780040_INSPECTIONS_20171231

NORTH CAROLINA .�
Department of Environmental Qua

O i _W - - 6- b -_X;P-7
Type of Visit: O"tompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: O tcoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: (o— f/ Arrival Time: (� ,' �� Departure Time:� County: Rp�+s— Region:
Farm Name: , h �.,.��' Owner Email:
Owner Name: �,- -fz z/YIe r. L� Phone:
Mailing Address:
Physical Address:
Facility Contact: ,�/j���cc�—Title: Phone:
Onsite Representative: Integrator:
Integrator• -v
Certified Operator: � � Certification Number: /
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Longitude:
Design
Current
I 17esign Current
Design Currenf
Swine Ca a�
pty,
t „'I
Pap.
o
We# Poultry Capacity . i?op
4 Cattle Capacity Pop. _
Wean to Finish
Dairy Cow
La er
Wean to Feeder
Non -La er
E
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Gurrenf
Dry Cow
Farrow to Feeder
©. I;oul Ca acEPoP.
jNon-Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
5
Turkey Pouits
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes �No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other_
a. Was the conveyance man-made? [:]Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify 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
E3-<o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
B-No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
to
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �G
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
16To
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
D- o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
CEJ 'Co
❑ 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
�o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
D �o
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes e'IVo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �/��Y� 1l0•h�,—IA
V
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Duo
❑ 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
[]`lq-o
❑ NA
[] NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage &Permit readily available? Ye_ []"No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [3-1�o ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [Ej�o ❑ NA ❑ NE
23. If selected, did the facility fail to instal I and maintain rainbreakers on irrigation equipment? ❑ Yes []No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

t, Facility Number: - Date of Inspection: J
24. Did the facility fail to calibrate waste application equipment as required by the permit? es ❑ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Efles ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes �o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑i -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 ofthe inspection did the facility pose an odor or air quality concern?
❑ Yes
�o
❑ 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
0-114o
❑ 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
[aWo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[EjNo
❑ NA
❑ NE
33. Did the Reviewer/]nspector 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
�b
❑ NA
❑ NE
recommend
uvd
dm 14c-I� r-Crcu`C C(
Reviewer/Inspector Name: Phone: �1D�0'f7,<S/
Reviewer/Inspector Signature: _ Date: 7 -2,9/ s
Page 3 of 3 21412015

=9 /7
0
8
Type of Visit: 0-Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 01 routine O Complaint O Follow-up Q Referral O Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: Departure Time: '�'� County:. Region:
Farm ]Name: � �,����� T�l/!� S_ Owner Email:
Owner Name: %jJ�o• j,���u,,� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: ,Qr,U».t.� Phone:
Integrator:
Onsite Representative: j'--c—
Certified Operator: Certification Number: 99-
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
CDattle Capacity Pap.
Wean to Finish
La er
ai Cow
Wean to Feeder
Non -La er
Da' Calf
Feeder to Finish
J "
Da' Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
Dr. P,oul
Ca aci
P,o ,
Non -Da'
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
I I Beef Feeder
Boars
Pullets
Beef Brood Cow
"-
Turkeys
Other
Turkey Poults
Other
I
10ther
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation? [:]Yes MNo ❑ 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
RNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
allo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili Number: 7- Date of inspection:
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 DNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 159�3_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [R No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes _0 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [K No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Ap2lication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [a No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. RZ Yes io ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[� PAN ❑PAN > 10% or 10 lbs. ❑Total Phosphorus ❑Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ®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
[Z No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
S No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
10 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 EQ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22_ Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Eg-No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

Facility Number: gl-- Date of Inspection: - J
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes J�J`No ❑ NA [] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ER -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 fast survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ®, No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes [�JNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
0,No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
F0 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
LK 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
[a No
❑ NA
❑ NE
Comments (refer to question )V)�Expla►n any YES answers and/or any additionallrecaazmendations,or any;other tommen24
ts k
Use drawings of facility to tielter3e><plain:situations (use additional pages as.necessarvi
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Phone: /. fi �U S
Date: /
21412015
Page 3 of 3

`Type of Visit: UCompliancc Inspection V operation Review Q Structure Evaluation U Technical Assistance I
Reason for Visit: oatme O Complaint O Follow-up O Referral O Emergency Q Other O Denied Access
Date of Visit: © Arrival Time: Departure Time: r7 County:Region:
Farm Name: ,2 �� 6�'-Ms Owner Email:
Owner Name: �%Qy fY /%% �r ���/ire— Phone:
Mailing Address:
Physical Address:
Facility Contact: 57 Title: �2�j�j/` Phone:
Onsite Representative: Integrator:
Certified Operator: Ss Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Non -La er
D P,oai
I Layers
Non -Layers
Pullets
Turke s
Turke Puults
Other
Design
Capacity
Design
Ca achy
Current
Pop.
Current
POP.
Design Current
Cattle Capacity Pap.
DairyCow
DairyCalf
DairyHeifer
Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
G�
Farrow to Finish
Gilts
Boars
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes RNo ❑ NA ❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3
21412014 Continued

