton'"
Wean to Feeder 3591 3r2
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons,
Holding Ponds /Solid, Traps AC
❑ Subsurface Drains Present
❑ No Liquid Waste Managen
Area
Discharges & Stream Impacts
I. is any discharge observed from any part of the operation?
❑ Yes BIN,
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other /
a. If discharge is observed, was the conveyance man-made? El Yes EINo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) El Yes BNo
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 [9 No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes [ l+io
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes E o
Waste Collection & Treatment ,
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway El Yes EKO
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: !
Freeboard (inches): 2 �D
05103101 Continued

/` i
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes 21N,
❑ Yes [ lqo
❑ Yes B<
❑ Yes Ei�Ko
❑ Yes 2<01
❑ Yes 93<0
❑ Yes 9
12.
Crop type K K e_ IS- C oo s4- ( 02q
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
q
b) Does the facility need a wettable acre determination?
❑ Yes
,�;'�N
I� �oc)
This facility is pended for a wettable acre determination?
ElYes
o15.
v
Does the receiving crop need improvement?
❑ Yeso
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
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
BIN",'
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
�No
E
20.
1s facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N
21,
Did the facility fail to have a actively certified operator in charge?
❑ Yes
E<o
22,
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
two
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
El Yes
,�
L7Na
24,
Does facility require a follow-up visit by same agency?
❑ Yes
No
25_
Wje any additional problems noted which cause noncompliance of the Certified AWMP?
ElYes
2'No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
,- y
Camarents (refer to questivii #0} �Erplarnany�,YES ansRers and/or any recommeadabau_s or any othe inments.
Us�e'diawings of facility to b"e er eipfa n�situafzon�s. {oseaiiithonal page sias�n teary):'
Field Copy ❑Final Notes
nn �
Reviewer/inspectorNamel'`i, `LLB t'
Reviewer/inspector Signature: Date:
O5103101 Continued

r "%
Type of Visit QKCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facilih• Number
Date of Visit. -zi � p Time: oa
%
rO Not Operational 0 Below Threshold
Permitted ❑/C,e`rtifieed 1 Conditionally Certified ©Registered Date Last Operated or/Above Threshold:
Farm Name: aLZ40.4- /)4y[x !'4r'"t _ Counh"—(�o�Je-Sa'+� —
Owner Name: l [ QL/f 3 Phone No, YZZ
Mailing Address: 7 3 T9.,Cool b , O LId dye
Facility Contact: „ D L,.m e / Title:
Onsite Representative:
Certified Operator:L-
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' • a Longitude ' C�
M
Design _Current._.
S'V1'in@=-- - _C'noaaiTv Pnnnt9 n
Wean to Feeder
S Z
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Soars
Design ::Current Design Earreot
* . ` Ca>Aacrtv==PnDtilstion ;Cattle Caascrtr Poinuli tiol
Nutnber.ofLago©ps ; =;;�I� - ❑ Subsurface Drains Present ❑ La oon Area ❑ S rav Field Area
HoltitngaPoads"/ Soud c.TrapsI.❑ No Liquid Waste Management Svstem 4h
Disebartres A- Stream Impacts
I. Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If ves, 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 capacin, (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inchcs):
05103101
❑ Yes KNO
❑ Yes �No
❑ Yes 9�No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes ANo
Structure 6
Continued

Facility Number: Z f — 3 Date of Inspection —z OZ
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over appli atio . ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type eG-r• /1� erg �O� a
❑ Yes ONO
nA
❑ Yes jV No
❑ Yes No
❑ Yes �(No
❑ Yes No
❑ Yes No
❑ Yes OlNo
13,
Do the receiving crops differ w4th those lesignated in the ertified Animal Waste Management PI (CAWMPr
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ YesINO
b) Does the facility need a wettable acre determination?
❑ YesNo
c) This facility is pended for a wettable acre determination?
❑ Yes
K No
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
)� No
18,
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WliP. checklists, design, maps, etc.)
❑ Yes
<No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
PrNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
qsio
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
1� 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 ReviewerAnspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
o
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comotents (refer.tti_question #) =:Explain aby YES saswersnd/o :ar anv reiurnamerida6o>is or aay.othier=oommeats
ii
Use drsvvings of facility to iietter e=plam smatroea�(ase additiotial:pages as tiecessary} --
_ .• `�❑ Field Copy ❑Final �Note-
IJ-.«-��
Nee / B 5,9A, � 1-a,/ iv t—t e N- / ' vl TQ / - d s._— p G r Ni a—
P P
Awl'
Reviewerlinspector Name Q
Re-dewer/lnspector Signature: Date: -42-
05103101 v I Continued

