820054_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental QuA

FZ1
Reason for Visit: Routine O Complaint O Follow-up Q Referral Q Emergency O Other 0 Denied Access
Date of Visit:Arrival Time: 84 Departure Time: County: cS' h off%
Farm Name: M e,ih-_Y►tiy L&f Owner Email:
Owner Name: rl 041e. (0 'y1 (i Phone:
Mailing Address:
Physical Address:
Facility Contact: C"+15 6ayurd' ` Title:
Onsite Representative:
Certified Operator: s Geo
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region:
Integrator: ICA (S 75 _
Certification Number: 0 _
Certification Number:
Longitude:
Design Current
Design
Current
Qeslgn Current
ty
ltry
Capacity
to Finish
La er
Dai Cow
to Feeder
Non -La er
Dai Calf
to Finish 1 6
Dai Heifer
to Wean
Design
Current
D Cow
to Feeder
D , P,oultr,
Ca aci
Ao
Non -Dai
to Finish
L
La ers
Beef Stocker
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Turke s
urke Poults
Other
Discharges and Stream Imnacts
1. Is any discharge observed from any part of the operation? ❑ Yes NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes [] No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes []No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No L7 A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [ qo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 0"NNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 214,12015 Continued

Facili Number: - Date of Ins ection: 0-1. --c
Waste Collection & Treatment
4. is store a capacity (structural plus storm storage plus heavy rainfall) less than adequate? [] Yes 7+11o_
1`o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [ ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): S
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
LQK'o ❑ NA
❑ NE
waste management or closure plan?
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
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
❑'1-0 ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
14. Do the receiving crops differ from those designated in the CAWMP?
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[f go ❑ NA
❑ NE
maintenance or improvement?
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �Io
Waste Application
❑ NE
acres determination?
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
2 -No ❑ NA
❑ NE
maintenance or improvement?
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes [g No
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload [] Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s): C r3 a
13. Soil Type(s): (fa 1k 0!4
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 l_f �''o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �Io
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes [DNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes [g No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [j N ❑ 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 ❑.3Qo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [] Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes No ❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: - Date of Inspection: u.ve—
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ 10 ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes CB"&o [DNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes []'iw ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes EKo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
/
[B110
❑ 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
[R<o
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[nl�o
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[:4<o
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Ek<o ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative? ❑ Yes E j o 0 NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ YesFj__No ❑ NA ❑ NE
Commentst(refer"to qui:stlon #)-3Ezplain anysYES answers and/or"any addit€onol recommendatlons orluny other comments
5 a»Y Ned �rtadL .. a� i, # . #;iir
1J`srawings�aftAcili_' ;tabetterex la situs sI( usea.dditlona�l,paes as, necessa , J �,
- quo-3o$-6esr
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
L
Phone:
Date:
2/4/2015

vlc c I r7 A&, r 7_Wit-
iV l-sion of &ater RFfflferG
Facility Number - © R Division of Soil andnservation
� Other Agency
Type of Visit:om liance Inspection Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up 0 Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: vd t County: Region: T[
Farm Name: N p �C�d+til fltiq �ii VCL�Ja( t1I+� Owner Email:
Owner Name: Tr, ,1 ..�-.v� {a I'k _e _ Phone:
Mailing Address:
Physical Address:
Facility Contact: CG �� 3ar�[yi C% Title:
Onsite Representative: f
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: V(1?5
Certification Number:
Certification Numher:
Longitude:
Swine
Design I
Capacity Pop.. Wet Poultry Capacity Pop.,
C*attle
IDesign Current
Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non l a er_
Dairy Caif
Feeder to Finish
C �� ;I ,� ¢� y[ �' `
L
j�iKp�` I' �IY9J I7 IIIb II
Dai Heifer
Farrow to Wean
kcrt l'Ia t Design' rren t
Cu
Dr Cow
Farrow to Feeder
ti '4 ifs z +f . o
wD ltraC.a acct , Y
Non-Dairy
Farrow to Finish
Layers
''4i^
Beef Stocker
1
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
'�?
Beef Brood Cow
M
�k
lit
ther
_ TurkeyPoultS
OtherOther
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'? (Ifyes, notify DWR)
e. What is the estimated volume that reached waters ofthe State (gallons)?
d. Does the discharge bypass the waste management system'? (If yes, notify DWR)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ NA ❑ NE
Yes ❑ No EJITA ❑ NE
❑ Yes ❑ No [g -N--❑ NE
❑ Yes ❑ No
❑ Yes [E]No
❑ Yes jfNo
[ ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3 21412015 Continued