Facili Number: - D Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Eg No ❑ NA 0 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?:
191
Designed Freeboard (in): _ f
Observed Freeboard (in): Z2__
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
.Q No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
2 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
LigNo
❑ 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
4K[ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
allo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
RNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
CE�jNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
FNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[g No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Eallo
❑ NA
❑ NE
Reouired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[3 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
CE3 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 allo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and i" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes allo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes RNo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 214120I4 Continued

Facility Number: K I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes J,No
�• 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes RNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [,No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes [g No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
0 Yes RNo ❑ NA ❑ NE
❑ Yes SNo ❑ NA ❑ NE
❑ Yes JZJ No
❑ Yes Ej No
[—]Yes ,LNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES airswers and/or;any'additional recommendatiousror�kany',otifer,comments.
Use drawings of facility. to:better explain situations (use'addrbonal{pages "ss'necessary). �
64, -,r L u �-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9iv-�/33 33�
Date:
21412014

(Type of Visit: (6-Coce Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emereencv 0 Other 0 Denied Access
Date of Visit: y 1 Arrival Time: .' O Departure Time: ? County: Region:-
Farm Name _ 1 , 4j_- / a . t'-PX !r _ Owner Email:
Owner Name: _/%tognr� e- !�� m� _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: AgeS s,,1— Phone:
Onshe Representative: Integrator:&e'.144 r'P'41
Certified Operator: Certification Number: 10Ze
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle
11
Design Current
Eapacity Pop.
Wean to Finish
La er
Layer
Dairy Cow
Dairy Calf
Wean to Feeder
Feeder to Finish
to Wean
'-"- .. Dairy Heifer
Design Current Cow
D . P,onlh Ca aci P.o , Non -Dairy
La ers Beef Stocker
to Feeder
to Finish
!FarTow
Nan -La ers
Pullets
Beef Feeder
Beef Brood Cow
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ®No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [—]No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes [] No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes �, No ❑ NA ❑ NE
of the State other than from a discharge?
Page l of 3 21412014 Continued

FaciliNumber: - Date of Inspection;
Waste Collection & Treatment
4. Is storage capacity structural plus storm storage plus hey rainfall less than adequate? Yes
S P ty ( P g P �'Y ) q ❑
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): -Z
Observed Freeboard (in): 17-
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
�gNo ❑ NA ❑ NE
[:]No ❑NA ❑NE
Structure 6
[] Yes [K No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [5�No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑Yes � No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Pj 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 �&Ycs ❑ No ❑ NA ❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes ;K No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. JZ Yes [:]No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [] Heavy Metals (Cu, Zn, etc.)
❑ PAN Ed PAN > 10% or 10 Ibs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): ,/ i a O vro�3 wr� / ✓/t
13. Soil Type(s): i'��rc,�y: //dCo✓� _ _--
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes JoNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 5Q No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes [A No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[Z No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
JE No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Callo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Eg No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists D 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? D Yes XNo
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes F%2-No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Ins eetion:
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 to No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes to No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes El No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
El Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
[:]Yes VLNo ❑ NA ❑ NE
[—]Yes 54No
❑ Yes 0 No
[:]Yes XNo
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question.,p) ,Explain any.YES answers and/or any additional recommendations or any other comments}
Use drawings: of facility to better explain situations (use additional pages as necessary). ;
� K �A;/r�/ _F9 d-20 e�a-&
Reviewer/Inspector Name: _+✓+`.
74 eve
Reviewer/Inspector Signature:
Page 3 of 3
Date: y �s
21412011

E I H s 694 ( lam I?
Type of Visit: 0 Com fiance Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: - Arrival Time: A I Departure Time: County 4 �'r)L4__ Region.
I Ely
Farm Name: J - ' lkt,_ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: six
Onsite Representative:
Certified Operator: 1
Back-up Operator:
Location of Farm:
Title: (,lJ Phone:
Latitude:
Integrator: I(
,a
Certification'Number: �733L�
Certification Number:
Longitude:
Design Current
�°
Design Current
��
Design Current
5wEne
CapacityPop _
Wet Poultry
Capacity Pop- .Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
�,.
$�
Layer
I INon-Layer
_
=
vv
`4.
� �s _
Design Car iht�
Dai Cow
Dai Calf
Dairy Heifer
Cow
Farrow to Feeder
D , P,oul
R
Ca act =:Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Other
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 DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
[:]Yes �o ❑ NA ❑ NE
[:]Yes
[:]No
�A
❑ NE
[:]Yes
❑ No
[JXA
[] NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No [ZI-NA ❑ NE
[:]Yes F/1Xo ❑ NA ❑ NE
❑ Yes 5No ❑ NA ❑ NE
Page 1 of 21412011 Continued

CK
FaciliNumber: - Date of Inspection:
i
Waste Collection & Treatment 5�,�
14. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes L.'j4o ❑ 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?:
q
Designed freeboard (in): {
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�lo
❑ 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
I3-Nw
❑ 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
allo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
! n Ko
❑ 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
FTKo
❑ NA
❑ NE
maintenance or improvement?
Waste Aoplication
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 [�'N, ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �i y- r� W Wz4"+' . 6({ 66*,A
13. Soil Type(s):
14. Do the receiving crops differ from those designated in t e CAWMP?
[] Yes
E&No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0-'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
F7j3ffo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
fi No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[�ib
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
0Jlo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
0 Yes
EB o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [J-No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes VNo
❑ NA ❑ NE
23, If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: a- Date of Inspection: 7
' 24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes UD.Aio ❑ NA ❑ NE
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes [DXo ❑ 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 BJ-No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes EB o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes Q],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 Rio ❑ 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 gj-l�o ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes E&Wb ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [1 o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [Too 0 NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 6'e[—] NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments
Use drawings of facility to better, explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature
Page 3 of 3
Phonelt c7J_2
Date: 3
21412011

