780084_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: _ ��,�;� rn G L-r� . �ar,.-�_ Owner Email:
Owner Name: ', d �� �Q ,_,_ Phone:
Mailing Address:
Physical Address:
Facility Contact: I a, 4'j Title: &e-u.-I Phone:
Onsite Representative: �'e., I Integrator:,-`,�
Certified Operator: t.�y�.� Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design Current
Design Current
Swine
Capacity Pap.
Wet Poultry
Capatyk F'op. ;;
Cattle Capacity Pop.
I 11-ayer
I jNon-Layer
I I
-
Dairy Cow
Dairy Calf
Dairy Heifer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
`'
, P,oult . „,,Ca
Design " mrr�ent
ac ;i Po
Dry Cow
Non -Dairy
Farrow to Feeder
Farrow to Finish
ers
llets
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
:rNon-Layers
Boars
rke ser
-
rke Pouets
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 �No ❑ NA ❑ NE
❑Yes
No
❑NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes [-]No
[:]Yes R No
❑ Yes allo
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3
21412015 Continued

l+�
Facili Number: jDate of Ins ection: /
Waste Collection & Treatment
t 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes V ,No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
1 denti fi er:
❑ NA ❑ NE
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes M No ❑ NA ONE
(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 N No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? 0 Yes RNo [DNA
❑ 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 E&No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
/
12_ Crop Type(s): 15,-/Xn 1AA* / _AV LU 0 C 0 i--:2.S co✓.I
13. Soil Type(s): _2)a E / A f oA
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes allo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? MYes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes W 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 t4No ❑NA ❑NE
❑ Yes CE 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 RNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design 0 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 ❑ I20 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ SIudge 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 21412015 Continued

s: Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[DIo
❑ NA ❑ NE
' 25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
01 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
B'No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[ o
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
© No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes E o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes �lo ❑ 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
[;T o ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3-go— ❑ NA
❑ NE
33. Did the Reviewer/]nspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Q-No ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
[—]Yes
Q'i ate❑ NA
❑ NE
Comments refer to 466stion # Ex lain any YES;answers and/or any additional.recommendations or any other, cumments.�E
Use drawings of fac Iity`to better eipl 4h sftnations (nse additEonalpages as necessary).
/ .cam`
/\j6 -I
Reviewer/Inspector Name:
Phone:
Reviewer/Inspector Signature:IZ—
�W
Page 3 of 3
Date:
21412015

9
i ype or v tsu: %:; i, ompuance inspection V Uperanon xeveew V Ntructure r,vatuanon v i ecnntcat assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: f- Arrival Time: '"f^J Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name:-�j>�;� /%lG /rm--+� Phone:
Mailing Address:
Physical Address:
Facility Contact: � �� A'4" ,.,� Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Fop.
Wean to Finish
Design Current
Wet Poultry Capacity Pop.
Layer I
lNon-Layer I
Design Curren t
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
11
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Dr. P,oultr, Ca a P,o
Layers
Non -Layers
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Beef Feeder
Beef Brood Cow
Boars
Pullets
`
Other
Other
Turk e s
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 2' No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
D Yes [:]No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
E2�No
❑ NA
❑ NE
❑ Yes
Zjj_No
❑ NA
❑ NE
Page I of 3 ,2
- /4/2U1 S Continued

y Facility Number: _ Date of Inspection: % I
Waste Collection & Treatment
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes 'RNo ❑ 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 ®. No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes Q No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? [:]Yes allo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes RNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes allo ❑ NA ❑ NE
maintenance or improvement?
Waste Apolication
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 C3�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 0 Evidence of Wind Drift ❑/Application Outside of Approved Area
12. Crop TYpe(s)rirn[�l�
13. Soil Type(s): a
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes allo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes 0 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
a No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
allo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
allo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[allo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Othcr:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes MNo ❑ 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 B-No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection: /�-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ONE
z
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes R 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 Z No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes SNo ❑ 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 CaNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the [] Yes [0 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
[4 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
EZ No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[R No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
C.No
❑ NA
❑ NE
�''",! � J�/1'ra( /t�5 .��r.•_- �t ► �7t', l��fT% 8�-z��r a v�� � �� i �5��
Reviewer/Inspector Name:
Reviewer/Inspector Signatuz
Page 3 of 3
Phone:
Date:
21412015

(Type of Visit: -UComp ' nce Inspection O Operation Review Q Structure Evaluation U Technical Assistance
Reason for Visit: Moutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: G- J Arrival Time: / Q D t7 Departure Time: f' County: Region: Fl.o
Farm Name: V""d f%%G /".7' 1��21�Owner Email:
Owner Name: 122✓i o[ �f'iG f�>-.��^ Phone:
Mailing Address:
Physical Address:
Facility Contact: 6kALi Title: Phone:
Onsite Representative: ��� Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
@attle Capacity Pop.
inish
Layer
DairyCaw
WW
eeder
Non -La er
DairyCalf
Finish
DairyHeifer
Wean
WGilts
Design
Current
Cow
Feeder
Dr, P,oul
Ca aci
Po .-
Non -Dairy
Finish
Layers
Beef Stocker
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
OtherI
ITurkeyPoults
Other
I 10ther
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes S No ❑ NA ❑ NE
❑Yes No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [] Yes ® No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters []Yes CD -No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

FaciliNumber: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 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 L.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 j!j 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 E] No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes MNo ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes �No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No ❑ NA
D NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes CELNo ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload 0 Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window❑ Evidence/ of Wind Drift ❑ Application
Outside of Approved Area
�
12. Crop Type(s): y
F
13. Soil Type(s): 9),0-9 -bi 2 A�
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes fK No ❑ NA ❑ NE
IS. Does the receiving crop and/or land application site need improvement? ❑ Yes M 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?
Reauired Records & Documents
❑ Yes ®. No ❑ NA ❑ NE
❑ Yes �l No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
JEJ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
2[No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
RNo
❑ 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
allo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakcrs on irrigation equipment?
❑ Yes
[0-No
❑ NA
❑ NE
Page 2 of 3 214120I4 Continued

Facili Number: 7 jDate of Inspection: / L
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes allo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [1 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 0 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
❑ Yes
&J No
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
ELNo
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
[] Yes
0 No
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
F1 No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
allo
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
f�LNo
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[B—No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments {refer to question #)z Explain any YES answers-�and/or any additional recommendations or. any other comments.' tvm
Use drawings offacilityla..better explain situations (use additional pages as.necessary). -
arras ./ 5 d. b;
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �_'!TaC)
Date: , $ =G _d`�Pl/__
21412014

,5-#k / ;:z -/s
ivisioa of Water Resoarees
Facility Number ®- �� O Division of Soil and Water Conservation
© Other Age_cy
Type of Visit: GrCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
[2eason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: — --1 Arrival Time: ,' O Departure Time: r O County:�y`—,_ Region: P?Z_C)
Farm Name:f,W�„� /►'i G I V�•f Owner Email:
Owner Name: M "_'tiN0( %ii C'=- _ Phone:
Mailing Address:
Physical Address:
Facility Contact: �a�s d� ni��-dw Title: qY✓J Phone:
Onsite Representative: �S Integrator:
Certified Operator: �- Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Design
Cattle Capacity
Dairy Cow
Dairy Calf
Current
Pop -
Wean to Finish
Layer
Wean to Feeder
Non -Layer
eeder to Finish
a
""
Design Current -Dry
. D . P,oul i aci P,o
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Cow
Non -Dairy
Farrow to Finish
Layers
Q.
Beef Stocker
Gilts
Non-Laye
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes allo ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes [-]No
[:]Yes [:]No
[:]Yes ONO
[:]Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3
21412014 Continued

