780076_INSPECTIONS_20171231

NOHTH CAHULINA
Department of Environmental Qual

'.. II Fa'c'ifity Nura`ber I W ]NI %
(Type of Visit: O-Compliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Ooutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ��Arrival Time: Departure Time: J County: 7un)-� - Region: PJ�l)
Farm Name: f %F��rn;7j�- ! �.�ri %$�r.E�rxx�TY-.l�Owner Email-
Owner Name: r—ar, :L-Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator:---- Certification Number:3�'%
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Curren
N,
Design CurrentW-8
Design
Current
Swine pacity Pop.
Wet Poultry
Capacity Pup. Cat,n
Capacity
Pop.
t.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dair Calf
Feeder to Finish
4veO
uf}
airy Heifer
Farrow to Wean
N
"..;' Design Current
D , P�oiult . iti,: „ Ca ae' P,o .
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
I 113eef Brood Cow
Boars
Pullets
Turkeys
Other
Turkey Poults
Olhcr
10ther
j
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes DNo ❑ NA ❑ NE
❑ 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
KLNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Yes
JE�No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: %ff - % L Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[KNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):^
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
MNo
❑ 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
E� 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
0 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
12�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
ELNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[3-No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[gNo
❑ 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) Sl ue �eyc✓"� ��d' f ,uJ/F ra �� ���a�-s
13. Soil Type(s):,,,,,j
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E� No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑. No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�q No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
� No
[] NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
� No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
EA No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [:]Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[:&No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
allo
❑ NA
❑ NE
Page 2 of 3
214120I5 Continued

L
Facility Number: - 6 Date of Inspection: -ice i
S
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [Z No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [gNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes M No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 10 No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [RNo ❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes [3-No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comtients (refer to q©eshoo`f#}_ Explain apy'YttES�auswers and1cWany aadxt 6iWxecommendatians or any other comments.. 1 j
F IM = ° J r.a m,;i7d ilf +I y�;-'i'1k" J11. is q
Use drawings of ,facility, totter explain srtuahons_(nse`additionalpages'as necessary).
Reviewer/Inspector Name: Phone: 72d
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412015

y` r 7
- v'isio of Water Resources
Facility Number L� - 7�i O Division of Soil and Water Conservation
© Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: toutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: i! — / Arrival Time: ; D fl Departure Time: County: Region: 7�C�
Farm Name: hike, , sjyr; i ,�, Z?.,, 4,ow za �.,�) Owner Email:
Owner Name: p/L� sm; Phone:
Mailing Address:
Physical Address: I jL
Facility Contact: rGha /T Title: Phone:
Onsite Representative: �r.�- — Integrator: �,*jf.p�
Certified Operator: I Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capabw city Pop.
Wean to Finish
Wet Poultry
fLayer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
IDairy Cow
Wean to Feeder
I lNon-Layer
Paul
[Layers
I
Design
Ea aci
Current
P,o .
Dairy Calf
Feeder to Finish
Da ig Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D Caw
Non -Da'
1Beef Stocker
I Beef Feeder
Gilts
Nan -La ers
Boars
Pullets
I
I
1P--Mr-odCnw
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 ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes �Io ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes gNo
[-]Yes �No
DNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facie Number: - 7 Daoinspection: -30 — J
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes fEgNo ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes O 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 [ff No
[] NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes r!fNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[3 Yes 0 No
[] NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes :A No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes [ELNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes [a No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 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): -/"" r�z-�� / �tJ�r 1 �.-r �
-
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 E. No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑X No ❑ NA [] NE
acres determination?
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 [a No ❑ NA ❑ NE
Renuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes No
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No
the appropriate box.
❑ WUP El Checklists []Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Z54 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 Z No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes C No
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

• Facility Number: - Date of Inspection: 6-. 3 v�o/
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
allo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
allo ❑ 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
JR-No [DNA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
, }C No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
allo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
{& 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
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[:]Yes
[ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
[:]Yes
® No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
[:]Yes
E_No
❑ NA
❑ NE
Reviewer/Inspector Name:
Phone: }f03c7 Qi�3`I
Reviewer/Inspector Signature:
Page 3 of 3
Date:
21412015

i ype of visa: tytiompuance inspection v uperanon meview U nitructure Evaivatton V t ecnmcai Assistance
Reason for Visit: (3110'utine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: ' p County: �Qf�Y+ysr.� Region: �� D
Farm Name�rS�J�F /n11 � /G�'�1 �!/Gr�7 � Owner Email:
Owner Name: _ /� j�®�"�jyy; �I L =� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
On site Representative: J�� Integrator:,�1�/���/�
Certified Operator: <r,�` _ Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design
Cbrrent
Swine
Capacity Pop.
Wet Pqultry
Eapacity
Pop.
Cattle Capacity
Pop.
Wean to Finish
Layer
airy Cow
Wean to Feeder
I
JNon-Layer
I
a' Calf
Feeder to Finish
9,�p
Da' Heifer
Farrow to Wean
WEB
a Cow
D
Farrow to Feeder
D , P,oul
Ca aci_
Pao
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turke Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a�discharge?
[:]Yes [ o ❑ NA ❑ Ni
[:]Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes [�JNo
❑ Yes [&No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3
21412014 Continued

Facility Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3 No
❑ 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): --Z—' ----- ,
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
®. No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® 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?
D Yes
21 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[Z No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9, Does any part of the waste management system other than the waste structures require
❑ Yes
[� No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
� No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0C 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 Wind/ow ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):/�/
13. Soil Type(s): ,*
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
l6. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
❑ Yes
ELNo
❑ NA
❑ NE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes [.a No [:]NA ❑ NE
❑ Yes [a No ❑ NA ❑ NE
❑ Yes Callo ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes � No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [a No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E[ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

FaciliNumber: - 7 jDate of Inspection: 6
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C!jNo ❑ NA ❑ NE
�. 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes EINo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA [] NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [] Yes ® No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes fo No ❑ NA ❑ NE
❑ Yes Z No ❑ NA ❑ NE
❑ Yes [R No ❑ NA ❑ NE
❑ Yes M No
❑ Yes No
❑ Yes '51No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to gudfibn #� Explainlany YES answersand/nr any addihonalirecommendations or any other co�uments.
rh" : � i. -. i�= � �: ]k?,iY' J' _- ' _ - - � _'. .�•-.ice`-�Y' ' �_ y Irk
Use draRwgs of facit "-To tier explain situations:(ase;adii�honal;gages as„necessary;
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: -Z3D-­-
Date:
21412014

0
.;
ivis`iop of Water Resources
Facility Number ®- © Ditision of Soil and Water Canservat*on
QQ 1t. Agency
Type of Visit: 4D<ompliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 494outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ; 3 ti Departure Time: r County:ff_d22f_11Region:
Farm Name: / %Cr �� iTlti�f :� r��Siect�uwneEml:
Owner Name: g NR A r A jr—a"O' , /, /P Phone:
Mailing Address:
Physical Address:
Facility Contact: rq;�,,l,avr/ _&Qyf Title: Phone:
Onsite Representative: / Integrator:
Certified Operator: %J Certification Number: '1 J39_
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pap.
Wet Poultry
Capacityy
Pop.
Cattle Capacity Pap.
to Finish
La er
DairyCow
Dai Calf
HwWean
Wean to Feeder
Non -La er
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
D . P.oul
Ca aci
Ra .
Farrow to Feeder
Non -Da'
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream 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)
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 [,No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3
21412014 Continued

Fac#iq Number: - jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes CEI-No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in). -
Observed Freeboard (in): `
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
g4,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
C&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
E.No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[a 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
ER No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Ej3�No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 5No ❑ 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): zi-m -
13. Soil Type(s):
14. Do the receiving crops differ from thtsse designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
V�r_No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
4 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
M.No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
� No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
JRLNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
gNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [-]Yes X No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ja No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: ' - Date of Inspection: —G
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Eg�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 _F�sj No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [&No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
[DNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes P� No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes &No ❑ NA ❑ NE
❑ Yes fallo
❑ Yes M No
[]Yes C!J.yVo
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Continents (refer to question Explain any:`YES answers;. and/or any additional recommendations or any other codin eets� Wes:
Use:drawings of facility to better explain.sitgah ns (use_additional pages as necessary). .;
Reviewer/Inspector Name: ',_fr�L�%`�� _ Phone:O-'Lf 3 �s
Reviewer/Inspector Signature: Date:
Page 3 of 3 214/1011