Type of Visit: Qpomp ance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outin O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
i'
Date of Visit: krrival Time: Departure Time: County: Regi
Farm Name: C./ /%, Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Phone:
Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Wean to Feeder
Design Current D gn Current
Capacity_ Pop. Wet Poultry Capacity Pop.;
La er
Design Current
Galtle Capacity Pop.
Dairy Cow
Non -La er
Da' Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
-
n
D . P,oult . Ca aci Po
Layers
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Otber:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
[:]Yes r o ❑ NA ❑ NE
❑ Yes
❑ No
[E'1QA
[] NE
❑ Yes
❑ No
[jJ+A
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes [�o
❑ Yes [r10
[2,<A
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

[Facility Number: - Date of Ins ection:
Waste Collection & Treatment
4 GIs storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
1g "o- ❑ NA ❑ NE
❑ No R.?A-' ❑ NE
Structure 6
❑ Yes � ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[a-isTo
❑ 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
❑e .Na--
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]"Yes
C3-V6
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 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
W
12. Crop TYpe(s): C k� 19 C`,'tp' Y6 -0
Soil CG l~
13. Type(s):
14. Do the receiving crops di er from those designated in the C WMP?
❑ Yes
Imo""' .
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E2>d
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑W
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[)hio
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
[] Yes
F,4o"
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
4o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
t L.J,"'
❑ NA
❑ NE
the appropriate box_
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
['No
<
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
U
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facili Number: I I-Ll jDate of Inspection: '
24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q_Na� NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Na-0 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 ii],K*5' ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes Q,?do ❑ 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 �- ❑ NA ❑ NE
❑ Yes [Z>d� ❑ NA ❑ NE
❑ Yes L oMio ❑ NA ❑ NE
[:]Yes [] l o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [goNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes � ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes [2-1�o ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
21412011

I
—1_. Ill
Fype of Visit: ® Compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: ® Routine Q Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: 3 q Arrival Time: Departure Time:County: 19a hf,220Region: r90
Farm Nameg harto Pno-I Owner Email:
Owner Name: ll'}AtuA 1'►�C CA Ilufn Phone:
Mailing Address:
Physical Address: ROW lAtO L e. M 4f-1A2c! 0D, I7D w /A
Facility Contact: Fa rh Cra f IUM Title: f A2M Mttnl4ge Phone:
Onsite Representative: Integrator: 1170%Qy 4ROUAI
Certified Operator: 151up(ty jY1 rCA i turn Certification Number: /F 10 �Q
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Design
YD —ac i t­vj
C►urre. t=
E Uo aWet Poultry
Design
C*apacity
Current
Pop.
Cattle
Design Current
Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
I
Design
Ca aei
P,o
airy Calf
Dairy Heifer
Feeder to Finish a it
lU0
, _
„tD . P�oetlt ,
Farrow to Wean
Farrow to Feeder
I Dry Cow
Non -Dairy
Farrow to Finish
I Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Turkeys
Turkey Poults
Other
Beef Brood Cow
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge'?
❑ Yes [yNo DNA ❑ NE
❑ Yes ❑ No
[:]Yes [] No
❑ Yes
[li No
[:]Yes
[2 No
[::]Yes
1 rNo
[�fNA ❑ NE
ff NA ❑ NE
[DNA ❑ NE
❑NA ❑NE
❑NA ❑NE
Page l of 3 21412011 Continued

I IF
Facili Number: - Dqo IDate of Inspection: rj I Dot
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 6_610 ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 4'.7-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): L
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes UTo ❑ 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 24o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes VNo ❑ 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 [j2 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 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): C0 RR r wh.Q rtA ` ESL j b l pri ] _ 4 E4Lnn UD A I t{a'r .SGo 1 LJ f
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
[:]Yes No
❑ Yes ,� No
[:]Yes 0 No
❑ Yes I] No
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [5� 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 CE(No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
0 NA ❑ NE
Page.1 of 3 21412011 Continued

Facility Number: ~i - 0 4b Datc of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[fNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
0 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
VNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
[ZNo
❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the ReviewerAnspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[SINo
❑ NA
❑ NE
❑ Yes
[2"No
❑ NA
❑ NE
❑ Yes
[0"'No
❑ NA
❑ NE
❑ Yes
[dNo
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes
[XNo
❑ NA
❑ NE
[:]Yes
2"No
❑ NA
[] NE
Comments (refer to question #():-Explain any YES answers and/or any additional recommendations or ya ,0-tither comments,"
Use drawings of facility to better explain situations (use additional pages as necessary ).57
1�A�tiUn, �ki�u��udt£S , r .1zldS 10, Ke4 t oo p,
a tp—O R p S %-�F_ prt w l✓0
Reviewer/Inspector Name:
Phone: C1 1d%-L0,%Sk
Reviewer/Inspector Signature: Date:
Page 3 of 3 2/4/2011

RZ^-% -711.4120t 1 4V
R - V
Division of Water QuaEity
Facility Numbeater Conservation
© Other Agetcy
Type of Visit: (& Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: IF Routine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: Z ( OI Arrival Time: ? iao 4Departure Time: 730 County: po jr3t�jl
r
Farm Name: PT nto rQRatS Owner Email:
Owner Name: M 44 T.0 I A p c 0_q 1 fem Phone:
Mailing Address:
Region: rAb
Physical Address:
Facility Contact: ZZ?k u AST ni C[� A uM Title: r - i# k m M A V dW-X Phone: Q (O - ') 40 - 80.5'"6e
Onsite Representative: Integrator: M u R D 1Lv 8 R aw nJ
Certified Operator: R v AST �i C CA I Iy +rn Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design CurrentAM
DesignCurrent
,: ,
5wiae Capacity Pop. Wet Poultry x Ciippac�ty .Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish La er
airy Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
�'
000 = - :
Da' Heifer
Farrow to Wean
Farrow to Feeder
Design
D , P,oul _ C a i
Current
Pzo
D Cow
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qther
Turkey Puults
Other
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?
❑ Yes gNo ❑ NA ❑ NE
❑ Yes ❑ No Ea"'NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[:]No
LgNA
❑ 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
YNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili umber: jDate of Inspection: 1 !8
Rai
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
53 No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: #� —
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1'
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
[gio
❑ 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
[j""No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
2No
❑ 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
EgNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
�o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Fv-?"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 Area12. CropTYPe(s): CORN ,t.]hLA}sue ea rms : 1it;k MLpg yt,%,j ts0 I fLjhe_MJ
13. Soil TYPe(s): cor'y' .. 'Rk ca UM_0 F— —
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 [�J No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes G3"'No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[]Yes
[EfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
[]Yes
[ TNo
D NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Of
[g No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[20No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes [2�No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 2"'No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No
DNA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
E�'NA ❑ NE
Page 2 of 3 21412011 Condnued

Facili Dumber: - Q•{ O Date of Inspection: -7I
ae t
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[-]Yes
[dNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[g'N' o
❑ 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
[RrNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
[]rNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[VNo
❑ 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
[gNo
❑ 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
ErNo
❑ 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
02fNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
gNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
UdNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments:°
Use drawings of facility to better explain situations (use. additional pages as necessary).
ire¢-.D t.jK3Az F.gLap M,tN % cAl=bRa+t`D Va f
I—AgoaN , 54 R U CA V0,1ESI i Frt,10,5 100gk0 4?o00
fl£CdRt3S TN cp RO E R t KEPT LAO
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Qi0 - 433.3331
Date: -1 fill
214112011

ArAys
Type of Visit (r ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: /9' /o Arrival Time: �z� Departure Time: CountyRegion:
Farm Name: `Xet'vd �2y�"rS Owner Email:
Owner Nfkmr- A? k-)4c /9 cej/Ar X'&F Mani -
Mailing Address:
Physical Address:
Facility Contact: .5 �ilG LQ/UUAI Title: Phone No:
Onsite Representative: ` Integrator:r��'n1
Certified Operator: s7 Ct cla.- jL We Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Ewa
Latitude: F__] 0 0 ' 0 Longitude: [= ° [= , =
Design Current
DesignSPopnplation
ultry Capacity
Cattle Capacity Population
❑ Wean to Finish
10 Layer
❑ Dairy Cow
❑ W an to Feeder
1 10 Non -Layer I
❑ Dairy Calf
eeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Dry Poultry,
❑ Layers
❑ Non -Layers
❑ Pullets
ues
❑ Dairy Heifer
❑ Dry Cow
❑ Nan-Dai
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Cove
❑ Turkeys
Number of Structeues:
It
ElOther
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
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?
El Yes Ej o ❑NA ❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El NA
El NE
❑ Yes
LE�7,, Noo
❑ Yes
L�-iNo
❑ NA
❑ NE
❑ Yes
E? o
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: `7b
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 I Structure 2 Structure 3 Structure 4
El Yes 8-No ❑NA El NE
❑Yes B11oNo[I NA [I NE
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
v
Observed Freeboard (in): Z (v ,_,,%
5. Are there any immediate threats to the integrity of any of the structures observed? El Yes B<O ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.) �
6_ Are there structures on -site which are not properly addressed and/or managed ❑ Yes B o ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes ©'No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E71N. ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ETNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes B<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 ❑1 Application Outside of Area
12. Crop type(s) I�INtc� -f J_/q l', c�sst6%% lova�i✓ CO.SJ _ fivv,y- k/ ­ v5
13. Soil type(s) �,
14. Do the receiving crops differ from those designated in the CAWMP? El Yes Li'No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ,., BIN-'. ❑ NA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes L1 NNoo ElNA ElNE
17. Does the facility lack adequate acreage for land application? ElYes [5 o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 01�o­ ❑ NA ❑ NE
Reviewer/Inspector Name
Reviewer/Inspector Signature:
2007 1 rt o `>+- + �ru,'rc d rS7 ZO
Phone: /O+ K33- 33-s
Date: '/,—/ 9 — zo/o
Page 2 of 3 12128104 Continuea

Facility Number: 78 —gyp 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 El Maps El Other
❑ Yes
ErNo
❑ NA
❑ NE
❑ Yes
B o
❑ NA
❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
o ❑ NA
❑ NE
❑ Waste Application ElWeekly Freeboard ElWaste Analysis ElSoil Analysis
[IWaste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections, El Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
Er<o ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
LTNo ❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
i�o ❑ NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
3 o ❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
3<o ❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
L'_f No ❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
B<o
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[--]Yes
EF<o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
ElEk yes
o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
L +o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
�,
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
[I Yes
L, o
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
L`_Ko
❑ NA
❑ NE
Addrti' -id Comments and/or: Drawings:
Page 3 of 3 12128104

6Z7/cj"s 5-_/ 7 - C 7
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: 40 -0 I Arrival Time: y:3 Departure Time: %Qi County:
Farm Name: PEN Q a N J Zd
:: rA 4 / Owner Email:
Owner Name: Mar -Fe l F..• MG Cd!l �1 +✓r Phone:
Mailing Address:
46 b 250 Al Region: Af'�
Physical Address:
Facility Contact: Sf u d j'�C`-�i'l �t/rt Title: /�/_tl Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 c = ` 0 " Longitude: = ° = i = u
Design @urrent�A°
Desigtif Current
Design Current
ne .Capacity Po elation
rE
9t
`'Vet P ultryCa aciPo elation
Cattle Ca aci Po elation
Wean to Finish
❑ La er
❑ Da Cow
Wean to Feeder
-Layer
❑ DairyCalf
Dd Feeder to Finish
Z$g
ltry .;a
El Dairy Heifer
Farrow to Wean
❑ D Cow
Farrow to Feeder
Non-DairyFarrow
ers
to Finish
ElBeef Stocker
[EE31 Gilts
❑ Non -La ers❑
❑Beef Feeder
Pullets
s
Boars
❑ Beef Brood CoTurke
❑ Turke PoultsOther
❑ Other
i+lumber.of'StruCtures:
Discharses & 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 E No ❑ NA ❑ NE
❑ Yes ❑ No B NA ❑ NE
❑ Yes ❑ No E3 NA ❑ NE
❑ Yes ❑ No lJ NA ❑ NE
❑ Yes 0/N0❑ NA ❑ NE
ElYes O No ❑ NA ❑ NE
Page I of 3 12128104 Continued

Facility Number: 79 — Date of Inspection
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�N�o ❑ 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
I °'iNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
94. ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
DoNo ❑ 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 El Yes
..,,//
R o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes
�,
9, o ❑ NA ❑ NE
maintenance/improvement'?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evid©ence/of Wind Drift [I Application Outside of Area12.
Crop typer
s) ge M it t�� I� £ r asyU rer) (.IC rnl , t1,14 U t =QUAWAL5
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
9<o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0�—Ko
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[--]I-1
Yes
ivo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
01qo_
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Comments re er Ea uestianr# Ex IM an `#6
( _ q ) p y YES answers andlor any recommendations or any other comments.
Use drawrngs _off Mtyyto better egplaln situations. {use�ajdditional9pagesFas,necessary,
Reviewer/Inspector Name I T rv{ lS Phone:/�, i13 334�0
Reviewer/Inspector Signature: Date:`%0
Page 2 of 3 12128104 Continued

Facility Number: — Q Date of Inspection /D-D
ReQuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑'Vo_ ❑ NA ❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[}No
❑ NA
[--IN E
the appropirate box. ❑ WUp ❑ Checklists ❑ Design
g ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
9-1 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 Inspectionss E] Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
[I Yes
B o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
B" o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
©<o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
l: TNo
[I NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
B No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
B'5lo
❑ NA
❑ NE
Other Issues ,�
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes E wo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
2 o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
.,�
2 o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
BIio
❑ 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
El NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
,per
B lvo
❑ NA
❑ NE
Additional[Comments and/or.Drawtags� r"`
a
w
Page 3 of 3 I Z?8/04

C
Type of Visit pr-Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (3 outine 0 Complaint O Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 34 Arrival Time: S.011 A,., Departure Time: /O. Gib County: �l�es�.c/ Region: /=Zo
1
Farm Name: i"V e- lce'val _Ea,—X f Owner Email:
Owner Name: /l/laY1, 8. dt6r Phone:
Mailing Address:
Physical Address:
Facility Contact: s 4 r j� /!lL ��/o r�-� Title: lffe"'V* gfif Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = e = I = N Longitude: = o =' = u
7Fesin-u"-el t: Design Current Design
Current
Swine
ppulation
Wet Poultry
CapacityP pullatEonjCattle Capacity
Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Dairy Calf
Wean to Feeder
JE1 Non -Layer J
Feeder to Finish
Z a7900
I�Ir
u
❑ Dairy Heifer
❑ Farrow to Wean
'❑ Dry Cow
❑ Farrow to Feeder
Dry Poultry
❑ Non -Dairy
❑ Farrow to Finish
❑Beef Stocker
❑ Gilts
El Beef Feeder
❑ Boars
El Beef Brood Co
Other
❑ Other
-_
Other
='Number of Structures:
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Points
❑
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Yes
[I�
<
[I NA
El NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
El NA
El NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
[T�
El NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
,—,�
3 o
El NA
El NE
2. Is there evidence of a past discharge from any part of the operation?
[I Yes
0-5o_
[I NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes Yes
L1
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Number: 7 - Date of Inspection Ei 30-0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
N�o
❑ NA
El NE
a. If yes, is waste level into the structural freeboard?
El Yes
,[�3
L ] �o
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):L
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
BNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
0-iqo--
❑ NA
[:IN E
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
Bl o ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[Tl ioo ❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
�,�
Er, o ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
,�No�
L7 ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift Application Outside of Area
�❑
12. Crop type(s) �Crn( ��2 F r lkr C rN .JAC
bars
13. Soil type(s) - r
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
-Tom❑
G<o ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
❑'N-o ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
E31 or [3NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
BIZ ❑ NA
❑ NE
Reviewer/inspector Name avfls Phone: `//eta �•j334
Reviewer/Inspector Signature:_JV � Date: (i -30- ?r4
Page 2 of 3 12.128104 Continued

Facility Number: 79 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropiate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other �
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes 3 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 El -go' ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Bigo- ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
B'Ko
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0'1q—o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑<
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
go
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
L7 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0'l o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
,.,�
LTNo
❑ 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
���
Cl 1�o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
B o
❑ NA
❑ NE
Additional Comments and/or
12128104

'15d)e2 A, 041,11
® Division of Water Quality
Facility Number 'Q Q Division of Soil and Water Conservation
- O Other Agency
Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine O Complaint 0 Follow up O Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: z:q7 Departure Time: :Od County: AAbe-50 v Region:
Farm Name: P1)jG1a�vd &,,.s4 S Owner Email:
Owner Name: _ Iffarle.1 $( 42164 Phone:
Mailing Address:
Physical Address: L /a ,
Facility Contact: -5�z "T Alc�t/l,ti Title: „ '0</*A4 Phone No:
Onsite Representative: .5 Yam( 1411I 4 Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Gilts
Other
❑ Other
Back-up Certification Number:
Latitude: = o ='
= " Longitude: [=] o [=] ` ❑ "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
I11 ILI Non -La ei
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other J.
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?
Cattle
Design Current' '
Capacity Population ;
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy_
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
[0 No
❑ NA
❑ NE
❑ Yes
[4 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
0 No
❑ Yes
1;4 No
❑ NA
❑ NE
❑ Yes
[-4No
El NA
El NE
12128104 Continued

F'acifity Number: 7$
r'
Date of Inspection -2 - 0 71
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
N
Observed Freeboard (in): Z$
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 [9 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
P No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
N 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
[9 No
❑ NA ❑ NE
maintenance or improvement?
Waste Anolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
MNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
P No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or i0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Drift ❑ Application Outside of Area
/Wind
12. Crop type(s) L� er7c(u A �s�...� � C�Yn J W � t_ �. - �
4t �nra.�.�5
_
�r--
13. Soil type(s) ycA c-k - Am- Aoro tli/t c — Ca
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑
Yes
[9 No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ANo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
(A No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
J
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name 4Lve( Phone: TO. t33, 3330
Reviewer/inspector Signature: Date: Al- —26 - Zd a%
121261" uonunuea

Y
• Facility Number: -7 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ® No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes jNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ StockingF! El Yield ❑ 120 Minute Inspections El and i" ]fain inspections El Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
Qj No
❑ NA
❑ NE
❑ Yes
Q?No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
�M No
❑ NA
❑ NE
❑ Yes
(P No
❑ NA
❑ NE
❑ Yes
[;4 No
❑ NA
❑ NE
❑ Yes
[2f No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
[? No
❑ NA
❑ NE
12128104

Type of Visit p Compliance Inspection O operation Review Q Structure Evatuation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency Q other ❑ Denied Access
Date of Visit: I' 30 '(J� Arrival Time: %O. Jt`� Departure Time: County: Ieal�rysa� Region:
Farm Name: JA F m Owner Eail:
/Yl � Owner Name: t t-�w Aye C4l�W M
fQ�Phone: )
Mailing Address: 517 olile /C��.3 ��ti+d . Ahi'
Physical Address:
c�
Facility Contact: 5�lnr-/ _ d&-611,44 Title: Phone No: Q
Onsite Representative: 'ktAo e4 C Integrator: Kr-.Ol U�'oLJN
Certified Operator: Operator Certification Number:
Back-up Operator -
B
ack -up Certification Number:
Location of Farm: Latitude: = ❑ i 0Is Longitude: = o ❑ S = i4
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er I
I I JE1 Non -Laver
I
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
Design Current
Capacity Population,:;;
1
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
h
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 (9 No ❑ NA ❑ NE
❑ Yes
19 No
❑ NA
❑ NE
❑ Yes
(�?No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[R No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
R9 No
❑ NA
❑ NE
12128104 Continued

r
y
Facility Number: '7 — () Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P9 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [p No ❑ NA ❑ NE
Structurco Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
p s�
Designed Freeboard (in): !
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Eff, 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
[RNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
[:1 NA ❑ NE
S. 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
JK] No
❑ NA ❑ NE
maintenance or improvement?
Waste A _plieation
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
N'No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
WNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drib ❑ Application Outside of Area
12. CroP h'Pe(s)-
13. Soil type(s) � ,¢ _ A.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
5allo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
N No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination!❑ Yes
[M 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
[3No
❑ NA ❑ NE
Comments (refer tof'q tisu #) FExplun ES answers s>Zd/ar;anymmen ons or any atber catnments.
se drawings of facility�ta better explain sttnations. (use addition$Ipages:as necessary):
Reviewer/inspector Name �- t k. ; Phone:
e„v e
Reviewer/Inspector Signature: Date:
1-111WU4 Uanunuea

r -
Facility Number: $ — :0 Date of inspection
Reguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [RNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [;5 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
❑ No
10 NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
W No
[--]'NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
fo No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
R] No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes]
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[� No
❑ NA.
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
(;'No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[XiNo
❑ NA
❑ NE
12128104

IType of Visit 0 Compliance Inspection Q Operation Review O Lagoon Evaluation I
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number '] y O Date of visit: Time:
fo'/y-of O Not rational O Below Threshold
field
MWermitted Otertified © Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: W _ _ p ._ .r tears County:
Owner Name: gG ��s l� v Phone No:
N ading Address: _! S ?! e.� . .G cr _.._�e��. / N 4
Facility Contact: It'Ic�ct�/�a. Title: Phone No:._.1/a - y» -5
Onsite Representative. 51L er /f?C r! Integrator. ajl —god Z,,
Certified Operator.. + _ , Mc Cr.& ; , ,, Operator Certification Number-___1jYa 97
Location of Farm:
[$wine ❑ Poultry 0 Cattle ❑ Horse Latitude ' Du Longitude •
Discharses & Stream hngacts
I _ Is any discharge observed from any part of the operation? ❑ Yes G-Ko
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 9-Mo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes 2NO
c. If discharge is observed, what is the estimated flow in gal/min? r
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes G-No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes gNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes RNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes G.K0_
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure G
Identifier:
r,
Freeboard (inches): y
12112103 Continued

Facility Number: 7$ — yO 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/unprovement?
8. Does any part of the waste mana,ement 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
I0. Are there any buffers that need maintenance/improvenient?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crops C.JNK Yg :qy C Sao
v
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. 1s there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes Rio
❑ Yes �0
❑ Yes afq-o
❑ Yes 1 _ l o
❑ Yes �o
❑ Yes G�<oo
❑ Yes 94<0
❑ Yes Bf40
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes R No
❑ Yes M-Ko
❑ Yes ❑ No
❑ Yes am
❑ Yes 0.NCP
❑ Yes &No
ellield Copy ❑ Final Notes
PIeuse 0"0n,'/Bj- bare Riess ctr—*Wpl �,"&" -rdr 2r7s iT, I-ra /alas 4 I,'.„�
darc 4,rea s 4A=
9rcrss rove.
Reviewer/Inspector Name z
Reviewer/Inspector Signatures
See vertu .Se --a -4, e-cl- Ar w 90.w
Dates 1 U -/ 9 -
12/12/03 Continued

Facility Number: _.y0 Date of inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W-LRI',-chSpkJi9 , d%ig-maps etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
7-/5" -;,'. G 3 3.3
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design.
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewerfinspector fail to discuss reviewfmspection with on -site representative? `
28. Does facility require a follow-up visit by same agency? 1
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, slip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑-Sseeking-FeFmd ❑
❑ 120 Minute Inspections ❑
EFY-es ❑ No
❑ Yes ❑ ?6�
❑ Yes ❑No
❑ Yes [;JNo
❑ Yes U-No
❑ Yes S-No
❑ Yes DNo
❑ Yes
❑ Yes &Ko�
❑ No
❑ No
❑ Yes Ej<o
❑ Yes KWo
Q'les ❑ No
❑Yes El No
J E3 No violations or deficiencies were noted during this visit. You wf receive no further correspondence about this 'visit. I
/ / vo x0e & Cwr�.+� LOL 0^ $.1<< A✓i af�/ hof A-ae a rvP%
Of �e �!°O�-S PCi,.,,'!. .rh��lrt� Lv,'�� •+1a,� a CaAi
*31 Mr, r'1cCal1„�, S,gn�oi ��c fo��r 57`af,.y Ae
a O/ie,% on eWA,
"3S Rev;r� iL4c N/°DIS /of}+5,
• Grope Kee 'G"
' Nt&. Q i u►,r.� RR� Fo►r.�,s (t..ni fy 4.s.;, b%&I ' z -1)
elp ' r7
12/ITJ03

(Type of Visit Q Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: ® Tune: 1/; `>'�
Facility Number�Q��—�y—�
O Not Operational O Below Threshold
['Permitted ®'Certified /3 Conditionally Certified Q Registered Date Last Operated or Above Threshold: --
Farm Name: ...........County:.F?o....
Owner Name: r �� /1 it C �c� �J v�'l...... .._ Phone No: i U 4i-2--a —3--
Mauling Address:.._ s ..... �. 1 a r _....� !�a. C:r _ . �(----.....�Q.t�r
Facility Contact: Title W._.... .. Phone No:------------...--
Onsite Repr esentattve:. ._.__. _.....__ _.._ .. Integrator:
Certified Operator:._ _ .. .. _.._....... _.. _._......._...._.... .............. Operator Certification Number:.._.__._....__....._.__._....
Location of Farm:
[4-SW1ne ❑ poultry ❑ Cattle ❑ Horse Latitude a ` " Longitude • 6 96
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure l Structure 2 Structure 3 Structure 4 Structure S Structure 6
Identifier: .......... ... j..................
Freeboard (inches): ?.)
12112103 Continued