Facility Number: 111ate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �lo ❑ 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): r lil/
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
fZj 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?
IT 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
$6 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
P�§.No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
0 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
,�SNo
❑ 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): e,& ti
/ u �L✓��� `d1�16rcr--S / b�`�� e� / D v
13. Soil Type(s): (, ) p A-
l4. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E3 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes k3,No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes O 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 53-No ❑ NA ❑ NE
[::]Yes [SLNo ❑ NA ❑ NE
Required Records _& Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes F2 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes [BNo 0 NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes allo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Ej3,No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes F No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facility Number: 7 �f' - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes allo
t
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 0 No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
[—]Yes &No ❑ NA ❑ NE
[:]Yes ®.,No
❑ Yes Qjg-No
❑ Yes Q8-No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to goesttnn #} E plAh any YES answers and/6r4any-additional recommendations or any other comments.
Use drawings. of,facilityto bett1er explain.situations (use additional, pagesas necessary). ,, y
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: /r"J �3�3
Date:
2141201I

N a3 Rom A �0
Type of Visit: N Q'Com fiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
if
Date of Visit: Arrival Time: Departure Time: County jr— j�� Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: D [�(j't�4itle: Phone:
Onsite Representative: Integrator: i I
Certified Operator: ( Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
- Design
Current
Design Current
Swine Capacity Pop.
Wet PoultryCapacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish _ O -
- -;,T' _ .
Dai Heifer
Farrow to Wean
- _ Design
I
Current
Dry Cow
Farrow to Feeder
Ilr 1'iiult ,,Ca aei
l;o
Non -Da'
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
-
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
io
❑ 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
Cff 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
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[ No
❑ NA
❑ NE
of the State other than from a discharge?
Page l of 3 21412011 Continued

Facie Number: Date of Inspection:
I A!001*
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No (� ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in). -
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes D-M- ❑ 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 [ fo ❑ 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
Ko
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q'No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures
require ❑ Yes
I`-f"o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E3<o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes
❑ Nl <
❑ 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. Cro Type(s): �j�f- 96 d
13. Soil e(s):
/") Do t receiving crops differ from those designated in the CAWMP?
c
[-]Yes
[.d
❑ NA
❑ NE
15; Does the receiving crop and/or land application site need improvement?
❑ Yes
[2-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[—]Yes
[] fo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[Z) o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Lad'"o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
!jJ41°
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
o
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below,
❑ Yes
Q
❑ 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
0lo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
64)
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

1,//-
DF—acility Number: - Date of Ins ectiow
24.bid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
E.Wo ❑ NA ❑ NE
[3-go' ❑ NA ❑ NE
❑ Yes ®,Add ❑ NA ❑ NE
❑ Yes [jlo ❑ NA ❑ NE
❑ Yes ❑ ❑ NA ❑ NE
❑ Yes to ❑ NA ❑ NE
❑ Yes [2 o ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
Reviewer/inspector Name:
[3-"o
❑ NA
ONE
[ o
DNA
ONE
No
❑ NA
❑ NE
No
[�
❑ NA
❑ NE
Reviewer/Inspector Signature:
Page 3 of 3
2141201

type of visit: W compliance inspection U operation Review U structure Evaluation U Technical Assistance
Reason for Visit: 40 Routine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: / Arrival Time: Departure Time: County: WG65-0/E1
Farm Name:,f rv� Owner Email:
Owner Name: Phone:
Mailing Address:
Region:O
Physical Address:
t
Facility Contact: rM l C4jTitle: Phone:
Onsite Representative: 11 Integrator: C{
Certified Operator: Jp& Cal
Back-up Operator:
Location of Farm:
Latitude:
Certification Number: 235'7�D
Certification Number:
Longitude:
Design Current
Swine Capacity Pap.
Wean to Finish
Design Current
Wet Poultry Capacity Pop.
er
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
FLa
oner
Dai Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D . P,oul Ca aci P,o ,
Layers
Dai Heifer
Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turkeys
Turkey Polllts
Other
Beef Brood Cow
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
W 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
V] 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
E]�No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
qNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

[Facility Number: - Date of inspection: /,3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes FA No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [P NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:_ :e2—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): go
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes W 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 P 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
�3 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
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 J1'•u 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 Ou ide of Approved Area
12. Crop Type(s): (7=C4 a 6.y n "r [9--a SS (AL / I �!�' a� �1 , �ZZ.-V S
13.SoilType(s): Lip4Wleg WnP -r, t9plcLib&7-23 !2111cm!f�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
LEI No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
bg No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V9 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
1P 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
[P No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
M No
❑ NA
❑ NE
Page 2 of 3 214.12011 Condnued

Facili Number: - Date of inspection: a a t7 /3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes gg No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes P No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
PgNo
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
❑ Yes [n No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes
[P No
❑ NA
❑ NE
IP Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E§ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments..
Use drawings of facility to better explain situations (use additional pages as necessary).
"'Re-Ltveds WGVie° fiLo 2j(46
Reviewer/Inspector Name:
Phone: Q Id 1.33 .33 -00
Reviewer/Inspector Signature:
Page 3 of 3
Date:
21412011

k\ �j I Ilk1 9,1161LJOU
Type of Visit: �9'Compliance Inspection U Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit: 04outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: Q County: nn rb6uc,. Region:
Farm Name: L�a,)4 �kq ,_
--Owner Email:
Owner Name: U OWL �' Pbone: �L
�
Mailing Address:
Physical Address:
Facility Contact: Title: N 1=k Phone:
Onsite Representative: C( Integrator:
Certified Operator: l( Certification Number: 6
Back-up Operator: V�� j f Certification Number:
Location of Farm:
Latitude:
Longitude:
Y
Design Current � Design Current
Design Current
Swine
Capacity Pop. P•
Po aci Ca Vet�l' uh
P h'
Cattle Ca aci Po
P ty P•
Wean to Finish
La er
Dairy Cow
Wean to Feeder
on -Layer
Dairy Calf
Feeder to Finish
3 Z4DQ��~#
t..
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
D ,Poul . ;sCa aci Pop
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ors
Beef Feeder
Boars
Pullets
Turkeys
Beef Brood Cow
Other
Turkey Poults
Other
„mow
Other
,
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: T
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (1f 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 El"Nio ❑ NA ❑ NE
❑ Yes [:]No
[:]Yes [:]No
❑ Yes
[:]No
❑ Yes
[�No
❑ Yes
2 No
[EIINA ❑ NE
h1A ❑ NE
M/NA
❑ NE
❑ NA
❑ NE
❑NA
❑NE
Page 1 of 3 21412011 Continued

Facig Number: - ®" Date of ins eetion•
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 0 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 [g 1V 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
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
C3'h%
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[]Ko
0 NA
0 NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[2'<o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
` 4 o
❑ 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): S tv f "_ �.-Q �[', — C _� U
13. Soil Type(s): (J.' Al L
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[D,�Ko
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
F;;rgo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[E 1Ko
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
EEY�o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�To
❑ 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 �o ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ER-Nb ❑ 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 g�No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
Page 2 of 3 2142011 Continued