00
Type of Visit N) Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date ofVisit: Time:
E Facilitt, Number
t _..., . Nar O erationa] BelmsThreshold
® Permitted 11 Certified 0 Conditionally Certified [3 Registered Hate Last Operated or Above Threshold:
Farm Name: I' -, f CountykO 6eS "33 r21
Owner Name: � i)[._ U., C Phone No: __S l 6 64 ,2 a ,— .3 h i ,,;-
Mailing Address: LZ:�t rri C_ Le c3 cj (Dry: yr 4 01. 1 (a" CIL d C. ;Z li?.3 X 1
Facility Contact: C L!J7 rTitle:
Onsite Representative: im r►►
Certified Operator:
Location of Farm:
Phone No:
Integrator: __. ce rrra U I c
Operator Certification Number: f �.
5 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �` " Longitude a �• ��
Design Current
Swine C2natity Ponnlation
10 Wean to Feeder
3 Y
❑ Feeder to Finish
❑ Farrow to v can
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Ca acitF Population Cattle Capacity Population
❑ Laver I I JE1 Da'
❑ Non -Laver I ILI Non-Dain
❑ Other
Total Design Capacity
Total SSLW
rface Drains Present JjE1 Lagoon area 10 Spray Field Area
luid Waste Management System
Discharges & Stream Impacts
1. Is anv discharge observed from any part of the operation?
Dischame originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
b. If discharge is obsen-ed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed. what is the estimated flow in Ral/min?
d_ Does discharge bypass a lagoon system" (If yes, notify DWQ)
2. Is there evidence of 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?
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 Oricbesl: ,
05IV3101
❑ Yes 94
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes fD No
❑ Yes )Sj No
❑ Yes 4 No
Structure b
Continued

Facility Number: 7H — 34 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ 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 aced maintenance/improvement? El Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Aunlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes U No
12. Crop type Aeze n u dA= .4z sf k,� __(r f_Y&L n o' S
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes X] 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 P No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
W 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?
❑ Yes
P No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
LtOp No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
�Co ent efer to'quest<on'#} Explain nyYS anwen and/or an} recommetid onsrany other comments:
(llse.drawuigs,of facility to better eipl n situ ons.s(use additional; pages as necessary ❑Field Copv ❑Final Notes
3 .
fit" t t't' C o! raj .4-
Reviewer/Inspector Name cA
Reviewer/Inspector Signature: Date: ` O
05103101 Continued

Facility Number: g — Date of Inspection f,) � � Printed on: 5/4/2001
-34
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑Yes 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
Additional omments and/orDrawings:
05103101

Facility NumberETKj_EMtD
Date of Visit: Time: r
0 Not Operational 0 Below Threshold
APermitted Q Certified 0 Con •tionally Certified [3 Registered Date Last Operated A ove Threshold:
Farm Name: Yt1L1 a -v .. FanA.- ..... County:-_ Q
f � � t C�
Owner Name: ... le!LL � 1•Q N! ._ . x.4 ........ 41.5..................................... Phone No:............
Facility Contact: ......c..1.G I.IA' ... /,lS L°............Title:............. �` :...... Phone No: .......... .___ ..
93 Mailing Address: 7. T. CL.. ... �'.s..................................... �� i !. .... z . .�
Onsite Represent ative•. ........................................ JIntegrator•
Certified Operator: G
p .t. -lk.i ..................lr. .!.`.....-........ e=--------•-- Operator Certification Number:....
Location of Farm: I
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • A 0`4 Longitude �• �A «
Des,g!k ; Current : -, Deign Current . Destgn '
Catoacit Populabod ` Pp1dT Capacity Poanlation . 'Cattle Capacity ._
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
-_ Number of Lagoons
Holdnig Ponds / Sohd;Traps
Discharees & Stream Im rl acts
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
N0-
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 gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
o
A,
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
XrNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: .................................................................... ............................................................. ............ ...................
..
Freeboard (inches): 3
5100
Continued
on back