Type of Visit: L'.PC'ilmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: fQ Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: rrival Time: I ik.f'J'Departure Time: f (Jt/ County• 6 C-90- ( Region:V�Lf/
Farm Name: 04 Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
c�
ct
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator: k�cS 1 D C
Certification Number: Zo3
Certification Number:
Longitude:
Swine III
�' 6*
Tut
g ty urr
ban aci � Pop
Y
Wet Pouitry
Design
Capacity
Current
Pop.
Design Curren t
Cattle Capacity Pop.
Wean to Finish
La er
Non -La er
D , P■aultr
Design
Ca aei
Current
P,o .
Dairy Cow
Wean to Feeder
Dairy Calf
Feeder to Finish DUj
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Dry Cow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turkeys
Turkey Pouets
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)
❑ Yes NA ❑ NE
[:)Yes ❑ No [A.PM ❑ NE
❑ Yes ❑ No E3' AA ❑ 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 E3 A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes t.LJ""' [] NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes U ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Condnued

1Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [3-I'ts5"❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No IA ❑ 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
/^
E 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
I! "0
❑ 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
VjjNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[R<o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
eNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
dNo
❑ NA
❑ NE
maintenance or im rovement?
P -
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
D Outside of Acceptable Crop Window Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): �� W
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[V Np
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
6
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[Zj,?4.,
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
iDAIo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
`;
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
RNo
❑ 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 ff<0 ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes I__J No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Inspection:
2k Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [;1-16- ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [j,>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 E]Xo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes io ❑ 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? .r
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
[—]Yes No ❑ NA ❑ NE
❑ Yes D<O ❑ NA ❑ NE
❑ Yes ER<o ❑ NA ❑ NE
❑ Yes 0No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes UNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes F]3<) ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes FTNo ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or -any other commenti.
-
Use drawings of, facilityiw.better explain situations. (use:additional pages as necessary)....... - .
ca(tlt--dc0�'1 V[ j
it g,-A" 9"�4
Reviewer/Inspector Name:
l
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
Date:

Type of Visit: WCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (Tj Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County :7� /� Region: _�
Farm Name: P ikk-r- � . a +_ Owner Email:
Owner Name: ;S,- -r>'.' L� Phone:
Mailing Address: _ �7� L.O� eon:e
Physical Address:
Facility Contact: �� ,�.+ty'}�( Title: q4L-ce
Onsite Representative:
Certified Operator: It i
Back-up Operator: 4^ rti 0 4Ar
u
Location of Farm:
Latitude:
Integrator:
Phone:
Certification Number: Z0 5 �1
Certification Number: /9 n7
Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pap.
Wet Poultry -
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
o
vd
w
"-. - " -
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dry P,oul
Ca aci
ho P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream ImnaCts
1. Is any discharge observed from any part of the operation?
❑ Yes
[] No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[] No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[] No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[] No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[] No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

QI2 , lk
Facility Number: a-10 1Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No [] NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): r
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑ No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ 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): ��`N��s-.le-. qt 'S
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes [:]No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes [:]No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis [] Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

ra
Facility Numbe 16- 60 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [—]No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ❑ No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
DNA ❑NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ❑ No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes ❑ No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes ❑ No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes ❑ No ❑ NA ❑ NE
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes ❑ No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ❑ No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ❑ No ❑ NA ❑ NE
Comments (refer to question #):.Explain any YES answers and/or any additional recommendations or any other comments _
Use drawings of facility to.betier explain situations (nse additional pages as necessary).
cAlAwktolk of q1XS0-
S( ar, � q[ q(�' 13
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
P� W( 3 D. /, S
r
Phone: r/0
Date: Goo 3
21412011

1 ype of visit: tit uompnance inspection tv tiperatton xevtew V ,tructure Lvatuanon tJ i ecnntcat Assistance
Reason for Visit: 40 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: I 3''S4 plr, County: R4kwn
Farm Name: KOVL C�h f iL Owner Email:
e A
Owner Name: [� . Kc]� 9—05 ftz _14h FA Q.Wr� fAIgh Phone:
Mailing Address:
Physical Address
Region: Fko
Facility Contact: i rc,O1pb ht,�f _ Title: (� A {1%}e! (� Phone:
Onsite Representative: %91.S1 D Nlt" _ Integrator:
Certified Operator: Certification Number: a63dr
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
urret .. Design Current Design Current
DesiaciWet Poultry Capacity Pop. Cattle Capacity Pop.
Swine mP.,
Wean to Finish
Layer
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
9
Design Current
= D , Poul Ca acity P,o , =
DairyHeifer
Farrow to Wean
Farrow to Feeder
D Cow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Q_th
Turke s
urkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes dNo ❑ NA ❑ NE
❑ Yes ❑ No DNA ❑ NE
❑ Yes ❑ No [3 NA ❑ NE
[—]Yes
❑ No
[—]Yes
[ 1No
[—]Yes
[ f No
[5❑ NE
gl ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

s
Facility Number: IDate of Inspection: 3 as
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [�Wo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): i9
Observed Freeboard (in): 6�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[WNo
❑ 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
[2No
❑ 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
�o
❑ 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
[21No
❑ 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
[21�o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
gNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[2/No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[j?No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
f /No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes 2 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes d No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes No
❑ 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 ❑ No
gNA
❑ NE
Page 2 of 3 21412011 Continued

f
Facilih' Number: '1 - lQ Date of Inspection: ai`1 1
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[g"No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
�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
[ffNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
❑ No
❑ NA ❑L'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 [allo ❑ NA ❑ NE
❑ Yes E3"No DNA ❑ NE
❑ Yes UNo ❑ NA ❑ NE
❑ Yes FL2"No ❑ NA ❑ NE
❑ Yes
❑'No
❑ NA
❑ NE
❑ Yes
❑v "No
❑ NA
❑ NE
❑ Yes
EEYNo
❑ NA
❑ NE
refer Comments to q ( estron=# $Ezpla�n any YES ainswersand/oiran� ad`dlttonm "allrecomendationS ©Taanyrotlierncom ments. ten:. - x 0 V . ,
Use drawings of facia , to w 2i explain_situahons,( se addttipnal pages:as+necessary}.
Reviewer/inspector Name: �LM'A Z\'M t\ps Phone:
Reviewer/Inspector Signature: O Date: Jr7&)R I
Page 3 of 3 21412011

9 i h.s g/ / / / / �f-f-
Date of Visit: Arrival Time: Departure Time: 'DD County: Region: 7�
Farm Name: email:
Owner Name: J . �in1 j iir`. 4- ft—/ Phone:
Mailing Address:
Physical Address:
s
Facility Contact: tr „_j,o`S Title:rd G� Phone:
3
Onsite Representative: at i Integrator:
Certified Operator: l lJ Certification Number: cp'lz) 3p
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current Design Current
Wet Poultry !gap ityCattle Capacity Pop.
Layer Dairy Cow
Wean to Feeder
I INon-Layer
Dairy Calf
Dai Heifer
Dry Cow
Feeder to Finish
Farrow to Wean
"`
Design Eurrenf ` "
D , , P.oul Ca aCi Pa ..
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
113eef Feeder
Boars
Pullets
113eef Brood Cow
Othe
Other
Turke s
urkey Poults
Other
Discharzes and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes El"No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes [:]No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No Fl-,I,,<A ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No DINA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes tom ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes D-Igo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Ds ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes El No ❑ NA [] NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 2-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 Eb 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 ER<o ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [ErNo ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Q o ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes io ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes C ',Ko ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN • ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): L V U
13. Soil Type(s): C.
14. Do the receiving crops i er from those lesignated in the CAWMP?
❑ Yes
2<
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E21IQo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Ua o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Ra<o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
1B 110
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ 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
Mt o
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
o
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[3 Yes
[::]No
�❑ NE
Page 2 of 3 21412011 Continued

Facili Number: I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [R No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes to ❑ 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 2 ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA [g-Nf
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 E]<o ❑ NA ❑ NE
❑ Yes Er<o ❑ NA ❑ NE
❑ Yes E Io ❑ NA ❑ NE
❑ Yes !_ J Ko ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EKO ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
EE�Ko ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
MXo ❑ NA
❑ NE
Comments (refer to question # Explain any YES _answers and/or any additional recoinmendabons`or�any otber comments:
Use drawings of facility tw etter;exolain situations (use:additional pages as necessiryi.
Reviewer/Inspector Name:
Reviewer/Inspector S
Page 3 of 3
Phone: f,e —ZE —_3337
Date: A/
/4120H