Facility Number: - Date of ins ection
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 25-No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes [5'lqo ❑ 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 [Ef'o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes L7 q'o ❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [] Yes Io ❑ 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 [�o ❑ NA ❑ NE
❑ Yes []'No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes [0 No
❑ Yes �No
❑ Yes t No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
p
Comments,(refer to question. Explain any YES answers and/or any additional recommendations or any other comments��
Ve drawings of facility to better exlain situation ss (use additional pales as necessary).ry,
pa�/ dz5AA I Look a 6oO1
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date. ! 7 r
412011

aably No- / 0 ` (�O Time to •_f `"t s Ttrsfe Oul
Date
Farm Name �a� [�� � ��-7 Z' dtn J .� Integrator
0%,ne; _ _ (( _ _ ._ - Site Re t-)
operator f ` No.. -1 f
Back-up �..fA�., �_ No". T
GOc Cirde= General or NPDES
Crit nt
-
©esi Cun t
Wean — Feed
Farrow — Feed
Wean — Fmish
Farro�n► — Finch
Feed — Fmish 2p•i� b e�
GHts ! Boars,
Fafroan+—Wean _
Others
FREEBOARD_ Design
Observed • �J
Sludge Survey
CalibraiionfGPM
-" l
Grog Yletd
Waste Transfers
R m
Rain Breaker
Sold Test PLAT -
Wetfabie'Acres
v
Wemy Fr6Axwd � Da y.Ramiali
_ 1=i lnspbcfions
.
Spray/Freeboard Drop
VVeMer Codes [/ 120 min Inspections
Waste Analysis:
Dale en (tt1}
Date
Ni"geri (N)
PttWRWd
Soij
Pan
Windt
• ..
� � .8ti- ire;.;.,,;.- ;�_-
-

Type of Visit: @D Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: $ /a Arrival Time: /!3D Departure Time: County: �o6�son
Farm Name: �DA_ ttro M Lei9L) A M Owner Email:
Owner Name: n A U i-n M (~ IFLI n] Phone:
Mailing Address:
Physical Address:
Facility Contact: --Dqwp /1 IC JrACu Title: —01.Jn I~R Phone:
Region: C92
Onsite Representative:
'SArn e _
Integrator: MAy
g�j[yrlj
Certified Operator:
Al -no mCi'LanJ
Certification Number:
` jn19
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design 'Current
Swine Capacity Pop.
Design Current
Wet Poultry Capacity Pop. Cattle
Design Current
C►apacity Pop.
Wean to Finish
Layer
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Farrow to Wean
oo
a y
DairyHeifer
Design .Current D Cow
D , Paul , Ca deity P,o Non -Dairy
Layers Beef Stocker
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Pullets
Beef Feeder
Beef Brand Cow
Boars
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts j
1. Is any discharge observed from any part of the operation? ❑ Yes [g'(No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
r.
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 5XNA ❑ 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 [g"NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes EyNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes F!(No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

FaciliNumber: 7 - Date of inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �io ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 020fqA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:—�
Spillway?:
Designed Freeboard (in): 1
Observed Freeboard (in): c3 4
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Q 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 M"No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes [�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes l/ No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) -
9. Does any part of the waste management system other than the waste structures
require ❑ Yes P;rNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes Ea"No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes t No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure
to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): LJ 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 ❑ Yes g 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 0 No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Q 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 [dNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysir- ❑ 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 E� No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [YTA ❑ NE
Page 2 of 3 21412011 Continued

Facili • Number: -OS14 jDate of inspection: 3 M VOL
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 [3�No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
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 CA W MP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
[�(No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
Yes ❑ No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [Z No ❑ NA ❑ NE
❑ Yes [�No ❑ NA 0 NE
❑ Yes (D No
❑ Yes [� No
❑ Yes [>� No
DNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comqueston#): Explain any YESa"saer-and/oan}additiona! recommendations- omments.
Use drawings of facility to better: explain situations '(use additiondtpages ;as necessary).
�a.. .. ..
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: [phone]Z
Date: 3I tR bpi
21412011

Type of Visit: ompliance Inspection 0 Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: outine p Complaint Q Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: h / Owner Email:
s
Owner Name: xul GC A+ ^ - lc L-e ,,j Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: aO ii el 140c,,J Title: �01 Phone:
Onsite Representative: Integrator: �s _
Certified Operator: -bC0JL4 r i `li i Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
er Current
Design Current 41��MciDesign
Swine Capacity Pop. Wet,-Poultry-.-4-Capacify Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Dairy Heifer
Feeder to Finish
- `-
Farrow to Wean°Design
Farrow to Feeder
Current
Dr aPoulti -Ca ac P,o
Dry Cow
Non -Da'
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Dischar es and Stream Im acts
I. Is any discharge observed from any part of the operation?
❑ Yes
NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
�A
[n`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
[EI"M7C -�'❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
2;.N'e
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
&eo❑
NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

lFacility Ndmber: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P-Ko ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No Eq-N-,< ❑ NE
Struc e l 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 u tV 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 Q'No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
g] o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
La<oo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
E].N'50
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
g2-eo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E2114 ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l 0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of AA
12. Crop Type(s):
13, Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
❑ Yes
❑ Yes
B i`o ❑ NA
Z�o
NA
NA
❑NE
❑NE
❑NE
❑NE
❑ Yes E j ❑ NA ❑ NE
❑ Yes id'" 1O ❑ NA ❑ NE
[:]Yes Vo
❑ Yes E3<
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
❑ NA ❑ NE
❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes 024o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No A ❑ NE
Page 2 of 3 21412011 Continued

Facility Ntttnber: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes B"No D NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �o 0 NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of fast survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
t[4pplication 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
[T No
❑ NA
[] NE
❑ Yes
[:]No
❑ NA
E14«
❑ Yes
®"1q_o
❑ NA
❑ NE
[:]Yes Z2-do' ❑ NA ❑ NE
[:]Yes U4o' ❑ NA ❑ NE
2'res [—]No ❑ NA ❑ NE
❑ Yes
ja o
❑ NA
❑ NE
[:]Yes
io
❑ NA
❑ NE
❑ Yes
Q-Ko
❑ NA
❑ NE
Comments (refer to question.#) Explain �anyYES answers and/or any additional recommendations or. any other coentsT
Use drl:iawings`af facility to better explain situatious'(use additional pages as necessary)_
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Type of Visit Q•tfompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: I s3'*'D.0 Departure Time: /D; fJ County: Region: eew
Farm Name: _4�'>Q ki-d [_`[��[! /il/1 Owner Email:
Owner Name: G V I"I �T~Y . Phone:
Mailing Address:
Physical Address:
Facility Contact: .uiL�C4 A/ Title: �w�/i�l Phone No:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: E__1 o = { ❑ u Longitude: = o =
Design
Swine Capacity
Current
Population
Design Current
Wet Poultry Capacity Population
Cattle
Design
Oapacity
Current
opulatian
❑ Wean to Finish
❑ Layer
❑ DairyCow
❑ Wean to Feeder
❑ Non -Layer
❑ Da' Calf
Feeder to Finish ZCV
❑ Da' Heifer
Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Layers
❑ Non -Dairy
❑ Farrow to Finish
El Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
Brood Co
❑❑Beef
Turkeys
Other
❑ Other
❑ Turkey Pouets
❑ Other
Plumber of Structures:
Discharmes & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
El No
�,/
L�..,, NNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
El No No
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
L] l�A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
B No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
to
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility Number: Date of Inspection -Z r
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): 51
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes awo-l"❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) ,_,,
6. Are there structures on -site which are not properly addressed and/or managed Ela Yes l❑ 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? ElYes Oeo/❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes D<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 No El NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes CJ No ❑ NA ❑ NE
maintenance/improvement?
]I . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 9'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 ind Drift ❑ Application Outside of Area /
12 _ Crop type(s) [ f '� s�.t/' t�1 �4 -So�cS ��lcc �tt ��� �r� %.d C 4 S • /
13.
Soil type(s) AIM LA, $
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
L��Noo ❑ NA [3 NE
15.
Does the receiving crop and/or land application site need improvement?
Yes
ElE
kKoo ❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
l/ No ❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
NA El NE
;"N�oONA
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
L� ❑ NE
Reviewer/Inspector Name Phone: 910.9W.3360
Reviewer/inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility Number: 7 — Date of Inspection I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
❑ Yes B'No ❑ NA ❑ NE
❑ Yes L- < ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ 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?
El Yes
�[:]
El<oo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,L.i,'N�/o
�O
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Q,<o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
To
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
To
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
,.,�
LTNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
CTNo
❑ 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
, /
LTNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No�❑
NA
❑ NE
33. Does facility require a follow-up visit by same agency?
El Yes
Dlgo
❑ NA
❑ NE
Page 3 of 3 12128104