J
Facility Number: — Date of Inspection
5- Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ANo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes �No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes o
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes .4fio
11- Is there evidence• over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes
o
12. Crop hype DPf YNl d.tAct- h n__.r / tV,A
13. Do the receiving crops differ with those designain the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
9No
b) Does the facility need a wettable acre determination?
❑ Yes
*rNo
c) This facility is pended for a wettable acre determination?
❑ Yes
KNo
15. Does the receiving crop need improvement?
❑ Yes
WNo
16. is there a lack of adequate waste application equipment?
❑ Yes
gNo
Reauired 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.)
KYes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
AYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
j(No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
KNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
J9 No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
CkNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
0- No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Jallo
1.
yiQi�4itjijs:e d�fifiepd •v'*re )30" d0riAg �his:visit; •Yoh iv1i-tee'iye ti fu�tit0r
.•c
iisi) rideike:alloukthisvisit:•..-:•:.-.•.................:::..:... %%%-.•... .
Jse:dra.,_ in_.._.pages _ecessary) p,offa0i xtobeter xh9ations(useadlitie-tuas n
...
q�
IV eeol �-o P !7-1-- l {'��Derc o�Cirf r
�V4 4eere L� a,wke cI L& ber*t-i d Q � -f 4wc Q.r e a 9 rover`
4ele-0-s
Quc�r_cj l , V'cLril, t o,& gaai
Reviewer/Inspector Name^
Reviewer/Impector Signature: Date: 5100

,o,
^� 'a
I Facility Number: IV'— y I Date of inspection 111 A6 _
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?
Al
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes o
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 I No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional. omments'an or, ra
R; f !y
/I qq N
5100

_
0 Division of Soil and`W
X
E3 Division of Soil and W
S �
®.Division of Water Qua
_ ..
"_... Qther Agency Opera
- 0 eeation Review
Compliance Inspectron
ff
Iiispectaon
w F ^r -
10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Fullow-up of DSWC review 0 Other
Facility Number j S/ Date of Inspection 2 aaa�
Time of Inspection ! 24 hr. (hb:mm}
Q Permitted 18 Certifvd 0 Conditionally Certified 13 Registered 0 Not Operational I Date Last Operated:
Farm Name: ............ ...!,� l�L �` `- ...................... ........... county: ... .......j`.-d..f Eta."J.............................................
r��'... .
�1y - Phone No
Owner Name :!/L./..4--.......��r�/�e�....r..-
'' /� j� ................... ............
Facilitv Contact: ........ .....,( D'/�.............. Title: ...... ............-........... ...- .-. Phone No:
:Mailing Address. ..........��.- � O�Q L. ...........................
Onsite Representative:- �^ �!✓ Integrator. Cf,.ur..eCr G
1 ... .... �....r .......
Certified Operator...... .......... ........... Operator Certification Number :..........................................
Location of Farm:
r....................................................................... ..------ ...--------------- ------ .............. .........�
Latitude ' Longitude '
Design
Current =
Design Current Design Current-.
Swine '. Capacity
Population Poultry,. ,
Capacity , Pu ulationCattle Capacity Population.
Wean to Feeder fZ
❑ Layer
❑ Dairy
❑ Feeder to Finish
, ❑ Non -Layer
, . [] Non -Dairy
❑ Farrow to Wean
-
-
❑ Farrow to Feeder
. ❑ Other
❑ Farrow to Finish
_
Total Design Capaic y
❑ Gilts
=
❑ Boars
Tota1:.SSLW
Y - i Number of Lagoons..
❑Subsurface Drains Present ❑ Lagoon Area ❑Spray Field area
Hoidang Ponds/Solid Traps
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes KIN
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the convevance man-made? ❑ Yes )!�No
h. If discharge is observed, did it reach Water of the State'? (Ifyes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Dues discharge bypass a lagoon sy"tem? (If ves, notify DWQ) El Yes KNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3, Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �Oo
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:
pp• rr
Freeboard(inches): .......... �-t7.............................................. •.... ..... ............................... .............. ..................... ................... I............... ............. ,.....................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage. etc.)
3/23/99 Continued on back

Facility Number: 7p — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes KNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8- Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ }'es No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum Iiquid level
elevation markings? ❑ Yes ANo
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes *KNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes )KNo
12. Crop type � , - _/1 •. C✓�/F/r� _
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes NNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes MNo
b) Does the facility need a wettable acre determination? ❑ Yes R) No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement? ❑ Yes ANo
16. Is there a lack of adequate waste application equipment? ❑ Yes XNO
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes XNo
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 KNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes XNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes Ix No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ANo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes XNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes / P<No
24. Does facility require a follow-up visit by same agency? ❑ Yes tRNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ,&No
:: �10 yiolatioris :or. diAcier�c;ies -mere noted• during this:visit:. Y'oo 'Will •reaeiye fio. fu ther - : - , -
rorres oric�ence: ahi ' f this visit • . • . . .. : ::: : : ::.:. . .
Comments{refer to question #) Explain any YES answers and/orany i commendations or any'other comments s
Use drawings of�fadli to,better:explain s�tusf ons (use additional pagts as necessary) Y —
., - . _-..
a
JAL
Q r/
7
Reviewer/Inspector Name -
Reviewer/Inspector Signature: Date:

Facility Number: 7p — 3 Date of Imspection
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
XTo
liquid level of lagoon or storage pond with no agitation?
r� ``
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
�rNo
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
�Vo
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
AgNo
'AddifionaU Comments.an or rawings_'.

x� Dwision of Soil and Water;Conservat�on`= Operation Review 5 s `
y Dw�sion of Soil and Water Conservation - Compliancelnspect
Y
=` Division of Water. Quality = Gomplian'ce Inspection x
Other Agency Operation Review,:
_ _
Routine Q Complaint Q Follow -tip of DWQ inspection Q Folio,,% --up of DSWC review Q Other
Facility Number Date of Inspuction
Time of Inspection 24 hr. (hh:mm)
Permitted qCertified 0 Conditionally Certified 0 Registered © Not Operational ��Da``te Last Operated:
Farm Name: /.�P
.....� .�.1 •�.1.0'm..---.bfiv S I�C` YL-..-. ............. County :.-....... - .............. .............. .........
Owner Name:...[ '.�..1...t..a?': ` .-f..Z'.........t/ l...................................... Phone No: .............7,z.2-..
.................................................................
Facility Contact: .. 1 � .Z.. 1�lti.- 7V ►.5.. Title:............ .~ ......... ...... Phone No:...............................- ..-.......--......
j�
Mailing Address:..... .:.....G.lQ ... .... .. I.. ...... -. Q'4s���?1rLlt: ...-...�I( ........................2�� s7 ... 7 ................ .
Onsite Representative:... �J,��!vi yy4Lrn ...�..p Intil;rator:.................. .R.►^y��ll
...... L............... ....... .................._............
Certified Operator:,-,•,,, •t,L►!} ............ w p{r��!; ............. Operator Certification Number:......Iv„7D
Location of Farm:
f........................................................................................................... ...................................... ........... ................................................. -...........................................................
I
Latitude Longitude
Design Current
awline uapacuy
Wean to Feeder ,rSZ
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer T= 1[:] Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance elan -made?
b. If discharge is ohservcd, did it reach: ❑ Surface Waters ❑ Waters of the State
c. if discharge is observed. what is the estimated flow in galhnin?
d. Rocs discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I
Identifier: /I
Freeboard (inches): .......... .-...-•......
1 /6/99
Structure 2 Structure 3
Structure 4 Structure 5
k
❑ Yes ,(No
❑Yes No
❑ Yes No
❑ Yes ANO
❑ Yes No
❑ Yes No
❑ Yes VNo
Structure 6
Continued on back

Facility Number: 7g — ?41
Date of Inspection
5.
Are there any inmtediate t rcats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
L
❑YesNo
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
KNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
0 No
S.
Does any pact of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
KNO
9.
Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
❑ Yes
0,No
Waste Aonlication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
/[� No
11.
Is there evidence of over application`? [IPondine ❑ Nitrogen
❑ Yes
,�, No
12.
Crop type ............. cL
P YP ..... ICI..I.!I..........................
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14.
Does the facility lack wettable acreage for land application'? (footprint)
❑ Yes
A•No
15.
Does the receiving crop need improvement?
❑ Yes
jo No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
ANo
Reauired 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
ONO
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 certified operator in responsible charge?
❑ Yes]
No
22. Fail to notify regional DWQ of emergency situations as required by Gcneral Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Revicwer/lnspcctor fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes KNo
N.o.violatioi7S:Or deficiencies .were noted. during .ttiis-vkii:. I'•oti �ilfrec'eive nQ Nriher.:.
ed res'DiHidehee;aboitt;this'visit._•:-,-:•;•;•;•;•:•;•;•;•;-:•;•;•;-;•;•;-;•;•;•;•;•;•;•;• . . .
Coimments.(refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use di -*in s of -facility to better explain situations. use additional pages as necessary):., ' k
N E 4�o kav-e W e Q. C re_0.G a _+ w� iv
i�� ►1 L° °{-o P- tom �eC� n,C� l 1S Irrr -►
� CJ;4 _ J! P
to n o w - 5 9- to l vof a
o ve-,- L 11 4,w, l &O ks 5O 0j,
Reviewer/Inspector Name:
Reviewer/Inspector Signature: Date: 11/6/99

