820023_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

type of visit: t c;ompiiance inspection v operation xeview V structure Evaiustion V i ecnnicai Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency _0 Other 0 Denied Access
Date of Visit: Arrival Time: ,' Q2 Departure Time: Or County: cSr/�� S�/`I Region:
Farm Name: ,V�" S LL C Owner Email:
Owner Name; / �� &,, S,7,,C Phone:
Mailing Address:
Physical Address:
Facility Contact: /fa lj4r/w 6"—
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator: Sit,
Certification Number: 3 7s,
Certification Number:
Longitude:
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 N No ❑ NA ❑ NE
❑ Yes [] No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [�DNo
❑ Yes R No
Q9 NA ❑ NE
® NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3 2/412015 Continued
Design Current
Design
Current
Deslgn Current
Swine
Capacity Pop,
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
-
Dairy Cow
Wean to Feeder
Nan -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Deslgti
Current
Dry Cow
Farrow to Feeder
1�4
10 P,ottit
Ca acl
I',o
Non -Dairy
Farrow to Finish
k
Layers
Non -Layers
Pullets
Turkeys
Beef Stocker
Beef Feeder
Beef Brood Cow
;; Gilts
Boars
i
Other
Turkey Poults
Other
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 N No ❑ NA ❑ NE
❑ Yes [] No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [�DNo
❑ Yes R No
Q9 NA ❑ NE
® NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3 2/412015 Continued

Facili Number: jDate of Inspection: KLT 417
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 �iNA ❑ NE
Structue 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 p No ❑ NA [3 NE
(i.e., large trees, severe erosion, seepage, etc.) T'
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?
❑ Yes
[P No
❑ NA ❑ NE
the appropriate box.
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify
DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes]
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
[ No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[�g No
❑ NA
❑ NE
[] Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evid ce of Wind Drriif7t ❑ Application
Outside of Approv
Area
&,J.
12, Crop Type(s): Qu'�S
13. Soil Type(s): i V —ma` A �-
3
14. Do the receiving crops differ from those designatcd in the CAWMP?
❑ Yes
®l No
E] NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
TT No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
T No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[P 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
`rte No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [P No ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facili' Number: 2 - Date of Inspection:
❑ Yes
No
❑ NA
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
1p No
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
M No
❑ NA ❑ NE
the appropriate box(cs) below.
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge
levels
❑ Non-compliant sludge levels in any lagoon
❑ Yes
No
❑ NA
List structure(s) and date of first survey indicating non-compliance:
permit? (i.e., discharge, freeboard problems, over -application)
26, Did the facility fail to provide documentation of an actively certified operator in charge?
[:]Yes
No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[)o No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
r,—' No
E] NA
C] NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
2
❑ NA
❑ NE
Comments (refer to question #): Explain,any YE5 answers and/or any'additional;recommendations
1Us6drawings:of
or any other comments
' xia .�A
Facilely to better explainsituations (us e additionatpages as necessary).
V�a'c' iii C.e
`oto — 9 ` c> -- 2
po-r� P r
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
91D_ 9I)a-7"1DO C)
`Q Phone:
Date: 7
2/4/2011

Type of Visit: & Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: � Arrival Time; �'qG�,,, Departure Time: ,0County: 5 ��8^f Region:
Farm Name: old W= Rrro s uc Owner Email:
Owner Name: Abw.k_Etms .a . Phone:
Mailing Address:
Physical Address:
Facility Contact: AL,5'" zez Title:
it
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone: '
Integrator: ,5P;i► ,�e%qr
Certification Number: O .3
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [;@ No ❑ NA ❑ NE
[:]Yes ❑No
[:]Yes ❑No
❑ Yes ❑ No
[—]Yes [� No
❑ Yes ® No
50 NA ❑ N E
['NA ❑ NE
® NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued
Design Current
Design
Current
Design Current
e
km
Capacity . aPop.
Wet Poultry
Capacity
Pop.
Cattle Eapeelty Pop.
to Finish
Layer
Dai Cow
to Feeder
Nan -La er
Dai Calf
r to Finish
f
Dai Heifer
w to Wean
Design
Eurrent
D Cow
tFeed
w to Feeder
Dr Paul#r.
Ca aei
P.o
Non -Dairy
w to Finish
Layers
Beef Stocker
Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
I, III !11
!
Turkeys
r MIN
TurkeyPoults
Other
�wc-r�wmcsrsa� �--�s €s�uarw-�rc amra��a aas���euraa?!^_waw�car�m�
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [;@ No ❑ NA ❑ NE
[:]Yes ❑No
[:]Yes ❑No
❑ Yes ❑ No
[—]Yes [� No
❑ Yes ® No
50 NA ❑ N E
['NA ❑ NE
® NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Faciii Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 2 -
Spillway?: Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 43
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes " No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
F] No
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
M No
Lfw
0 NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NA
❑ NE
the appropriate box.
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Waste Application
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes `7a 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 _O�u_t�sidee of Approved Area
�
12. Crop Type(s): � �r "SS 6Q. � , S, , - 190 gof
d, � , u•t -,A
13. Soil Type(s): _ CrC(d 5 bftvV -6Vi4`1 `7 h -f v(kx / W4CI rte,
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 E]NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes PQ No [:]NA [:]NE
acres determination? 7�
17. Does the facility lack adequate acreage for land application?
❑ Yes
[5] No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
M No
Lfw
0 NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
© No
7®�
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
T
❑ W UP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
M No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stacking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