4X94 7 -0 y -Zt3 a q
!vision of Water Quality
Facility Number 0 Division of Soil and Water Conservation
— - - - - _ Q Other Agency
Type of VisitComppliance
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
0-1 outine O Complaint
O Follow up 0 Referral O Emergency
O Other ❑ Denied Access
Date of Visit: �Q lArrivvall Timme: . 60 / Departure Time: %�.�dO,�r..• County: l`-c&y- L Region:
Farm Name: DaLIJ ljt4�1/ �aVtjn „_ Owner Email:
Owner Name: b4 v d Re, t C of Phone:
Mailing Address:
Physical Address: 7 �` r
Facility Contact: _b sJ i d I �L i ri i Title: a,(m_fde�: Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [= 0 0 c = s, Longitude: 0 ° = d 0
di
Design Current
Swine Capacity. Population
❑ Wean to Finish
❑ Wean to Feeder
13 Feeder to Finish 2
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other -- - —
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -La el
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream 1_pacts
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 Current
Cattle Capacity P pulation
❑ Dairy Cow
❑ Dairy Calf
❑ Dai Heifer
❑ Dry 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?
e
❑ Yes 8 No ❑ NA ❑ NE
❑ Yes
❑ No
2-KA
❑ NE
❑ Yes
❑ No
G-IqA
❑ NE
C 1GA
❑ NE
❑ Yes
❑ No
❑ Yes
Bl' o
❑ NA
❑ NE
❑ Yes
©'1�10
❑ NA
❑ NE
12128104 Continued

Facility Number: 'Z a —t�
Date of Inspection - p
Waste Collection & Treatment
4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes B<o ❑ NA ❑ NE
❑ Yes ETNo ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
r
Observed Freeboard (in): Zg
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Bl o
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
El Yes
��
EJ.tvo
❑ 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
El
❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
046
❑ 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
011o'
❑ 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
[li
❑ 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 Window ❑ Evidence of Wind Drift ❑ Applicaat++i��on Outside of Area
/Crop
12. Crop type(s) i t4 �e= i "7 ) sjw�� �rF� `� ��.5,) . LG��`J✓
WL_7' S1212/
�
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
EJNNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement? El Yes
0<o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
2Vo
❑ 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 D% ❑ NA ❑ NE
IComments (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):
33. 3360
Reviewer/Inspector Name .72 -t/ S Phone., llb. M .33 0
Reviewer/Inspector Signature: 'ez� Date: -3,0 — 2�9
IZI.161" Conunuea

.. 7s-9�
Facility Number: -7g— Date of Inspection
Reuuired Records & Documents �
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes El No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes L] 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 CrNo ❑ 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
01�o
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
E'i�O
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes_-
O'1Io
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑'go_
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
B<o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3 o
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E ' o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
El -No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
El Yes
�..
ETNo
❑ 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
E No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
E! No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

OTN/C '4 �_ni_ nQ
(YDivision of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit
C�ommpliance Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
l7 Koutine 0 Complaint
0 Follow up Q Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: 16ZG "D O 11Arrival Time: ; 3d Departure Time: 7 .�3s County: P-6 Region:
Farm Name: _ bo_y ►cL M !;Jf4 A/ _ c'w-- . Owner Email:
Owner Name: Dav F cj Ak C i C.&N Phone:
Mailing Address:
Physical Address:
Facility Contact: �Q 41 �yl �l COL A./Title: dam+ ti C Phone No:
Onsite Representative: Vdui �yt�—� �-< +J Integrator: �itt4 Rriti Al
Certified Operator: K • ' 4'<A t&nI Operator Certification Number: 119FI [ q
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: 0 0 = = Longitude: = o = I =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Laver
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -La ers
❑ Pullets
❑ Turke s
❑ arkey 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 Current
Cattle Capacity Population
❑ Dairy Cow
UDairy Calf
❑ Dairy Heifej
❑ prycow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: E
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 ONo ❑ NA ❑ NE
❑ Yes
5No
❑ NA
❑ NE
❑ Yes
ffN.
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
O'NNo
❑ Yes
CJ lvo
❑ NA
❑ NE
❑ Yes EfNo ❑ NA ❑ NE
12128104 Continued

ti
Facility Number: 7 —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): r
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 0 No
❑ Yes ETNo
Structure 5
El NA ❑NE
❑ NA ❑ NE
Structure 6
❑ Yes ETNo ❑ NA ❑ NE
[-]Yes [t No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [f N ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes L7 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E No El NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes L7 No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
2 o
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
/Window
Crop type(s) P�-a(c(d c._ L �6r�.;✓ 1��u3ec gl� . G ���L�lOe�tn/
13.
ti
Soil type(s) R
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
�o
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
B o
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
BIN'
❑ NA El NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
�o
L"IN
❑ NA ❑ NE
18.
is there a lack of properly operating waste application equipment? ❑ Yes
C1 No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations ar any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Z �f ,nfn C C.
AL
PP/'� DI. ��ti-.t a,P--- �` d �°4d,
Reviewer/Inspector Name F-., j c k-"7 e�V e_(I
S Phone: %/Os
Reviewer/Inspector Signature: Date: (p -Z(o
12129104 Continued

Facility Number: '7S — g Date of Inspection -D
_Required Records & Documents .,/
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes E No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[' No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections
El
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
L7 1No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
G�N'
❑ NA
ElNE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
,o
L1 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
El"No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ NA
[I NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
[I Yes
,h�/No
L' No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
LJI No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
f
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
El No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
[I Yes
��/
L�J 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?
El Yes
N
❑ NA
El NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or
1228104

*` 0 Division of Water Quality
Facility Number 7 g g 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit ® Compliance Inspection O Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit ®Routine O Complaint Q Fallow up 0 Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: ,3 Departure Time: County: 4A-e_s-ew Region: 0" O
Farm Name: LJau[l AGAe y FQ,lH Owner Email:
Owner Name: _-bau,C /9C Phone: Wo,
Mailing Address:
Physical Address:
Facility Contact: / Title:
Onsite Representative: bQ-z,,rd
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator: - ,Or
-�
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ O = ' ❑ Longitude: ❑ o ❑
Design Current Design Current
Capacity .Population Wet Poultry Capacity Population
❑ La er
I-1 ❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
Design >Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifej
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
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
TNo
El NA
El NE
❑ Yes
[P No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[�' No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
12128104 Continued

}
.-' Facility Number: "]g— S Date of Inspection 2 -O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
['g No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
ERNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 ��
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[A No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[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
[0 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
[� 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?
It. 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 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop ❑ Evidence of Wind Drift ❑ Application Outside of Area
/Window
\
12. Crop types} �Gr7wl end C/%t.. 1, isf¢/l �`erii✓�[9revs� CA-rw/
LJ4jPs 4
13. Soil type(s) S Alo k
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 ® No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[A No
❑ NA
❑ NE
❑ Yes
[A 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): G
Reviewer/Inspector Name �- S _ Phone: 9/A X33. 33.30
�N L
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: `]s — gel Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [ulu4No ❑ 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 El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [5� No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
[:]Yes
X No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
W1 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
IN 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
,9� No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
14 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[5 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
Z 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
allo
❑ 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
ONo
❑ NA
❑ NE
33_
Does facility require a follow-up visit by same agency?
❑ Yes
71No
❑ NA
❑ NE
Additiohal Comments and/or Drawings:
Ld
Page 3 of 3 12128104

o�0� W Ar�gQ�
i.� —f
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
December 1, 2006
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
David McLean
David McLean Farm
855 McLean Rd
Lumberton, NC 283586699
Subject: Application for Renewal of Coverage for Expiring NPDES General Permit
Dear Permittee:
Your facility is currently approved for operation under one of the Animal Waste Operation NPDES General Permits, which expire on
July 1, 2007. Due to changes in federal rules, facilities that do not discharge nor propose to discharge may choose whether or not to
retain coverage under an NPDES General Permit. Copies of the draft animal waste operation NPDES general permits and the State
Non -Discharge General Permits are available at htt�r:/fh2o.enr.state.nc.us/aps/afouldownloads.htm or by writing or calling:
NCDENR — DWQ Animal Feeding Operations Unit
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Telephone number: [phone]
In order to assure vour continued coverage under one of these two types of general permits, you must submit an application for permit
coverage to the Division. Eric tosedyyou will find a `Request for Certificate of Coverage FacilAy Currently Covered by an Expiring
NPDES General Permit.' The application form must be completed and returned by January 2, 2007. Please note, you must include
two {2) copies of your most recent Waste Utilization Plan with the application form.
Failure to request renewal of your coverage under a general permit within the time period specified may result in a civil penalty.
Operation of your facility without coverage under a valid general permit would constitute a violation of NCGS 143-215.1 and could
result in assessments of civil penalties of up to $25,000 per day.
If you have any questions about the draft general permits, the enclosed application, or any related matter please feel free to contact the
Animal Feeding Operations Unit staff at 919-733-3221.
Sincerely,
Ted L. Bush, Jr., Chief
Aquifer Protection Section
Enclosures
cc (w/o enclosures): Robeson County Soil and Water Conservation District
Fayetteville Regional Office, Aquifer Protection Section
AFO Unit Central Files - 780084
Brown's of Carolina LLC
1� Carolina
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: (9 19)" ' �tKraffy
Internet: www.ncwaterouality.orc Location: 2728 Capital Boulevard Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
An Equal Opportunity/Affirmative Action Employer- 50% Recyded110% Post Consumer Paper Customer Service: [phone]

,. ,..�.,, --.-- 1♦'Davtsxpn of Water Quahtv,�,,.: � � I I
Faeili(y� Number; 7 $� O Diwsion of Soilsand Water Conservation
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: 3- 2- 4!p Arrival Time: /O.`SO Departure Time: County: D Region: t-`RO
Farm Name: Da v i j G Le A bi —�„�a cK4L_. Owner Email:
Owner Name: �at. I i c-� _ _�ectnl Phone:
Mailing Address:
Physical Address: ++ nn
Facility Contact: U t d C !i ea. ►J Title: CJ i.v Phone No:
/�
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = , = Longitude: 0 ° [_—] , 0 «
S%Ine
❑ Wean to Finish
❑ Wean to Feeder
%FeedertoFinish
h2oolziroo
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other -
❑ Other. _ _
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer _
❑- Non -Layer
Dry Poultry
❑
Layers
❑
Non -Lavers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges Si 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 Current
Cattle = Capacity Population
❑ Dai Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: ='
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
e. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
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 54No ❑ NA ElNE
❑ Yes
W1 No
❑ NA
❑ NE
❑ Yes
J�j No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
® No
❑ Yes
14 No
❑ NA
❑ NE
El Yes
�No
El NA
El NE
12128104 Continued

Facility Number: -%$— S� Date of Inspection -0- - 4
Waste Collection & Treatment
4- Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
9No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[gNo
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): .19
it
Observed Freeboard (in): 2-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
gNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[K No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ 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
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?
IL . 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 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
9 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
NFNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
El Yes
P No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
WNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Reviewer/Inspector Name Phone.42LV.
Reviewer/Inspector Signature: Date: 3-0 Z — Z d0 &
..___
1 L/LV/VY a�v..••...sa.r

'R r
Facility Number:? S — $ Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 3No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑ Checklists El Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes � No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V 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
�KNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[9No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
N No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
j3No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
p No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
O 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
XNo
❑ 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
[;9 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss reviewfinspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[VNo
❑ NA
❑ NE
o Addi6rial Comm �` � eats and/or Drawings
12128104

Facility Number Date of Visit: Time: I T Yur 4-n
0 NNot rational 0 Below Threshold
aermitted Q'{ ertified © Conditionak CerfMed 13 Registered Date Last Operated or Above Threshold:
Farm Name:
Qow"d -- "Czea„ Tr--_F"-M County:
Owner Name: pQ,�xl Me- 'Phone No:
?l ing Address: . P -...- M c L_tde3 d N % 3 T-Y
Facility Contact: . D a� -_--Al d ea � _
_ fix.. Tr ..Title: Phone No:
Onsite Representative: -- - --.- _ QuV-d &c 1-eftn _Tr - Integrator: ..
Certified Operator. QA,, �, :� , , ,� ( _ .fir _ _. _ . _ Operator Certification Number.
Location of Farm:
❑.Sfntine 0 Poultry ❑ Cattle. ❑ Horse Latitude • " Longitude • 4 �u
Swine
Wean to Feeder
to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
El Gilts
Dis� chaff & Stream Impa
meat � ,. -: °i>►
'ulatioti._'sp9 Cana
Other
Total Deign �9
1. Is any discharge observed from any part of the operation? ❑ Yes M-No
Discharge originated au ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes B-No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes [;No
c. If discharge is observed, what is the estimated flow in gal/min?
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes B-No
2_ Is there evidence of past discharge from any part of the operation? ❑ Yes [moo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ONO
Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes B'90
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: [ — -- .. _ . _ _ . W. _. _ ..._
Freeboard (inches):
12112103 Continued

• Facility Number. 17,q —g Date of Inspection--
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes 91110
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes !NO
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancefunprovement? ❑ Yes Rlqo—
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes Mwo-
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level [I yes Q-I'ro
elevation markings?
Waste Application
10. Are there any buffers that need maintensnceJimprovement? ❑ Yes BoRo
11. Is there evidence of over application? If yes, cheek the appropriate box below. ❑ Yes Dwo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
/jV.')C- TGY /ov /Jo j7�
12. Crop type SeMmj
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes QNo
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 EIM
16. Is there a lack of adequate waste application equipment? ❑ Yes RNo
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 2 No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 611Qo
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 EW0
Air Quality representative immediately.
FirW Notes
45
Cl +„ado di ►c bvr'a� Spit far olt�� /ivys. /rit. /ylc<ee., is try„� fo aes�-
Gar in CLia,► r s Gvrfen 4 • s
ReviewerAkspector Name
ReviewerAnspector Signature:
Date: 1 U - _-P ! - v
_1

- Faciiity Number: Date of Inspection p -o
Rewired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
s
❑ No
22. Does the fasility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! , checl l Cs, dop, mope; etc.)
❑ Yes
Q-Ko
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
EI#b
❑ Wane A7pheafien ❑ Preebe" ❑ R sis D�ei� Sig
3--7S` 34 7-30 -) 1.2
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑Nc
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
MWo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
[3-W
27. Did Reviewer/inspector fail to discuss reviewimspection with on -site representative?
❑ Yes
❑.w
28. Does facility require a follow-up visit by same agency?
❑ Yes
G No
29. Were any additional problems noted which caul: noncompliance of the Certified AWMP?
❑ Yes
QKo
LAMES Permitted Facilities
30. Is the facility covered under a NPDI S Permit? (If no, skip questions 31-35)
Q a
❑ No
31. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
RWO
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[moo
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
04weidf� -die ❑ uiaw ❑ "
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
��3�"-c.'r,•agrst' Mr, M�.Lr�,� fa �u.ke wus�e s rrp�t a ern.
(c�.e,y Gd-qo r,/a c+n.tys,•s / F
are 4 aey� �i d dL7�/f de fie
Gnd aPer srt.,,ale �a��. ✓
Mor. /►mean 445 A. G.sp ,PC *Ae Cerfr Fc«
% f r af- �Ny�ia C
11a14 fit Nl°Qts`j 13e,�,'�
4.ref JR ser.,,rf copy yr �per,,�
?r't hU✓st /-If
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r�#rm -e [ er�S
/ �f
�3 GI�t/ # 3y GOpi� o� T+le Slti��� SVrvY� Rh� �Lt Ca�6raFe'Uh s{
W4sif
/-ICGfSt firilo a 4u,OX d3C GGscA w. It FGir�.y hare. reev"
12112103

Type of Visit 40 Compliance Inspection O Operation Review O Lagoon Evaluation
Beason for Visit ®Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facilin. Number Y Date of Visit: A Time: 6b
?\ot O erational 0 Below Threshold
® Permitted ® Certified (] Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: _ D—:,Vi A h/l r L. County: 90kr1_ G-x_
Owner Name: Phone No:
Mailing Address: �a S �� crtp r TiZcSc�GQ l�v+��MJZ,as!35 a
Facility Contact: l�*1 � , !IA__e_i. n Title: Phone No:
Onsite Representative: Qi 64C_ Integrator: r
Certified Operator:. 06W1 Irw e Operator Certification number:
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• �• ��
Design Current
Swine rAngcity Ponnlstinn
❑ Wean to Feeder
® Feeder to Finish
3 ec>
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver I ❑ Da
❑ Non -Laver ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons (I ILI Subsurface Drains Present JLJ Lagoon Area JU Spray Field Area
Holding Ponds / Solid Traps ❑ No Li uid Waste Management System
Discharves & Stream impacts
1. Is anv discharge observed from any pan of the operation?
Dischar-e oriennared at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Rater of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (Ifves. noti6, DWQ)
Z. Is there evidence of past discharge from any part of the operation?
3. Were there anv adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste CiLlection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ SvillwaY
Structure 1 Structure ? Structure 3 Structure 4 Structure
❑ Yes [P No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes ® No
❑ Yes [A No
Structure 6
identifier:
Freeboard (inches): 3
05/03M Condnued

Facility Number: Date of Inspection i
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes (N No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes ® No
(If any of questions 4-6was 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 MNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [R�No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes WO
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes [NNo
IL Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes U No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 0& No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes Wo
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
10 No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
GINo
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
SZNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[$No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
Cl Yes
[R No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
qNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
UjNNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
W No
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
[S'No
24. Does facility require a follow-up visit by same agency? ❑ Yes RNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [9No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
vaivJiv] c.onanuea

t
Facility Number: — ti bate of Inspection
Odor ssu
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor 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/tempomry cover?
O5103101
❑ Yes ❑ No
❑ Yes 14No
❑ Yes W No
❑ Yes [P No
❑ Yes [A No
❑ Yes [ No
❑ Yes ❑ No

Type of Visit & Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Hate of Visit: f0 6z Time:
10 Not Operational 0 Belo' Threshold
® Permitted ® Certified /[3 Conditionally Certified E3 Registered Date Last Operated or /Above Threshold:
Farm Name: .6)" c� C'460.) /;a.«- _ _ County- RQS�Xv.J
Owner Name: // C�e9 Phone No: S 9119
Mailing Address: - Y5 ,.�f%7e6.st�r -o,4�r '" . ,frc�Oi�, /f/
Facility Contact: C N-" Title: Phone No:
Onsite Representative: }`
Certified Operator: _/�`��� �e� ",)
Location of Farm:
Integrator•Wi1f CiCd�/ y
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 0 0 u Longitude 00
Dischare s & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes K No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes �No
b_ If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes LZp NO
c. If discharge is observed, what is the estimated flow in gaUrnin? 7��
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes VNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes KNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes KNo
Waste ll cfion 8 Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes RINo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
30 "
05103101 Continued

Facility Number:
Date of Inspection 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes 19 No
❑ Yes �] No
❑ Yes
Yes;No
No
❑ Yes �wNo
❑ Yes $allo
❑ Yes 9No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ANo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
ANo
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
El Yes
No
15.
Does the receiving crop need improvement?
❑ Yes
tQ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
`{ANo
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
19No
(ie/ WLTP, checklists, design, maps, etc.)
❑ Yes
�(No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard(waste analysis soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
/IgNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
*o
24.
Does facility require a follow-up visit by same agency?
❑ Yes
Pj No
25_
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
�[No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Cotnineats {refer to [}ueshan #) EY0Ww say YES attsvrers and/or any recornm6dati6as ar ar*other comments, �r
Ltse;tirawtags of farilsty to better exptstn sttaaho (use addiaonaE pages as necessary)t 3
❑ Field Cony El Final Notes
Reviewer/Inspector Name - y
Re'vdewer/iuspector Signature: Date: l6 OZ
05103101 Continued

Facility Number: 7 — Yr Date of Inspection : U ,5 Z
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 anv 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 ❑ No
❑ Yes R1 No
❑ Yes EINo
❑ Yes �Q No
❑ Yes ®No
❑ Yes 9 No
❑ Yes CR No
05103101

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit gRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number ' Date of Visit: _O Time:
O Not O erational Q Below Threshold
Permitted Certified 1� �Cfjo/nditionally Certified 9 [3 Registered Date Last Operated or Above Threshold:
Farm Name: . :�?L............ `.0 �.. eGZ; tee...!... � r`:l' :\k..................... County:.....4.12e �Q?�..r......... W_. __.
Owner Name:.........................L" t..e..k- e.a.! 1, ..... te.............. Phone No: ......... 7 3 'ir-..
Facility Contact: ........(.F .n L°r........................................Title:.................I......�..........---........... Phone No: ..`.�........ ............._..
Mailing Address: .. ... [�A rit................................... ..... !1.(�.'er. 1,...1�1..I ......................... .. ..............
Onsite Representative: ...............................................Integrator: ,
............... l ...... ....� �— _ ...
Certified Operat0r:._b..0%s1!..d..................... .................. Operator Certification Number: ..................... ..._
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • & 14 Longitude • d Du
• ; -Design-; u -Current--
She Ca -CI - PO [IlaOn
Wean to Feeder
Feeder to Finish
Z
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Current Desigtii Chit
= .
Poultry Ca Po Wation Cattle . ; : Ct� Po ._elation"- .:
❑ Layer ❑Dairy
❑ Non -Layer ❑ Non -Dairy
10 Other
Total -De & Capad6'
Number of "' Subsurface Drains Present Lagoon Area ❑ Spray Field Area
��
i Holding Ponds. / Solid Traps No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes KNo
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) 0 Yes P(No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes o
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure
Identifier: ........................................... .................
Freeboard (inches):
5100 Continued on back