IL
--_-_�—.� �visiott of Water Quality
iFacility Number S 7(p Q Division of Soil YdWater Conservation
0 Other Agency
Type of Visit
Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
,.�ommpiiance
routine 0 Complaint
r
Q Follow up O Referral p Emergency
O Other ❑ Denied Access
Date of Visit: Arrival Time: 8: SSA.M Departure Time: : <<J' County: A6 bGSaAJ Region: `Zo
Farm Name: #1kc, 5'")L4 Z _'1r3f 41-A. 1. ;IVWNAA P"wi-) Owner Email:
Owner Name: R bla Kc- SM 41, FalYlvt L ` i Phone:
Mailing Address:
Physical Address:
Facitity Contact: Title: Phone No:
Onsite Representative: Integrator:
Certified Operator: I e�G'id 17�'7� Operator Certification Number: 249301
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = ' 0 « Longitude: = o = 4
Design Current
ISine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
[Feeder to Finish 7 -7&00
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Cither
❑ Other
Design Current
Wet Poultry Capacity Population
❑ Layer _
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ TurkeyPoults
❑ Other
Discharges & 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?
fA
Design Current
Cattle Capacity Population
❑ Dairy- Cow
❑ Dairy- Calf
❑ DairyHeifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
L7 NA
❑ NE
❑ Yes
❑ No
ENA
❑ NE
B<A
❑ NE
❑ Yes
❑ No
❑ Yes
9ilo'
ElNA
ElNE
El3 Yes
No
❑ NA
❑ NE
Page 1 of 3
12128104 Continued

a,
Facility Number: -]g—'7(p Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
_
E o ❑ NA
❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered ves, and the situation poses an immediate public health or environmental
threat otify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No ❑ 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
_,�
B'5o ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
Yes
ElLf
,�
'No L7 NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
�,_�
[TTo ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) evr.� �a� w.a ("ry , ni �bycXT e e�
J
13. Soil type(s) Aw
Coe -Is kQ #%ris , wd .F✓s .
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o El[! NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
ElD Yes
o ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
ElYes
ETNNo ❑ NA
El NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
L7N/o El NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
El Yes
3< ❑ NA
❑ NE
Comments (refer to quesiio6 O ' Explain any YES answers and/or any recommendations or any other comments 4� _y
tise drawings of facility to better explain situations. (use additional pages as necessary):
LI "^t t1�S reCuv� bc�N ut0��� �tr !ems-f�sf- 5si � 1es-� � a
ReviewerAnspector Name � i t �GV .S Phone: [phone]soo
Reviewer/Inspector Signature: Date: Z0/!7
12128104 Continued

i
Facility Number: 78 —%(p 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 E o ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other �,�
21. Does record keeping need improvement? If yes, check the appropriate box below_ El Yes EKo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
,EP,1
LT<o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
EIK
ElNA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
314`�o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
[I Yes
B o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0<
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
,.,
1.�'No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E3No
❑ NA
El 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?
ElM 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
,.,
Id'ivo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
,.,/
(3No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
2<
❑ NA
❑ NE
Page 3 of 3 12128104

37/- 0 S-- 19 e I
e- ivision of Water Quality
Facility Number ���3 O Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 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: 4-/i4( 49 9 Arrival Time: g'�Q /�-+ Departure Time: �.`3D County: 9046e S'aA1
Farm Name: r/akG 5111;A 1 fl- 04 SayaJ-JWR t R0A1d Q Owner Email:
nwner Nskmp- J L"i t a- 5V A "+1h Phnne-
Mailing Address:
Region: !/��
Physical Address: Facility Contact: R; LA'%4 V d HG !2C_S Title: AQ Ai4je b— Phone No:
Onsite Representative: `mod ��"7 4 �Integrator: Mu6o
Certified Operator:
Operator Certification Number:
Back-up Operator: .+eI^4tidyss Back-up Certification Number: Zb3$1
Location of Farm: Latitude: [= o = =SA Longitude: =0 0
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
'7 2b
1 ,3750
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dischart=es & Stream Impacts
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Cturrent
Cattle Capacity.. -Population
❑
Daia Cow
❑
Daja Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Co
Number of Structures: E
1. is any discharge observed from any part of the operation?
❑ Yes
E No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
El Yes
❑ No
����
NNA
El NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
El No
,LJ
IJ N-A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
B<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
&<o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
L_Tivo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility [Number: `% g— 71Fj
Date of Inspection 1 V—N 70
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
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3110
Structure 2 Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes dNo
❑ Yes E No
Structure 5
El NA [I NE
El NA ❑NE
Structure 6
❑ Yes ONo ❑ NA ❑ NE
❑ Yes 2 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes E N" o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 2<o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes B<o ❑ NA ❑ NE
maintenance or improvement?
Waste Application /
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes D No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes L` I No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Croptype(s) 23ekkAt"'d0L (yay ) . S0441f e6va -seed
13. Soil type(s) C.00k R q;Aj s Ei ct i-v,.,% �,/
14. Do the receiving crops differ from those designated in the CAWMP? El Yes E No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes [ �o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
[aj�o
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
2-go
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
0 No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ;ZE�V of s Phone: 49/0, 433. 333y
Reviewer/Inspector Signature: Ac�Date: -V — / V — za09
12129104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
E NNA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
E NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
[T<A_
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
LJ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
D<A
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑<
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
D�<A
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
❑ No
L~_ <
❑ 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
1--TNA
❑ 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
El Yes
❑ No
�,,N�
l_7 A
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
�/
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
El No
[ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
NA
❑ NE
Additional Comments and/or Drawings:
lqp4 L;wt c_ %--sr. - a 65e.vu-4 `-� bL� `pp ht.c# c N Fw f/S
SPA 1vo...,;P Aw- d
12128104

f l-rAs 7-0/-08
Type of Visit Ercompllance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: %p ZTdpO Arrival Time: i:Ua w Departure Time: County: .may
Farm Name: ,9 GS .0 ( f
Q Owner Email:
Awnar N9mP• R. 9nX., P v,,- . L. P. PhnnP-
Mailing Address:
Region: F�W
Physical Address:
Facility Contact: IMi � rD 1 Skrr A/Title: , l Y`� / mac<w Phone95�
No: �0, &ZO, 71
Onsite Representative: 1U;VQ_ o 1.54 ry Integrator: k0'Ol��.
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: El 0 =' = Longitude: = ° = I = u
Design Current
Design Current
Design
Current
Swine Capacity Population
Wet Poultry Capacity Pupation
Cattle Capacity
Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
n-La er t
Dry Poultry
❑ Dairy Calf
Ej Dairy Heifer
❑ D Cow
eerier to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Layers
❑Non -Dairy
❑ Beef Stocker
❑ Farrow to Finish
❑ Gilts
-
❑Non -La ers
❑ Pullets
❑ Turkeys
❑ Beef Feeder
❑ Beef Brood Co
❑ Boars
Other
Winds,
❑ Turkey Poults
❑ Other
❑ Other I
umber of Structures:
Discharees & Stream Impacts
1 _ Is any discharge observed from any part of the operation?
❑ Yes
<o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
El Yes
,�,/
LDf.N�o
[I NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
LI wo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
I
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
,/
E NNoo
❑ NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
B o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

j R
Facility Number:
Date of Inspection o
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
E 1�0 ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
B 151-o— ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed
❑ Yes
❑'K-o_ ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑<o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
G-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
B<o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
�,
E'No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[--]PAN ❑ PAN > 10%or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Croptype(s) eYw. U,—( HvL,,2 { 6rmi-j byeeSee_&J_ L)tc&t`, loeaNs
f o,F r'
13. Soil type(s) l�a0. _ L3 dL1R A,,, � AwA
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
ElNA
❑ 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
BIZ
❑ NA
❑ NE
17. Does the facility tack adequate acreage for land application?
❑ Yes
[a'go
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[f N
❑ NA
❑ NE
Reviewer/Inspector Name j 1 e j e _ 1 Phone: 9/O, J 3. 3330
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

j . . a
Facility Number: `7 g—'7 Date of Inspection Z7-08
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0'N-6 ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [J-lo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0-N-5_ ❑ 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
0-No—
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[4N
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0-T16
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
B-No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
D-N-o—
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
ElE Yes
��
1vo
❑ 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
�-,,�N
E 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
El Yes
,�
E lVo
❑ 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
[T o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
D-55—
❑ NA
❑ NE
Page 3 of 3 12128104

Facility Numbers
B Jj_ qrhlo) O v(
® Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 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: 4 ��' G 7 Arrival Time: !�. 3 t� iiry Departure Time: OZ % 3o County: IpGsM1 Region: �'e'�
Farm Name: 0V-c- SA, 4-1, �`r, # q Aa, "H e'S,VO/yN-t A-14wner Email:
Owner Name: R • �64r— S R_►w► AL. P, Phone:
Mailing Address:
Physical Address:
PalS:..J
Facility Contact: R GLAD i n!3a5 Title: Phone No: 910, 6zy, 7153
Onsite Representative: ����^�-► 14u �3 e— 5 Integrator: ±Iur - �t' ' f A1
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 0 6= Longitude: = o= f 0 u
Swine
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ La ers
❑ 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?
Design
Cattle Capacity P
❑ Dairy Cow
I�
❑ Dai Calf
❑ Dai Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ 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 [A No ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
® No
❑ Yes
[$ No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
12128104 Continued