Facility Number: Z 7, - Z Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
Other Issues
2$. 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? ❑ Yes ® No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes T No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
❑ Yes [P No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA 0 N
❑ NA ❑ NE
❑ Yes [ ` No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes M No ❑ NA []NE
>ax s•
Use drawings of facility to bet' � plaln�situations (use additional pages as, ne al recommendations or an other comment 1 I
q swersiand/ur any addition y
ter!exp cessary}•
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: ?Z/14
2/4/2015

(Type of Visit: 4P Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ! Departure Time: 0 .�County:
Farm Name: f"L �wt5 �Y►C . Owner Email:
Owner Name: 61d Oct k �� L L1' Phone:
Mailing Address:
Physical Address:
Region: /WD
Facility Contact: A't wy Title: Phone:
Onsite Representative: Integrator:
Certified Operator: III Certification Number: A173 V
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No � NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes V No
❑ Yes 1 No
�NA
❑NE
❑ NA
❑ NE
❑ NA
[ NE
i)esign
Current
Design
Current
Design C. en
Sw a
y
Plop,
Wet Pou�ultry
Capacity
Pop.
Cattle
CapacpiwXty1 P,op
aarp
Wean to Finish
I Layer
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
72 0
4,
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr, P,oult ,
Ca acl
I;o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
r-tG—ilts
Non -Layers
Beef Feeder
1_113oars-
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No � NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes V No
❑ Yes 1 No
�NA
❑NE
❑ NA
❑ NE
❑ NA
[ NE
Page I of 3 2/4/2014 Continued

Facil4 Number: 911-2-3 Date of Inspection: /b
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
�No ❑NA ❑NE
❑ No NA ❑ NE
Structure 6
Spillway?:
❑ Yes
No
Designed Freeboard (in):
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
_
Observed Freeboard (in): 37
❑ NA ❑ NE
the appropriate box.
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ;T No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑Other:
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes Z] No
❑ NA
❑ NE
waste management or closure plan?
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis []Soil Analysis
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ®No
DNA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Renuired Records & Documents
❑ Yes
❑ Yes
❑ Yes
No
No
No
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes 1P No ❑ NA ❑ NE
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
5D No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis []Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[� No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes n0"] No ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

F'acility'Number: Rv2Z. 2-3 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(cs) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a AOA 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? O Yes �] No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes P� No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes P No ❑ NA ❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes [P° No
❑ Yes 5@ No
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: A /_T_
2/4/2014

'r
10 Division of Water Quality
'Facility Number- © 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
u i i i u�r r�rrW�
Date of Visit: Arrival Time: t Qw' Departure Time; Fit 1 County: $ kp-5'pri Region:
Farm Name: �m -tI "o V Fa-,�-s r Owner Email:
Owner Name: old 04L FOA -),,As 1:.LC Phone:
Mailing Address:
Physical Address:
Facility Contact: _ l Title: Phone:
Onsite Representative: Cr Integrator: ac
Certified 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
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Non -L
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
�i. Were there any observable adverse impacts or potential adverse impacts to the waters
�'-'he State other than from a discharge?
�e 1 of 3
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[]Yes—
fl
❑ NA
E]NE
❑ Yes
❑ No
NA
❑ NE
[]Yes
❑No
NA
❑ NE
❑ Yes []No
❑ Yes E�)No
❑ Yes Eallo
® NA ❑ NE
❑NA ❑NE
❑NA ❑NE
2/4/2011 Continued

1(iacilit Number: - 2 Date of Inspection: 4
/3
Waste Collection & Treatment
❑ Yes
No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[P No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
1P NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
IT Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
Designed Freeboard (in):
Required Records & Documents
Observed Freeboard (in):�ja
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
MR No
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
the appropriate box.
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[5 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[] Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable
LCrop
,Window
� � ❑ Evidence of Wind �D+riftt ❑ Application Outside of Appr v4 ed Area f
12. Crop Type(s): CGt57rt ►�'. n^"'prR �i-�E �t / � � l}✓ii-� I " i✓Jk 1,-S i r
13. Soil Type(s): �1"�lt� f�� �jqra.— -r/O4f
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
IT Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
MR No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
§a 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 TrInsfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes "�" No
Page 2 of 3
L
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
2/4/2011 Continued

Facility Number: - Date of Inspection: a
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? [:]Yes 5 No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes PM No
Other issues
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[q No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[ No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
Z"
3 I. Do subsurface rile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
J;a No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
[a Yes
No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA ❑ NE
Comments (refer to -question ft Explain any YES answers -and/or .any additional. recommendations: or any; other comments, "
Use drawings of facility.tobetter explain situations (use additional pages.as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
�3'P
Date: q 4'? -fAz
2/4/2011

` A�i
Division of Water Quality „•
Facility Number 0 Division of Sol] and Water Conservation
0 Other Agency
Type of visit: 0 Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: S Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: /;W4 �,, Departure Time: County: Region:
Farm Name: i�va1� S ��� Owner Email:
Owner Name: f� i'�f Phone:
Mailing Address:
Physical Address:
Facility Contact: 14_ilyi� Ae— 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
Boars
Other
Other
ia
91
Latitude:
Phone:
Integrator: A Z. Z C
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non-i.a er I.--- -. .. I Ed
Pullets
Other
Poults
Design Current
Discharges and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes � No [:]NA [3 NE
[:]Yes ❑No
[:]Yes ❑No
NA [] NE
P1 NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [:]Yes ❑No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [a No❑NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters C] Yes I'M No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

Facility Number:Date of Ins ection:
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 rO 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
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[] Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[] Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Approved
Area
12. Crop Type(s):_'jW;)j_4 - . .•t
13. Soil Type(s):GW
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
® No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�E No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
T
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [E No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? []Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

w -
❑ Yes
j�j No
❑ NA
Facility Number: - Date of Inspection:
and report mortality rates that were higher than normal?
j"
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Yes
® No
❑ Non-compliant sludge levels in any lagoon
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
List structure(s) and date of first survey indicating non-compliance:
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
�3 No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
j�j No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
j"
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
[DNA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA
❑ NE
Comments(refer to question #):. Explain any YES answers-and/or;any additional reeominendatlons!or, any other comnnents:
Use drawinos of:facility,to better.explain situations (use additional pages as necessarv):
Reviewerdnspector Name:
Reviewerllnspector Signature:
Page 3 of 3
Phone: gib' - 4V
Date: 6 z
2/4/2011

� � )a€vis"ion of Water Quality
Facility Number ®- O Division of Soil and Water Conservation I
© Other Agency
type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
teason for Visit: 0 Routine 0 Com la€nt 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: { I Arrival Time: Departure Time: �(,� County: S Pspni Region:
Farm Name: /� t f 1 b rook- 1 'tans '1�— Owner Email:
Owner Name: 614 Oak Farmc LLL Phone:
Mailing Address:
Physical Address:
Facility Contact: lea.. 5W l_Qe._ Title: Phone:
Onsite Representative: t� Integrator: M t l,t�o —drown . LLL
r �g
Certified Operator: Certification Number: 37V
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
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 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 5 No ❑ NA ❑ NE
❑ Yes
Design Current
[P NA
es
Dfign Current
Design Current
❑ No
[0 NA
❑ NE
y
Swine
Cap ctty ap.
(.''V1'et'Poultry -'"Capacity
rPop.r` "'"
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Dairy Heifer
Fceder to Finish 2
Farrow to Wean
Design Current
Dg Cow
Farrow to Feeder
l)r,: P,o_ultr
C•a aci Pio
Non -Dairy
Farrow to Finish
Layers
Non -Layers
k
Beef Stocker
Gilts
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Othe
Ur ey Poults
`' a
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 5 No ❑ NA ❑ NE
❑ Yes
❑ No
[P NA
❑ NE
❑ Yes
❑ No
[0 NA
❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes No
®NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 2/4/2011 Continued

Facility Number: 16w, - a3 Date of Inspection: t I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes gg No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure t Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): G Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
Tj
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
® No
E] NA
E] NE
waste management or closure plan?
T
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[;g No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
RM No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E�j No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes T No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): &5' 1 BWMQC t 6465 A A, SM{ iir6,0Vrrwwd ,
r
13. Soil Type(s): WQA17]t+��wQ�. NAA&V uM r1v1AC CTplds '��
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes M No C]NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes EP No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes Q!3 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑Yes LP No ❑ NA
❑ Yes E� No ❑ NA
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes §0 No ❑ NA
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes K No ❑ NA
the appropriate box.
❑WUP ❑Checklists ❑Design [:]Maps ❑ Lease Agreements []Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1� No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Ep_No
❑ NE
❑ NE
q N
❑ NA ❑
❑ Weather C
❑ Sludge Surve;
❑ NA ❑
❑ NA ❑
Page 2 of 3 2/4/2011 Continued

tacility Number: DatI Io
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below. T
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA [] NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? 0 Yes C ] No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes [� No E:]NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or,any iother-comments
Usepdrawings of. facility to better explain situations (use' additional pages as accessary}.
� y"
Reviewer/Inspector Name:
Reviewer/inspector Signature
Page 3 of 3
Phone: 9110_V3 _-F_11100 j
X7
Date: i 12,81t I
2/4/2011

Division of Water Quality
Facility Number J _ a� O Division of Soil and Water Conservation
-- O Other Agency
IType of Visit a Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit; rvZ10 D Arrival Time: ++ Departure Time: �: H, County: —56 Region:
Farm Name: +' l i I I _ro Owner Email:
Owner [Mame: cid 4 i uC Phone:
Mailing Address:
Physical Address:
Facility Contact: aG� STitllee: Phone No:
Onsite Representative: 0Integrator: -�,.Jy\ _
�f/9 39)8
Certified Operator: Operator Certification Number;
Back-up Operator: [ t / Back-up Certification Number:
Location of Farm:
Swine
Latitude: [::] o =' ="
Longitude: ❑ o =, =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer 1 11
❑ Non -La er I J1
Other
❑ Other �_�.J
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
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?
Pai � ge 1 of 3
❑ Yes 'P No ❑ NA ❑ NE
❑ Yes
❑ No
FNA
❑ NE
❑ Yes
❑ No
[5] NA
❑ NE
NA
❑ NE
❑ Yes
❑ No
❑ Yes
EpNo
❑ NA
❑ NE
❑ Yes
1p No
❑ NA
❑ NE
12/28/04 Continued
J

Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 1h No ❑ NA ❑ NE
❑ Yes ❑ No a NA ❑ NE
Structure 5 Structure 6
❑ Yes ;F1 No ❑ NA ❑ NE
❑ Yes ,!] No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [21 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 Pj No ❑ NA ❑ NE
maintenance or improvement?
Waste Ammlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes M No [3 NA [3 NE
maintenance/improvement?
11.
Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes
W No [INA
❑NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [:]Heavy Metals (Cu, Zn, etc.)
12128104
Continued
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑`Evidences of Wind Drift ❑ Application Outside of Area
12.
r
Crop type(s) t8 t 1Q (Wa., 7.. '1� 0VL✓S�2G{� C-t�►-k Str'7b
13.
Soil type(s) JA -)a t /rl ��A
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
P No ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
[P No ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
[] No ❑ NA
❑ NE
Comments (refer to question #) txplatn atiy YES answers andltir any;recommendations or any other coments
e ..Y � I to ima ill i N".
Use drawings of facility b'etter'ezplain � situations (nseytidditional pages as necessary.);
Reviewer/inspectorName ���illu�l-�'��
i
Reviewerhnspector Signature:
°� ��� �, "" d 7 u '�N � ��
r tW . ;
Phone:
Date: /$ 1zofv
Page 2 of 3
12128104
Continued

Facility Number: — Date of InspectionlYj/Lo110
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ((� No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists❑ Design ❑ Maps ps ❑ 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
FNo
[:1 NA
El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
9No.
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[P No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes®
No
El NA
❑ NE
and report the mortality rates that were higher than non -nal?
l
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
1PNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes®
No
ElNA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
e
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
M No
CP
El NA
[:1 NE
33. Does facility require a follow-up visit by same agency?
El Yes
No
❑ NA
❑ NE
Additional'Coniments'�a�nd/osrDra�vin s - '; ''r�se
Page 3 of 3 12/28/04
Page 3 of 3 12/28/04

Facility Number
* Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency I j
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I Arrival Time: .� Departure Time: County: Sot% Region: -1k='• ---
Farm Name: I' _Aywo _ PkVI`5 5k' Owner Email:
Owner Name: D k4 Oak " S LL C Phone:
Mailing Address:
Physical Address:
Facility Contact: M"4 ` wo
Title:
H
Onsite Representative:
k
Certified Operator:
l j Phone No-,
Integrator: rr10 H, LLC
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Latitude: ❑0❑,0" Longitude: ❑o❑, ={1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
11 ❑ Layer
❑ Non -Layer
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ qLa Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl I
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 .9 No ❑ NA ❑ NE
❑ Yes ❑ No 09 NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes ❑ No �S NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes O No []NA ❑ NE
12128104 Continued

Facility Number: - Date of Inspection LL�LJ
Waste Collection & Treatment
4. Is storage capacity (structural plus stone storage plus heavy rainfall) less than adequate? ❑ Yes SjNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �D NA EINE
Strur,ture I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: f
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in); O ?
5. Are there any immediate threats to the integrity of any of the structures observed'? ❑ Yes IRNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes PP 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 PSNo [INA ❑NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes (&)No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes CR No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ca ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 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
13. Soil type(s) LAbA rna,,,, —{JAZ , M V" r\ —
V -
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
N No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
NNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
M No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
R No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
FlNo
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): I
L
er/Inspector Name Phone: 9W --K33 `33bQ
wer/Inspector Signature:MEL,Date:
12/28/04 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes NfNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ,V%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. ❑ Yes Jallo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
§allo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
;-No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
&No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ONo
❑ NA
❑ NE
2T
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
t'NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
J�PNo
❑ NA
EINE
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
[5,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
PSNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�hNo
❑ NA
❑ NE
Page 3 of 3 12/28/04

x ivtsion�af Water Quality
FaClltty :Number 8� 4 ODlVlSlon of Soil and Water Conservation
� D;Other'Agency.
1 k
Y
'R
{; f
v i
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit *Routine O Complaint O f=ollow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 1t 0'7 Arrival Time: t'1 :30 Qr, Departure Time: County: ' 2k2ego Region: E&e
Farm Name: _ _iili Ibro fir- , a� _ Owner Email:
Owner Name:. /`� << 1�_ Phone:
Mailing Address: 314 r-pX Lake.. Dr, , CI e'rl4h /l G
J
Physical Address:
Facility Contact: QrS�.Q�I Lee. Title: Phone No:
tl
Onsite Representative: Integrator: _ArPL
Certified Operator: t t Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =0 =4
=61 Longitude: = ° = I =
Swine
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other .
❑ Other
Design Current Design Current
Capacity Population -Wet Poultry. Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle ,.Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dai
❑ 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 EpNo ❑ NA ❑ NE
❑ Yes ❑ No [B NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No 09 NA
❑ NE
❑ Yes IPNo ❑ NA
❑ NE
❑ Yes ERNo ❑ NA
❑ NE
11/18104 Continued

Facility Number: — 3 Date of Inspection 7 f b
❑ Yes
�No
Waste Collection & Treatment
[__1 NE
15. Does the receiving crop and/or land application site need improvement?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
§�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? '
❑ Yes
❑ No ?NA ElNE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: I
No
❑ NA
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Designed Freeboard (in):
❑ NA
❑ NE
Observed Freeboard (in): 3to
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
No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
[Yes
T'
❑ No [:INA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes�No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[� Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Apolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
KNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
E[No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�No
El NA
[__1 NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
�gNo
❑ 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
$a No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
7. u7ey d i. meas a,rauj b o`f� (asaov�c.
FewVA t �l icy. (1ec9--4s
Reviewer/Inspector Name �e_ Phone: t 7/0 J 00
Reviewer/Inspector Signature: Date: /
IW8104 Continued

i . ',-
Itacility Number;a Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes g No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 10 No ❑ NA ❑ NE
the appropirate box. ❑ WDp ❑ Checklists
❑ Design El Maps El Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes PiNo ❑ 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 A No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'?
❑ Yes
� No
❑ NA
El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ff[No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ffNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
®No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
BNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29,
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
N 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
�jNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3. 1.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[�rNo
❑ 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
[9 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[gNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
12/28/04