J
! .. —- -
Wk
su Division of Soil and Water Conservation [] Other Agency �a
Division of Water Quality��
Routine 0 Complaint0-Follow-up of DWQ ins ection O Follow-u of DSWC review O Other
Facility Number 3 Date of Inspection
Time of Inspection 124 hr. (hh:mm)
0 Registered A Certified [3 Applied for Permit 13 Permitted � Not Operational Date Last Operated:
FarmName... .............."/ M..... .w ..... &:'r....................................... County:............... tl 3...................................
Owner Name: Ali -Ill. ..... ... �..:............. ioe"Vis
.............................................................. Phone No: ..............
.......... 1...................3Jr. ............
Facility Contact: ................1.e,
e.�-........----..... Title:................................................................ Phone No: ........................................ ...........
Mailing Address: ...........O.x..........1............................................!1(I!S/�itrLy.........C......................... .,G?.;.r?� ...,........ f J r
Onsite Representative: ..... J!.MtY....!.....�N�lit....:integrator:------q,�1 .4..�1...------r,�-•..,17�'_
Certified Operator ;............. +min-n.............. �i. / .-
�----�.. C!.'!......-.I....... ................ Operator Certification Number ......... ---820-3...... ....
Location of Farm:
Latitude r�-�0=1 « Longitude =• =' =11
. Design :o-t Current Design"Carrenf<Desigri Current
w S�vtneCa acrt Po 'iilatlon
Poultry pactty Popufatibn Cattle " C`r act=Po uiat2on
....
❑Dairy
FLaye,
Layer ❑ Non-Dairy
Y u
❑ Other
x .,«
Tota! Design Capacity 3 55-
- ��.
m
A z,
`x
! Numi�er of Lagoons! Holthng Ponds `
❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
.. .. ......rf
-
❑ No Liquid Waste Management System
..e..,
.: ..'
�#
�
Wean to Feeder
Feeder to Finish
(] Farrow to Wean
❑Farrow to Feeder
S
�
❑Farrow to Finish
❑Gilts
❑Boars
General
1. Are there any buffers that need maintenance improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: [I Lagoon ❑Spray Field El Other
a_ If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Surface Water? (If yes, notify DVdQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge b}pass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
S. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fait to have a certified operator in responsible charge?
❑ Yes ONo
❑ Yes V9 No
❑ Yes ffNo
❑ Yes 19 No
❑ Yes ZNo
❑ Yes J4 No
❑ Yes f ANo
❑ Yes '$[' No
❑ Yes P;rNo
❑ Yes JKNo
7/25/97 Continued on back

Facility Numhcr:
8. Are there lagoons or storage ponds on site which need to be properly closed'?
Structures (La2ootts,liolc inpI'omids, flush Pits, e(c.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2
Identifier
Freeboard {#t} .......... .................
10. Is seepage observed from any of the structures?
Structure 3 Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
❑ Yes KNo
Structure 5 Structure b
.........................................................................
12.. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers'?
Waste Applic�atiog
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff centering waters of the State. notify DWQ)
15. Crop type ............................... ......... .......... ........ 1......... .........
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application'.
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
r
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit''
❑ Ye: KNo
❑ Yes 0 No
xiQ Yes ❑ No
❑ Yes Z No
❑ Yes XNo
..................................................
[) Yes
;K,N'o
❑ Yes
JQ ,,No
{ Yes
❑ No
❑ Yes
JUNo
❑ Yes
P(No
❑ Yes
X No
XYes
❑ No
❑ Yes
)KNo
❑ Yes
KNo
❑ Yes
❑ No
0 No.violations or deficiencies were; noted -during this; visit. You Will receive 'no further
correspondence about this visit.. ;
Coiirttments (refei'to question:#): Explain any YES answers and/or atiy teecormrnendations or any either comments. ',
Useadrawusigof facility to better explain 'situataons '(use additional piiges as necessan }:
< x:
C �Q
a � "tr
CAPAIP. KQOJ Gc� 6Y74
_:TXk- a Poq,,yv�;,� to
U7/_ 97
sisvw�i, a,L fib �OXVL�—a .�
0
Rev iewerMspector Name�o . -
DUJ'Y1
Reviewer/lnspector Signature: Date: