780087_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

Type of Visit: 4P Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: 0 Routine p Complaint O Follow-up O Referral O Emergency Q Other Q Denied Access
Date of Visit: MOT11 Arrival Time: Departure Time: .df1 County: )V&o�% Region:
Farm Name: Owner Email:
I f
Owner Name: Fl Hsp•-j Phone:
Mailing Address:
Physical Address:
Facility Contact: A�If C y i)�/' 'rcyl Title: Phone:
Onsite Representative: � integrator: �ipf
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
:•
Design Current
', Design
Current
Design Carrent
Swine
Pop E Wet Poultry
Capactty.
P.op�'
Cattle Capacity Pop.
11 gg�,Capacity
Nl',.E
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
H
Dairy Heifer
Farrow to Wean
Design
Current:
D Cow
Farrow to Feeder
D . ,iP.oul "
CaacYt
P,op
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
y x 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
01 NA
❑ NE
❑Yes
No
[PNA
❑NE
❑ Yes ❑ No
❑ Yes EP No
❑ Yes Fj] No
NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412075 Continued

,acili -'Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No0] NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: !
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 110 0
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes rC�tNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) TP
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
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 tp No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes T � No 0 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?
TT
I I _ Is there evidence of incorrect land application? If yes, check the appropriate box below_
❑ Yes
No
0 NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable C op Window ❑ Evidenc of W'nd Drift ❑ Application Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
FW No
❑ NA
❑ NE
IS. Is there a lack of properly operating waste application equipment?
❑ Yes
Qq No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes M No
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EM No
❑NA ❑NE
❑ Weather Code
[:]Sludge Survey
❑ NA ❑ NE
❑ 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 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No ❑ NA ❑ NE
the appropriate box(es) below_
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes �] No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, aver -application)
31 _ Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes [j] No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes P No ❑ NA ❑ NE
Explainy ions or any, other comments..
U .draewia(rs of facmu t6 better expla n s tuat ans (use add :tio/ al pages as, neieessa mmeadatt'
g ty, ry)•
To F? - pw
Reviewer/Inspector Name: 4—Phone: '3 300
Reviewer/Inspector Signature: y Date:
Page 3 of 3 21412015

// .
Division of Water Resources
Facility Number ®- ® © Division of Soil and Water Conservation
DQ Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 2 T�Ar/Irival Time: : $ Departure Time: grti County: 0 Region: jJ
Farm Name: � "e 'J'-A"s" Owner Email:
4
Owner Name: / 1e gcif nsc of Phone:
Mailing Address:
Physical Address:
Facility Contact: ladi e _Title:
Onsite Representative: H
Certified Operator: K
Back-up Operator:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current Design Current Design Current
Swine Capacity Pap. Wet Poultry Capacity Pap. Cattie Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
_ ' Dai Heifer
"`Design Current Dry Cow
Dr afoul Ca aci P._o . Non -Dairy
ILayers Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
;, ...:.
Other =:-
Turke s
Turkey Poults
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[]Yes
❑ No
© NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[5Q NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
® NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
V] No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facili'Number: - Date of Ins ection: Z Z
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
54 NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): e3�K
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
T
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�j No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[�j 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 ❑ Ycs W No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes � No [DNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
15a No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�D No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
C@ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[K No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
NJ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below,
❑ Yes
® No
❑ 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
[Z] No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[]Yes
® No
❑ NA
❑ NE
Page 2 of 3
21412014 Continued

Facility Number: jDate of Inspection: Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes a] 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)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
J�j No
❑ NA
❑ NE
[—]Yes W No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [ No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes C] No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes r7l No ❑ NA ❑ NE
Comments (refer to question #f): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessarv).
cJ�UT
e.. J�� Pl,�5t.01A un4 A 2aZ0 .
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
J
Phone:
Date: �I
21412014

i ype of visit: W uomptrance inspection V uperanon mevtew kj atrucrure Evamatton V t ecanicat Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: � Arrival Time: Q . vD At Departure Time: ,'pp County:
Farm Name _Qr �'e �!� f OrdyrNt j4&.2 Owner Email:
Owner Name: ,6614zQ _TU h Sen Phone:
Mailing Address:
Physical Address:
s
Facility Contact: , rn S6I1 Title: Phone:
Onsite Representative: a!
Certified Operator: H
Back-up Operator:
Location of Farm:
Latitude:
Region: r-
Integrator: p� 4 GJ
Certification Number: �a
Certification Number:
Longitude:
Design Current Design Current
et Poultry CapacityCattle
Swine Capacity Pop. Wet!
Wean to Finish Layer
Design Current
Capacity Pop.
iry Cow
Wean to Feeder
Feeder to Finish
S
Non -La er
iry Calf
Dairy Heifer
Dry Cow
y£#
Dt:Poul Ca �aci - P,o :.
Farrow to Wean
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
$oars
Pullets
Turkeys
Turke Poults
Other
I
I Beef Brood Cow
_ Otber - _
her
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man --made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
[—]Yes [—]No ❑ NA R NE
❑ Yes
❑ No
❑ NA
NE
[:]Yes
[—]No
❑ NA
NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) 0 Yes ❑ No ❑ NA m( NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [:]No ❑ NA [�j NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [:]No [DNA [)fl NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facili Number: Date of Ins ection: 3_
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure I
Identifier: !
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 2 Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ NA ® NE
❑ NA NE
Structure 5 Structure 6
❑ Yes [:]No ❑ NA W NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑ No
[] NA
Qg NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[] No
❑ NA
NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ No
❑ NA
NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
❑ No
❑ NA
NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [] No ❑ NA M-71 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
(Wiind�ow l ❑%Evidence of Wind Drift C0 Application Outside of Approved Area
12. Crop TYpe(s): (!] S .r A"V r"- '7 t.Y►'grSAJ. /�!, CO.,, l Ate-x_ a_
13. Soil Type(s): _N_9A /QQ
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes [:]No ❑ NA NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes [:]No
❑ Yes 0 No
❑ NA X NE
❑ NA J4 NE
❑ Yes
KA No
❑ NA
❑ NE
❑ Yes
No
F
❑ NA
❑ NE
❑WUP ❑Checklists [:]Design ❑ Maps [-]Lease Agreements ❑Other:
21. Does record keeping need improvement? I f yes, check the appropriate box below. ❑ Yes T No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
[] NA ❑ NE
[] Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facffi Number: jDate of Inspection: /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Cg 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)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[:]Yes
[—]No
❑ NA
C?f-NE
❑ Yes [] No ❑ NA V] NE
❑ Yes ❑ No ❑ NA W NE
❑ Yes ❑ No ❑ NA P3 NE
❑ Yes ❑ No
❑ Yes [:]No
[:]Yes [:]No
❑ NA ® NE
❑ NA �+�+��"" NE
❑ NA NE
(Comments (refer to question#): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional panes as necessarv).
re- vile 19,pi
se
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 2Y33-4300
Date: 3' 30 ,�
21412014

type of visit: 4V Compliance inspection U Vperation Review U structure Evaluation U I eclinical Assistance I
Reason for Visit: * Routine O Complaint 0 Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: 0,g994_/ Region:
Farm Name: �re�4tSO1'► Z Owner Email:
Owner Name: a-. 4hSa Phone:
Mailing Address:
Physical Address:
.m
Facility Contact:
yr G Qo hoyrOr, Title:
Phone:
Onsi#e Representative:
��iQ�[ Jo ,rOi-7
Integrator: r,,�/1
*- GJ�
Certified Operator:
14
Certification Number:
Back-up Operator:
/
jVW e J24m 06 L..,
Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Design Current
Design Current
Swine
Capacity
Pop.
Wet Poultry
Capacity Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
3 Z
$
Non -Layer
Dairy Calf
Feeder to Finish
_ "
Dairy Heifer
Farrow to Wean
Design Current
D Cow
Farrow to Feeder
`D ,P,nW
Ca aci �Po .
Non-DaLry
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
1
113cef Brood Cow
IS 44,
Turkeys
-
Other
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 DWQ)
❑ Yes J�j No ❑ NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No 0 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes M No ❑ NA [:]NE
3_ Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes CP No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

f
Facility Number: -17 Date of Inspection: (u
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes f 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): 112-11
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA [3NE
(i.e_, large trees, severe erosion, seepage, etc.) PU
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
V9 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
§2 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
Uni No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0 No
❑ NA
❑ NE
maintenance 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 yOutside �of� Approved Area
pt
12. Crop Type(s): `.Dl_.S
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWW? ❑ Yes [n No ❑ NA ❑ NE
l5. Does the receiving crop and/or land,application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [�] No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. is there a lack of properly operating waste application equipment?
[] Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes q 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. T
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ONE
Page 2 of 3 21412011 Continued