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancehinprovement?
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 maintenancetimprovement?
11. Is there evidence oLover application? t
12. Crop type l7 Pl`w (A&A ki as
13. Do the receiving crops differ with those desi
14. a) Does the facility lack adequate acreage fo:
b) Does the facility need a wettable acre dett
c) This facility is pended fora wettable acre
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
I7. 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?
Oe/ 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?
........ .... ........ .......
yiolg�igl s:or dgfc�epc�e wire Rpted• �l . th#s:vNsiti Yost wi�� �-eegiy... fi.... .
corresvondenCe.abaifth' islt_'...._'.'...'.'...'..'.'.'.'.'.'.'............'..'.
❑ Yes No
❑ Yes \p
❑ Yes ANo
❑ Yes PNo
❑ Yes gNo
❑ Yes gNo
❑ Yes O(No
❑ Yes KNo
❑ Yes Flo
❑ Yes %fNo
❑ Yes P(No
❑ Yes gNo
❑ Yes ANO
❑ Yes RNo
❑ Yes No
❑ Yes No
'U ( Aen huff llt�q + li / m, &_ Sure k . e6 t,Li G1 r i J' ree eT T�-IF 0;
Per s - L14er; y+arj —L Tu leS
Was,je o�-e�yS�S 7� Cb✓Cr �...�` d—�tti$� ���iCtS ?� IDer+titt(d�.
06j
Reviewer/Inspector Name
Names
Reviewer/Inspector Signature: �,,� Date: _z —O 5100

1
Facility Number:
Date of Inspection �z ICJ
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
es
ky
❑ 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
ANO
28. Is there any evidence of wind drift'during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
PNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
O(No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
ONO
31. Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
6#6-
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
5100

Jy Routine 0 Complaint 0 Follow-up of DW2 inspection 0 Fallow -up of DSWC review 0 Other J
Facility Number . S Date of Inspection �zp
Time of Inspection o U hr. (hh:mm}
® Permitted W. Certified [3 Conditionally Certified Q Registered 3 Not O erational Date Last Operated:
�,4vipl i/1�r� �N�-`"^ Coun :.........ICp�,�Sd.-J
Farm Name: .................�...j...`..................c------.......................--------.......------------......------------. h............................... .............. .......................
Owner Name: a� / �` �� Phone No:...1
•-------------------------------------.....---------.................----------------------.. —
Facility Contact: .......f.........r�i ..... % Gi ..... Title: ...................... Phone No: ..................--------.-----...................
Mailing Address: ........... $r A..14 O� ��I...... G.G. /r✓ G �,.. ......_ .. ...... .
p
Onsite Representative:.....'��y�J......................................... Integrator:......... . wv� J dd•se �-f
Certified Operator:......., � ............ Operator Certification Number: .... „.._.......................„.„....
Location of Farm:
Latitude • 9 4s Longitude • 1 E4
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑Yes ®No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ® No
2. Is there evidence of past discharge from any part of the operation? []Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? []Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: y� 41
Freeboard(inches): .......................................................... ... .......................... .....
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 9 No
seepage, etc.)
3123/99 Continued on bark

.,
Faci14 Number: IF — y Date of Inspection —�
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes IgNo
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ®No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ,] No
Waste Aonlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ,® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes , ] No
12. Crop types,. •rG+4 , s�/�.a<A�/1 , /��.��7 _ -- __
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ,(�3:No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes 5a No
b) Does the facility need a wettable acre determination? ❑ Yes ff No
c) This facility is pended for a wettable acre determination? ❑ Yes N No
15.
Does the receiving crop need improvement?
❑ Yes
RNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
J,NO
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
W No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
�No
19.
Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
04 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
[RNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail -to discuss review/inspection with on -site representative?
❑ Yes
TO No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
NO'Abial i0iris, pr (iCl�clt'nCiCS -we . p. d. diWiIlg Ahls.vlslt. • Y'oli Will tOOK46 0 fui-th�r
corres� o deHke: albou>i. this :visit:: : :: ' ' :: :
-..�
Commertts (refer tq^gaestton #} Explarn anyYES answers and/or any recommendations or.any other comments
Use drawuigs of faciLty to better_explain situations (use additional pages as necessary)
A6
r / /
Cca.✓>��w� �� � � / Gl � �.��t�.v�f�i� ate✓ r.✓S,�r rl�-�
Reviewer/Inspector Name x
Reviewer/Inspector Signature: 7/",2�Date:

Facility Number:' — 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? �T
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 10 No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes JEJ No

0 Division of Soil an"
- 1, "13 Division of Soil and
Division of Water Q
Other Agency, R Ope
r Conservation .Operation Review =f _ -_ Y `
''
Conservation Compliance Inspection
CompLance inspection
r L"
�=Review.
VRoutine Q Complaint Q Follow-up of DWQ inspection 0 Follow-up of DSWC review Q Other
Facility Number 7 Date of Inspection
Time of Inspection 124 hr- (hh:min)
Apermitted 0 Certified [J Conditionally Certified © Registered JE3 Not O erational Date Last Operated:
%�/J G / � fir'
Farm Name: ......1�1.01............!..'.!......L LGL'1'...-.614 rneL_ ..--....................... County:......., 2 C Sol-�Y........ ............. .......................
Owner Name: ..... Pau40.(.......................m�"��Q � . Phone No:.... 1.3�.:...�f�5~�.-..............................
.................................................. .....
Facility Contact: ........ 'rhe>".................• Phone No :...................... ............................
C ..-.. Title:.............fit.1.-,..............---.................. �—
f % rI
Mailing Address: ....5-7
..�...5 .... ll 1...-.�L.4 { ............................................... ...... �€ Il.lI1 >- j ../V L' ............... .Z�3
Onsite Representative:....!1d� integrator:......../1,��(f/.f.....4...O.G'
/`�... ..... r
Certified Operator: 1�� ✓l: .lL.�.. a��c5— ,� r Operator Certification Number:.. ........................................
Location of Farm:
AL
...........................................................................................................................................................................................................................................................
Latitude �� ���
Longitude
Design Current
;; Design_
'C_urrerit;: -"
—
Design. Current
Swine _:, r Ca acity Po ulation
_° Poultry Ca acity.;,Po
pulation ,,.Cattle _
Capacity Population
❑ Wean to Feeder
❑Layer
=_. ❑ Dairy
=
Feeder to Finish 32-00
- ❑Non -Layer
� ❑ Non -Dairy
❑ Farrow to Wean
— — -
F � ❑ Farrow to Feeder
❑ Other
❑Farrow to Finish
'Total Destgn Capacity
32U�
❑ Gilts
Boars
Discharges
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes A No
Discharge originated at: El Lagoon [I Spray Field ❑ Other ,r A,
a. If discharge is observed, was the conveyance man-made? ❑ Yes �NG
h. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes t�No
e. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? f yes, notify DWQ)❑ Yes Na
2. Is there evidence of past discharge from any part of the operation? ❑ Yes o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 4 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway []Yes J�No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: it
Freeboard (inches). ........ ..l..........
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �f No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 70 —7? Bate of Inspection S=9
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
El Yes
kNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
AJNo
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes-
No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
gNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
ONo
11.
Is there evidence of over application? ❑ Excessive P riding ❑ PAN
❑ Yes
gNo
12.
Crop type /moo /�
13.
Do the receiving crops differ with t ose designated i the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
XNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
KNo
b) Does the facility need a wettable acre determination?
KYes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
P'No
15.
Does the receiving crop need improvement?
❑ Yes
$�No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
PQ No
Required Records & Documents
17_
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
$LNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.) � �
❑ Yes
No 9
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
24.
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
tjNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23,
Did Reviewer[Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
WNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
W(No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
V No
" o yioiaticjtis'or . iencies were noted duringthis'vis. it' Yoi} iviil �eeeiye Rio fui•#her
correspondence ahaniti this visit:::::..:...:::::::: :: ... :::::.:... .
99

1 ti
Facility Number: Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes D(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 allo
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 K 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 permancnt/temporary cover? ❑ Yes No
3/23/99