I
�'- Ha3
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: � � Arrival Time: �� Q Departure Time; D.`QO County:_ Region: _
FarmName: Owner Email:
Owner Name: di OakjY�wt5 LLC_ Phone: 11D "6'g2-�t(yo (
Mailing Address:
Physical Address:
Facility Contact: MTitle: Phone No:
u
Onsite Representative: Integrator., f r l GU'h Orow iN
Certified Operator: tq Operator Certification :Number: 11? 3i8
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 =g Longitude: =o=, ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population .
❑ Daia Cow
❑ Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures::
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
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?
Page I of 3
❑ Yes 09No ❑ NA ❑ NE
❑ Yes ❑ No 1- NA
❑ NE
❑ Yes ❑ No NA
❑ N E
❑ Yes ❑ No NA
❑ NE
❑ Yes [;R No ❑ NA
❑ NE
❑ Yes ED No ❑ NA
❑ NE
12/28/04 Continued

Facility Number: e�3 Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: o�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �r l u
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ONo ❑ NA ❑ NE
❑ Yes ❑ No t2NA EINE
Structure 5 Structure 6
[--]Yes IgNo ❑ NA ❑ NE
❑ Yes KNo ❑ NA EINE
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 6No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes KNo ❑ 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 'g,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 K 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
ip No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
91 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[--] Yes
9No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
t&No
[:jNA
C1NE
18. Is there a lack of properly operating waste application equipment?
[:1Yes
9 No
❑ NA
❑ NE
lO f�Km' 6vqkc"$
Reviewer/Inspector Name ` ' f Phone:
Reviewer/inspector Signature: Date: 1116
Page 2 of 3 12/18104 Continued

• 4
Facility Dumber: Date of Inspection 1111
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? []Yes K No [INA ❑NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA EINE
the appropirate box. ❑ WDp ❑ Checklists
❑ Design ❑Maps [3 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 [3 Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge'? ❑ Yes 9 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes K]No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
W No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
99 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
OgNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
25No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
F No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
MNo
❑ 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
5No
❑ 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
)UNo
❑ 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
JB No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,'Q No
❑ NA
❑ NE
Addltianal Comments xndlorrDrawings. NM
w
Page 3 of 3 12/28/04

i�
Type of Visit 0 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: it % �� Arrival Time: Q Departure Time: p ! C0Q ^ County: .SD N
Farm Name: Ukrnok
syn 1Avrrm s- ' C Owner Email:
Owner Name: ` f t W1 i r ! [Q7T f►t S Phone:
Mailing Address:
Region: )9010
Physical Address: -
Facility Contact: W` T `'ra_ • S Title: Phone No:
Onsite Representative: w• _ ..S Int grator: r " —4-12 r
Certified Operator: 77, ----- -HA, 51
Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = 0 ='
0 Longitude: 0 ° =' 0 "
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Design Current
0 No
Design. C►urrent Design Current
❑ NE
Swlne
C►apacity Popnlatiou
Wet Poultry
Capacity Population Cattle Capty Population
❑ Wean to Finish
❑ Yes
❑ Layer
�NA
❑Dai Cow -
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ Wean to Feeder
® NA
1
❑ Non -Layer
c. What is the estimated volume that reached waters o£the State (gallons)?
❑Dai Calf
ER Feeder to Finish
0 (�
❑ Yes
❑ Dair Heifer
❑ Farrow to�Wean
❑ NE
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
[:INA
❑ NE
❑ Non -Dairy
❑ Farrow to Finish
4 N
❑ Layers
❑.Beef Stocker
❑ Gilts
❑ Non -La ers
.�
❑ Beef Feeder
❑ Boars
Page 1 of 3
❑ Pullets
❑ Beef Brood Cow
Other
i
❑ Turkeys
❑ Turkey Poults
-r.=
�*
❑ Other
❑Other
` Number of'Struc ures:
wo
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
0 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made? 4
❑ Yes
0 N
�NA
❑SNE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
® NA
1
❑ NE
c. What is the estimated volume that reached waters o£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
f�No
[:INA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
4 N
❑ NA
EINE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: Date of Inspection I iaj/�g
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: o2
❑ NA
Spillway?:
15. Does the receiving crop and/or land application site need improvement?
Designed Freeboard (in):
1� No
r
Observed Freeboard (in): 32- � j
❑ NE
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.)
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
fqNo ❑ NA El NE
through a waste management or closure plan?
No
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
[$ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
® No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
❑ NE
9. Does any part of the waste management system other than the waste structures require ❑ Yes
C�.No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
rZ No ❑ NA ❑ NE
Jai
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below, ❑ Yes
1KNo [INA ❑ 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 El Evidence Drift ❑ Application Outside
nofWind !of -Area
12. Crop type(s) �1'� I.tf o 44" t 5A4q`(; V" , c"', , WAA4 so, /NL 's
13. Soil type(s) VV
Lt
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
1� No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
71 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
No
❑ NA
❑ NE
Comments (refer. to question ft Explain! any.YESanswer' s and/or anyrecommendati6ns or-an"yother comments. `.
.Use drawings of facility to better explain',situations (use additional�pages as necessary.):"
Reviewer/Inspector Name F T -- --� Phone:(210) 3 3t�
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/04 Continued

Facility Number: fia — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes FR f No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes N No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists
❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 17 No [INA El NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
V No
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
UNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
A No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ER No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
N No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
$5 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ER No
❑ NA
❑ NE
AdditionW.Comments and/or,Drarvings:
AL
�jcce [�Cc ilcc&yds,
Page 3 of 3 12/28/04

t
L
f Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
n for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: �/ �Jf Arrival Time: 'd Departure Time: County: _,San Region: FAD
Farm Name: -r-da 46 r SV Zir c. Owner Email:
Owner Name: k!. %`, _- __ �a Phone: /irwrC
59,E 3s?o
;Mailing Address: E -2.1c lC1 1 i' __Rdacz /1' � M NL
Physical Address:
Facility Contact: L✓• T, /W& AJ Title:
Onsite Representative: W. / . 5 _
Certified Operator: (4z 1r,
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
LJ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Coll
Phone No: �_l0- O tin
Integrator:
Operator Certification Number:
Back-up Certification Number:
=0 =&Lam" h ❑° Com` D"
Latitude: Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
1' ❑ Non-Layet
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
[-I Turkeys
1E] urke Poults
❑ Other
Discharizes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made`?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ DEy Cow
❑ Non -Dai
❑ Beef Stockei
❑ 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 Lligo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
ED -No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
11/28/04 Continued

Facility Number: ga — 1 3 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: .r 2
Spillway?: tiy o
Designed Freeboard (in): /_9; -r—
Observed
Observed Freeboard (in): .3 3 IF
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 2Vo ❑ NA ❑ NE
❑ Yes [j No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 2'�o ❑ NA ❑ NE
❑ Yes Ea No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes []"No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
QTNo
❑ 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
DoNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2'1 o
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect 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 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ElEvidence of Wind Drift [:1Application Outside of
•
Area
-746 3e. 7 % Yd
i&L
12. Crop type(s) Pre/g, SMgt%f�aeu:_ Gem., G✓.is�_/—--
13. Soil type(s) If 6,,9
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
BN o
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
9•I5'o
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[--]
Yes
❑ No
❑ NA [CLAVE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA B NE
18. Is there a lack of properly operating waste application equipment`?
❑ Yes
911 o
❑ NA ❑ NE
Mi. / IR/fry�f iS Ws�fl�.�� O�1 pa/� GItP3 d/pVw� IAwG0�1 i�
ector Name 4' f
Reviewer/ins
p c Phone: q/U-4eel;7�0
Reviewer/Inspector Signature: Date: L •/3 O
12/28/04 Continued

Facility Number: - P3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑-wzo- ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MX ❑ NA ❑ NE
the appropirate box. ❑ ❑ Chec is ❑gn ❑ M❑ O�
21. Does record keeping need improvement? If yes, check the appropriate box below. 2111yes ❑ No ❑ NA ❑ NE
❑ -WetateAppliemiop ❑Wye -Free/ l ❑ �5 ❑ ❑ ❑
❑Il_ ❑ &eckinli (<rop Yield ❑ Rain Inspections ❑
22. Did Did the facility fail to install and maintain a rain gauge`?
23. If selected, did the facility fail to install and maintain rainbreeakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipmera 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?
❑ Yes
0.3�o
❑ NA
❑ NE
❑ Yes
[Zj Qo
❑ NA
❑ N E
❑ Yes
P -M-5
❑ NA
❑ NE
❑ Yes
E -No
❑ NA
❑ NE
❑ Yes
[U -Ko
❑ NA
❑ NE
❑ Yes P"NO [INA ❑ NE
❑ Yes a<o ❑ NA ❑ NE
Oyes E?iI o ❑NA EINE
❑ Yes
[?f�0
❑ NA
❑ NE
❑ Yes
[2rNo
❑ NA
❑ NE
❑ Yes
QONo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments andl6r Drawings;V
al.,oleo s e ktep a eraio 7,,'�i'a( �ar►h.
I ICas� in,�wl " Frea4,oj G�arT icos
!2128/04

Il..tz�s:�t!� �;i:"I,'�=�y,�-�.S:is.?.'�i(sY; f'�'�1xi?� .3. � ?.S �i'.�'•,4'xS�:ii��C3�.S�Ja <{ ��I."7�'_' •k�ris..ki.r,l:..,� -u:i. . ,.:.�:� .. - i<.: i r ... +.. , _ e .. S _ , y:.: N x-:�3 ,.. �� ,. ,'�1' . :x ., I I
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit *Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Datc of Visit: 7 9 0 Time: a 5 5-
Facilih• lumber �3
�,,,��� 10 Not Operational Below Threshold
Q"Permitted 0,16ertified U Conditionally Certified ©Registered Date Last Operated or Above Threshold:
Farm ]lame: .# r e Fa r M S County:
Owner name: I✓• T. /lia its s Phone No: _ '110 ` 9%2 — 3 S "Iii
Mailing Address: �! ��. N '2A
Facility Contact: W T. MAIIA,' s Title: Phone No:
Onsite Representative: Integrator: 'Clown V / Car l"'?
Certified Operator: W %�'a,� T _ccn h, t Operator Certification Number:
Location of Farm:
M.6wine ❑ Poultry © Cattle ❑ Horse Latitude ' i � Longitude ' �
Design Current
Swine rnnnrity Ponulation
Wean to Feeder
U�Keeder Finish I 6 iffoO
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons l �. l
Holding Poads I Solid Traps I
Design Current Design Current
Poultry Capacity Population Cattle Ca acity Population
❑ Laver El Dairy
❑ Non -Laver I I ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
id W
YL ►scharge & Stream [Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is obsenTed, 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, notif , 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 & Tnearment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Identifier: l a.
Freeboard (inched: In
�
❑ Yes 2N0
❑ Yes [2No
ElYes O No
❑ Yes DNo
❑ Yes �No
❑ Yes E(No
❑ Yes &No
Structure 6
05103/01 Continued