FaAlity Number: 2 Date of Inspection ERI
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ❑ No
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/nnprovement? ❑ Yes ❑ No
S. Does any part of the waste management system other than waste structures require maintenancerunprovement? ❑ Yes ❑ No
9. Do any strictures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ❑ No
Air Quality representative immediately.
C {urefer to gaestioa:Exp3m it�yYFSvas andJoraa3► or i of COMM
drnW�ty enstastio(aseField Copy ❑ Final Notes,
AP
a, =r
A,
ReviewerAWsspector Name
Reviewer/Inspector Signature: Date:

i
E3 Division of Soil and Waterf Conservattan Operation Review s
D Division of Soil and Water'Conservation CompH ncetiLicpectwn
Division of Water alt F Comx'lxance Ins ecttan
`�" -cty + i F y „tea
*r Othei-Agency Operation Review a :T,x f x-
19 Routine 0 Complaint Q Follow-up of DWQ inspection 0 Follow-up of DSIVC review 0 Other
Facility Number 78 Date of Inspection G
lime of Inspection 24 hr. (hh:mm)
® Permitted 13 Certified © Conditionally Certified © Registered 10 Not O erational Date Last Operated: p ..........................
Farm Name: ...-.-.-.::... �✓ .�� ld ------------ Count}':
Sal✓
Owner Name:.......--- i/-.// •-.��G �1. !! ............................... Phone No: 6/..?...���!�-..-^Z2f/................
Facility Contact: .... ANOP�r.�....-..,.11..... -. �ie'4� Title: .........................--.................... Phone No:
Mailing Address:.....-.Ir..✓....-..-...iGt'Jt_.ieG�' `�4 .. ..........I&W14
....L..O...........
.s�....�..G...t,.r...(.F..ffF...s�
Onsite Representative:..... ................... Integrator-'...�, *Ae
Certified Operator:......, j •..• -, • � . .............. Operator Certification Number: ..........................................
Location of Farm:
Latitude 0.0` Longitude • �� L i °'
1. - ._. .
Design Current Design : _ Ctirreiit . , Design Cuirent
Swine, < Capacity Population Poultry:- Capacity. Population Cattle Ca acify Po ulation '
❑ Wean to Feeder ❑ Layer ❑Dairy
Feeder to Finish ❑ Non -Layer ❑Non -Dairy
❑ Farrow to Wean
[] Farrow to Feeder ❑Other
❑ Farrow to Finish Total Desigir Capacity.
❑Cilts� --
❑ Boars T©ta1.SSLW
Number of L-agoons - - ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
' Holding Footle / So1�d Traps , ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes -kNo
Discharge originated at: ❑ lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made" ❑ Yes )�TNo
b. if discharge is observed, did it reach Water of the State`? (If yes. notify DWQ) []Yes N No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ycs, notify DWQ) ❑ Yes ITNo
2. Is there evidence of past discharge from any part of the operation'? ❑ Yes K No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [$No
Waste Collection & Treatment
4- Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes PNo
Structure I Structure 2 Structure 3 Structure 4 Structurc 5 Structure 6
Identifier:
Freeboard (inches): ............3Z 1r
...................... ................................... .................................... ................................... .................................. ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 10
seepage, etc.) / `
3/23/99 Continued on back

Facility Number: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
12 No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
'Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
X-No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
�No
Waste Application
10. Are there any buffers that need main tenance/improvement?
❑ Yes
P�No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
ANo
12. Crop type ,8
13. Do the receiving crops differ with those esignated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
ju No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
%No
b) Does the facility need a wettable acre determination?
❑ Yes
PE.No
c) This facility is pended for a wettable acre determination?
❑ Yes
AN
15. Does the receiving crop need improvement?
❑ Yes
allo
16. Is there a lack of adequate waste application equipment?
❑ Yes
;RNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
[RNo
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
1'No
19. Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
A No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
JR•No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
J No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ATo
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative? ❑ Yes KtNo
24. Does facility require a follow-up visit by same agency? ❑ Yes ; No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes RNo
E.�'Vo yiQl'alftons:or• deficiencies -were hated• during 4his:visit� y0if will i•eceiye rjti fu ther ( "
cor'res oridence abatit. this :visit. ::.
Comments (refer o queshtoiJi ) :Explarii any,YES a"swers and/or any recommendatrons°or.any other cotnmeats
Llse d -awutgs of facility to better-explarri`stfuati6iK(use additional pages as necessary)
/liar Alr�,�*,�/�rr� ---�•v
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: Date:

Facility Number: ],? — (1 Date of Inspection ZP
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes 1WNo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes JkrNo
28_ Is there any evidence of wind drift during land application'? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes P,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 P4 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 ANo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes JKNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes 14-No