0&.
0 Division of Soil and Water Conservation 0 Other Agency
tH Division of Water Quality
• Routine O Cam laint O Follow-u of DW ins ection O Follow-up of DSwC review O Other
Facility Number
Date of Inspection
� `
Time of Inspection ® 24 hr. (hh:mm)
13 Registered Certified © Applied for Permit 1 Permitted 13 Not Operational I Date Last Operated:
Farm Name. 5:V4J Ir1eL� r v✓i County I�o&E5o_f7 .....................
,,.,.,....... a�............................................ ..................
Owner Name: Ad did I �l C � Plk�i . q10 /.� 17 FS�. .. ........................................--.-•--...................... Phone No.
n �1
Facility Contact: t..}am r . ` .�-ern......... Title: .................................... Phone No:...................................................
Mailing Address: ...... &....... -J ......SPX......... ............ Gl�!�.� 0 ?�• NC...... � 8
i
Onsite Representative:....--...................................................... d� � s �+'aLJ.!7a.............
Certified Operator-- _.. J)C,IJ ,K........... PICIe.an Operator Certification Number, .......... IVY?
Location of Farm:
Latitude �' �� �« Longitude
r� Desrgn= Current' 'FDesign` "Current q
Swine ti c Capacity Popnlahoa Poultry Capacity -;Population 'Catl
❑ Wean to Feeder
Feeder to Finish
-
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑Layer 0
„', ❑ Non -Layer ❑ N
❑ Other
4 k
Total Design Ca
a Total:"
Subsurface Drains Present
❑ No Liquid Waste
;Design- • Ciirrent'r
e ;Capacity Popuiation
icy
n-Dairy
n.,.
�acity 3Q00
Area' I0 Spray Field Area
General
1. Are there any buffers that need maintenancelimprovement?
❑ Yes
9No
2. Is any discharge observed from any part of the operation?
❑ Yes
O(No
Discharge originated.at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
I[No
c. If discharge is observed, what is the estimated flow in gal/min?
_ N//4
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
PO No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
No
maintenance/improvement?
5. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7/25197
Continued on back

Facility Number: 8— g
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons.tfolding Ponds, Flush Pits, etc.)
9. 1s storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes 1K No
❑ Yes 9 No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
.......--.fr......................................................................................................................................................................................
� Freeboard (ft)`.....................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes No
11. is erosion, or any other threats to the integrity of any of the structures observed'? ❑ Yes No
12. Do any of the structures need maintenance/improvement? ❑ Yes No
(If any of Questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify.DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
XNo
Waste Application
14. Is there physical evidence of over application?
❑ Yes
OdNo
If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type lt.,rr�!i�,a
_
.. ........................................................................................
lb. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
X No
IT Does the facility have a lack of adequate acreage for land application?
❑ Yes
XNo
18. Does the receiving crop need improvement?
❑ Yes
9No
19. Is there a lack of available waste application equipment?
❑ Yes
JUNo
20. Does facility require a follow-up visit by same agency?
❑ Yes
JXNo
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
El Yes
jo No
22. Does record keeping need improvement?
XYes
❑ 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
P(No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ZNo
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
0 No.vio'N ions or deficiencies were. noted during this: visit.- You.will receive no further
: correspondence a'Wit this.visit.
r toy question #) �Eipl
:tin any.'Y'ES answers andlpr ally-recoinmendattons-'or any other comta
tinsttuations.:(use additional pages,as'necessarv)
I
Star[P
? I25197
Reviewer/inspector Nameav'�-E.r� W " `1 �
_ r q:�:'
Reviewer/inspector Signature: t�, Date: w ~a�.3
A

t ❑ DSWCAnimal Feedlot Operation Review'=n
o ^4Fp ¢ was . � .` .`` "� °�." � � •c':--�, to '� xx .::'�'� �� '..�„ � ¥� ''n^k.`� r
10
�� :� -� � -� DWQ�Animal Feedlot Operatlon�Slte,��nspech©n� x�� �� ��:�
Routine O Complaint O Follow-uR of DWQ inspection Q Follow-up of DSWC review O Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ eg►stered ❑Applied for Permit
// (ex:1?5 for 1 hr 15 min)) Spent on Review 0
ertified ❑ Permitted or Inspection includes travel and processing)
❑``Not Operational Date Last Operated: ------ _. .._... �. j . .I. _ _.. ..�.........p.............
Farm Name: Cau my:.
' � r
Land Owner Name:... . �v l _ . _._ L!.. _. ._ .._ Phone No:.r..?.3�.. .... _... _ .. _
Title:&- 0.1&,q —Phone No:....
Mailing Address:. B _a.i 4 r� ... .. t..�r^! �w� b e rQ +�1.. C �3! 5'V
i
Onsite Representative: ..._._ .........Integrator:..._........f.*. �` S
d�_._....—,_.�.....................................
Certified Operator: ) f 1� _ L` � [ ' ^.. .. ._.,,,...., Operator Certification dumber: _LgI
Location of Farm:
h.l 5 ._ �^ 1. la.... s�.11.. �...._ 4
Latitude �• �� �� Longitude �• �04
Type of Operation and Design Capacity
i`.r,"r} ems:- „p„+Sv s 'Crta�t :y,r �A#.xw "^ Fps-``4a - amss �':'.3 'ya•^ t�" Z't;..
r, EDesig"n," Current � � � �iiesign � 3 CnTrent � �� �DesA�A
Ca aci Po ulat an = Poul! 3' Ca achy 'Pd6ulati n. ...... acI& Po ulation
.yr d
❑ Wean to Feeder k4A Layer ❑ Dairy
N
Feeder to Finish Z 0 0 t ❑ Non -La er x ❑ Non Da
Farrow to Wean
xH 'ru��r%'+ �a
El Farrow to Feeder :'. Total�DesYgn CapaCilty 200 s.
Farrow to Finish
0 _
Other
"y�e,��,,'�?."
�Numt►er of�Lagoons! HoldingePonds°. ❑ Subsurface Drains Present .,
❑ Lagoon Area $ ❑ ra Field Area y
ss 3, _. ..sa....... `�p }r .. ........
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes No
2. Is any discharge observed from any part of the operation?
❑ Yes o
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes 0No
b. If discharge is observed, did it reach Surface Water'? (If yes, notify DWQ)
❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes ANo
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ yes 'KNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes XNo
4/30/97 maintenance/improvement?
Continued on back

r �
Facility Number:._,
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?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures¢.aagoons and/or Holding. Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure 1 Structure 2 Structure 3 Structure 4
3.7
10. Is seepage observed from any of the structures?
H . Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes ANo
❑ Yes P o
❑ Yes /�il o
❑ Yes �(No
Structure 5 Structure 6
Waste Application
14. Is there physical evidence of over application?
(If in excess of WQ(MP, or runoff entering tern of the S te, notify DWQ)
15. Crop We ...5l ................_._.,_... ...........
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For -Certified Facilities Un(y
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?
Coiriments,(refer to Oestion'-Ezplain`any-YES answersVand/or any recommeridattotis`or any o
❑ Yes /
❑ Yes o
❑ Yes XNo
❑ Yes *o
❑ Yes R(No
❑ Yes ANo
❑ Yes fi� No
❑ Yes ANo
❑ Yes No
❑ Yes )4No
❑ Yes �Io
❑ Yes ONo
❑ Yes 0,No
❑ Ye
s C
Use drawmgs offiacility to better explain sitilations (use .additional pages as necessary}
_..,
k_
Nlr, rvL��e�� flas wark a& cLO DSWC sL'qge-5
FiV_-L4 S ibek Saao�� 1 ow Qit-��5 0.J-e died i K , Gaff
Se
Record �eeQring jocks g �J' • - e5TQ7i j'eep;ri5 o�a% �
pj eneld Qeltx4�
i `&' - Owe"m3lIn aver. le
Reviewer/Inspector Name *.. ` ; ;` s
Reviewer/Inspector Signature: �, Date: q%
cc: Division of Water Quality ester Quality Section, Facility As ssment Unit 4/30/97