Facility Number: _2 —�
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Ael'INud & . S m a I[ bra, n , WeJ, 50Y Le
❑ Yes ®'Io
❑ Yes 040
❑ Yes 2<0
❑ Yes ❑'f4o
❑ Yes ❑-Ko
❑ Yes M o
❑ Yes Leo
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
UA
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
04o
b) Does the facility need a wettable acre determination?
❑ Yes
[-4o
c) This facility is pended for a wettable acre determination?
❑ Yes
�o
15. Does the receiving crop need improvement?
❑ Yes
1140
16. Is there a lack of adequate waste application equipment? ❑ Yes 914l
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 21go
19. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 214o
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes [T&o
Air Quality representative immediately.
`tRrr9aliYtlFrtu'' :.II:Y`B;:Yp ;i'::$'lii `.::,,.J.;CIc'l ',ry �._,�..'J ,t., 3, xv`.lY;'01ii'130 ....;i ..�,:.t,.x. .i.S ..3.: .lJt:La,.,.., 'a.r,zf, i.J,:... , .MAIt1L'P •^iNa�'��li
Comments [refer�ta,questton #}.J} Explauu any YES,answgrs and/or atty.recammendattoas.ar any,other comments: II.�,,,,'1 f1!
1>: S}�.�5_€,iuf, •'' . 11i1:s ' 1 1 ai; a tNiS'J1• 'I' 1..rv� IJ 7.. ti `ill#s�...,.„tN'. if€."f .._ .... .,., f .a �}iFJ 1 1 1 } - ;!•i
iLise draw�egs,of facility to;better1sezplafn siWations ,{use additional pages as necessary) iii?; ` [s�.Field Co [:1 Final Notes
ryr uaI S 'J ;: Ij. F J :. 31 Vis) 3i' t a.r : , �:,€ " i , ! IE} 1: ,} i 1 'i: r ,# , {f < .:a: s uj 1 i; , F� s., Copy
'ry £-rFFi :'l}} 1S,{�.s tl�:((..,,Iflll;_F jjr�lf'.. Ilri€' S: .SI I 'Sf� CJS {F{j� F" -'£.F. e'f���J�{{j: �q)N�`'i'I�SF €fj f.{' �. FliE�'V s�.� �i j Ij �,,.1 E - J Jh F�� �If1!fJ IIYN ��.1. }�tf5! 1.}:'�IFJi f.:��: �,�ll l 11 MF 1 '
I.:i:3?e. f1,113�1�Yz9>1...311i<u ...IfE.fie.3j`;jFd.l'.�Iriif lli}s:�f. Y£1 ..fIIF.fF.+J. •. L.YI. q:-OI1.13.17 .:'Hrr,..�.ses.. ji�l. S£J. fY..11: .:.i F..?e.le Fr. .'N..�Y'.4)€!>.rf.. I .3, .:.<3:. .. S_s € ..!". ..i 3.J .f.1.
Mr. l//!1s ,s rKa�le;,' 49 eSta�1 4 gloe/ glass ceve,-
Se is arovn•/ /125 aery,
Reviewer/Inspector Name er.0 }' I " €{ 1€ '
Reviewer/Inspector Signature: 132&k Date: 'y - 9-o k
12112/03 Continued

Facility Number: Y.2 --j Date of Inspection 4-0
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? Q Yes ❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ice s s, de�igrt�p etc.) ❑Yes [j,Fdo
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q>o
❑ VANWAPPheaftTn-.P FreeboM 0 ha nisi ❑
24. Is facility not in compliance with any applicable Setback criteria in effect at the time of design? ❑Yes o
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
M -No
25.
Fail to notify regional DWQ of emergency situations as required by General Permit?
ev,'elveJ Crop Y,'ofv( tcor,,s
�10
HaS Comple>< 1OL4 T Seel Ted,"9 �or ' A� t y ep/
(ie/ discharge, freeboard problems, over application)
❑ Yes
27.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
0140
28.
Does facility require a follow-up visit by same agency?
❑ Yes
14N/0
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Q No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
2 -'mss
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Gy 10
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
CR"�o
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
+2 -Ko
34. Did the facility fail to calibrate waste application equipment? ❑ Yes Mwo
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑'Suw iu� ❑ Crop Yield Form ❑ ke nfalf ❑
❑ ❑
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
dt�-- 1
dditiiarial ra �t , � r�
'i..3:...:�
;€
3 ,
EJI, /1}r /nn %t S �arPd >r 1►e COC ano� ie°rms'l- was �� S douse. 2.�sPi-c or
•
Ma:l 0110 Aer Copy o f e17C�+�
ev,'elveJ Crop Y,'ofv( tcor,,s
HaS Comple>< 1OL4 T Seel Ted,"9 �or ' A� t y ep/
12112103

Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
General Information. 1
Farm Name: Coonty:."Sa=f_s-�
O wr Name:_ Cne (t oty-N-_ /)I p, L, r — _ _ done No: $ — S/
On Site Representative: �o� _ a �wso« _Integrator,ROC—_
Mailing Address: _ 'R4- 2L Q�azs 3C. -
Physical Address/Location:—CLL— 15-2 1.90 l r_e��r
Latitude:_ / 1 Longitude:
Qnerat{on Dgsrb on: (based on design characteristics)
Type of Shine No. of Anirnak 7pe of Poidoy No. of Animals type of Cank No. of Aniff+ais
O sow . O Layer D Dairy
O Nursery 0 Non-Lay+ez G Bea(
0 Feeder
ether s o Livesrocie t Number Ani+nals: (o q j o
Nwaber of Lagoons: (include in the Drawings and Observations the freeboard of each lagoon)
Is a dwelling located within' 200 feet of waste application?
Is a well located within 100 ftet of waste application?
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Ia animal waste land applied of spray irrigated within 25 feet of Blue Line Stream?
AAI — 7arau717JM
Yes O Nom?
Yes 0 . ,NQ,O
Yes O No,i
Yes Q No -d
.w.
Lagoon
• Is lagoon(s) freeboard Iess than I•foot + 25 year 24 hour storm storage?:
Yes O
Nodw
U seepage observed from the lagoon?:
Yes 0
Nogf
is' erosion observed?:
,Yes Cl
NoXf
Is any discharge observed?
Yes O
Na
Q Manmade Q No: Man-made
Cover Crop
Does the facility need more acreage for sprayi S?:
Yes 0
No,,d
Does the cover crop need hnprovement?:
Yes 0
. No �l
( liar the crops which need imp enreA0
r
crop type: (�o� s� _ - - Acreage: .
Setback CrUcHa
Is a dwelling located within' 200 feet of waste application?
Is a well located within 100 ftet of waste application?
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Ia animal waste land applied of spray irrigated within 25 feet of Blue Line Stream?
AAI — 7arau717JM
Yes O Nom?
Yes 0 . ,NQ,O
Yes O No,i
Yes Q No -d
.w.

Maintenance
Does the facility maintenance need improvement? Yes D Na
Is there evidence of past discharge from any part of the operation? Yes D NO2(
Does record keeping need improvement? Yes D NO D
Did the facility fait to have a copy of the Animal Waste Management Plan on site? Yes D NO D
Explain any Yes answers;
Signature: - - 1�3-�•� �.,.-} - - _ Date:
cc F=91ty &sessmeu Unit Use Mrachm na V JVeeded
Drawinga or Observall ILY�
Pf
alb
e.��
3 '
• 1
' � .. ... .•rte - ._.� r�.r
{.moi/Yi '�rJ :w•t • � .,, _ .. l+nAr'1r��r�. r�•.r• �•r �r�. JL' `frr�+.A �r.�.•�arr � `�. .�� 1f...,
' •f �� ► • « • +y•'.�'... n•en ;.1•w•�• 'n •,w7 t : {• •�!.•• • /. �•rrwrr•r►.• n .r . ..
r
AOI — 7anuw7 1740% .

Site Requires Immediate Attention: %
Facility No. 07--S34
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
Farm Name/Owner:.
Mailing Address:_
County:
Integrator:
On Site Representati
Physical Address/Lo
DATE: t , 1995
Time: lt:3s A1+ -
7!=FL=tea
9MY_.
Phone:_ - 3S:2o
_ Phone:
.o r.4-rspt4i'm e�.T -d lilt,
Type of Operation: Swine 1cc Poultry Cattle
Design Capacity: S'tir's ; Number of Animals on Site: ZO
DEM Certification Number: A DEM Certification Number: ACNEW
Latitude• Longitude• '
Circle Yes or No
Does the Animal ' Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) d3s or No Actual Freeboard: 2 Ft.'—Inches
Was any seepage observed from the 1a oon(s)? Yes o>dD Was any erosion observed? Yes or No
Is adequate land available for spray? or No Is the cover crop adequate? (yi�or No
Crop(s) being utilized: _ crops t-Co�L
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? dDs or No
100 Feet from Wells? ds or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or&&
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes ordW If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage withver crop)? Yes o<9
Additional Comments: T4 a- _�1�s_*r�_-;orw► -
��cc�►a+► `7
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

,.f Site Requires Immediate Attention: _ILI,^
Facility No. a 531
-
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE:0 2- , 1945
Time: t1,35 NA
Farm Name/Owner: j.7L 2jjHa.S
Mailing Address: 5 i 6ts tlL
County:
Integrator: Phone: (alio) 51Z 35 7o
On Site Representative: _Curt e Zw, rw, c.k Phone:
Physical Address/Location:.j-4 m 1h Co,%4- �4a. &Atrseckan - ##- pit's . Gam_ I_ -A j�& JAW, 191�y
Type of Operation: Swine .� Poultry Cattle
Design Capacity: i Number of Animals on Site: szo +rfad 1.a.. L
DEM Certification Number: A DEM Certification Number: ACNEW
Latitude: ° Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
{approximately l Foot + 7 inches)
es or No Actual Freeboard: a- Ft. o Inchesk10WC4)
Was arty seepage observed from the agoon(s)? Yes or& Was any erosion ob ed? Yes or
Is adequate land available for spray? 0-s ar No Is the cover crop adequate? "or No
Crop(s) being utilized: ow o
Does the facility meet SCS minimum settack criteria? 200 Feet from Dwellings? or
100 Feet from Wells? �0 or No
Is the animal waste stockpiled within 100 Feet of USGS Blue -Line Stream? Yes or&
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line:
No
Yes or
Is animal waste discharged into water of -the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o If Yes, Please Explain.
Does the facility maintain adequate waste management records (voLumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes orQ§0)
Additional Comments:— re is ,- its re.�_ J&rm . T^ oygtgL �_ t4 Qd sy+aPe.
^.
Mr. illA.' LI:g it- 1,'..%6A LaA-1-rtl,.G+
Inspector Name
�:Zj
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

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