Facility Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes N No ❑ NA ❑ NE
the appropriate box(es) below_
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [� No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
29. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e_, discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes On No ❑ NA ❑ NE
[:]Yes M No ❑ NA ❑ NE
❑ Yes 50 No ❑ NA ❑ NE
[:]Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
(Comments (refer to question ##): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
ReviewerMspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
a t _ Phone: �jl - 334[)
A,._." Date: bA /
21412011

(Type of Visit: 0 Compliance Inspection O Operation Review p Structure Evaluation O Technical Assistance j
Reason for Visit: 0 Routine Q Complaint O Follow-up O Referral O Emergency 0 Other Q Denied Access I
Date of Visit: [ i ' Arrival Time: �.' a Departure Time: County: '40E--Q1J Region:fl
Farm Name: e j0h n5%' -I- Owner Email:
Owner Name: iddrf 6 i�y%%h Phone:
Mailing Address:
Physical Address:
Facility Contact: A/0-1. �.j 02L V 6n Title:
01
Onsite Representative: `r 64\e- JBA45eh
Certified Operator: u ,
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Swine Ca sign Currents
'ty P p-.,tWet
Design Current s:
P-sultry Cap city P p
Design Current
Cattle Capacity P-
an to Finish
Wean to Feeder
3 y
v
La er
Dairy Cow
Da Calf
I
INon-Layer
I
Feeder to Finish
Design Currenf
Dr, Poult • , Ca aci Pop.
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Dry Cow
Non -Dairy
Farrow to Finish
Layers
Non -Layers
-
Beef Stocker
Gilts
Beef Feeder
Boars
Pullets
Turkeys
Turkey Poults
Beef Brood Cow
ig
Other 21
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
[]Yes W No ❑ NA ❑ NE
❑ Yes
❑ No
[�j NA
❑ NE
❑ Yes
❑ No
�j NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes [] No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No [] NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

>Eiacili Number: Dateof inspection: !Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PU 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 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?
T
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
P No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Pg 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
[29 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [� No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window/ ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12, Crop Typc(s): cay 6 Qi) r -5;, . {r—rsZL_ Q om(
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
`P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[i] No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[� No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available'?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility 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 M No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes W No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes Co No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

acili Number: jDate of Inspection: gF
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below. T�
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fait 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:
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes F
No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [] No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary). ,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: qj p - 41-1506
Date: J// q1j 3
1 011

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 0 Denied Access
Date of Visit: f t 1 Arrival Time: I Q tYsq.M Departure Time: County: gogELqo Region:
Farm Name:{ yb Y 2 Owner Email:
Owner Name: G<Wt; 6bILtLSp►, Phone:
Mailing Address:
Physical Address:
Facility Contact: �ant�., �hhS�'" Title: Phone:
Onsite Representative: �. fOl�l v+s0�"` _ _ _ Integrator:
Certified Operator: 4 Certification Number: mg<,
Back-up Operator
Location of Farm:
v Certification Number:
Latitude:
Longitude:
Swine
�4 it
bbDesign Current
G p city; . Pvp. a
a '
`� Design Current Design Current
HicPPultry, WCapacity P-op. Cattle Capacity Pop.
Wean to Finish
La er iry Cow
Wean to Feeder KEE 35 Z
-Layer
Dairy Calf
Feeder to Finish
iry Heifer
Farrow to Wean
Design Current Dry Cow
Farrow to Feeder
Dr P.o_ult . -a aci P,o . Non-Dai
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Boars
Turkeys
rth7err
Turke Poults
- �.m..,:�.:a:w�.�uaas:r+ua..su.a.wuc3s•
••. ..
r:-:-ar..r.F.r�ea-ase. -arms..•
Discharges and Stream Impacts
1 _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ® No ❑ NA ❑ NE
[:]Yes ❑ No NA ❑ NE
❑ Yes [:)No NA ❑ NE
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 [P
No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [0 No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection: JL
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): 3a y
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
No ❑ NA ❑ NE
No NA ❑ NE
Struc e 6
❑ Yes ® No
❑ Yes (� No
❑ NA ❑ NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [� No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? []Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) T
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? T
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 11 No [DNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift []Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): b-f-o
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility 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 Pp No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Trarlsfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22, Did the facility fail to install and maintain a rain gauge? ❑ Yes] No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

[Facility Number: 170- Date of Inspection: !! 7--
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes] No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes 1� No ❑ NA ❑ NE
❑ Yes Qn No ❑ NA ❑ NE
[:]Yes T No
❑ Yes 11 No
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes EP No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ® No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers add/or any additional recommendations or any other comments.
--1
Use drawings of facility to better explain situations (use additional oases as necessary).
Reviewer/Inspector Name:
Revi ewer/] nspector Signature:
Page 3 of 3
Phone:
Date: s ! f42-
21412011

It ype or visit: v compirance inspection U uperatton xevtew U Ntructure k vamatlon U recnmcal .assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: (t y., County: R060,5)'j
Farm Name: 1� '11hh %701 4�L _ Owner Email:
Owner Name: �L15"I Phone:
Mailing Address:
Region: 1; 0
Physical Address:
Facility Contact: JOA n Title: Phone:
Onsite Representative: i} AkLACa� J6 h h Sod Integrator: ,4jrj _,o4,,,� ��yp� OW
Certified Operator:
N
Back-up Operator:
Location of Farm:
Latitude:
Certification Number: jg%9 q
Certification Number: 191K
Longitude:
�Degn
C
Currentl
Design Trent
Design Current
Swine #: Capactty .Pop; ' Wet�Poultry
w
Capac ty Pop µ Cattle
Capacity Pop.
w .
Wean to Finish
I
11-ayer
Non -La er
Dairy Cow
Dairy Calf
Wean to Feeder
9
Dairy Heifer
Feeder to Finish
tt�" --
Farrow to Wean
iDesig.. urre.nt.::
Dry Cow
D . Poul
� ..
Ga �i P"
a � o
Non -Dairy
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
50t�
,.
Turkeys
Other.: �
Turkey Poults
Other
Other
Dischar es and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes � No ❑ NA ❑ NE
[]Yes ❑ No ®NA ❑ NE
❑ Yes ❑ No N NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No W NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [P No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 03] No [] NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

FacilitNumber: - Date of Inspection: 1 J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
toNo❑NA ❑NE
❑ No Ej NA ❑ NE
Structure 6
[—]Yes 0 No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes "No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes g] No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes V No ❑ NA ❑ NE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [A No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. [] Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
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]
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[]Yes
[,V No
❑ NA
❑ NE
❑ Yes [A No ❑ NA ❑ NE
❑ Yes q No ❑ NA ❑ NE
❑ Yes ❑({ No ❑ NA ❑ NE
[:]Yes fp No ❑ NA ❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes P No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [n No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

l;acil' }Number: - Date of Inspection: i/
24_ Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes jJNo
the appropriate box(es) below. TT
❑ 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 [In No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes i 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 GAWMP?
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 M No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA [3 NE
❑ Yes �j No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
� No
[:]Yes
(� No
[::]Yes
® No
❑ NA ❑ NE
❑NA ❑NE
❑ NA [] NE
_.....,............. _ - , - ........ "- r ii . - -
Reviewer/inspector Signature: ` Date: q11f
Page 3 of 3 21412011

_ 1
_ e Division of Water Quality
+Faciiity Numberj� Division of Soil and Water Conservation
Q Other Agency
Type of Visit IP Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: [] J Departure Time: County: K5'0?J Region: PP 7 _
Farm Name: x�tP ��6�i?SOh�2 Owner Email:
Owner Name: =iip (JbAr O n
Phone:
Mailing Address:
Physical Address:
Facility Contact: r? 6 1,5OPI Title:
Onsite Representative. #
C�
Certified Operator:
Back-up Operator: _W&"12t7
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number: lg
Location of Farm: Latitude: 0 0 = 6 0 « Longitude: = o = , = «
Design Current
Design Current Design Current
Swine Capacity Population
Wet Poultry
Capacity Population Cattle Capacity Population
❑ DairyCow
❑ Wean to Finish
❑ La er
Wean to Feeder 2
❑ Non -Layer
❑ DairyCalf
Feeder to Finish
❑ DairyHeifer
❑ Farrow to Wean Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish El La ers
❑ Beef Stocker
❑ Gilts ❑ Non -Layers
❑ Beef Feeder
❑ Boars ❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other ❑ Turk ey Poults
Number of Structures: ED
❑ Other I JEJ Other
I
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the wasic 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 W No ❑ NA ❑ NE
❑ Yes
❑ No
WNA
❑ NE
El Yes
El No
EpNA
❑NE
NA
❑ NE
❑ Yes
❑ No
❑Yes
J�jNo
❑NA
❑NE
❑ Yes
t2 No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Date of Inspection �^
Facility Number: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[NA El NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?, -
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
f 9 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
[ANo
❑ 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
4No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
LP' 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
V] No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload` ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
76
❑ PAN ❑ PAN > 10% or 10 lbs ElTotal Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window Ll Evidence of Wind Drift ❑ Application Outside)
of Area
�
12. Crop types) �� kt �-/T[G�.i/ . �• az � � GrV� .
(`
OKRA 1 f�r1Y�►
;s
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
51No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
Dg No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
19 No
❑ NA ❑ NE
Z
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):
-�,, , Piccs.I I v,4 r-Pc" k r,s9,
Reviewer/Inspector Name Ta. Phone: 7/0 53-33av
ReviewerAnspector Signature: N1 14 Date: Q
_ I _r � 12/28/04 Continued
u's< , of -

Facility,Number: Date of Inspection D
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 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 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
1p No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑Yes
❑ No
NA
El
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
rv' No
❑ NA
❑ NE
25,
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes]
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[n NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1�1 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
1� No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
YNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
s
Page 3 of 3 12128104

Type of Visit 4D Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: I /o-�h County: R OBF-SOAI Region: i;w
Farm Name: Fi r', TO"nSdn a Owner Email:
Owner Name: 'i L u6Lkv5Phone.
Mailing Address:
Physical Address:
Facility Contact: r�' e l�l�hrc$D^ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
l Phone No:
Integrator: 11 1 t �C
Operator Certification Number:
Back-up Certification Number:
Latitude: = o =1 =1 ,, Longitude: E__1 ° = = "
Design Current Design Current Design Current
Swine ;Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
�. _.
❑ Wean to Finish
❑ La er
❑ DairyCow
Wean to Feeder
Q
❑Non -La er
❑ Dai Calf
❑ Feeder to Finish
❑ Dai Heifer
❑ Farrow to Wean
D ,PouiLL,:. ❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ La ers
❑ Beef Stocker
❑ Non-ers
El Beef Feeder
❑ Farrow to Finish
❑ Gilts
❑ Pulletsts
El Brood Cow
❑Turkeys
❑ Boars
-
Otber
❑ Turkey Pouits
❑ Other
❑ Other INumber of Structures:
i
;�.
Discharges & Stream Impacts
_ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of 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 PNo ❑ NA ❑ NE
❑ Yes
❑ No
�NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ No NA
❑ NE
❑ Yes
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
1P No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes A] No ElNA El NE
a. If yes, is waste level into the structural freeboard? ElYes /❑ No RNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in).
5.
Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
i� 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
CRNo
❑ NA ❑ N E
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7.
Do any of the structures need maintenance or improvement? ElYes
� No
❑ NA ❑ NE
8.
Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
No
[INA [INE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9.
Does any part of the waste management system other than the waste structures require ❑ Yes
No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10_
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11
_ is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) CoaSltx
i &rvinuk J&5S Ofct.1 t 5m. G9.r'0_.,vt okffQ�d�
C�►'t� �oa i :�:
15
13. Soil type(s)
RIQAnS Pa
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
t5No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
? ❑ Yes
® No
❑ NA
❑ NE
t7. Does the facility lack adequate acreage for land application?
❑ Yes
$3 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P9 No
❑ NA
❑ NE
Comments (refer to question #i): 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):
2VI 51e 51,E � a5 vvy
1
61-od �r" , FKce,j (Ike
Reviewer/lnSpector Name r 'kz' v Phone: 4910— 3 _,5
Reviewer/inspector Signature: Date: 9 D9
12128104 Continued

Facility Number: — Date of Inspection '—-
Reouired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUp ❑ Checklists ❑ Desig
n ❑Maps El Other
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
F9 No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes F3 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
P0 No
❑ NA
❑ NE
❑ Yes
In No
❑ NA
❑ NE
❑ Yes
19 No
❑ NA
❑ NE
❑ Yes
E) No
❑ NA
❑ NE
❑ Yes
NNo
❑ NA
❑ NE
❑ Yes
V No
❑ NA
❑ NE
❑ Yes F No ❑ NA ❑ NE
❑ Yes F) No ❑ NA ❑ NE
❑ Yes 9 No ❑ NA ❑ NE
❑ Yes IS No ❑ NA ❑ NE
❑ Yes V No ❑ NA ❑ NE
12128104

t
® Division of Water Quality
(Facility Number 70 ivision of Soil and Water Conservation
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 40 Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: [37114 Arrival Time: Departure Time: County: RAP-Sb►1 Region: �D
Farm Name: jFtAsQ►ti,-a Owner Email:
Owner Name: F7dCute_ rx5061 Phone: 60) 6iZ13--08gA
Mailing; Address:
Physical Address: Facility Contact: 00e_ j-0A^S0jA Title:
Onsite Representative: Y
Certified Operator: If
Back-up Operator: N10_"C!! GArIS0111
Phone No:
Integrator:tl�'A''-�1
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [� o [ = =it Longitude: = ° ❑ , = «
Design Curt•eut Design Current
Design Current
Swine
Capacity Population Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wcan to Finish
❑Laver
❑Dai Cow
Wcan to Feeder
3sj� p0 ❑Non -La er
Dairy Calf
❑ Fccder to Finish
El Dairy Heifer
❑ Farrow to Wean
Dry,'Poultry
❑ D Cow
❑ Farrow to Feeder'''
❑
Lavers
❑ Non -Dairy
❑
Farrow to Finish
" ❑Non Lavers
Beef Stocker
Gilts
❑ Beef Feeder
EBoars
❑ Pullets
10 Beef Brood Cowl I
== _f-,;_: ❑ Turkeys
O#her
❑ Other
❑ Turkey Poults
❑Other
Number of Structures:
Discharp,es & 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?
h. Did the discharge reach waters of the State? (Ifyes, 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 ofthe operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 oj3
❑ Yes fi] No ❑ NA ❑ NE
❑ Yes
❑ No
b9 NA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
S NA
❑ NE
❑ Yes
❑ No
❑ Yes
n No
❑ NA
❑ NE
❑ Yes
fpNo
❑ NA
❑ NE
12128104 Continued

L
Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 `
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ 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 rFNo ❑ NA ❑ NE
❑ Yes ❑ No [jjNA ❑ NE
Structure 5 Structure 6
❑ Yes 19 No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �5 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 P5 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 1PNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes fig 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 ofAccepta�Cble Crop Window El Evidence of Wind Drift ❑ Application Outside of Area I
12. Crop type��}
s) � ms4al JQ A,% %)j:5rn �
- 'rn f� , G&, ,� Lan -
13. Soil type(s) 4. S — ��qq
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 1J No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application'? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
®No ❑NA ❑NE
[9 No ❑ NA ❑ NE
P9 No ❑ NA ❑ NE
� 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):
ReviewerAnspector Name _ qy(� j Phone: &10 33ev
Reviewer/Inspector Signature: Date: 311410a
Page 2 of 3 12128104 Continued

ti
Facility Number: — rf Date of Inspection 3
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes n No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ ❑ Maps
Design b p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. [-]Yes S No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes M No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [21 No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
V3No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[7[No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Dq No
Iri
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
69 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
[P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑Yes
0 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Division of Water Quality
1 2 Facility Number 6 a O Division of Soil and Water Conservation
O Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit (♦ Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Q Arrival Time: : t{ j QIr1 Departure Time: i Q County: � y" M Region: FR0
j t B4Farm Name: d Vv ns�%'t #a� Owner Email:
�11 ' I� o 839
Owner Name: Eidfe J_oAngOrr Phone: �� �b2�3-
Mailing Address: NIv a'B3 LfG)
Physical Address:
Facility Contact: FA��� _��hASOf1 __ Title: Phone No:
Onsite Representative: ( Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =o ❑ [ 0 u Longitude: 0 ° ❑ I
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
h ❑ La er
o1 3 6� ❑Non -Laver
❑
Wean to Finis
Wean to Feeder
Feeder to Finish
El
Farrow to Wean
ElFarrow
to Feeder
El
Farrow to Finish
El
Gilts
❑
Boars
Other
❑ Other
Dry Poultry
Non -La
Pullets
LJ TurkeyPoults
Oth ❑ er
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Cattle
Design Current
Capacity Population
i
❑ Dai Cow
❑ Daia Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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)?
Number of Structures:
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 PNo ❑ NA ❑ NE
❑ Yes
❑ No
(p NA
❑ NE
❑ Yes
❑ No
r NA
❑ NE
I!p NA
❑ NE
❑ Yes
❑ No
❑ Yes
$No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
12128104 Continued

• FaCiliv Number: 10- Date of Inspection S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
EP 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): '3 71/
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
$1 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
`i°'' 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
Cg No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[A No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
Wo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers. setbacks, or compliance alternatives that need
❑ Yes
�d No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application'? If yes, check the appropriate box below.
❑ Yes
Pa No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Croptype(s) b*-MtAdA &fQSS (Hk. I'CtS L_SMall &v4y4
13.
Soil type(s) NpA '
14.
Do the receiving crops direr from those designated in the CAWMP?
❑ Yes
P9 No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
I] No
❑ NA
El NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
f] No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application`?
❑ Yes
(9No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
E;�No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
S r� ►1 ,� f f t tG `�'� 16 h t Nils .
A.
iraocQfea.rM" rece4 VQff ,
Reviewerlinspector Name Phone: U) 107-3
Reviewer/Inspector Signature: Date: 0�
12128104 Continued

r 4
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (9No ❑ 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 ❑ 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 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
14 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�9 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�0 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
rM No
[INA
[INE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
$3 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
10 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
� No
❑ NA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
(�jNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
1�9 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

� Division of Water Quality
Facility Number -] ® $ O Division of Soil and Water Conservation
-- 0 U#her Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: ApAe50,.1 Region: rft,d
Farm Name:' e, Z_:TQ►I /V5.0 "1 Z Owner Email:
Owner Name: 62Uz t _ _ •S �LtnZ�D.�J Phone:
Mailing Address:
Physical Address:
Facility Contact: ��� J_O��I,�QN Title:i�/.C�f� Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: ED o FT � " Longitude: ❑ o= d 0 is
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Layer
❑ Non -Laver
❑ Wean to Finish
CA Wean to Feeder 3,552
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑
Layers
❑
Non -Lavers
❑
Pullets
❑
Turkeys
❑
Turke Points
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State'? (If yes. notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Dairy Calf
Dairy Heifer
Design_ : Current:_.;.'
Capacity Population
Dry Cow
Non-Dairy
Beef Stocket
E.
Beef Feeder
Beef Brood Cow
Number of Structures:
d. Does discharge bypass the waste management system? (If yes. notify DWQ)
?. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes (9 No ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
(3 No
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
12128104 Continued

4
Facility Number: 79 — S 7 Date of Inspection 3
Waste Collection & Treatment
4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes CZ No ❑ NA ❑ NE
❑ Yes (9 No ❑ NA ❑ NE
Structure 5 Structure 6
identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[9 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
CgNo
❑ 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
CW'No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
W No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
%No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
WNo
❑ NA ❑ NE
maintenance/improvement?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
VNo
❑ 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 CropWindow El Evidence ❑ Evidence of Wind Drift Application Outside
of Area
/
12. Crop type(s) �1 d •
'e, L.)
C.rop.S
13. Soil type(s) N, RQA
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
rX No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
tO No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination[:]
Yes
9 No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
M No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA ❑ NE
Comments (refer.to gnestioni Explain any YES answers `and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name FA c-kqReve-1,s Phone: 0/0) 5V
Reviewer/Inspector Signature: Date: ,3 -07-2-oo (o
12128104 Continued

. • 3 —0 --off RA_
Facility Number: 7 — g 7 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ yes X No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VgNo ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement'? If yes, check the appropriate box below. ❑ Yes El No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Q9 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?
El Yes
,nj No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit'?
❑ Yes
Z No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
9 No
❑ NA
❑ Nl3
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
Jai 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 concem?
❑ Yes
O 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
19No
❑ 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
;K No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
UKNo
❑ NA
❑ NI,
12128104

1
.t
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ®Routine Q Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Datcof\visit: Te/.a 70`f Time: �1p
Facility Number
ro Not Operational Below Threshold
® Permitted ® Certified E3 Conditionally Certified 0 Reggistered pate Last Operated or Above Threshold
Farm Name- _ � �� � � 1b 0 AU _ County:—lznnb L esonJ - 4
Owner ?dame: Phone No:
Mailing Address: OS- 1i r{-► et. G
Facility Contact:
Title:
Phone'so:
Onsite Representative: �+ ttiro ru Integrator: V v 12j, — r o w 1t
n #
Certified Operator: ��otCt ��� r+ so a Operator Certification Number: & if
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 �` �" Longitude '
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Po Motion
® )mean to Feeder ❑ Laver ❑ DairyElFeeder to Finish 10Non-Laver ❑ Non -Dairy
❑ Farrow to %Vean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ BOM Total SSLW
Number of Lagoons
Holding Ponds I Solid Traps
Subsurface Drains Present
No Liouid Waste
Discharges d Stream Impacts
1. is anv discharge observed from any part of the operation?
DischarRc originated at: D Lagoon ❑ Spray Feld ❑ Other
a. If discharge is obsen-ed. was the conveyance man-made?
b. if discharge is observed. did it reach "'ater of the State? (if yes. notify- DWQ)
c. If discharge is observed. what is the estimated flow in zalimin?
d. Does discharge bypass a lagoon system? (If ves. notif\. DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there anv adverse impacts or potential adverse impacts to the 'haters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure t Structure 5
Identifier -
Freeboard (inches): 11
.,
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes [3 No
Structure 6
05103101 Continued

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
closure plan?
(If any of questions 4-6 was answered yes, and the sitnation 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 ❑ Yes No
elevation markings?
Waste Applications
10. Are there any buffers that need maintenancerunprovement? ❑ Yes W No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes 53 No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type rrM ac� J4aE;t .S w,a, it 6 wd t, ►,, OS
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes [B No
c) This facility is pended for a wettable acre determination? ❑ Yes EZI No
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ® No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there; any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
IN
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ® No
Air Quality representative immediately.

I
Facility Number: '7 p — Y7 Date of Inspection i- 1 1/QY
- 1
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes dj No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application) ❑ Yes [SNo
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes [$No
28. Does facility require a follow-up visit by same agency? ❑ Yes No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No
NI MES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, slip questions 31-35) ❑ Yes No
3I . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32_ Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crap Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
12112103

Type of Visit IS Compliance inspection O Operation Review Q Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facilin .Number Date nf Visit: b Time:
Aot O eratinnal 13e1v�Threshold
® Permitted ® Certified 13 Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: _ E: CM ie— j"-, ynSGx WCounty: /eS fit. (-'_6___
Owner Name: 4 Phone No: 916 y3(rG.
FlailingAddress: �L� ��- t��tC� Q�'±G tni� '/� „t1c b
Facility Contact: Title: C�_ e-rr--f Phone No:
Onsite Representative: Ed '4 [ p- intn sM-' Integrator: rr'-, l�
Certified Operator: I L4',1_ e- Operator Certification Dumber: 19 f q4
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 0` 0` Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
® Wean to Feeder ❑ Laver ❑ Dairy
❑ Feeder to Finish ❑ Non -Laver ❑ Non -Dairy
❑ Farrow to Wear
ElFarrow to Feeder Other
j] Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area JEI S rav Field Area
Holding Ponds / Solid Traps ❑ No Li uid Waste Management Svstem
Discharges & Stream Impacts
1- Is anv discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. lfdischa ee is observed, did it reach )rater of the State? (if ves, notii}v DWQ)
c. If discharge is observed, what is the estimated flow in eal/min?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ)
?. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure ? Structure 3 Structure 4 Stricture 5
Identifier:
Freeboard (inches):
05103101
❑ Yes [a No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes Q9 No
Structure 6
Continued

I
Facility Number: — g hate of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [ No
seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes EP No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes U No
9. Do any stuctures tack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes $3 No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 1�5No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes allo
12. Crop type R UC16 A— Gr r1e _ 112 S '
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes EA No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes [�ZNo
❑ Yes U No
❑ Yes ® No
❑ Yes allo
❑ Yes 41 No
❑ Yes [%No
❑ Yes Q No
❑ Yes [A No
❑ Yes ® No
❑ Yes No
❑ Yes No
P No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
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): E❑ Field Cony ❑ Final Notes
T4f yy) J vim. C;, -,:�o �- (� ti- (o aLcA vcr e 6
Reviewer/Inspector Name �— N
Reviewer/Inspector Signature: Date: f a Ts
05103101
C417
Continued

t
I~acility \umber: -fg — Date of Inspvctiom
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior below El J 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 (51 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. «Vere 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 submeroed fill pipe or a permanent temporary cover? ❑ Yes ❑ No
Additional Comments.and/or Drawings: _
05103101

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number hate of Visit:
= Permitted 0 Certified 13 Conditionally Certified © Registered
Farm Name: AZL�%f_ :J01,11- a-)
i
Owner Name:
Mailing Address: Th /-m✓.::4 /Cor
Facility Contact: Ls� fir, c� �-5!/>/iJ Title:
Onsite Representative: �fiz c"I�f�2%SU.*J
Certified Operator:
Location of Farm:
Time: ' O
Date Last Operated or Above Threshold: _
Count••
Phone No:
C 6
Phone No:
Integrator: G'.riGe'�� � r-z;��
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' � Longitude
`Design . .. Current. Design = Cnrrent -.; . '_Design =: Current
Swine -Capacity Population Poultry Capacity Population. Cattle = CapaCWr, Populatwn
® Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ —Boars
Number of Lagoons ; 0 . ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / SoLd,Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharoe is observed. what is the estimated flow in eal/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ)
2. is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
«'aste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure ? Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inchcs): S
05103101
❑ Yes KI No
❑ Yes O-No
❑ Yes RNo
❑ Yes
®'No
❑ Yes
IRNo
❑ Yes
P No
❑ Yes
® No
Structure b
Continued

R
Facility Number: 7 —
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
12. Crop type
❑ Yes ONO
❑ Yes (EtNo
❑ Yes ® No
❑ Yes [RNo
❑ Yes ® No
❑ Yes No
❑ Yes No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
"RNo
b) Does the facility need a wettable acre determination?
❑ Yes
PNo
c) This facility is pended for a wettable acre determination?
❑ Yes
allo
15.
Does the receiving crop need improvement?
❑ Yes
JS� No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
E No
Required Records R Documents
17.
Fail to have Certificate of Coverage g General Permit or other Permit readily available?
❑ Yes
PNo
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 is oil sample repo
❑ Yes
ANo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
[I Yes
�No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
)9 No
22.
Fail to notif}. regional DWQ of emergency situations as required by General Permit?
❑ Yes
1ANo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
19 No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
PErNo
25_
Were any additional problems noted which cause noncompliance of the Certified AArMP?
❑ Yes
PNo
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments:(refer.to question #) -Explain any YES ansssers aadlori_: any- �etommendattons or anv:other:tamnaentL-_
s
Use drawing§ of facility to better ezpiaui s�tnatiaas: {use addtt onsl pages as necessary) ❑ al Notes
_-- ... ❑Field Convi Final
C15) 2—
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: _
05103101 Continued

1W
Facility lumber: % — ;7 Date of Inspection o 3d Dz
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below, ElYes tJ 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 P�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) r
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Ikere 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 permancntrtemporary cover? ❑ Yes No
05103101

- Dr*Wbli of Water Quality
0Drvtston of Soil and Water Conservation -
-Other, gency,_.
s
Type of Visit A Compliance Inspection Q Operation Review p Lagoon Evaluation
Reason for Visit xRoutine O Complaint O Follow up O Emergency ]Notification O Other ❑ Denied Access
Facility Number Date of V isit: /Q Ti€ne: T'Oy� Printed (on: 10/26/2000
Q Not Operational Q Below Threshold
)(Permitted 0 Certified [3 Conditionally Certified 0 Registered Date Last Operated r bove Threshold: .........................
Farm Name: _...1.. ........Q.i..t ....Z. County:. ,:6,.S.,t�--..-_ .....................
......... ............................ .......... ........... .
Owner Name: .�.......................J.Q_,�14-g__rT7..................... PhoneNo............Z 3..1. ...............................
Facility Contact: .......... .1.e�.%.M=..5°..............................
....'I'itle:........
.................
Mailing Address:...JJ r.R.....�.._....i.d -g-.._.4/ C/zzJ ...
Onsite Representative:............/ . .
Certified Operator:.zZAdl..Q-..... .t....... .........................................
Location of Farm:
... Phone No: �-
. � ......�...C......:..:..ZS"3 5ld
....
Integrator: C v Q
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ° 0 Longitude a 4 s&
Design Current
uwtur
Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharues & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes,T0
Discharge originated at: ❑Lagoon []SprayField ❑ Other !!�� r
a. If discharge is observed, was. the conveyance €nan-made? ❑ Yes KNo
h. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) El Yes R(No
c. If dischargc is observed_ what is the e,timaled flow in tral/min?
d. Does discharge hypass a lagoon system? (11' yes, notify DWQ) ❑ Yes Po
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
Structurc I Su-uLture 2 Structure Structure 4 Structure 5 Structure 6
Identifier: ......... ...... ........................................................................................................................ ............................................................
Freeboard (inches):
5/00 Continued on back

Facility Number: —1 Date of Inspection �fr(, -i0 Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes /�N0
seepage, etc.) ' l
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes &3"ko
(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
12. Crop type Mprm LAAct- h_Q..4 / S.Q.. ��; rt� : �. a oerseea 1 JhF
13. Do the receiving crops differ with those desi jn�(ed in the Certified Animal Waste Managemetit Plan (CA
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available'?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes �J No
❑ Yes �No
❑ Yes �N0
❑ Yes No
❑ Yes o
? ' ❑ Yes No
❑ Yes o
El Yes No
El Yes No
❑ Yes 1�'No
❑ Yes 2No
[]Yes XNo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 6rNo
❑ Yes XNo
❑ Yes P(No
❑ Yes $,No
�: Rio . , ati6lr s or deficiencies •were aoted� d(Wing �his'visit.' • Y:oti 3i iii-e- -eiye ti6 further • : • ']
canes nde' Ce: about this :visit_ • • • . .. • .• •
Comutents {refer tgquestion #) Explain any YES answers and/or any recommendations or any other comet_ eats._
Use°drawits of:faciii to -better explain situations. use additional pages as:,necessa
AL
/,gl)t /&f �" 1� 41�,/lF4rlfgr�kepl. I
T
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: —26 -0/ 5100

Facility Number: 78'
Date of Inspection Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
❑ Yes
j�No
liquid level of lagoon or storage pond with no agitation?
' 1
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
o
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
0
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
30_
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
J
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
KNo
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
Additional, omments an- or _ ra . -
5/00

4 -.r
Division of Soil and' Water Conserva�on Operation Review _
4-, ©Division of Soil and=Water Conservation =.Compliance Inspection r :�
® Division of Water Quality Compiranee Inspection _-
Other Agency. Operatrton,Revlew
d:
E® Routine Q Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
Facility Number Date of Inspection 6 11 1�
Time of Inspection �'Q 24 hr. (hh:mm)
pr Permitted © Certified © Conditionally Certified 13 Registered [3 Not Operational I Date Last Operated
FarmName: ...................................... ......................................... County: .......... ,��Q..%�..-................................-.....................
Owner Name: -........ 1-...:`64 JV---).................. Phone No: y%o :........................................��..............
/ ��
Facility Contact �,d :1..��'!`l Title:......-..-........................................................
................ ............ ..... 1...... Phone No:
;Mailing Address: � C3. .c�.i 7�/ a.�% f .ti-.a.✓/ Q
.... ............................... ...--� ... � > ... :...............�... ..... f.. ......
Onsite Representative:4(f f�6 ... 41 U.Gi�T73�J .................................................
ter........... .............................1.............................. Integrator:...... .. .1�
Certified Operator: ......... .//.......� . ,je?.C.�!s.1� • Operator Certification Number: ..........................................
..... .... ..... ..... .............................
Location of Farm:
A.
..........................................................................................................................................................................................................................................................................
Latitude 0 ° i Longitude ' ° 64
Design Current;-.]';. Design Current Design Current
Swine Capacity Population i' Poultry , :Capacity Population.' Cattle Capacity Population
ff-w-ean to Feeder
,J ;�Z
f
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
:
❑ Subsurface Drain❑Lagoon Area ❑Spray Field Area -
;. � Number ofLagoons _ s Present
Hoidtng-Pdnds'/ Solid Traps ❑ Na Liquid Waste Management System
Discharge & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes E3No
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 IS No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Discs discharge bypass a lagoon system" (If es, notify DWQ) ❑ Yes ® No
2. Is there evidence of past discharge from any part of the operation? El Yes P No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes PLNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes P:No
Structure I Structure 2 Structure 3 Structure 4 Structure; 5 Structure 6
Identifier:
Freeboard(inches): ................................. ...... .................. ---........................................................--.--..............................-..-..-..----....--...
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Eq No
seepage, etc.)
3/23/99 Continued on hack

�V
Facility Number: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
(j'No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
P-No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
N"No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
),No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
RNo
11. Is there evidence of application? ❑ Excessive Ponding ❑ PAN
El Yes
P No
/over
12. Crop type E7 .e.�, d .S n��aleOV_A�
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14, a) Does the facility lack adequate acreage for land application?
❑ Yes
J�:No
b) Does the facility need a wettable acre determination?
❑ Yes
[RNo
c) This facility is pended for a wettable acre determination?
❑ Yes
[;-No
15. Does the receiving crop need improvement?
❑ Yes
)91 No
16. Is there a lack of adequate waste application equipment?
❑ Yes
P(No
Rettuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
{iel WUP, checklists, design, maps, etc-}
❑ Yes
gJ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
/KNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
5�No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
bfNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
discharge, freeboard
El Yes
�No
(le/ problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
CkNo
24. Does facility require a follow-up visit by same agency?
❑ Yes
CR No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
O No
�, CVO •vi6iatigtis.oi C�ericiencies •{!lire noted• ilitrFrig �h1S, V1Slt. You ,WI�. [ eet?1Ve ii0 UI r _
icorris• oride' e: about: this visit..... •. • :.:.:. ...:: ::: ::: :: :
uesbon #) Explain any YES answers and/or any recommendati
ty to-betteir explain situations (useaddihdnal pages as necessary
77
Re-6ewer/Inspector Name
Reviewer/Inspector Signature:
Date:

1
Facility Number: 7 -- Date of Inspection z/ d
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
N 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
9No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
PUNo
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
fia-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
�9No
31. Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
Wo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
ff No
.... ..r..rAdditiona ommenls and/or wO�a",
�.
l

it
_..
O Division of Soil and Watei'Conservation - Operation Review
©Dwision of Soil and Water Conservation - Compliance Inspection -
Dwrsion of Water Quality'- Comp ltanceInspection
Other -.Agency Operation Review. _ -
III Routine Q Com taint Q Follow-u of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number late of Inspcctiou
rime of Inspection F�M 24 hr. (hh:mm)
© Permitted kce
rtified [3 Conditionally Certified [3 Registered E3 Not O erational Date Last Operated:
�- �%
Farm Name: e O t, S-0Y`-- County -..-..... /L•d .....................
Owner Name:.s�.4?..I`? ei,5 �� .... Phone No: ................6 z ...................................
'._ _ -1-
Facility Contact: ...........Q.Qr.Qe// ..... Title :.............................................. Phone No:.�. +---.........................................
Alailing Address: iC' ......+.�.. (- ..T.T.. .................. t�1^ L!'� Q-h . .. �... .................. ...........-..............
2 k3o
Onsite Representative:.. ...L.l�'ip.. ... f / ... ................ Integrator:..... c4r"rb.r.{ .-r ......................... 4 .... .... ................
Certified Operator:....! ......................... �a��.h . Operator Certification Number:..........................................
Location of Farm:
t............t
Latitude �• �� 0+' Longitude
Design Current
Swine Capacity Population
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I L IQ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area JEJ Spray FieId Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
1_)ischart;es & Stream lm_ pacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ La,=oon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance roan -made',
h. If discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the State
c. II'discharve is observed. what is the estimated flow in hal/min?
d. Does discharge hypass a lagoon system?
2. Is there evidence of past discharge frorn any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Struc€ure 3 Structure 4
Identifier:
Frechoard(inches) ......... ....................................................................................................................
Structure 5
❑ Yes JTo
❑ Yes No
❑ Yes No
❑ Yes ANo
Structure 6
116199 Continued on back

pr
Faeiiity Number: %
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
)No
Structures ds
(Lagoons,Holding Pon, Flush Pits etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
❑ No
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
........................
.................... .........................
Antifier:
Fr (ft
10.
Is seepage observed from any of the structures?
❑ Yes
KNo
_"N 11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
gNo
1y 12.
Do any of the structures need maintenancelimprovement?
❑ Yes
K No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
J 13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
JO No
Waste Application
"-14. Is there physical evidence of over application? ❑ Yes ;q No
(If in excess of WMP, or runo f entering waters] off the State, notify D Q)
15. Crop type .......9ev.!1.... .. -.,(.. a 1.+....11.r .......... ............l-:D:r.;`YL......................................... ......... I ............ .........
...
�16. Do the receiving crops differ with those designated in the Animal aste Management Plan (AWMP)? ❑ Yes jo No
`` 17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
v19. 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?
--,22. Does record keeping need improvement?
For erti Wd or Permitted Facililim Only_
',v 23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
',24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
M-No.vidlatioit -6i dertciencies.were;ntited;during this:visit.,You:vxill receive n' o'-ftirther
coerespbndehbc ti out this:visit:
G"j deco ds, l
Need Yvacre
9 �,�W w �G��
❑ Yes No
❑ Yes No
❑ Yes P(No
❑ Yes PtNo
❑ Yes 0 No
Mh
❑ Yes X4 No
❑ Yes JM No
❑ Yes A No
❑ Yes ONo
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: /aLl- 1 Date: 2

pi' JW o -:y
0 Division of Soil and Water Conservation ❑Other Agency M
'�Dtviston of Water Quality
v.
Or
�4
. . ....... . .
s
10 Routine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other
Date of Inspection
Facility Number
Tune of Inspection 24 hr. (hh:mm)
© Registered g Certified [3 Applied for Permit © Permitted JE3 Not O erational Date Last Operated:........,
' # County:C2.............. Farm Name: 1.r........--.�10 1k�N.............I. ..... .......................
oh /0 6aS 8�3y(
Owner Name:........... dir............................. �rhkiS .... . Phone No:
Facility Contact: .............Tern . Title: Phone No: ....................................................
Mailing Address:Ceil:.riY►i.Ztti.- Q...�`3�..
.� :.......,... n........................................................................... ,�.....N............................................
Onsite Representative:......... dl..C-z�....... s e ...... g �--GLI jai.; . 5.......f` .. c
Integrator: ................ , . 5 _../t.
Certified Operator...............l E-t" .............. ----- .*s r ....................... Operator Certification Number, .... ._. �gj.[..l...........
Location of Farm:
C
C
Latitude • ' 0" Longitude =• 04 0"
,m Design
= Current '£ Design
Current ' ' Design C�rrenl
" S cvrne m Capacity
.. r
Population ` Potittry`r<° Capacity. ;Populafiae Cattle Capacity Populahon a
x.
, r .
"r ❑ Layer
❑ Dairy
;;, ❑ Non -Layer
`'N ❑Non -Dairy
(.}: -6llf A"
<: Other
.•� x
v 1
Total Design .Capacity
Total
140 4 Niiiiih r of Lagoons / Holding Ponds; ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area _
`� a� �A �e z r r- r _?' ,}. R 4abt5 +s�sgoE� ,� ��,� yy ... ....... � :,ay:&'•ix
��d.A�u r.$,���i. „�.�.._+a �x �s x# b'r�"F tom.: &`�I �. FtS •'��
s,.Rk-• .. ❑ No Liquid Waste Man ement System
q Y
�r,>�.�
f «�A
,�
Wean to Feeder
35j�
�r
El Feeder to Finish
❑Farrow to Wean
Farrow to Feeder
Farrow to Finish
❑ Gilts
r
Boars
General
1. Are there any buffers that need maintenance/improvement?
El Yes
J9 No
2. Is any discharge observed from any part of the operation?
El Yes
M No
Discharge originated at: ❑Lagoon [I Spray Field ❑Other
a. If discharge is observed, was the conveyance man-made?
❑Yes
ANo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DVJQ)
❑Yes
No
c. If discharge is observed, what is the estimated flow in -al/min?
d. Does discharge bypass a lagoon system? ([f yes, notify DWQ)
❑Yes
,93 No
3. is there evidence of past discharge from any part of the operation?
El Yes
R1 No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
El Yes
0 No
5. Does any part of the waste management system (other than lagoons/molding ponds) require
El Yes
Od Na
nnaintenanceJi mprovement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
El Yes
Pff No
7. Did the facility fail to have a certified operator in responsible charge?
❑Yes
PQ No
7/25/97
Continued on back

Facility Numhcr:• y — g
8. Are there lagoons or storage ponds on site which need to be properly closed? El Yes jQ No
Structures tLaq.,00ns,liolding fonds, Flush Pits, etc.1
9- Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes [KNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboardtdt): ............. G...1 r.............................---........................................................................................................................................................
10. Is seepage observed from any of the structures?
Lam.. Ycs
9No
11. Is erosion, or any other Threats to the integrity ol- 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 inaximuni liquid level markers'?
❑ Yes
No
Waste Annlication
14. Is there physical evidence of over application'?
❑ Yes
U1 No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
j fLsf.'t2.l�t�-
15. Crop type .......CO�l �1�
---.�.....�R'Y.75>:X.+.'..... 91.L1zM2-.�J.�Cl......��1/..5............................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
ANo
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
;0 No
18. Does the receiving crop need improvement?
Cl Yes
9No
19. Is there a lack of available waste application equipment?
❑ Yes
X No
20. Does facility require a follow-up visit by same agency)
❑ Yes
X No
21. Did Reviewer/]nspector fail to discuss review/inspection with on -site representative?
❑ Ycs
No
r
22. Does record keeping need improvement?
[J Yes
No
For Certified or Permitted Facilities Only
,
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
El Yes
No
24. Were any additional problems noted which cause noncompliance of the Certified AW,MP?
❑ Yes
No
25. Were any additional problems noted which cause noncompliance of the Permit'?
❑ Yes
❑ No
0 No.violations or deficiencies were'note'd during this visit. You.will receive no further
correspondence about this visit.
yComments'(refer to question #): Explain any YES answers and/or`any recommendations ;ar any other Zo- m xtents ;
IJse drawings of facility to better explain situations. (use additional pages as neressan)
7/25/97
��
Reviewer inspector Name se-
Reviewer/Inspector Signature: Date: 6-

0
=71MOXIT-7n,
Facility Number 7
Date of Inspection I -T--Z0-V -7
Time of Inspection Q Use 24 hr. time
Firm Status: Total Time (in hours) Spent onReview
or Inspecdon (includes travel and processing)
Farm Name. - County:
Owner Name: a39G,
Mailing Address: 2$3O
Onsite Representative: weip-ator. C-ex r r ir
Certified operator: W;3 h A S r:Z. Operator CuMeadon Number.
MIMMW,
Latitude Longitude
113 Not Operational Date Last Operated:
Type of Operation and Design Capacity
MR
.S �Ud3b
ses
to Feeder Dairy
R-eder to Finish Non -Layer ID Beef FL
Farrow
arrow to Wean
F—mmw- to feeder
...... ......
Fan w to Finish
- �-gt
e&' ?�, 0 Other Type of Livestock
777;
40.
GenjW
1.
buffers that need 13 Yes gNo
I Is my discharge observed
[I Yes gNo
a. If
convryance mmi-made? E3 Yes oNo
b. If discharge is observed, did it
notify DWQ) E3 Yes JdNo
c. If discharge is observed, what is die estimated flow in gaLhnin? N 114
d. Does discharge bypass a lagoon system? ([f yes, no*
E3 Yes / Iallo
I Is there evidence of past
No
4. Was there any adverse impacts to the waters of the State other than from a discharge? El Yes PI No
system (other than lagoons/holding ponds) require M Yes 0 No
nuintenanecrunprovement?
Condnmed on back
Number of Lagoons !Holding Ponds m=
Subsurface' Drains Present
KI Lagoon Area —Spray Field Area J�
Are there any
franc any part of the operation?
discharge is observed, was the
reach Surfitce Water? (If yes
DWG
discharge from any part of the operation? E3 Yes �
S. Does any pan of the waste management
Number of Lagoons !Holding Ponds m=
Subsurface' Drains Present
KI Lagoon Area —Spray Field Area J�
Are there any
franc any part of the operation?
discharge is observed, was the
reach Surfitce Water? (If yes
DWG
discharge from any part of the operation? E3 Yes �
S. Does any pan of the waste management

6. Is ficility not in compliance with any applicable awback criteria?
7. Did the facility fail to have a wed operator in respomible charge (if inspection after IAM7)?
& Are then lagoons or stmagc ponds on site which need to be properly closod?
5troctures (Lagoons and/or 1oldlim Ponds
9. Is structural freeboard less than ado pu te?
Fmdx=d (ft). .lagoon 1 Lagoon 2 Lagoon 3
.IL/ -- .� -
10. Is seepage observed from any of the ?
11. Is erosion, or any other d m a to the integrity of any of the atriums observed?
12. Do any of the structm m need
(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 saucwr+es lack adguaie markers to identify start and stop pumping levels?
Waste Application I,
14. Is there physical evidence of over application?
.(If in excess of VW, or runoff entering waters of the State, notify DWQ)
15. Crop type 8Qf nt ejj C6.-
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For�Certifed Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow up visit by same agency?
24. Did Revieater/lnspcctor fail to discuss review/inspection with owner or operator in charge?
❑ Yes
0 No •
❑ Yes
D No
❑ Yes
IANo
❑ Yes RNo
Lagoon 4
❑ Yes / NO
El Yes [I No
❑ Yes ❑ No
❑ Yes W Rio
D Yes 0 NO -
Yes No ~
D Yes &No
❑ Yes *o
❑ Yes A�Io
D Yes ONo
❑ Yes 6NO
❑ Yes ONo
❑ Yes ONo
❑ Yes No
C6niM*ts (refer to question# ',Explain arty YES ais*ws andloinny recommendatio' ns 6r aay.otlrGr rovmrew ,
Use�dra�vmgs of facility to better Iatn _smgns tese addrfianal es as "'
J //
vK r s %it 5. "ff
8
Reviewer/Inspector Name
Revfwer/Inspector Signature:
�f
Date:
-9 7
cc. Divisian of Water Ovalim
ester O.. itv Seelian. FacU&v
Asseims t Unit
1 1 / 14/96

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Eddie Johnson
Rt. 1, Box 443
Fairmont, NC 28340
Dear Mr. Johnson:
e��
IDF-=HNF;Z
DIVISION OF WATER QUALITY
June 2, 1997
SUBJECT: Annual Compliance Inspection
ELJ Farm & Eddie L. Johnson Farm
Registration Nos. 78-87 & 78-21
Robeson County
On May 20, 1997, staff from the Fayetteville Regional Office of the Division of Water Quality
inspected the subject swine facility. Please find enclosed a copy of our Compliance Inspection
Report for your information. It is the opinion of this office based on the information provided and
observations made during the inspection that the facility was in compliance with 15A NCAC 2H,
Part.0217 at the time of the inspection. Please refer to the comments section on the rear of the
inspection form for information regarding your facility.
Please be aware that all swine facilities with a liquid waste collection system designed for a
minimum of 250 hogs must have a certified waste management plan on or before December 31,
1997. The district NRCS office, Agriculture Extension office, or the Division of Soil and Water
have specialist available to assist you with upgrading of existing facilities and certification.
If You have any questions concerning this matter, please call John Hasty at [phone].
Sincerely,
" Z C. ,O
ohn C. Hasty, Jr.
Environmental Specialist
cc: Operations Branch
Central Files
Audry Oxendine - FRO DSW
Ed Holland - Robeson Co. MRCS
Wachovia Building, Suite 714, Fayetteville N14��FAX [phone]
North Carolina 28301-5W C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

I nd tjrW mbw I
Farm Ski: .,rM ac -` =I
Tim oflaqwcdn b Use 24 hr. AMC
IToni nerve (b btarl) Spew enRerdsw �
or Eupeedoa t ada I travef and proc"Shw
�T i.r .r.rrrru i- ) G iirirr�r�.
ft,�d,, . i Bay43 1 c�i r w� O ni . A! C, 28 3 0
. Onsire Repraeotatfre: f' � -
„� Number: 1 ! 9
Lecadon of Farm:
Not D rational Dane Lass Operated:
TYpe of Operation and Design Capacity
-.. � � _ �, � _ �.. a�•x`' � ,},�1, �w _ -.-i�,"�'- _. rr�-:i�,��. � +h. ': �ifait-��ssi�`f.,F-.4,a 'yr��rp"�� f+�., _.a�,.�s�T�Ls; 1�„i'yyy,wiKik'�.,�.^•F
�„�•'�` �`- a �• ;»� 11 �L�'"k=
���yy
WC�iIi t� Feeder
,�uliii
�-'�'�
y7Y..�
to Finish
;� p Nao-
Hoef
. .
RFeedff
t71
Fwmw—to A
ClEg_rMw_-to Finish
�', (3 OtherType ofuvesoock
.J;"
.�1.�:. �,.��t w.-3 -
r-s:,,---. s• si'�•«:rw+ �K", �,��tit-'�"�F`��) �'�
-rf '�- ^ �..-
�!�.� . -'1 ' .w����.�
��ss ' Na�ber of La ooni`l,Hold�ng a s r Subsurface Dsaim Pawns a
'•�ti'�.'.'litlL�h "'"�"1'tF:�+rP`,.../�l� /'167Y AmLft
00-
I. Am that any buffers that need ntaintenanale.. --
2. b any discbags observed fig any part of the o OWW?
a Ndischarge is observed. was the oanveysnce tie?
b. If discharge is obscw4 did it natb Since W&W7 (if yes, aatity DWQ)
c. If discharge is obtaved, wbat is d e t&tWmftd flour in gaifmin?
d. Dots discharge bypass a Iagoon systaa7 (Lf yes. notify DWQ)
3. Is there evidence of past dixcbwp bum any past of the opcedim3
4. Was there any advern impacts to the waters of the Seale other than firrsm a discharge?
S. Does My pars of the waste asassageraeot sysoem (other than lagaMas/bolding ponds) mquas
13 Yea 9NO,
D Yes gNo
Mu ANo
Yes j6N6
Q Yes No
D Yes PfNo
Q Yes No
1# Yes No

b, is docility not in CauWbwm wft nay % glimble n6K* WftUk7
7. Did cube hc9hy IB to sae a ow Mod ogamw is r eganD la daW (if it ins oboe 1 LWM
An tb= iagoom: or sterW pemds am aite vbicb weed in, be pmpmly aimed?
ftrnctnrew (L agma Lgft- ROWina Polndal
P. b anctttral fiadoard lees dan adegmde?
via A M -, 4(4 AAffnanI Law= 2 lagoon 3
70. L seepage observed from nary ofdw imxknO uj
l L L wo6 m, or any other If a io fie Wes* afaRy afOt xvwmm obmveV
It Do any of the nwnaintemanceamp
¢f any of quadm 9-I2 was answered yes, and Ot aknatfon pans an
Immediate pub& ba th or enviroameatal threat, sooty DWQ)
13. Do any of the stywPuaes lack adqustc markers identify start mad stop
K Js those physical evidence of ova apphand m?
Of in ex m of WMP. or runoff enaft waters of the State, =tiiy DWQ)
13. tray type 8er esJ a
X M aloe active mops di$er with those designated in the Animal Waste Managemept Flom?
27. Don *C faulty have a Lek of Magwte manage for Lad appbeadva?
38. Does the cover crop need impsaveMMO
19. U there a loci: of available irrigation equipment?
For CeMfled Facilitira t3n1t+
20. Does the facdiry fail to have a cagy of tbt Animal Waste Maaagasreat Him rudify available?
21. Does the begity fees to tom*sy witb the Aai=l Waste Management PLn in any way!
22- Does noor+d keeping need improveamml?
23. Does facffity require a ibIlow-up volt by same agency?
24. Did team fad to diseuas mriwwfmspeet . With awma or operator 0 Chw
- 13 Ya
A No
13 Ya
0 No
t} Yes
rANo
O Ya No
LW=4
E3 Yea PNa
E3 Yea [INo
❑ Yes 13 No
fl Yea PVO
13 Ya 1% No -
tY Yes *
13 Yes No
E3 Ya , \No
D Yes X(No
E3 Yes $No
D Yes dNo
Q Yes ONa
13 Yes I*No
tl Yes AND
Couuutats (refer to qutstica }: .aaY YES aaswasimdlaraayseccimmmdations'os �n}r.othrr _ _
Us dravvia�s offac s;yBoa beucr
w
jA
0swkwerdnspeaur I x!' tt Z[ .' .r 4-M
Periwer/snspertar Signature: Dam: ZD -9 7
= Div&im of Kato Qmatity,4Wwler O#W4 Senior,, FacUrty Au=meW Ureic

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
April 3, 1997
Eddie Johnson
Eddie Johnson #2
Rt 1, Box 443
Fairmont NC 28340
IDEHNR
REGIME®
A P Q 0 71997
SUBJECT: NKo� °tolat q!E
Deeb� i gfrator in Charge
Eddihnsan #2
Facility Number 78--87
Robeson County
Dear Mr. Johnson:
You were notified by letter dated November 12, 1996, that you were required to designate a
certified animal waste management system operator as Operator in Charge for the subject facility by
January 1, 1997. Enclosed with that letter was an Operator in Charge Designation Form for your
facility. Our records indicate that this completed Form has not yet been returned to our office.
For your convenience we are sending you another Operator in Charge Designation Form for your
facility. Please return this completed Form to this office as soon as possible but in no case later
than April 25, 1997. This office maintains a list of certified operators in your area if you need
assistance in locating a certified operator.
Please note that failure to designate an Operator in Charge of your animal waste management
system, is a violation of N.C.G.S. 90A-47.2 and you will be assessed a civil penalty unless an
appropriately certified operator is designated- Please be advised that nothing in this letter should be
taken as absolving you of the responsibility and liability for any past or future violations for your
failure to designate an appropriate Operator in Charge by January 1, 1997.
If you have questions concerning this matter, please contact our Technical Assistance and
Certification Group at [phone].
Sincerely,
for Steve W. Tedder, Chief
Water Quality Section
bb/awdesletl
cc: Fayetteville Regional Office
Facility Fife
Enclosure
P.O. Box 29535, XwvcAn
WA%� FAX [phone]
Raleigh, North Carolina 27626-0535 Equal Opportunity/Affirmative Action Employer
Telephone [phone] - 50% recycles/ 10% post -consumer paper