Facility Number: -7 7 (,
Date of Inspection #—J/- o 7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes]
No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No ❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure
5 Structure 6
Identifier: a # /
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3S
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[ No ❑ NA
❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[� No ❑ NA
❑ NE
through a waste management or closure plan?
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
T No ❑ 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
No ❑ NA
❑ NE
maintenance or improvement?
+
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ No ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or I0 lbs ❑ Total Phosphorus [:]Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drifl El Application
Outside of Area
12. Crop type(s) C YL. t �. 0. !ta.-, _ � gs�"l (/OywSred J
GJ 1_ .
13. Soil type(s) R 0- , W a4 $ . A,,, $
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
] No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[--] Yes
FIE No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
i R_ Is there a lack of properly operating waste application equipment?
❑ Yes
[j No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
A&
Reviewer/Inspector Name FfcR'_V ej 5 Phone: 9/0, 4133, 33-50
Reviewer/Inspector Signature: R P1t.1-.1 Date: # —//"' - O6 -7-
12128104 Continued

Facility Number: -7$ — Date of inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes N No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 50 No ❑ NA ❑ NE
the appropiate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[� No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
T No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
V No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
U9 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[P 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
0 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
[A 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
[P No
❑ NA
❑ NE
1228104

Type of Visit a Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other El Denied Access
Date of Visit: /z`OCo Arrival Time: Departure Time: f County: �bGse ^� Region: F�-0
Farm Name: `-✓ft�vM, * Farm art PoK46Pner Email:
Owner Name: _Tiui 4 ZEZ:TL0a_ L P Phone:
Mailing Address:
Physical Address: Facility Contact: /r'l �A
, Get 4 e ( A09/940A/ Title: Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator: _ A4 Bf u A/ coOperator Certification Number: Z 0 3 7 V
Back-up Certification Number:
Location of Farm: Latitude: = o = I 0 t[ Longitude: 0 ° =, 0 1
1
Design
Current
Poulation
DesignlCUrrealDesign
Wet Poultry Capacitpnlation
CurrentCcity
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Nan -La er
❑ Dairy Calf
Feeder to Finish IMP I
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish
❑ Layers
El Beef Stocker
❑ Gilts
Non -La ers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[V No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
M No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
17No
❑ 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
qNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
qNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
[5(No
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12178104
Continued

Facility Number: 7:�— (p Date of Inspection
Waste Collection & Treatment
,,��,,��QQ
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes
[A No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
ICJ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): Lq
y
Observed Freeboard (in): 43
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0 No
❑ NA
❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
fA 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
M No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[9 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
[;R No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0 No
❑ NA
❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Be- -lutj a Ha... Swtkl�i1 ►rzinj Soy (oea"_s
� a�
13. Soil type(s) lu A Am B
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [A No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 5N No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments
Use drawings of facility to better explain situations. (use additional pages as necessary.): `
Reviewer/Inspector Name i e k Q v e tS ( Phone: (9/0) V 33 -3330
Reviewer/Inspector Signature: Date: - / Z — Z O D (e
f age 2 of .i 12128104 Continued

Facility Number: 'Tg — (o Date of Inspection 7- z-O4
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes C9 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 09 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps ❑Other
21. Does record keeping need improvement? 1f yes, check the appropriate box below. ❑ Yes Q9 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain 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
[:9 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[29 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
[M No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
;A 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
WNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings
Page 3 of 3 12128104

Type of Visit
ompliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
0 Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: IfTD Departure Time: /® County: Region: ^
Farm Name: yS./the _ _ Owner Email:
Owner Name: �L�yl_� �J5mp 14 6r !., e Phone:
Mailing Address:
Physical Address:
Facility Contact: .Y��tGCL S��"t Title:
Onsite Representative: _4" —
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certifica ion Number: ?a D _
Back-up Certification Number:
Location of Farm: Latitude: 0 n= 6 0Sd Longitude: = 0 0 I= U
Design Current
Design�rCurrent Design Current
Swine
Capacity Population Wet Poultry
Cap tyPopiilation Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ DairyCow
❑ Non -La er
� ❑ DairyCalf
i�* ❑ DairyHeifer
❑ Farrow to Wean
Dry Poultry
T� y�� ❑ D Cow
❑ Farrow to Feeder
a� ❑ Non -Dairy
❑ Farrow to Finish
ra
Y ❑ Beef Stocker
Gilts
XR
�s ❑BeefFeeder
PO Boars
y ❑Beef Brood Co
Other
�.
❑ Other
}" Numberof Structures:
❑
Wean to Feeder
®
Feeder to Finish
t7
�DD t'7
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges &Stream Impacts
I.
Is any discharge observed from any part of the operation'?
❑Yes
[� No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field ❑Other
a. Was the conveyance man-made?
El Yes
4 No
❑ NA
❑ NE
b. Did the discharge reach waters of the State`? (If yes, notify DWQ)
El Yes
K No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑Yes
� 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 adverse impacts or potential adverse impacts to the Waters of the State
El Yes
�No
❑ NA
❑ NE
other than from a discharge
12/28/04
Continued

r
Facility Number:�— Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes J4 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes PQ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PgNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes A] 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 E�No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes UQ 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 50 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes RNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes DqNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
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
U� No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
RNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
PkNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
RNo
❑ NA
❑ NE
[*,any YES:answers audl
site situatibns: (use! addiao�
00
Reviewer/Inspector Name _`: ; ` ; Phone:
Reviewer/Inspector Signature: Date:
12128104 Continued

I
Facility Number: — 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 EgNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soi] 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
Q'No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Q( No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
NNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
NZNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
KNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance
pliance of the permit or CAWMP?
Yes
ElU
��
(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
3 E
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
P�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
KNo
❑ NA
❑ NE
12128104

Type of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number 7 Date of Visit- ® rune:
O Not Operational O Below Threshold
13-frermitted �certified 11 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
� J�
Farm Name: {L-s_�_ J I',---- F�a►.� fg GVgad_ eewZ County: �,s ��. F�0
Owner Name: R, Hoke $=I -A &caws-.. LIB. __-• Phone No: . t!D- 42H -- 2153-------- ------ -
Mading Address: y03g .terra CLiur�t; �� ^ . F�:r is1�]t IA
Facility Contact:
Title:
Onsite Representative:_
Certified Operator: c l! !'✓ P��sT+>�-
Location of Farm:
.... Phone No:
Integrator: CGrroll foa 2L. e-
Operator Certification Number:
g�-6rine ❑ Pouttry ❑ Cattle ❑ Horse Latitude • �u Longitude •
Discharges & Stream Impcts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ 6
Discharge originated at: ❑ Lagoon ❑ Spray Feld ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 2No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes O-No
c. If discharge is observed, what is the estimated flow in gal/min? 4r
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes &M
2. Is there evidence of past discharge from any part of the operation? ❑ Yes [g•IQo
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 G-Ko
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier -
Freeboard (inches): 3
12112103 Contbuted

k'acility Number: 77 —7 & Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
LINO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
Jallo
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 maintenancertmprovement?
❑ Yes
Ewo
8. Does any part of the waste management system other than waste structures require maintenance!improvement?
❑ Yes
RNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
B-No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancefimprovement?
❑ Yes
❑ No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ firozen 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.
0-Field Copy ❑ Final Notes
Oue.
s10et
eres.%+ eq 140
1-9ee., Olir7". �u�...
•1os �o/aws
�o use
u
PT o
: /he r
f1 n Giles 4. ✓
f 4 e.
/'° RYC�g r.ss
5�•�/ {o
cs�p6/.�J
ee �
9 raas C vvCr,
ReviewerAmspector Name
ReviewerAhspector Signature:
Date: /p - Z-V-a
12112103 Conluued

Facility Number: -`J (p I Date of Inspection
R_ eauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes ❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
27. Did Reviewer/inspector fail to discuss review/inspection with on -site representative? ❑ Yes ❑ No
28. Does facility require a follow-up visit by sauce agency? ❑ Yes ❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
NPDES Pera tied Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
I2/12/03

Type of Visit ® Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: Time: D ii
8 G
Not O erational 0 Below Threshold
Permitted ® Certified ©Conditionally Certified 0 Registered Date Last Operated or Above Threshold
Farm Name: f w S ) County: U2 e Sa,1. �2 a
Owner Name: K, ke Sryn'r4-. �``l� L. � — Phone No: 4 O % 8
Atailine -address: 4O a.9 . T a-vya f I C,
Facility Contact: e� F sti•a_r __ Title:
OnsiteRepresentative: N1; a, e-.Q __ P-=�-S"-
Certified Operator: i ill. c i. 6 oQ
Location of Farm:
Phone No:
Integrator: Co O
Operator Certification Number: 2_6 3 q O
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude b 4 Longitude • •
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle capacity Po ulation
❑ Wean to Feeder ❑ Laver ❑ Dairy
® Feeder to Finish O ❑ Non -Laver El Non -Dairy
❑ Farrow to Wean
El Farrow to Feeder Other
El Farrow- to Finish Total Desi t Capacity
❑ Gilts
❑ soars Total SSLW
I Number of Lagoons t I ILI Subsurface Drains Present nL Lagoon 'Area JLJ Spray Field Area
Holding Ponds / Solid Traps ID No Lifiuid Waste Management System
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge oeiginated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach %dater of the State? (if yes. notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notiN, DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment '
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 3
❑ Yes
wo
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes ❑ No
❑Yes EDNo
❑ Yes ['-No
❑ Yes 4No
Structure 6
Identifier:
Freeboard (inches): $
05103101 Continued

Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, [] Yes 171 No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes P No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 9 No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal
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?
(CAWMP)?
16. Is there a lack of adequate waste application equipment?
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes C@ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 9 No
❑ Yes ® No
❑ Yes W No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
No
�] No
No
P No
IM No
15 No
[9 No
$j No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
iir any<'oth Pcomment
Uk.drawrngseof facilityo b0ter eiiplam situations:(uses dPtion dal p ge as necessary )ns
El Field Copy [Ell Fin Notes
f al
ek
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: La. D
05103101 _ Continued

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

Date of visit: D 6 GZ Time- L = �
Facility Number 7 �
Not Operational 0 Below Thresbold
M Permitted ® Certified [3Conditionally Certified ©Registered Date Last Operated or Above Threshold:
Farm Name: Sf1//.��//j� �i✓7 County:
Owner Name: Phone No:
Mailing Address: y12 -,1' �o..�A �i�iveG� �¢� �./dl'TD/✓/ � /r�G 'Z(P7Y6
Facility Contact: ��� ��*f^ Title: Phone No: T
Onsite Representative: -_ /�1--�' /d/�Integrator:
Certified Operator: �•'p'r / ��—'� Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ cattle ❑ Horse Latitude 0' 0 0" Longitude 0'
Current Current Current
Po
Swine Ca aCih Po ubttion,Pou1 __..- .
"
C scity -Po `iilati©u Cattle
-Ca seitv... olgtton
Dairy
Wean to Feeder [] Layer
❑
_' ❑ Feeder to Finish t ❑Non -Lay er ; = ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder_ ❑Other _
❑ Farrow to Finish Tdtal;Des>gn CapaCih
❑ Gilts
❑ Boars - - Total SSCW
-Number.of Lagoons ❑ Subsurface Drains Present ❑ La oon Area r.
❑ S ray Field Area
Holding Ponds/xraps [] No Liquid Waste Management System 4
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation? _
Yes ElNo
Discharge originated at: ❑ LaQoon ❑ Sprav Field X1Other J711�4
a. If discharge is observed, was the conveyance man-made? El Yes ®No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes [9No
c. if discharge is observed, what is the estimated flaw 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? ❑ Spillw•av ❑ Yes 91 No
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

Facility Number: j — %,"
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Analication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Diu d� sip,,// �.�/� <cJ�
13. Do the receiving crops differ with those designated in the Certified Animal rite Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Re uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18- Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19_ Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20- Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes P"No
❑ Yes allo
❑ Yes No
❑ Yes] No
❑ Yes El No
❑ Yes N No
❑ Yes � No
❑ Yes ArNo
❑ Yes 14No
❑ Yes � No
❑ Yes 7 N
❑ Yes K No
❑ Yes PRNo
❑ Yes M No
❑ Yes C0 No
❑ Yes 4 No
❑ Yes �9 No
❑ Yes X No
❑ Yes t No
❑ Yes 171 No
❑ Yes E[No
❑ Yes 4 No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to questtan #) Explain aap l'ES am ers audfar any recnmmendatioas ar anv other cornmehts. s �
Use drawtttgs of facttty W better explsua s�ivatt+ (vse addt�oaai pages sser�s,ary) ❑ Final Notes,w'� x
Field Conv ❑
---•° = __.. _.W� -..-...:�.. ..�:,� .: -.:. ..-a _ ��.. ®,�_.._.��.w.��_��:�_-tee._;`-_,,�
Cr 4. dU� Pr f''IzS��! GL• �� /%� G�i�i�.9� ...L�/ V.'t/ yfC'T/��
`
XS1/7z"5""14 ,Or
� %T/L�T OV Oi�llhceQil/'14K� �%/� O/ ` ruc l�.t'���<
l
!6
1i
Reviewer/Inspector Name x.
Reviewer/Inspector Signature: Date: Z
05103101 Continued

Facility lumber: 709 —,7� Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes M No
❑ Yes g No
❑ Yes El No
❑ Yes F) No
❑ Yes No
❑ Yes No
❑ Yes WNo
Additional Comments andlor Dr2wings:
O510310I
O510310I

i' . . %
�- D><vi n of Water Qualrty
Dlvlston of Soil and Water Conservation
r
Q Other Agency. - -
F
f Visit Compliance Inspection 0 Operation Review O Lagoon Evaluation
n for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of visit: Time: E== Printed on: 10/2612000
Q Not Operational Q Below Threshold
Permitted [3 Certified [3 Conditionallyy Certified © Registered Date Last Operated or Above Threshold: -----.-..............
Farm Name: Ste' l/G1N..11�C. ! L2nd .......... County:...... DZeSO........... ..........................
.................... .
�j
Owner Name:..St..... d. �C..... ,S►�-r.!....................................... Phone No: -..........-....,.>., ............................
Facility Contact: . f. C�Qe I a.� ........ l'itle:......... !�MG}z.:.............................. P one No:........................-..........................
MailingAddress: Q one � , /r 'r'M f'l� / v C 2F3 i14
.., rJ'......r> ...................��... % f....................- i........-.---....... y.......................---...-.................-..-.................
Onsite Representative: ,�'��. g Interotor........-........it..
...........................
..................... -..S..r-4.� .4.0...�
Certified Operator: ... ,1.C....4.,/AJ........ AAASF-li1?�--...................... Operator Certification Number:.. .......-
Location of Farm:
_ Igr
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �� 0= Longitude �' �° �64
Design Current
awinc
)Vean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
Design Current
Cattle Ca acity Population
❑ Dairy
❑ Nun -Dairy
Total Design Capacity 7 9,70
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream imlaactS
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system:? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I
Structure 2 Structure 3 Structure 4
❑ Yes �No
❑ Yes No
❑ Yes o
❑ Yes XIo
❑ Yes No
❑ Yes o
❑ Yes XNo
Structure 5 Structure 6
Identifier:
Freeboard (inches)
5100
.....-....I ................. I.......
'2S -
Continued on back

r
Facility Number: 8 — Date of Inspection —D Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
ANo
seepage, etc.)
�'' \�
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
Yes
�0`0
(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
S. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
4NO
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
[�No
11. Is there evidence of over applicati n? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
' NNo
I2. Crop type P
13. Do the receiving crops differ with those designa d n the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
X No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
[0No
b) Does the facility need a wettable acre determination?
❑ Yes
�No
c) This facility is pended for a wettable acre determination?
El Yes
o
15. Does the receiving crop need improvement?
❑ Yes
JKNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
N To
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes XNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes dNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil smple reports) ❑ Yes No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ANo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes Wo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes VNo
24. Does facility require a follow-up visit by same agency? ❑ Yes 9No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes i No
' �'Vo •yiQlat�ris vi- def ciertries •mere �Qtiecl- dirr;�ng phis: visit: • Yoit will •reeeiye iio t'ui-ther • ; - •
Mireso orideirce.'abaitt: this visit.:.... ; ...... ; . ; .... ; . ; .......... .
Comments (Fifer tA= ion ft "Explain any.YFS answers and/or any recommendations "or,any other comments: "
_ _ - - - _
i?se drawmgs of -facility to:better explain situations. {use additional* as necessary)-
L ..
Q SG1.rL t�•+v qe.T Say 1 S�.p �iC,S f,,a ��i,r ••.. �,c td� ve kto�t�-��� . `
All p14 Aco aeJ 6Qer� se� -/v/ we7l,-_L le cze res.
IUCJ7 0j0jje& _(j, J.1 /6a/ks � o,eat,
404 160kS" 9atd d- wc%1 ,y oi,4Q:,. ed ,
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: - -�-- 5/00

1
Facility Nurnber:7 — (a Date or Inspection
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not Iocated near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (ix- broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Printed on: 1/4/2001 V
❑ Yes No
❑ Yes 1To
❑ Yes No
❑ Yes No
❑ Yes No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Reviewer4nspector Name tea �sx
".w,a...�e.c .,_4*a:.
Reviewer/Inspector Signature: Date:
01/01/01

