780095_INSPECTIONS_20171231

NUH I H LAHULINA
Department of Environmental Qual

W
Type of Visit: Q'Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: erf outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: . HS Departure Time: County: /'� �ti"'� Region:
Farm Name: �� GIY�-=-,1 �ifia'L Owner Email:
Owner Name:zn Phone:
Mailing Address:
Physical Address:
Facility Contact: j�- g'�_ I (- An:2 Title: r- Phone:
Onsite Representative:
Certified Operator: I 's —
Back-up Operator:
Location of Farm:
Latitude:
Integrator: Smcr/'1'
Certification Number: a/.3%
Certification Number:
Longitude:
Design Cnrrent
Swine Capacity Pop.
Wet Poultry
Design
.
Capac ty
Current
Pi
Design Carrent
Cattle Capacity Pap.
Wean to Finish
Wean to Feeder
Feeder to Finish
Layer
Non -Layer
airy Cow
airy Calf
airy Heifer
Farrow to Wean
Design
Cnrrent
D Cow
Farrow to Feeder
D , I;oult ,
Ca aci
Po
Non -Dairy
Farrow to Finish q`.
Layers
Beef Stocker
Non -Layers
Beef Feeder
Gilts
Pullets
Beef Brood Cow
Boars
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 DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes �o ❑ NA ❑ NE
[] Yes
[:]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[—]Yes
[:]No
DNA
ONE
[::]Yes
®,No
❑ NA
❑ NE
[:]Yes
[gNo
❑ NA
[_]NE
Paige I of 3
21412015 Continued

Facility Number: - jDate of Ins eetion: jy—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[j]No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑-IGo
D NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): /191
Observed Freeboard (in): 3 q
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
�o
DNA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
F�o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Er&o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
Er�o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑Yes
�o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [ 1No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or i 0 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): y1�'42_ / D Cr �•CS r- ?�
13. Soil Type(s): L y wa 37 / IV6 J¢
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Q No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? Yes [io ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [ErNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[:]Yes
�o
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
[a -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? Ifyes, check
D Yes
[D"No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [DNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and It' Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes 2rNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [T No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number. jDateof Inspection: Z; —/1—
• 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �o
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �o
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 13-<o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes []'No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
0 NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑Yes [ o DNA ONE
❑ Yes [2�No ❑ NA ❑ NE
❑ Yes [TNo ❑ NA ❑ NE
❑ Yes ['TNo ❑ NA ❑ NE
[Yes
❑ No
❑ NA
❑ NE
❑ Yes
[3-No
❑ NA
❑ NE
❑ Yes
Eallo
0 NA
❑ NE
Coinmeuts (refer to question #)• P Y y
' . Explain any YES answers and/or an additional recommendations or any other comments.
Use drawings of facili to better explain situations use,additiona! pages'as necessary).
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: 6, // �'7/a--
21412015

5-
Type of Visit: 0<omptiance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other //O Denied Access
Date of Visit: Arrival Time: ; D/] Departure Time: .OD County: Oh is Region: `
Farm Name: � 19 G 1� /M Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: _ �YC _ Title: C5l-4� /-t w e ­ Phone:
Onsite Representative: ��'- Integrator:,! I
Certified Operator: J�la-�� Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
l7esign Current Design Current
Design Current
Swine. Capacity Pop. Wet Pointry ilililpll Capacity Pop.
Cattle Capacity Pop.
Wean to Finish ff I Layer
Dairy Cow
Wean to Feeder
Non -Layer
-" _
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
D , P,vul Ca aci P,o -
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Non -Layers
Boars
Pullets
#s
Turke s
Other'
T urkey Points
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 1,1!)-No ❑ NA ❑ NE
❑ Yes [-]No
❑ Yes ❑ No
[] Yes
❑ No
❑ Yes
allo
❑ Yes
FZLNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facifi Number: - �j Date of Ins ection: — u/--
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 DNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):3
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes RNo ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
[—]Yes ® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes Jallo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes [allo
❑ 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 Q No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes [R] 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): 3 r-✓/rl'Wq � svr/j�rc�
13. Soil Type(s): L yZ GUI Z5
14. Do the receiving crops from those designated in the CAWMP?
[:]Yes 2jNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
E�j 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 KNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes Callo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
KNo
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
M No
❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
RNo
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
allo
❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[RNo
❑ NA ❑ NE
Page 2 of 3
21412015 Continued

[Facility Number: - Date of Inspection: --[
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes allo ❑ NA ❑ NE
• 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes jANo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No C] 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
[Z 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
�4No
D 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
jo No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
2jNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAW MP?
❑ 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
0 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: _�rrv-7�j Phone:
Reviewer/Inspector Signature:
Date: /'�!
Page 3 of 3 21412015

Type of Visit: ompliance Inspection 0 Operation Review p Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: 5i7Arrival Time: j Departure Time: I / ? 3 County:
Farm Name:�� p/g�/rn. (DO µ�`� �- Owner Email:
Owner Name: ��� r/e•—•—� Phone:
Mailing Address:
Physical Address:
Region: FT— 0
Facility Contact: �,,� �� Title: Phone:
Onsite Representative: 5�� Integrator:
Certified Operator: Certification Number: 3
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Des FNLCurrent
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Poultry Capacity Pop.
Design Current
@attie Capacity Pop.
airy Cow
I
ILayer
I
Wean to Feeder
11
INon-Laycir I
E
Dign Current
MUM
D , P,oult . Ca aci P.n
Layers
a Calf
Feeder to Finish
a Heifer
D Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -La ers
Pullets
Beef Feeder
Beef Brood Cow
If
Boars
Other
Other
Turkeys
TurkeyPoults
Other
Discharaes_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 [ZNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
No
❑NA
❑NE
[:]Yes [—]No
❑ Yes [a No
[:]Yes fZ_No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412014 Continued

Facility Number: - Date of Ins ection: j=
Y6
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
J
❑ Yes
[2 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): _310
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
fgNo
❑ 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
RNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
Yes
W❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[3 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
[3 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes ®,No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Ar;/W16'eG/Ar/Q/r.-3Tr rl
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[a No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[R No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
K No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
UqNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
14 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
®. No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes No
❑ Waste Application ❑Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 1371 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Dateof Inspection:
—/ 7~ /h
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes allo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes allo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
33. Did the Reviewerllnspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes
allo
❑ NA
❑ NE
❑ Yes
Z No
❑ NA
❑ NE
❑ Yes
21 No
❑ NA
❑ NE
[-]Yes [KNo [] NA ❑ NE
❑ Yes [!jNo ❑ NA ❑ NE
C] Yes &No ❑ NA ❑ NE
❑ Yes [a No
❑ Yes fR No
[-]Yes EE�No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to questionft Explain any YES answers• or any additional recominendations or any other corrunents. f
Use drawings of facility to better explain situations- (use pages as necessary).
YL
Reviewer/Inspector Name:
Phone: 9�-33 aa
Reviewer/Inspector Signature:
Page 3 of 3
a
Date: / 7 01Z,.
21412014

hype of visit: U'i:ompliance Inspection U Operation Review U Ntructure Evaluation U Technical Assistance
Reason for Visit: elroutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: S-y—l.� Arrival Time: ; D O 1 Departure Time: fj! .37 County: �honr34'`
1I M�u6L,� 02�
Farm Name: Owner Email:
Owner Name: <A%%� ��..✓ Phone:
Mailing Address:
Physical Address:
Facility Contact: 12III_ 4i,,e L-..— Title: gg2s�fli7 Y Phone:
Onsite Representative: �r�A�
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Region: FX O
Integrator: to
Certification Number: All 13
Certification Number:
Longitude:
UWQCurrent Design Currcnt
Swine Capacity Pop. Wet Poaltry C+ p caty' ` Pop.
Design Current
Cattle Eapacity Pop.
Dairy Cow
Dairy Calf
Wean to Finish
La er
Wean to Feeder
-Layer
Design Current
D . P.oultr Cs aci Pao P.
La ers
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Gilts
Non -La ers
Boars
Pullets
Beef Brood Cow
J
Other .:
Other
Turkeys
Turkey Poults
Other
Discharees and Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [8.No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DI [:]Yes [:]No [] NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes allo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [-]Yes R No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facili Number; - Date of Inspection: — t-j-
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes gg.jVo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 1L 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 K 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 [a No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes KLNo ❑ 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 Z&No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes C&No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 2�-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 tbs. ❑ 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): Se/'m4A. /Dv, z, e �i�
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes S No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Q No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes Pallo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
g No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PSNo
❑ 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
ER 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 [LNo
❑ 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 [Q_No
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes QNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Ins ection: — /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 2!.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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or 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
M, No
❑ NA
❑ NE
❑ Yes
[K No
❑ NA
❑ NE
❑ Yes
[& No
❑ NA
❑ NE
❑ Yes J5Q No ❑ NA ❑ NE
[:]Yes Callo [DNA ❑ NE
❑ Yes M'No ❑ NA ❑ NE
❑ Yes fRj No
❑ Yes [& No
❑ Yes [�No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #t): Explain any YES answers and/or any additional recommendations or any other. comments:
Use drawings; of facility tp better expla�n.stnations (use additional pages. as necessary).
Reviewer/Inspector Name:
Phone: 9;7rr4�-oo
Reviewer/Inspector Signature:
Page 3 of 3
Date: l5 Gf .5-
21412011

BINS 17 s 'W-(V
IType of Visit: UCom nce Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up 0 Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County:5
Farm Name: Ip�4C C� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: � Title:
Onsite Representative: L( Integrator
Certified Operator: C
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region: w
t=__u;I C 4
Certification Number: -2r—1 f J 7
Certification Number:
Longitude:
Design' Current - DesignCurrent�*� , Des Current
,'� "a •r ��,Yk _ ' Ada'..;� 7'
Swine Ca acePo VVet Poult , Ca act �Po Cattle Ca act Po
P_ h P- ry P h P�, P xy P•
Wean to Finish La er DairyCow
Wean to Feeder Non -La er DairyCalf
Feeder to Finish Dairy Heifer
Farrow to Wean Design Current Dry Cow
Farrow tNon-Dairy o Feeder D . P,oul Ca act Ixo .'
Farrow to Finish Layers I Beef Stocker
Gilts Non -Layers I Beef Feeder
Boars Pullets Beef Brood Cow
Turke s
Othe_Turkey Poults
NJ Other Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes Ha<o ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Qj.�hib
❑ Yes [3No
[]NA ❑ NE
�NA ❑ NE
❑'DNA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

FaeiliNumber: ty - 7 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E -N6—❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No [J-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
&J�
❑ 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
C9 l o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
�o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Rio
❑ 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
U3.A o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[-i-
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes ❑ No Eq,116 ❑ 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): 6 r�y"Lµ al t _'(S - - -
13. Soil Type(s): L "r 4 ctl " �,{/G � AV I
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. is there a lack of properly operating waste application equipment?
Required Records & Documents
[:]Yes
[2' o
❑ NA
❑ NE
❑ Yes
[ o
❑ NA
❑ NE
❑ Yes
[jj'No
❑ NA
❑ NE
❑ Yes [a No ❑ NA ❑ NE
[:]Yes [3 o ❑ NA D NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[e lo
[] NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
E3 o
[] NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21 _ Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
®'o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield Ell 20 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[:]Yes
C� 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 21412011 Continued

FariLity Number: 1 Date of Insp ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes io
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes L7 O
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes El -Rio
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i_e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Revicwer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes [ 1`o ❑ NA ❑ NE
❑ Yes C31 o ❑ NA ❑ NE
❑ Yes C31�_o ❑ NA ❑ NE
❑ Yes Q'IGo ❑ NA 0 NE
❑ Yes [;Io
[-]Yes [TNo
❑ Yes [�No
❑NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
4 r
Reviewer/inspector Signature:
Page 3 of 3
Date: 11 Te4_ 1
21412011

Type of Visit: (�r`C��om��pliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: Outine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County
Farm Name: C— ,G Owner Email:
Owner Name: Cl,l l G�G+�'� Phone:
Mailing Address:
Physical Address:
Facility Contact: P JAP.�,�Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
=� Cr Region
Phone:
Integrator: /Z CL
Certification Number: 9 f 7
Certification Number:
Longitude:
Design t?urreat
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design C►ucrent
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Non -La er
-
Dr. Foul
I
Ga acity
en
P,o P.
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Dairy Heifer
Dry Cow
Non -Dal
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
113eef Brood Cow
Gilts
Non -Layers
Boars
Pullets
Turkeys
Turkey Poults
Other
I
Qther
Other
Discharges and Stream Impacts
1 _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes [q q ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes []No ❑-NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes [] No [ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No �lA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes gg-No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [Ejl�o ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Q.-K-6 ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [ -K-o ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): ^�4 —
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �o ❑ NA 0 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
[�o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
03'go
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Ea*l�o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[t-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
[31f90
❑ 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):'2-<00'%A S (�
13. Soil Type(s): L Q
14. Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
[p-l"go
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Q�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Vo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�o
❑ NA
[] NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ZNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Ef-No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[3No
❑ NA
❑ NE
the appropriate box_
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, cheek the appropriate box below.
❑ Yes 0<0
❑ 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 [3'No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes WNo
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 0- Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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:
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?
(refer to question ff): Explain any YES answers and/or any addi
gs of facility to better explain situations (use additional panes as
UCA_� t 9'n- -"--7
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
to-rv�l'�
q- 7-2-0l3
No ❑ NA ❑ NE
Fff No ❑ NA ❑ NE
[:]Yes
�No
❑ NA
❑ NE
❑ Yes
[ * o
❑ NA
❑ NE
❑ Yes
[ ITo
❑ NA
❑ NE
[:]Yes []No ❑ NA ❑ NE
❑ Yes L 7 . ❑ NA 0 NE
❑ Yes []'1Vo ❑ NA ❑ NE
[:]Yes [] No ❑ NA ❑ NE
❑ Yes ETNo ❑ NA ❑ NE
❑ Yes to ❑ NA ❑ NE
ons or any other comments.
Phoney b�_
Dat*x,
21412011

type of Visit: 0 Compliance Inspection U Operation Review V Structure Evaluation U Technical Assistance
Reason for Visit: GeRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I Arrival Time: Departure Time: 1 q County: Robfsp\
Farm Name: �oU�j� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Region: F/Zn
Facility Contact: LJ Z pg n] M C. k 4 A hA Title: (� i.0 I r k Phone:
Onsite Representative: _ q1n 1= Integrator: to UiL 1"'ZR[tcs-t (�
Certified Operator: } e q tJ '(`t1 \ • p
Back-up Operator:
Location of Farm:
Latitude:
Certification Number: 2L413"7
Certification Number:
Longitude:
�rDesIDesl�
Pop.
�tepactty
WetPaCapac�tyPap Cattle Capacity Pop.
:..
La er Dairy Cow
Non -La er Dairy Calf
Wean to Finish
Wean to Feeder
3%_a
a ' St3
Feeder to Finish
`"
:`'" Dairy Heifer
Farrow to Wean
esign Cnrrent Cow
'
Farrow to Feeder
D . PouliryWINEwaciPo
. Non -Dairy
Farrow to Finish
113eef Stocker
113eef Feeder
Gilts
Non -La ers
Boars
113eef Brood Cow
Turke s
Other
Turkey Poults
Other
Other
Discharses and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes Q No ❑ NA ❑ NE
❑ Yes ❑ No [✓]DNA ❑ NE
❑ Yes ❑ No [E3"`NA ❑ NE
[]Yes [—]No
❑ Yes ❑ No
❑ Yes [B No
[]DNA
❑ NE
[YNA
❑ NE
[] NA
❑ NE
Page I of 3 21412011 Continued

Facili Number: 1 - Q Date of Ins ection: 1 a
Waste Collection & Treatment
4, Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [3No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [YNA ❑ 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 [ErNo ❑ 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 [ o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [gy o
❑ NA
❑ NE
S. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [y No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [E]'No
❑ NA
❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [3/No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [TNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes &`No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ENo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ 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
❑ Yes [2"'No ❑ NA ❑ NE
❑ Yes [WNo ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[D No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
[l'No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
[-]Yes
[�yNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
(2/No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[—]Yes
[:]No
53"NA
❑ NE
Page 2 of 3 21412011 Cor dAned

Facility Number: - 9 5 Date of Inspection: 1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EfNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes [3"No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes �No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [2"INo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes E✓ No ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
[:]Yes [g"No ❑ NA ❑ NE
[:]Yes ["No ❑ NA ❑ NE
❑ Yes ETNo
[:]Yes [ErNo
[-]Yes P�(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 Dases as necessarv).
Reviewer/inspector Name
Reviewer/Inspector Signature
Page 3 of 3
Phone: 9f0 :309-( & j-
Date: - -7 lLEf )- --
21412011

Type oI visit: vo C,.;,ommppliance inspeenon u Vperatlon Kevtew U Structure Evaluation V recttntcat Assistance
(E I
Reason for Visit: xoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: �Av/ Arrival Time: Departure Time: /��, _County:
Farm Name: ���� Owner —E'm�ail�:
Owner Name: - t -�,Q4 — aAI} Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: Dec," �&1=eziio Title: Phone:
Onsite Representative: _ i!�_cr.Q } Integrator:
Certified Operator: Aox, Le,-/7? Certification Number: aq J
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Cenit Design
Cint
*. - Design Current
Swine °,
Capacity Wet Eoultry Yrv`'Capacity
Popp
Cattle'f C►apacity Pop.
. sPap4
Wean to Finish
Layer
Wean to Feeder
Farrow to Feeder
Boars
Feeder to Finish
Farrow to Finish
Gilts
Discharges and 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ NA ❑ NE
[] Yes ❑ No C]' NA ❑ NE
[:] Yes ❑ No [9-11FA_ ❑ NE
❑ Yes
❑ Yes
❑ No
[] NA
❑ NE
❑ Yes
�10
❑ NA
❑ NE
❑ Yes
I-1 'moo
❑ NA
❑ NE
Page 1 of 3 2/4/2011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment ��
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes L71Vp ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No P-10C ❑ 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
lldl"O
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
EK
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
[—]Yes
�o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[v]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
[D-Ko—
❑ 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 s.'i o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of AcceptableCropWindow ❑ Evidence of Wind DDrr`ift ❑ Application Outside of Approved Area
12. Crop Type(s): �[�fl w � Ci ►� / � ]
13. Soil Type(s):
IQ
14. Do the receiving crops duffer 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 dNo
❑ Yes D<O
❑ Yes [2lo
❑ NA [] NE
❑ NA ❑ NE
❑NA ❑NE
❑ Yes E3 No ❑ NA ❑ NE
[—]Yes [ No ❑ NA ❑ NE
❑ Yes [No ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [yfNo
❑ 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 12fNo
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
E2(NA ❑ NE
Page 2 of 3 21412011 Continued

Faeffi umber: Z Z I Date of Inspection: '1
0�
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
g No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[RfNo
❑ 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
[1f No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
[0'NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[RrNo
❑ 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
CgNo
❑ 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
[3"No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
G2"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
[2(No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[j]"'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
fl�rNo
❑ NA
❑ NE
Reviewer/Inspector Name
:��, S . %\nQPS
Phone: 9 I D - 'nP
Reviewer/Inspector Signature. Date: -j II! aoll
Page 3 of 3 21412011

)q-r,"5 s-a& - zo/D
Type of Visit 0'66mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit " outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Z9- /e Arrival Time: q; i'G7 Departure Time: 3S ,., County:
Farm Name: (N« A -1 Owner Email:
Owner Name: Gtc�t _ NeA,N Phone:
Mailing Address:
Physical Address:
o_v
Region-
Facility Contact: ��'� ^� %!i%C��[:nI Title: r� v"" �p^'4-✓ Phone No:
Onsite Representative: Integrator:
Certified Operator: nn �/ V740,rVg bZgf Xd� i.J Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = g =4 Longitude: = o = , =
esign Current Design
Napacity Population Wet Faultry Capacity
CurrentgC•uxreine
Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dai Cow
Wean to Feeder
j�-L SC+0
❑ Non -Layer
❑ DairyCalf
❑ Feeder to Finish
❑ Farrow to Wean
Dry Poultry
❑ La ers
ElNon-Layers
❑ Pullets
El Turkeys
❑ Turkey Poults
❑ Other
DairyHeifer
❑ Dry Cow
❑ Non-Dai
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
❑ Farrow to Feeder
El Farrow to Finish
Gilts
❑ Boars
Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
i . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ` o ❑ NA ❑ NE
❑ Yes ❑ No [ NSA
El NE
El Yes El No LJ'NA
❑ NE
❑ Yes ❑ No LJ NA
❑ NE
❑ Yes D o ❑ NA
❑ NE
❑ Yes [3 o ❑ NA
❑ NE
12128104 Continued

Facilit 'Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes L'SNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Db Z-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 40""
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes L7 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) _
6. Are there structures on -site which are not properly addressed and/or managed ❑ L
Yes _'fNo ❑ 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? [3Yes L're/No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ,.
9. Does any part of the waste management system other than the waste structures require El[R Yes ❑ NA ❑ NE
maintenance or improvement?
Waste Apnlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E o ❑ NA ❑ NE
maintenance/improvement? �,�
11. Is there evidence of incorrect application? If yes, check the appropriate box below. [I Yes C7 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
O NNoo ElNA
ElNE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
©'No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
El NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,���o
[3<c. ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ErNo ❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name I Jam;,
.S
Phone: `PO. Y3.3. 3300
Reviewer/Inspector Signature:
Date: Zol D
Page 2 of 3 12128104 Continued

Facility Number: % — CS Date of inspection
Re.. u� Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ETNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA W MP readily available? If yes, check ❑ Yes LYNo ❑ 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
B o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1"
Rain Inspections ❑ Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EK
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
E N
[Io NA
ElNE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
o
L�—i'/
El NA
NE
2&
Did the facility fail to have an actively certified operator in charge?
[I[3 Yes
o
❑ NA
❑ NE
2T
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
LfNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
L_TNo
❑ 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`?
El Yes
/
B o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
El Yes
,��
E 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
E No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
ffNo
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

Division of Water Quality
Facility Number �] Qj q 5 Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit Er6ompliance
Inspection
O Operation Review O Structure Evaluation
0 Technical Assistance
Reason for Visit
01 outine O Complaint
O Follow up O Referral O Emergency
O Other ❑ Denied Access
Date of Visit: S O�i-� Arrival Time: Departure Time: 11 ., 00� County: &I6`_SO'V Region: r
Farm Name: Ge1,t4e- A4Ckt"i l Fay,,._ (141; Sp�,+`J AP Owner Email:
Owner Name: Geo�y-c_' Me_t ezl Phone:
Mailing Address:
Physical Address:
Facility Contact: �tJ �c- t t-a-c-) Title: t'�vaN �iUctn�tp- Phone No:
Onsite Representative: '0e"x'.j MJe'-^t Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 0 ❑ ' 0 « Longitude: = ° = 6 ❑ u
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
Wean to Feeder 13 55 L
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -La et
Dry Poultry
U Non -Lavers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
LQ Other I—
Discharees & Stream lmpacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Capacity Population
❑ Dairy Cow
EIRLia Calf
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes BNo ❑ NA ❑ NE
❑ Yes ❑ No 3 NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No 31I A ❑ NE
❑ Yes RNo. ❑ NA ❑ NE
❑ Yes BNo ❑ NA ❑ NE
12128104 Continued

Facility Number: _78 — 95 Date of Inspection
Waste Collection & Treatment �
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ElE Yes No ❑ NA ❑ NE
a_ If yes, is waste level into the structural freeboard? ❑ Yes 0 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3z �r
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
Q No
❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
CJ 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
El�
No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑Yes
Q No
El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes
����
L7 No
❑ NA ❑ NE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
C7 No
❑ NA ❑ NE
maintenance/improvement?
.
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
��
L� No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 1 o Ibs ❑ Total Phosphorus [:]Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) '8 C NaI tl C— r. � O+ 5.
13.
Soil type(s) 0Ja b
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
L'7 No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
ElNA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
,9'<o
L—�, NNo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
E] oo
❑ NA
ElNE
18.
Is there a lack of properly operating waste application equipment?
ElYes
�
L3No
❑ 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):
AL
ReviewerAns ector Name -33.333 Sf
p {�ic� Re�l��5 Phone: �lO,�}
Reviewer/inspector Signature: ,[tom Date: zoo?
12128104 Continued

Facility Number: 713 — cj, j 1 Date of Inspection S-Oly�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes O No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes O No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists ❑Design [I Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
2 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 Inspectionss El
Weather Code
22,
Did the facility fail to install and maintain a rain gauge?
❑ Yes
NNoo
El NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
,B,
I_(N
❑ NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
FNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑,go
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
B<O
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
10
❑ NA
❑ NE
Other issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 0�<o ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
2 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
D<o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
ETNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
ElLi Yes
��/
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
allo
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

Type of Visit lrCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: /Z.'3o ,., County: �oSc�✓ Region:
Farm Name: OGQ We —I" -411 A"ie Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: 1>90 pi ik L A Ck^.f Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No: -/
Integrator: +'
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = c = I 0 u Longitude: 0 ° 0 ` = u
Destgn Current
Swine 7Y t 2Ca ci tiPo { ul h n
ty p
WetPotil
�y�
Desi n urrent
o g
Capacity Population
Des' n Current
Cattle �� Populai'on
N y�P , yr
LCapacity
❑ Wean to Finish
❑ La er
❑Dai Cow
® Wean to Feeder SZ
❑Non -La er
❑Dai Caif
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
'"4.
Dry Pti yam.
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
O#her¢
❑ Turkeys
❑ Turkev Poults
-
Number of Structures:
❑ Other ❑Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[M No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a- Was the conveyance man-made?
❑ Yes
❑ No
LI NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
Lyf NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
01�o❑
NA
ElNE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
ElYes
0 NooNA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued
W

Facility Number: Z— Date of Inspection
Waste Collection & Treatment ��
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes L7 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes O No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ,3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 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 L'J 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? El Yes IT No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ETNo ❑ 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 L�No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes EJ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes eNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind /Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) _ L pia g ge/7
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes [JNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 0No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes El"
No
17. Does the facility lack adequate acreage for land application? ❑ Yes No
18. Is there a lack of properly operating waste application equipment? ❑ Yes No
❑NA ❑NE
El NA El NE
❑NA ❑NE
❑ NA ❑ NE
Reviewer/Inspector Name !� Gv C� 91a, i133. 33
G S Phone:
Reviewer/Inspector Signature: Date: 7-Z9—Z OQ 0
Page 2 of 3 12128104 Continued

Facility Number: —7 O T 7S� Date of Inspection _ Zy-o
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes LT No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes B<o ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 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
❑ NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
�B{o
I� tvo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ElNA
ElNE
26.
Did the facility fail to have an actively certified operator in charge?
ElYes
r0'1�o
L] No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Quo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[I Yes
��
BIN
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
B No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
�
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
2 o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 I.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
E3*<o
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additioaid Comments and/or Drawings:2,
Page 3 of 3 12128104
Page 3 of 3 12128104

[Facility Number 7 $ 9S
0 Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
(Type of Visit ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit *Routine 0 Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 3-2$- b7 Arrival "rime: �]:OD Departure Time: County: 1Zo1­e50r.l Region: FOe-0
Farm Name: V td� e.ei*ta..+ a N,-+.a Owner Email:
Owner Name: ��r E. 9 t ,,, Phone:
Mailing Address:
Physical Address: �� ll C fo -rap * 2r
Facility Contact: � � ry t-` e+ ^1 Title• 0 "`� �t Phone No•//-- `9/O, d'Z9.996y
Onsite Representative: —ytAj —ACA C.4xr/ Integrator: M L,.,T 6 gVbwtj
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: =o ❑ ' = Longitude: ❑ ° ❑ ' = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La y er
3552, 3-5-00 10 Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharges & Stream Im acts
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)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
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 N No ❑ NA ❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
[ANo
❑ NA
❑ NE
❑ Yes
[FPNo
❑ NA
❑ NE
❑ Yes
[A No
❑ NA
❑ NE
❑ Yes
[21No
❑ NA
❑ NE
12128104 Continued

Facility Number: 7 g— 9S Date of Inspection 3-LS-O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[Q No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[NNo
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 30
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
W 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
® 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
[3)No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
m No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes R No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
i
12. Crop type(s) 1?_'e -tN►.u,�-C'_ � P�%�V4� SsVall to r4'_'j rOV44"scc a
13. Soil type(s) L IX�14L AV #
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
M No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
`� No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating; waste application equipment? ❑ Yes
[XNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name
iZ e Ve- S Phone: 9/0. q33, 3330
Reviewerllnspector Signature:
Date: 3 - Z 8- O 7
12128104 Continued

Facility Number: 7S -95 Date of Inspection 3-ZS- D7
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
❑ Yes V No ❑ NA ❑ NE
❑ Yes 9 No ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [$ No ❑ NA ❑ NE
❑ Waste Application [:]Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ 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?
33. Does facility require a follow-up visit by same agency?
Comoents and/or Drawings:
❑ Yes
7 No
❑ NA
❑ NE
❑ Yes
Q9 No
❑ NA
❑ NE
❑ Yes
Ig No
❑ NA
❑ NE
❑ Yes
to No
❑ NA
❑ NE
❑ Yes
IyNo
❑ NA
❑ NE
❑ Yes
p No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes [fi No ❑ NA ❑ NE
❑ Yes ISM No ❑ NA ❑ NE
❑ Yes
R No
❑ NA
❑ NE
❑ Yes
[gNo
❑ NA
❑ NE
12128104

Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of visit: 7 - 1 q 04 Arrival Time: Departure Time: Q`; County: G a Region: F/l�
Farm Name: Geo m c Atr. eG N a- vie,, �/Vrc�✓S �«�tiJ Owner Email•
Owner Name: { /yi e, Lt4 AJ _ Phone:
Mailing Address:
Physical Address:
Facility Contact: __ b ecw AG L era..! Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No: p
Integrator: XYU 4 Q f?3-6j".j
Operator Certification Number: .
Back-up Certification Number:
e Latitude: Longitude: =O'= , 0 "
Design Current
Swine apaty Popu Ccilation
Design Current
Wet Poultry Capacity Population
11:1 Layer I
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Wean to Finish
I
1
Wean to Feeder 13 $
❑ Non -Layer I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Layers
❑ Non -Dairy
El Farrow to Finish
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[XNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
1�6 No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
P No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
PNo
❑ NA
❑ NE
other than from a discharge?
Page l of
12128104
Continued

Facility Number: 7S— gJ Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ON E
a. If yes, is waste level into the structural freeboard? ❑ Yes to No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): _ _ / g r40
Observed Freeboard (in): 29 N
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes *o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes LNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered ves, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 7�4o ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [VNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ yes E El NA El 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 06 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)
13. Soil type(s) L
r i
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
IN No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
V1 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name s �C.v 3 Phone: [9101933 -3.301D
Reviewer/Inspector Signature: J,Date: —7 Zu a to
rage z of .5 J-/ta/U4 uonunuea

A
Facility Number: -71-9 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps ❑Other
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
rffNo
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes To ❑ 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?
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
3 I. 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
[� No
❑ NA
El NE
❑ Yes
[8 No
❑ NA
❑ NE
❑ Yes
[)d No
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
❑ Yes
[9No
❑ NA
❑ NE
❑ Yes
[A No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
10 No
❑ NA
❑ NE
❑ Yes
[�j No
❑ NA
❑ NE
❑ Yes
[RNo
❑ NA
❑ NE
Page 3 of 3 12128104

Jr
Type of Visit Q—Compliance Inspection O Operation Review O Structure Evaluation O 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: ! DD Departure Time: --o County: 41 DJZ19 S'� Region: JfX
Farm Name: G er // ow /.{ Owner Email:
Owner Name: �� __%%7 el- e—oa -- Phone:
Mailing Address:
Physical Address:
Facility Contact: �� L �a...t _ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: =] o = ' 0" Longitude: 0 ° a f 0
6.
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
[:]Layer
❑Nan -La et
Dry Poultry
❑ Lavers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current;:.;;.:,,
Cattle Capacity Population
❑ Dairy Cow T
❑ Dairy 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 No ❑ NA ❑ NE
❑ Yes
ZLNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
No
❑ Yes
[KNo
❑ NA
❑ NE
❑ Yes
21 No
❑ NA
❑ NE
12128104 Continued

Facilit
y Number: Date of Inspection T74Ar_
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 RNo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ 3 fl
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
P4 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
Xj 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
;K No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
�No
[I 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
qNo
❑ NA ❑ NE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
LN No
❑ NA ❑ NE
maintenance/improvement?
. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
ZNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ FAN > 10% or t 0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ElEvidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Z�e krnl L 1, h-,-r
"/
13. Soil type(s) /, Y ! -,&), x
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
W No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
C� No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[] Yes
Q No
❑ NA
❑ NE
IT Does the facility lack adequate acreage for land application?
❑ Yes
Z No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
10 No
❑ NA
❑ NE
Comments (refer_to question ft: Explain any YES answers and/or any recommendations or any other comments.
Use drawings of.faei�ty to better eipiain.situations. (ase additional';
as necessary):'
Reviewer/Inspector Name �- ,� j Phone• ::KA-I, —/,S
Reviewer/Inspector Signature: Date: le-� -,.2 —aS--
12128104 Continued

Facility Number: Date of Inspection �rr
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 5INo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes jo No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. IN Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking PCrop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
E? No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Q No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
fW No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
C{No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
D?LNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
RLNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
RNo
❑ 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
4 No
❑ NA
❑ NE
f 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
54 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
A No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
QNo
❑ NA
❑ NE
I2/2VO4

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other 0 Denied Access
Date of visit: �� 1�Icy Tune:
F -Facility Number $ g 5
Q Not Operational Q Below Threshold
Permitted ® Certified 0 Conditioonnaailly�C/ertified 13 Registered Date fact Operated or Above Threshold:
Farm Name: . _ 52 ���% �, _ L '! ��x sty W� County; _ _ _/S v [i s v :✓ Y /' �i
Owner Name:.. G < C' r- - /'%�! t Phone No:
Mailing Address:..___3 V �. ... 1. ___
Facility Contact: Title:. Phone No:
Unite Representative: cfo j G T
....... / � ��� v'� Integrator:
Certified Operator: �� c :.� - Operator Certification Number:
Location of Farm:
al
Swine ❑ Poultry ❑ Cattle [3 Horse Latitude Longitude �• �° 0"
Swine
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
.Cj]Urr=t, =Des
j Other
Current -Dew Current
�:Po Lion: Cattle;
Dairy
Non -Dairy
:..Total ,Des*n`,Capadty.
Total SSLW
Nmnber cilt'I�agoans ..
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in ga.Umin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes 10 No
❑ Yes ❑ No
❑ Yes ❑ No
/V ,//I
❑ Yes ❑ No
❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [3 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier
Freeboard (inches): 13�i
12112103 Con inued

Facility Number: Date of Inspection e
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes IN No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes gj No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancehmprovement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenancerimprovement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level Yes No
elevation markings?
Waste Avolication
10. Are there any buffers that need maintenance/improvement? [:]Yes No
11. Is there evidence of over application? If yes, check the appropriate boa below.
❑ Yes No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type .67e 01.1" L pa //,_, " / rn � // G r<: ; r+
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 0 No
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building sttuctu e, 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
Au Quality representative immediately.
❑ Yes ® No
❑ Yes P No
❑ Yes IV No
R3 Yes ❑ No
❑ Yes �E No
❑ Yes P No
❑ Yes [$ No
❑ Yes ® No
❑ Yes 10 No

Facility Number: 79 — 25 Date of Inspection
Reanired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ 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?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32_ Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes MNo
❑ Yes M No
❑ Yes Ej No
❑ Yes [ No
❑ Yes ® No
❑ Yes ?] No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103

Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ®Routine Q Complaint Q Follow up 0 Emergency Notification O Other ❑ Denied Access
i Facility.Number - Date of Vicit: [S Time; b )
E ..�. ,. dot O eratiortal Below• Threshold
® Permitted ® Certified © Conditionally -Certified 0 Registered pate Last Operated or above Threshold:
Farm Name: C-tpc�A i'VLC`� r�S �•Lf��ia� � � a °'rSj6L} County: IZ.3 Lg a,=&3
Owner _dame: Grp a" tNaG-_ �r� _ _ Phone No: � d��„ C14 6 l
Mailing Address: _ 31 Z(3 2CCA __l-c:: r rti
Facility Contact- CrPu(::p k' ykC.i o Gu. Title: b W c.Qr _ _ Phone No:
Onsite Representative: - r` Integrator:
Certified Operator: C"et) t'ON C Operator Certification Number:
Location of Farm:
W Swine ❑ Poultry ❑ Catle ❑ Horse Latitude 0' 9 0" Longitude 0' 0' 0�
Design Current Design Current Design Current
Swine Ca acit• Population Poultry Capacity Population Cattle Ca acih• Population
® Wean to Feeder ❑ Laver I I 1 ❑ Dairy
❑ Feeder to Finish 10 Non -Laver I I Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ goy Total SSLW
Number of Lagoons ❑ Subsurface Drains Present Lagoon Area S rav Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges B: Stream impacts
1. Is anv discharge observed from any pan of the operation?
Discharge ori--mated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. if discharge is observed, was the conveyance mar -made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
1 Is there evhdence of past discharge from anv part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure
❑ Yes CA No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes Q No
Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

Facility Number: — Date of Inspection 0 0
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes M No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes 1� No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [ 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 [5�No
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes q No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes W 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. 1s there a lack of adequate waste application equipment?
Reauired 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 � No
❑ Yes W No
❑ Yes 1�9No
❑ Yes P3 No
❑ Yes No
❑ Yes No
❑ Yes [�INo
❑ Yes 51 No
❑ Yes Ep No
❑ Yes 4 No
❑ Yes [ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Ciimments QiAerto qu-Mon #)::ExpWri aO YES,answers..and/or.any recommendations or any other comments.
'Use.drawrngs of fac�lrts to better ezplatn sitirahons (use:additaopa!_pages a'sEpecessar}} . - [] Field Copy ❑ Final Notes
.-
H,
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 " ( If Continued

Facility Number: Date of Inspeclinn a�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt.
roads. building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes P No
❑ Yes 4No
❑ Yes E,No
❑ Yes ❑ No
Additional Comments find/ar-DraWittrs:F:�. - ' w
05103101

Type of Visit ® Compliance Inspection Q Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine C) Complaint O Follow up ( Emergency Notification O Other ❑ Denied Access
Facility Number 7 Date of visit: Time:
rO N,75yerational 0 Below Threshold
Permitted ® Certified 0 Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: c^/�✓ f.4�h-' C_ , vkf�fi l�ounh j'��
Owner Name: vG %� C�izref.ri Phone No: r%/o/
Mailing Address: _ .3 1.2 G J. Lam. �CO,�d i ,¢ ,�ixe G jj
Facility Contact: _. �ho �I �� _ Title: Phone No:
Onsite Representative: Gp�y��� G�� Integrator: (ijC/n�/ �.✓�
Certified Operator:Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' " Longitude * 0
Design Current :Design- �,.Current _ Design Cogent
Swrae :. aacit-PulataeCapacity Population :Cattle Cs scrR = Pj ulahon17
-
® Wean to Feeder 1 S`S Z ❑ Laver ❑ Dairy
❑ Feeder to Finish ❑ Non -Laver ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder Other
❑ Farrow to Finish Total' Design, Capacity' _ -
❑ Gilts -
❑ soars Total SSLW
Nnmt>er of l,sgoons M ❑ Subsurface Drains Present ❑ Lagoon Area ❑ S rav field Area
Holding Ponds 1 S61idTrapsM ❑ No Li uid Waste Management System _
Discharges & Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Laeoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if ves, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes .1No
❑ Yes )RNo
❑ Yes ANo
❑ Yes XNo
❑ Yes 10_No
❑ Yes No
❑ Yes �kA` Nlo
Structure 6
Continued

Facility Number: 79 — 9j'-
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage. etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. 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?
❑ Yes 11No
❑ Yes allo
❑ Yes [5kNo
❑ Yes MrNo
V_
❑ Yes PNo
'Waste Application
10-
Are there any buffers that need maintenance/improvement?
❑ Yes
PUNo
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
;r No
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
PNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
PNo
b) Does the facility need a wettable acre determination?
❑ Yes
P[No
c) This facility is pended for a wettable acre determination?
❑ Yes
P No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reauired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP heclsts, design, maps, etc.)
❑ Yes
No
19.
f ✓
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
ERNo
20-
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
,® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
,R No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative.) ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes NNo
25- Were any additional problems noted which cause noncompliance of the Certified ANNIMP? ❑ Yes J�"No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to ques-don #j: Exphttn any YES answers andlo� aay reeommendatrons or anv other tomme�ts,
-
Userawlags of fac�th io beterezplaiti srtuattaas (use additJana) pages ss aecessars) '- Field Cotry ❑ Final Notes )
_
�r
Reviewer/Inspector Name
Reviewer/Inspector Signature: ..a Date: /o ve_
05103101 Continued

Facility- Number. 7F — ?-rl Date of inspection
Odor- Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt.
roads, building structure. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s). inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes t No
❑ Yes NJ No
❑ Yes ® No
❑ Yes 9 No
❑ Yes ;R No
❑ Yes e&' o
❑ Yes A No
Additional Comments and/or `Drawings: -. --
J
05103101

2-, s
' 3
ma
0 Divistoet of Water Quality mm
0 Disiots of Soil and Water C ryonservation
of Visit O Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Datr of Visit: �Time: E—== Printed on: 10/26/2000
O Not Operational Q Below Threshold
Permitted 0 Certified 17 Conditionally Certified [3 Regist r p e Last Operated or Above Threshold:
Farm Name: .... ......�....1.:. e� r. Q �''R. ... County: d �:i5.............................................
Owner Name: y� C 1 q
....e0.r..�t.�.................I..'.�......4.e.a..Ir...�............................. Phone No: ......... �2,..�..�..L..�..�.�..1...................................
Facility Contact: ...... FP.4.K.P..r..................... ...... ... Title: ............. Phone iVo:...................................................
Mailing Address:..... [.. .........� fi�d. t ." wL � k:] ...1. �C.1.1. ...
�... 4................................................... NC
... /
Onsite Representative: ........ A9�4k E!.E-7 ........................................................... Integrator:............f`.r'A...[.1..-/�T ................................
Certified Operator:.�� _l 0.r �-.;e ..... �L.... .. ................... Operator Certification Number: ..........................................
Location of Farm: _
T j
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �� � Longitude
Swine
Design Current Design Current
Capacity Population Poultry Capacity Population
❑ Layer
❑ Non -Layer
Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds / Solid Traps
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy I I -d
Total Design Capacity
Total SSLW
Subsurface Drains Present 1111 Lagoon Area ❑ Spray Field Area
No Liquid Waste 1•lana2ement
Dischar;ees & Stream Im act5
1. Is any discharge observed from any part of the operation'?
El Yes
Ko
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
JNo
h. If discharge is ohscrvcd. did it reach Water of the State? (If yes, notify DWQ)
❑ Yes
o
c. If' discharge is observed, what is the estimated flow in gal/thin'?
d. Hies discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
No
II \\o
2. Is there evidence of past discharge from any part of the operation'?
❑ Yes
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway
❑ Yes
So
Structure I Structure 2 Structure , Structure 4 Struclure 5
Structure 6
Identifier: ............................ .................................... ......... ...........................
....................................
Freeboard (inches): oe (D
5100
Continued on back

i.
Facility Number: _ S Date of Inspection 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 KNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes kNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes kNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes Vo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes kNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence over application? n ❑,Excessive P�nding ❑ PAN ❑ Hydraulic Overload ❑ Yes No
I s
12. Crop type OE011 UdaXQ_0-M;1'
13. Do the receiving crops differ with those designated • the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design'?
21. Did the facility fail to have a 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?
: o yiolatitjris :or deGcienc>ie5 •were potted• diWing this'visit} Yoi� will r. eeeiye tno fui thgr
correspont�eirce. abkk this visit`
omments (refer to question #)c .'�Explaia'any YES -Answer's and/or any"reco ul nendations i
- . .-
se drawrngs of facility to better explain situations. (use additional pages as necessary):
any oilei
❑ Yes ;tNo
o
ElYes
❑ Yes kNo
❑ Yes No
❑ Yes KNo
❑ Yes KNo
❑ Yes [!�No
❑ Yes P�No
❑ Yes [$ No
❑ Yes ONo
❑ Yes Q�No
❑ Yes dNo
❑ Yes U�No
❑ Yes U$ No
❑ Yes CO/No
.in
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
5100

Facility Number: — Date of Inspection L� �� Printed on: 1/4/2001
30_ 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)
31. Is the land application spray system intake not located near the liquid surface of the lagoon? El Yes No
32. Were any major maintenance problems with the ventilation fan(s) noted? (Le. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
33. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes o
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Reviewer/Inspector Names i _ -F-a
Reviewer/Inspector Signature: Date:
01/01/01

13 Permitted PLCertified [] Conditionally Certified 13 Re 'stered C] Not Operational Date Last Operated:
�/� % ter p ..................
Farm Name: ..... .z�Or-�. .....C...:_.:.C` eq,, ,!/ Qrcyt �Pu1.'!.!t1 F._� county: d CT?--- ...................................
Owner Name: If 'L - M C fC� Phone No:
....................................................................................... ,/.:%................................... _... ......
------------
Facility Contact: .......0..e.(..� .............I......... .... Title: r ,.............. Phone No:
Mailing Address: ....fL.J.........�.1........s.�� . �� /...'e5 �`.✓�.P...� ...1 `�. ........ 2�`3 7 6
..................................................... .....
i
Onsite Representative:.......... W,l`t �. . . Integrator: ............. ��.Jr
...............
G
Certified Operator... et Q:C::C.:.........r . .................. Operator Certification Number: .............................. ...........
Location of Farm:
Latitude =0=i « Longitude =• =` =11
Design Current Design Current Design 'Current
wine Ca acrty Po ulation . Poultry Ca achy.:Po ulatioii Cattle M Ca aci �°Po ulatro>v -:
❑ Layer �: ❑ Dairy
-_' ❑ Non -Layer ❑ Non -Dairy
_:.
❑ Other
:. -Total Design Capacity
TOtal E►SSLw
Subsurface Drains Present ❑ Lagoo ❑ Spray F' td A
Numbe-i- Lagoons ❑ n Area ie rea
Holding Ponds`/:Sohd Trags _ f = ❑ No Liquid Waste Management System r ,4
❑Wean to Feeder
- Feeder to Finish
3
❑Farrow to Wean
❑Farrow to Feeder
Farrow to Finish
❑ cil�
Boars
Discharges & Stream lmnacts
1. Is any discharge observed from any part of the operation?
Discharge on=inatcd at: ❑Lagoon El Spray Field ❑Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection &Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? El Spillway
Structure I Structure ? Structure 3 Structure 4 Structure 5
Identifier:
2
Freeboard (inches): .......... ✓.�.ry...........................................................
❑ Yes �No
❑ Yes ['�No
❑ Yes KNo
[]Yes
P�No
❑ Yes ONO
❑ Yes �W`o
[]Yes
E�No
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑yes J&No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 7Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Ap2lication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? Q Excessive Ponding ❑ PAN
12. Crop type
13. Do the receiving crops differ with thosd(tesignated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there'a lack of adequate waste application equipment?
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?
Oe/ VqT, 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?
9.oatjesr.... -' - • - -h:wl>s dfcecvodrviic - Yoi-tec..fid.1.ru.it.oro.:6resi) deitelof thivtasi... .
❑ Yes gNo
❑ Yes o
❑ Yes rwo
❑ Yes �No
❑ Yes o
❑ Yes RNo
❑ Yes M10
❑ Yes ANo
❑ Yes ANo
❑ Yes )�No
❑ Yes allo
❑ Yes qNo
❑ Yes J&No
❑ Yes A No
❑ Yes J j No
❑ Yes ONo
❑ Yes WNo
❑ Yes _4kNo
❑ Yes Po
❑ Yes P No
❑ Yes YNo

Facility Number: -- Date of Inspection -zZ -
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes
No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or "
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes &(No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes P11
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No

Division of:Soil and Water Conservation'- Operation Re"view ��
� rvrsrorl o£Soil arid'Water Conservation -Compliance Iirspectioq
Division of _Water Quality--- 6inpliance Inspection
Other -Agency =_Operation Review. W r
ISRRoutine 0 Com laint 0 Follow-u of DWQ ins ection 0 Follo«-u or DSWC review 0 Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
0 Permitted Certified ©Conditionally Certified ©�gi tered_L �] Not O eratiuna] Date Last Operated:
Farm N. .... r' `�G +t rwt ountv:........ .
c' ��.e SQy.-�................
Owner Name: -.- P o A'`.. c.... fllG e�H� Phone No: -...-... ��. ..... Q C................................................................................................
Facility Contact: .........l�r . .y e....................................Title:..............-... ....... Phone No:
Mailing Address: ................. f.- .. .. ::.....:
�:� 1 5..................................
Onsite Representative: Yt e r� Integrator: rf_0 p...............................................................................C....Q:...............I.................................
Certified Operator:._. coxlr
..... Operator Certification Number: ..........................................
CLGa, ........
Location of Farm:
A,i
.......................................................................................................................................................................................................................................................................... T"
Latitude �' �� ��� Longitude --
Design Current
Swine Capacity Population
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Soars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer T= JE1 Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity -,7,5— 2 __
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area
Holding Ponds 1 Solid Traps JE1 No Liquid Waste Management System
Discharges A. Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Disc•hari_,e uriginaied at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
h. If discharge is observed, did it reach: ❑ Surface Waters []Waters of the State
c. If dischari,.e is ohserved. what is the estimated llow in galhnin•?
d. Does discharge bypass a lagoi,n system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than From a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Identifier:
Freeboard (incltcs):
Structure I Structure 2 Structure 3
��.. ..............................................................
Structure 4 Structure 5
❑ Yes kNo
❑ Yes No
❑ Yes No
El Yes fip No
❑ Yes KTNo
❑ Yes X No
❑ Yes 9 No
Structure 6
116/99 Condinrced on back

t - a
Facility Number: ff— Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] YesNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes gNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
S. Does any pact of the waste management system other than waste structures require maintenance/improvement? Cl Yes o
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
❑ Yes
0 No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
�KNo
IL
Is there evidence of over applicatio ? ❑ Pondiing ❑ Nitrogen
El Yes
gNo
12.
Crop type
............8 .._.r.................. ..................................................................................................................
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
XNo
14.
Does the facility lack wettable acreage for land application? (footprint)
❑ Yes
J% No
15,
Does the receiving crop need improvement?
❑ Yes
j,'No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
OrNo
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
XNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
�( No
19.
Does record keeping need improvement? (ic/ irrigation• freehoard, 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
No
21.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application) ❑ Yes �No
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative`? ❑ Yes No
24- Does facility require a follow-up visit by same agency? ❑ Yes No
NA.viaJations or. deficiencies .were nabed duringiis..........................visit:. Ytiuvili.reeeive na� further
egrrespotrideh&' abbot: this visit.. .........:. ..:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:..:.:.:.: .
Comments (refer to question #): Explain any YES answers and/or any:'recommendations.or.any other comments.
-�.
Use d_ravrings,of facility to better explain situations. (use additional pages as necessary)
Ue lej�4A_
&,J�
aj a,� 04e1- COi R4,1LL s a re- t a rJe r^,
Reviewer/Inspector Name
Reviewer/Inspector Signature: k �—(,j Date: 2 A Z _ — 11/6/99

13Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
10 Routine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other I
Date of Inspection
Facility Number
Time of Inspection E=24 hr. (hh:mm)
Q Registered Certified 13 Applied for Permit © Permitted 0 Not Operational Date Last Operated :...................•,•„••
Farm Name. � � County:.....................�UVC.So...............I .......................
Owner Name: f'.. ...(' L Phone No: ,�� ' 6 e-Q�...................
... . r+......... �............ ......... ......_........................
Facility Contact: rl Stgn Title: Phone No: ...........
................................................................
MailingAddress: ..............:94.....,. �..... .................. .`-r . ......................... C..l► . ........ C............ ........... ........... ............... �
nn / / a�
Onsite Representative: dr GL Integrator: :............r��r S �-!lC
p /..?......,5r....................•-m1a-............._.......................... g................ ....... ....
........................�... ........
Certified Operator;.....,...,. G ... Operator Certification Number;............ �a
Location of Farm.
Latitude Longitude"�• �° 0"
{General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is obsened, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes )6No
❑ Yes A No
❑ Yes �(No
❑ Yes 0 No
❑ Yes No
❑ Yes No
(A'I'No
gNo
❑ Yes No
❑ Yes No
Continued on back

Facility Number. — f
8. Are there lagoons or storage ponds on site which need to be properly closed'?
Structures fLavoons.11oldinu Ponds, Flush Pits, ete.!
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes XNo
❑ Yes X No
Structure 5 Structure 6
Identifier:
Freeboard (ft):...,.... .....I .............
10. Is seepage observed from any of the structures'?
]I. Is erosion, or any other threats to the integrity of any of the structures observed'?
12. , Do any of the structures need maintenance/improvement?
(1f any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14, Is there physical evidence of over application'? r
(if in excess of WMP, or runoff entering waters of the State, notify 3)"
I5. Crop type --. -..-- - .. „�
/...-.
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW,MP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
N
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 Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit'?
❑ Yes O No
❑ Yes X No
❑ Yes XNo
❑ Yes X No
❑ Yes XNo
........... L _...................
❑ Yes
ANo
❑ Yes
00 No
❑ Yes
No
a ❑ Yes
JgNo
❑ Yes
ON No
❑ Yes
ANo
❑ Yes
No
0 No.violations or deficiencies were noted during this:visit..You.will receive no further
. . . . . . . . .
correspondence about this.visit. :
❑ Yes ANo
❑ Yes ANo
❑ Yes ❑ No
r
0
Comments (refer tb q' gestion`#): Explain any YES answers andlor'atiy recor6mendationsor any,other co-lnmetnts t
Use,drai-wings ofefatility to better explain situations. (use additional pages as necessary ' a
}.
70.
f-4iu L(A
q —
CkJJa Jan ter-i k4yJ4 fth5
4�]
Reviewer/Inspector tiame
Reviewer/Inspector Signature:T r, s _ Date:
r,

of
WA&W=
Facility Number �j E
Farm Status: e Q t s4ere4
Farm Nam: e-
Owner Name: (gebe!tco- A4 C Ly-S
,ration;Aevie—,
e Ml- U
Follow-up of DSVVC review 0 Other
Date of Inspection
Time of Inspection Use 24 hr. time
Total Time (in hours) Spent on1teview
or Inspection (includes travel and processing)
county:
Phone No:(9z,-6)
Mailing Address:R-�. 1 s: 96)(5)( Q r m g P,+ 22340
OnsiteRepremtadve: dlbf4 541A6-5 Integrator-. Ca r ro I
Certified Operator- 1;eoc!4a I.M C Le(Operator Certification Number.
Location of Farm:
Latitude Longitude
113 Not 2mrational Date Last Operated:
Type of Operation and Design Capacity
g
tWX7
igwa- - o0itry"N%EZ
0
Wean to Feeder 10 L-Wer ...... .....❑Dairy
0 Feeder to Finish 113 Nbn-Layer 10 Beef
M
1, =armw=to Wean Farrow 2
to Feeder
AD Farrow to Finish 17,10RX 13 Other Type of Livestock
M iuiibei.of,Lag"ns Holding Fonds Subsurface Drains Present
_
Lagoon Area Spray Fidd
13
General
1. Are that any buffers that need nuantenan entl ❑ yes NO
2- Is any discharge observed from any part of the operation? E3 Yes !"o
a- If discharge is observed, was the conveyance man-made? 0 Yes P(No
N
b. if discharge is observed, did it reach Surface Water'? (If yes, no* DWQ) 0 Yes 0,o
c. If discharge is observed, what is the estimated flow in galhain?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) El Yes PNo
3. Is them evidence of past discharge from any part of the operation? El Yes No
F�
4. Was there any adverse impacts to the waters of the State other than from a dischargc7 El Yes �dNo
5. Does any part of the waste management system (other than lagoons/bolding porids) require E3 Yes �No
maintenzi en
Candnaed on back

6. is facility not in compliance with any applicable setback criteria? ❑ Yes jw�4ro -
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/11"? ❑ Yes ❑ No
B. Are there lagoons or storage ponds on site which need to be properly closed?
tructures (LaZoons and/or Hold!n Ponds)
9. Is structural freeboard less than adequate?
Freeboard (ft): r Lagoon 1 Lagoon 2
10. Is seepage observed from any of the strictures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintcu ncrlimprovement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
Lagoon 3
I3. Do any of the structures lack adquate markers to identify start and stop pumping levels?
Waste Application
14. Is there physical evidence of over application?
.(If in excess of WIT, or runoff entering waters of the State, notify DWQ)
15. Crop type C 4 � �L .
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 Certified Facilities Onl
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 Amaral 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 Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes PNo
❑ Yes P o
Lagoon 4 / `
❑ Yes ;No
❑ Yes ANo
❑ Yes qNo
❑ Yes P(No
❑ Yes �No-
[3 Yes X
No
❑ Yes AiNo
❑ Yes JKNo
❑ Yes gNo
- XYcs
❑ No
❑Yes
gNo
? ❑ Yes
gNo
❑ Yes
UNo
Yes
❑ No
mrneiit5 (ref_ rr to �uestron #1� • Expisur any YES_ answers aadloraany,�rrcommendations nr arty other coa�eatsk - � 3„�; .�[VC-*Se dra 4 f tj+.t0L��,.Y [tr8ti ILSC $ - z Y* $ •r�'t a , E' Q r� �?�2 i� 3
O faCl�li l7� Cxplain 5r onS. � ddrbOnal•p ges a5: � .�
2& # it f N6 ewe was pf eser\t a+ +1,,e xrw� . �A5f)ea - on
W'X-S Co c�e��ed -t'�ro luglti lei r Se ry icQ perSo.
4 -/9 -'17 Recc,veof joL sg , &--a �y�k,e,.i f ka-..
Reviewer/Inspector Name. �`'a.,
Reviwer/Inspector Signature: Date: Z V
cc. Division of Water Ouality. Water Ouality Section. Facility Assessment Unit l 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. George McLean
Rt. 1, Box 511
Fairmont, NC 28340
Dear Mr. McLean:
A N?W'A
0
1DEHNR
DIVISION OF WATER QNALTTY
July 8, 1997
SUBSECT: Annual Compliance Inspection
George Mclean Farm & Double D 1-8
Registration Nos. 78-20, 78-94, 78-95
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 I SA 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 need any of the copies of the information which you forwarded to me please let me
know and I will return it to you.
If you have any questions concerning this chatter, please call John Hasty at [phone].
Sincerely,
ohn C. Hasty, Jr.
Environmental Specialist
cc: Operations Branch
Central Files
Audry Oxendine - FRO DSW
Ed Holland - Robeson Co. NRCS
Wachovia Building. Suite 714. Fayetteville5043 �T'`MC FAX 91D 4Bfr0707
North Carolina 28301-An Equal Opportunity Affirmative Action Employer
Voice 9 }a486 1541 50% recycled/ 10°/6 post -consumer paper

Routine
Follow-UD Of
Facility Number tj:E (ij
Farm Status: f e re4 _
tzon= e
;ation Site sperhoa
Follow-EE of DSWC review 0 Other
Date of Inspection
Time of Inspection Use 24 hr. time
Total lime (in boors) Spent onReview
or Inspection (includes trawl and processing)
F=mName: county. k0be.VrL
0"iWName.: ggeewq'p. M C LSAA01- Phone No.k?
Mailing Address: - -gi-, 1 5)1 /VC 21310
OnsiteRepresentative- a66L, CcLrrolk
t
Certified Operator: Operator Certification Number:
Location of Firm:
.Latitude Longitude
10 Not 02erational Date Last Operated:
Type of Operation and Design Capacity
--'.'Svvine Poultry Numbit
L1 Wean to Feeder0
F Layer
0 Feeder to Finish
N6n
Beef
E3 Farrow to Wean
0 Farrow to Feeder
Farrow to Finish
er Type Of Uvestock
LOP"
Number
Aag '�onif 0 ing Poirds
'
Subsurface Drains Present
Spray Field Area. Lagoon Area SP
t
Getters
I. Are there any buffos that need xnaintenan ?
2- Is any discharge observed fi= any part of the operation?
aL If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Surface WatcO (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flaw in gat(min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is them evidence of par discharge fimm any part of the operation?
4. Was there any adverse impacts to the waters of the State other than from a discharge?
S. Does any pan of the waste management system (other than lagoons/bolding ponds) TrquiTe
mBintenancelinquov=ent?
E3 Yes gNo
E3 Yes ONO
13 Yes ;No
E3 Yes J(No
/ ❑ Yes;No
E3 Yes F No
13 Yes ONO
13 Yes ONO

I
6. is Nci!itl- *TM+t in c hence with nary► applicable setback criteria?
Yes
O(No '
7. Did the facility fail to )rave a certified operator in responsible charge (if inspection after WPM?
❑ Yes
❑ No
11. Are there lagoons or storage ponds on site which need to be properly closed?
13 Yes
�No
Atructures LLaeoons and/or Holdinsr Ponds]
9. is structural fieoboard less than adequate?�
❑ Yes
/EiNo
Freeboard (ft): ogn 1 Lagoon 2 Lagoon 3
Lagoon 4
10. Is seepage observed from any of the sErucUm?
❑ Yes
*No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
19No
12. Do any of the structures need maint=anc wimproycnumt?
❑ Yes
ONo
(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 adquaite markers to identify start and stop pumping levels?
❑ Yes
P(No
Waste Application -
14. Is there physical evidence of over applicatian?
n Yes
fi(No
(If in excess of WMP. or runoff entering waters of the State, notify DWQ)
C '0 Q �r�1_____._.
15. Crop type ,
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
13YesNo
X
17. Does the facility have a lack of adequate acreage for land application?
13Yes
XiNo
18. Does the cover crop need improvement?
❑ Yes
$�,No
19. Is there a lack of available irrigation equipment?
❑ Yes
0,No
For Certified Facilities Ooly
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
- XYes
❑ No
2I. Does the facility fail to comply with the Animal Waste Managem=t Plan in any way?
! ❑ Yes
gNo
22. Does record keeping need improvement?
? ❑ Yes
PNo
Z. Dees facility require a follow-up visit by same agency?
O Yes
qNo
24. Did Reviewer/lnspector fail to discuss review/inspection with owner or operator in Charge?
Yes
❑ No
Commehts (refer to.question #): Explain any. YES answcrs,.and/oranj recominendations or any other comments:'.
Use drawings of facilityto beau explain situations._ (use additional papa as;necessary)�„ ,; -
c 4"rr-- . -Vn.sDe--i orJ
ZD. * ,A-Zq. No D&e. t,� p r'eser,,t cz -{ kr'
W45 CovA�(-1+CA a[ug1r.. �e-c Sr.rV1Ce Person-. 11
-57 leece:ved LA-kX%�e AA06•%cr3e"—%e,j f lv+�-.
-
4
8
Reviewer/Inspector Name
Reviwer/Inspector Signature:
cc: Division of Water Quality, Water Quality Serrion, Facility Assessm«f rl-a
Date:
1 v,(77--