® Routine Q Complaint Q Follow-up of DWQ ins ection O Follow-up of DSWC review O Other
Facility Number ] Date of Inspection 6 .
Time of Inspection �•fl 24 hr. (hh:mm)
® Permitted © Certified 13 Conditionally Certified 0 Registered 0 Not C13erational Date Last Operated:
Farm Name: ............/... .`.'......... �T....._....s.1,ee�L��wivii�.... !�•County: rF �i��................----................
----------
Owner Name: ............ ._...Y<7•. ........... Phone No: f� - ) ..................................J�....-.....
1"�1110-10 `--4
1,��
Facility Contact: ..... ��� ...--........... _P_ ..•...................... Title: ................................ Phone No: --..-..- ... .....................
�f / � ,{ Jam- /��•�
Mailing Address: 7 ...... -, ?r✓!s'......I4......rr...--•............:¢... f...... C�/..... �[...... 4-�
--...... �.�._T.... 41 - . ` .........� ....................
Omsite Representative: ...... %e%%Gssr -,l��s-J .... Integrator:......�J•fr�,�[?��-�...����-�,�� S�
Certified Operator:-•„-,,,- �f� 'd_ , / � .� ...... Operator Certification Number:
...............................................................................................
Location of Farm:
Latitude �' �' ��� Longitude =' =' =11
Design r Currerif': Design :Current — Design Current
--
Ca acrty_ _Po iiliatron= Poultry Ca acr .;Po ulation ,Ca "aci . ila6on
P tj . Po P
❑ Wean to Feeder
Feeder to Finish
0
p
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
❑ Gilts
?
❑ Boars
❑ Layei
❑ Non -Layer
❑ Other --
.:- Total Des�g
W
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon El Spray Field El Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system"' (It -yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
zy`
Freeboard(inches): ..................................................................................................................
❑ Yes qNo
❑ Yes 0 No
❑ Yes allo
❑ Yes E-No
❑ Yes UNo
❑ Yes Eallo
❑ Yes JR No
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3123/99
❑ Yes [�tNo
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?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/mprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste
14, a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there'a lack of adequate waste application equipment?
Required Records & Documents
IT. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes 'No
❑ Yes
IQ, No
❑ Yes
IRNo
❑ Yes
�•No
❑ Yes
RNo
❑ Yes
AD No
Plan (CAWMP)?
r..
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20_ Is facility not in compliance with any applicable setback criteria in effect at the time.of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24, Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0' i'� Yiolaiigris a d ficieneie5 wgre noted dudrig ihis:v-is
t: Yoh wiil ;eeeipe titi futthgr'
eot esooiidence: abniit this visit_ ......: ::::::::............::::::. .
❑ Yes P No
❑ Yes [;.No
❑ Yes ER No
❑ Yes eMNo
_ ❑ Yes R No
❑ Yes No
/�� � �a��fisr.� ��-s�� p`Z3 C'p..f�ty� !-%/��� /.✓ ytz-G�// �ic�� 5�c�
❑ Yes )[No
❑ Yes ,fNo
❑ Yes VS[No
❑ Yes JRNo
❑ Yes f No
❑ Yes Q No
❑ Yes No
❑ Yes No
❑ Yes No

Facility Number: % -�- 7� Date of Inspection
Odor issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes fa No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes jg�No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 0 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 W No
30. Were any major maintenance problems with the ventilation fan(s) noted? O.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes V[No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 0 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes [ZNo

Date: 3 ci cet v ec; Nat Ce—
3 - 20 -0-b
Division of Water Quality
225 Green Street -Suite 71.4
Fayetteville, NC 28314
Subject: plan of Action
Name:
Farm �
Facilit,
Addre!
Phone; ? 1 Y
I NC 2.g3 q a
Checked below are the items to be carried out on the above farm:
X1. Check inside and outside of buildings for water leakage and
water usage,
2. Repair and adjust any problems concerning excess water.
_ 3, Inspect beans around the lagoon(s) to wake sure that
water is not eatexing-the system. Repairs wffl be made
where problems are identified.
4. Review flushing. and pit recharge schedules. Reduce
flushing and pit recharges where possible.
5. Closely monitor the soalang and clean -out of buildings
between herd placements. Reduce time and amount of
water usage as much as possible.
6. Check the moisture levels and crop conditions .in all
spray fields. Utilize applications on winter cover crops
• according to CWAW (original or' amended).
7. Utilize the 30 day prior to planting practice on.those fields
to be planted in row crops.
,ucE� HLIiiS 3MCiH `�� SQiai�d S, ili�2i2i�> r)GSZ 9LZ oTG M fit.ST (Mt nO-Zi�!i�)

L4
8. Review CWAMP and begin spraying on coastal berinuda as
soon as plan allows (follow all regulations re: runoff).
9. Obtain required permission from adjacent Landowner to
spray on designated fields. Amend the CWANLP before
any fields not currently on the CWAW are utilized.
X- 10. Investigate the feasibility of installing pressure reducers
on water lines.
Additional practices to be used:
�1 eta � l `� � • � r. �
"11�.
Signature
Date 3

j] Division of Soil and Water Conservation - Operation Review
0 Division of Soil and Water Conservation -Compliance Inspection
Division of Water Quality - Compliance inspection
Other Agency - Operation Review
Q Routine O Cam laint Q Follow-u of D1VQ ins ection Q Follow-up of DMVC review A
Other
Facility Number Date of inspection
Time of lnspcction 'd7? 24 hr. (hh:mm)
Permitted El Certified 0 Conditionally Certified ❑ Registered E3 Not O erational Date Last Operated:
Farm Name: ....... �'Q J a to cz Count _...............
Owner Name:.............. L �"(�.. �!!�t_ �� Phone No: �d Z�l 7� �3....................................
............ ... a ....... ..... ..... ..... .................................................�...............
Facilitv Contact: .. �1,ePoly*u- ... ..............Title:............_.. Ph No.
[� one �!...................................................GI`�
Mailing Address:..........!..�Z�. Mom. C.lv. 1 ................................ ..............`�.:+`''!`ip?^ .1. j......!"..Ct ................
Onsite Representative: ��Ce ,_, 15 Integratorr-�.✓. �?.//5......_..................
...... ....//............................................ g
Certified Operator:.. .�_ e _,� l�4ti� ............ Operator CertiFcrtion Number:
......... ..............................................
Location of Farm:
Latitude a 6 " Longitude 0 C « _
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder i Layer ❑ Dairy
❑ Feeder -to Finish ❑Non -Layer ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains PresenE10 Lagoon Area ❑ Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System
Di.cchaEg!js & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
h. If discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the State
c. If discharge is observed. what is the estimated flow in gal/tnin?
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: � �.............!i
Frechoard(inches):................................................................................................................... ..... .......................
......
❑ Yes - �To
❑ Yes ANo
[:]Yes ,4No
❑ Ye No
❑ Yes No
❑ YesAT40
❑ Yes YNo
Structure 6
1/6199 Continued on back

+racntty Number: 72f — 7& 1 Date of Imspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pact of the waste management system other than waste structures require maintenance/improvemestt?
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid Ievel elevation markings?
Waste Application
10- Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Ponding ❑ Nitrogen
12. Crop type.................................................................................................................................................................
[:]Yes
j No
❑ Yes
Qk�o
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. Does the facility lack wettable acreage for land application'? (footprint)
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required_ Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a certified operator in responsible charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
0: i�io.vialations otr deficiencies ...n' 4t d dtiring 1fiis;visit:. Ytiu �nlll.re�eive na further. . -
eorresbMdeitce' abotat: this v isit.; '
❑ Yes ❑ No
❑ Yes ❑ No
[]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ((No
❑ Yes 2140
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): I h / %'
Dcariwcj 0. ro[� .Ae -Ct 6(1er cL Lilo-6 m;n� (�� JAOp .Ge "" 4,ad f- Y-l;arf, i
)�.ol Q O `ice e CL I; c CJ:6-A_ C r`e. q_r fp� : �`eG�l jLo e Scv b e- k
-Ke- _ra r 9• L� o �',t J 5 �� 4 �`� a-.ti i i S /? oT ! h� S i a��
P j _r9 f� •I�
/,Ctra rUr�- �iti1� i"o &)L4 USed 7-b be T_ 4c b,_cco bd /or
�a i c1 M `� ., P615 �p
Reviewer/Inspector Name -31- 4
Reviewer/Inspector Signature: �iy� Y Date: I1/6/99

[] Division o, Sorl and:Water'"Conservation =Operation Revrew
0 Dinseon of.Soil "and Water Conservation -Compliance ][irspectron
Division of Water Quality:- Compliance j
nspection L
Otlrer'Agency Operation Revrew-- jr r t _z
10 Routine 0 Com laint 0 Follow-up of DWQ inspection -0 Follo.r U of DS% C review 0 Other
Facility Number 7 Date of Inspection
fine of inspection ', OVJ 24 hr. (hh:mm)
Permitted [3Certified 0 Conditionally Certified 0 Registered 10 Not Operational Date Last Operated:
/////Farm N:rme: ......- VQ h FL C;T,
P4 n 1 County Sd.:�-. .............. .... 3...........................................
o e
Owner Name:..... }r.T .�r....Q ...-.. .. ...�.1.t=?i� .r+............ Phone No: ...........Lrl.z.f?. ..7rJEJ..................................
Facility Contact: ..... fitic:........ f4KA .�.. ...-..--. Phone No: ...................................................
q.q /1 Q / �3e/0
9ailiiig Address: Q� /....... h.Gl....4.r. .�.....I�GC•. f...rTn-t.Q�l..l...,i.....N.4- .......................... �:.........T........... ......... ......... ........... ......-
Onsite Representative: ...........................................:..............................
................................................... Integrator:..........A.v.r`4..l.y...�S...............................-.....
1 y ....
Certified Operator:....�..4. I S i Operator Certification Number:.....- ..................................
7B3`f 0
Location of Farm:
.... .
Latitude����.. .............---
�:�.........Longitudc..•�••�� �«..........._-...............-.......--�-•--.........--...-•..........
tom
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder 10 Layer I I I[] Dairy
Feeder to Finish JE1 Non -Layer I ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity 2 p
❑ Gilts
❑ BoarsETotal SSLW
Number of Lagoons ID Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
Holding Ponds / Solid Traps I I[] No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ElLagoon ❑ Spray Field ElOther
a. If discharge is observed, was the conveyance ntan-made'!
h. if discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the State
c. If discharge is observed.. what is the estintated flow in gal/tnin?
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & "Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier: it
FreeboardOnchcs)�......... .............................................................................................................................
Structure 5
❑ Yes )WNo
❑ Yes 9No
❑ Yes No
IUIA
❑ Yes No
❑ Yes My
No
❑ Yes A No
❑ Yes )K No
Structure 6
1/6/99 Continued on back

It�
Facility Number: — (late of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (icl trees, severe erosion,
4 seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require main ten ancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
Waste Ap2lication
10. Are there any buffers that need maintenance/improvement?
❑ Yes �NO
❑ Yes RfNo
❑ Yes wilo
❑ Yes KNo
❑ Yes gNo
❑ Yes 10 No
11, Is there evidence of over application? ❑ Ponding E] Nitroge / / es No
12. Crop type ; .G ...........`:�X .1 ........ ".�..��....OL
......... ...fi .�� 's"L'............................................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes XNo
14. Does the facility lack wettable acreage for land application? (footprint) []Yes j6No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a certified operator in responsible charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(icl discharge, freeboard problems, over application)
23. Did Reviewerlinspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency'?
0_ N.o.vioalatiahs.or defcieric'ies.we're noia d durin* Ais:visit:. V-66 wi B .reeeive nor further .:.:
; ... . spo�idei� . . a. . ..this .:: ; . . . . . ... ... .... .. . .
❑ Yes ANo
❑ Yes P(No
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes ANo
❑ Yes V(No
Cl Yes A No
❑ Yes A No
❑ Yes 9No
❑ Yes KNo
omments (refei to question #) ­Ezplarn'any YES answers and/or any"recommendations or any other comments a�
Ise drawtngs;of#acilityto_6etter_ezplain situations. (use additional pages as necessa - ?
n,) R
P—T zz"llWU11 ,,, �r 4,,!2�d F° U1°q e`
AolvtSed ge real
erP 1 6L d6� /,OA" r►,',, cz�-d �� .
AL
Reviewerfinspector Name
Reviewer/Inspector Signature:
Date: Z - * 1� 9 I 1 /6199

0 Division of Soil and Water Conservation [3 Other Agency
[Division of Water Quality
14D Routine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other
Facility Number Date of Inspection�-
Time of Inspection 24 hr. (hh:mm)
0 Registered XCertilaed [3 Applied for Permit XPernutte/Id 3 iNot O erational Date Last Operated:
Srvn' S �SaVr h ©M� Count RaD�. r7
Farm Namc:.............! lT,t....�.......Cr' ►... ............/1..9....... y:.........................................................................
/� l� �_.. ....... L .... p
Owner Name:... "c-t t..... e t .f �4 �A,f� S - .. Phone No. i /0 — 6019 „- W53
p .
Facility Contact:.......... (. . ...... [.Q1<:5��!... Title:....................................................------...... Phone No: ......... ............................---..........
..Mailin Address:............ .....C&rd ...... i........ ....... ....................... Onsite Representative:......►,.! �1..� ..( L"o i5 Integrator: ............ �....�...................... Int rator•.................... t'C?........................... ,.... -
Certified Operator ............ !.......-(------........PQISrs,,,,.„-„-,_,,,-,,,, Operator Cerifi
t'cation Number* ........
o3a..
Location of Farm:
Latitude Longitude �• �' �«
General
1. Are there any buffers that need maintenancelimprovement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenancelimprovement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
0
'o
❑ Yes ONO
❑ Yes JXNo
❑ Yes A No
❑ Yes M No
111/A
❑ Yes f21No
❑ Yes ONo
❑ Yes JkNo
❑ Yes XNo
❑ Yes M No
❑ Yes ONo
Continued on back

.y
Facility Number: Ig-
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes No
Structures (La=oons,Holding Ponds, Flush fits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ANo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
It
Freeboard(ft)' c.................. .................................... ................................... .................................... ........ .................... ...................... ............
..........
10. Is seepage observed from any of the structures? ❑ Yes KNo
11. Is erosion, or any other threats to the integrity of any of the structures observed'? P<Yes ❑ No
12. Do any of the structures need maintenancelimprovement? AYes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes (KNo
Waste application
14. Is there physical evidence of over application? ❑ Yes JXNo
(If in excess of WMP, or runoff entering waters oftheState. notify DWQ)
.��5?,cr.-.Glf?,!r....D.V{a........ {,Li far ........................
15. Crop type /w .................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW.MP)? ❑ Yes ONO
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes ANo
18, Does the receiving crop need improvement? ❑ Yes ONO
19. Is there a lack of available waste application equipment? ❑ Yes KNo
20. Does facility require a follow-up visit by same agency? ❑ Yes No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
22. Does record keeping need improvement? kYes ❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes ONO
24, Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes JUNO
25. Were any additional problems noted which cause noncompliance of the Permit'? ❑ Yes KNo
0 No.violations or deficiencies were noted -during' this. visit.; .Yoitmill receive no further
- correspbndence about this. visit'.-..'
Use drawings of f tcd�ty to'better`explain srtnations {use addtliitnal pages'ss necessarv) � =
an W s-4w-o � -�
k)� -to e3 f;s A a.. 574; kl le Cel,� tiln 4,;aX cn�_ 45 sin
as rss: b %
PP, . .
n I . _ m n _ _ .SF /� �t 7125/97
o
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: A —

-Ahidial-f0ed1ot -'0p'6fAtidtr­R0_yj,ew--� DSWC,
W _W:sIA,
Feedlot - z AhimalFe -00
DWQ�'
"M Z
r:Wdhj.SifdJft"speqi6n
�dkkn
, ..:.. •.. - — 1:k� :
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection
Time of Inspection a 24 hr. (hh:mm)
Total Time (in fraction of hours
❑ Registered [I Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review
Farm Status: 0 Certified rdPermitted or Inspection (includes travel and processing)
W
0 Not Operational Date Last Operated:
Farm Name: 5-Av--Q. M na L_ _. Po ft J_ ­­.". County*
Land Owner Name:.._/4kc.._-. . ..... . ..... Phone No:Liti—r) q 7'z — T91L.—
Facility Conclact: Title: SQL Ie_w»nL_ Phone No: ZZ LEXeql..
Mailing Address: AJ .7
Onsite Representative: .... . .... . ... . ....
Certified Operator: Operator Certification Number:
Location of Farm:
SW fee.
SO
............................... .... . .... - - ----- . ... . .... . .....
Latitude 0 4 " Longitude
Type of Operation and Design Capacity
7
X
Des -,us<x -
Poultry pulatonl-
o%
vadiV1666 i6on
r
Wean to Feeder LLLayer Dairy
Non -Lay Non-DaiTy
z'ELFeederto Finish --75?- Eld, e r
i: 11 Farrow to Wean 0-7.
Farrow to Feeder r797 7— Z) mz.
Farrow to Finish
❑ Other A
--mvw
I0 Subsurface Drains Present
10 L2gOOn Area ❑ Spray Field Area
Gen"
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: D Lagoon D Spray field D Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
• Yes KNo
• Yes XNo
• Yes ANo
❑ Yes
No
A
El Yes XNo
• Yes /<No
• yes XNo
• Yes )<No
Continued an back

_j to
Facility Number:... 1K... -- %.�..,»
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ YesXNo
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ❑ No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes A�Lo
Structures (I,a ;oons and/or Holding UPM
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes )9rNo
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
2,..5 /»» .. .. ...... _._....... - .......... - ».._. _ ..» _.
10. Is seepage observed from any of the structures? ❑ Yes gNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes /�No
12. Do any of the structures need maintenance/improvement? ❑ Yes X` No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid Ievel markers? ❑ Yes XNo
Waste Aanliration
14. Is there physical evidence of over application?
❑ Yes X to
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. 'e
Crop type 1� .—ILL, ......... _....»» .... _..._— ._.......... --..� ...» ...._
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes ANo
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes ONo
18. Does the receiving crop need improvement?
❑ Yes XNo
19. Is there a Iack of available waste application equipment?
❑ Yes WNo
20. Does facility require a follow-up visit by same agency?
❑ Yes KNo
21. Did Reviewer/Inspector fail to discuss reviewrinspection with on -site representative?
❑ Yes ANo
Eor Certified Eacilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
Yes ❑ No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes *o
24. Does record keeping need improvement?
❑ Yes No
Comments,;(refer to questron#} Explain any YES ;answers'.and/or any recommendations or any other coinmesits: ` `
Use drawings of facility to better ezplam situations: {use additronal pages as necessary)
, y
,�,-�
$� 22. � C� e`�- `F`f•e t.caas4-�e Iv1A.�'►g4e.v.en.-}` PIa�s �r. no�` a. ii0l e aA-the
9
-�; Ae e�-+-ke ' +-s�r.+i onl. leiJcof Vqs recelve-A o s reykes+ej C
r-euleaed lay {-fie. i ,srec4-nr. he is e.o,,ple�ea.
Reviewer/Inspector Name
Reviewer/Inspector Signature: _ /�t�.._ C lwa� , a Date: 7 - Z S'-2 % -
cc: Division of Water Quality, Olater Quality Section, Facility Assessment Unit 4/30/97

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
IDF.=HNF:Z
f DIVISION OF WATER QUALITY
July 8, 1997
Mr. Robert Smith
Rt. 3, Box 734
Fairmont, NC 28340
SUBJECT: Annual Compliance Inspection
Hoke Smith Jr. Farms
Registration Nos. 78-17, 78-18, 78-19,
& 78-76.
Robeson County
Dear Mr. Smith:
On July 2, 1997, staff from the Fayetteville Regional Office of the Division of Water Quality
inspected the subject swine facilities. Please find enclosed a copy of our Compliance Inspection
Report for your information. It is the opinion of this office based on the information provided and
observations made during the inspection that the facility was in compliance with 15A NCAC 2lEi,
Part.0217 at the time of the inspection. Please refer to the comments section on the rear of the
inspectionrm for information regarding your facility.
You informed me in your letter that Mr. David Hedgepeth was working with you in getting
your waste management plans revised for the above mentioned farms_ Please be advised that since
these farms are permitted, there are many more items that have to be addressed in the waste
management plans. Please read the permits carefully and make sure all components are with each
plan at each site.
If you need any of the copies of the information which you forwarded to me please let me
know and I will return it to you.
If you have any questions concerning this matter, please call John Hasty at [phone].
Sin ,
ohn C. Hasty, Jr.
Environmental Specialist
cc- Operations Branch
Central Files
Audry Oxendine - FRO DSW
Ed Holland - Robeson Co. NRCS
Wachovla Building. Suite 714, Fayetteville NlLq _ FAX [phone]
North Carolina 28301-5043 C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

' 1� >. '' 4 ..k •* ,,•.-,:'^t3 �. ,yY ;... �,, . : a ..x - x 3. .�� . » _; up y - � *3 -: '^x3 ,'" �'" �
Operation Review �
J x.,w.
'�' � �^.�'�.. K,�4 � '' " €
DWQ.;AntirlaI Feeditt 4peratlon S1#e Iaspectlon�
r,:�'''�'�;°
Routine O Com taint O Follow-up of DW2 inspection O Follow-ue of DSWC review O Other
Facility Number
Date of Inspection
-] $ 7%v
Time of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status• ❑ Registered [IApplied for Permit (ex:115 for I hr 15 min)) Spent on Review_
❑ Certified IxPermitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated: //��
Farm Name: S$� <x .,,.� k- Po " County: 9 d g6 wi �.
j.� / O1 Z Z
Land Owner hame:..�..�.......St�! ! �--._ -- --- --- Phone No:{ 9� 1 `� - IV-7
Facility Conetact:jl Title: Phone No:
Mailing Address: 3 0 73
Onsite Representative: �� Integrator: Car ro Il 5
Certified Operator: __LDS !�.' ifi,.. _. ,_ „...._...... Operator Certification Number: Si 1.2 L
Location of Farm:
Longitude
Type of Operation and Design Capacity
«e m &DeSigA 3Ilrrent:z sa``� Kei'DeSign,s CD17ents �a t]]e5lgnx Z`Elr[ent
' x ,�> .�:.:.`�
Ca act =Po a acifvf-Po elation;,:Calahon. Cattle..' r..-Ca aei £Po ul'ation
❑ Wean to Feeder` ❑ D
' ' Feeder to Finish Z U on -Da'
Farrow to WeanMP
Farrow to Feeder f TT otal Design Capaetty % Z D,�
11171 Farrow to Finish
no other Total SSL��� 3
Number of Lagoons°/ Holding Ponds F '.J ❑ Subsurface Drains Present ��;
m k 1, °
.re
Lagoon Area ❑ Spray Field Area
General
I. Are there any buffers that need maintenance/unprovement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/36/97 maintenance/improvement?
❑ Yes VNo
❑ Yes t<No
❑ Yes J�No
❑ Yes No
N
❑ Yes �No
❑ Yes ,jNo
❑ Yes PNo
❑ Yes V.No
Continued on back

-r1
_ A °.f,
Facelity Number:.. 7 � •._ i
6. 1s facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Stru tres �goegs antijor Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4
2.7
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
-12. Do any of the structures need maintenancelimprovement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes XNo
❑ Yes 0 No
0 Yes ,Xo
❑ Yes �No
Structure 5 Structure 6
Wastr,Anolication
14. Is there physical evidence of over application?
(if in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type per-ON?� ..._ AEL4
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a Iack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certified Facilaties 0&
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes )R(No
❑ Yes 'oNo
❑ Yes ONO
❑ Yes 6No
❑ Yes tg:No
❑ Yes ANo
❑ Yes ONo
❑ Yes PNo
❑ Yes R'$Jo
❑ Yes O(No
❑ Yes %No
P(Yes ❑ No
❑ Yes *0
❑ Yes E(No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other. comments.
Use drawings of facility to better explain situations. (use additional pages as necessary). w
Z2. c � � l t� +ke was4a MaY1AJer►� n'� I iarti k�s nc+ 0.,.a%LJoIe o-+ the
-A �} J
Tine osr n +ke I s�c.41 oN. t OGN "irks received cxs retL,&;+ed a,J
r-.-,j'te-oecl ta,�+fie i h Stec. --or. l e_ •I *,spec4 %ati IS COKAP144
Reviewer/Inspector Name
Reviewer/Inspector Signature: /! (' Date: 7 � � � —9
ec: Division of Water Quality, Water Quality Section, Facilijyr Assessment Unit
4/30/97

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Robert Smith
Rt. 3, Box 734
Fairmont, NC 28340
Dear Mr. Smith:
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[DEF.HNFZ
DIVISION OF WATER QUALITY
July 3, 1997
SUBJECT: NOTICE OF DEFICIENCY
Sugar Hill, Hedge Farm,
Savannah Pond & Aaron Swamp
Facility Nos. 78-17, 78-18, 78-19,
& 78-76
Robeson County
On July 2, 1997, staff from the Fayetteville Regional Office of the Division of Water Quality
conducted an inspection of the Hoke Smith Complex. At the time of the inspections, no one from the
farms was present. These inspections were conducted with the help of Mr. David Ray, service person
for said farms. The waste management plans for these farms were not available to the inspector,
therefore a complete inspection could not be perfomed. These waste management plans should be
kept on site and made available for future inspections.
In regard to the deficiency noted during the inspection, the following actions are requested:
Please provide this office with a copy of the waste management plans, including waste and
soil analyses and irrigation records for the above mentioned farms so that a review of the
plans may be conducted and the inspections completed.
Please provide a written response to this office on or before July IM as to the actions
taken or proposed to be taken to resolve this deficiency. Nothing in this letter should be taken as
absolving this facility of the responsibility and liability of any violations that have resulted or may
result from these deficiencies.
Wachovia Building, Suite 714, Fayetteville FAX [phone]
N%q
North Carolina 28301-5043 CK An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

Page 2
Mr. Smith
If you have any questions concerning this matter, please call John Hasty at [phone].
Sincerely,
/% 7
eohnC
C. Hasty, Jr.
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine-FRO DSW
Ed Holland -Robeson Co. NRCS
Carroll's Foods-Laurinburg Office