Facility -Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [EFNV--0 NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No E3 -N -K- ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[2-<o
❑ NA
Spillway?:
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E],110
❑ NA
Designed Freeboard (in):
acres determination?
Observed Freeboard (in):
17. Does the facility lack adequate acreage for land application?
❑ Yes
�lo
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
to
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
Required Records & Documents
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?
20, Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
E3<o
❑ NA
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
[3' 1`a
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit'?
[] Yes
LTJ ' o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
EYINo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
to
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No [] NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 3 S 6 ry I4 f-
13. Soil Type(s):
G0
❑ NE
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Q-46__
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[2-<o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E],110
❑ NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�lo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
6No
❑ NA
[:] NE
Required Records & Documents
19. Did the facility fail to have the Certificate of'Coverage & Permit readily available'?
❑ Yes
E34
❑ NA
❑ NE
20, Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
E3<o
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
2l. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E3<o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [] Weather Code
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge'? ❑ Yes ❑ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes d] No ❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes F— fro ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge'? If yes, check ❑ Yes CTNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey O 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 F],Ko"� ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes l5'" o ❑ NA ❑ NE
0 Yes No ❑ NA ❑ NE
❑ Yes CfNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes []No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes [D '''o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [3'lqo— ❑ NA ❑ NE
, q and/or. any, l recommendations or any other comments.
. Explain, Commetts (re er to,� west on p y YE answers additional ona
Use drawingko'f facill. ` to;better ex` l>tin situad6ut (use additional a es as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
cf� vv-us-.-6e-S(
Phone: 7(0--133`333
Date:
21412 15

wks Vi k.�iD
,vision of Water Quality
Facility Number - O Division of Soil and Water Conservation
o Q Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 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: County:
Farm Name. t'~d2' %�� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Cu 4, �3 eV AOPTitle: Phone:
Onsite Representative: tt' Integrator: e 6 — IT
Certified Operator:
Back-up Operator:
Location of Farm:
M,TIM
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Region: PTCO
Certification Number: / 7 M
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Laver
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 ❑ NE
❑ Yes ❑ No ENA E
❑ Yes ❑ No �A E
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [:]Yes [] No ❑'NA 0 NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [?'go ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Id Of
Facility Number: - Date of -CP�D LKS
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [3 -blame ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [aN.6— [] NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [QIqo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes �o ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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
1:201�o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[ff'No
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[;[*�4o
❑ NA
❑ NE
maintenance or improvement?
❑ Sludge Survey
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[24o
[] NA
❑ NE
maintenance or improvement?
1 t . Is there evidence of incorrect land application? If yes, check the appropriate box below.
[] Yes
13<0
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 ibs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved
Area
12. Crop Type(s): r x-"
13. Soil Type(s): )nox
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[2"'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2rNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ff"No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
[:]Yes [EI'No ❑ NA ❑ NE
❑ Yes ETNo ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[3No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
/ZNo
❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists [] Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[ff'No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard [3 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 [1"�No [DNA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ["No ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

i
Faciliq Number:- Date of In ection:
24. Did thi facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [S-ilo_ ❑ NA ❑ NE
25.1's the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ❑ PK ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [;I.ND- ❑ NA ❑ NE
Other lssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
L2090
❑ 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
C3-113-
❑ 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
�
❑ 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
[g -Kb
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�o
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
Vo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Cj�Ao
❑ NA
❑ NE
Comments (refer, to.:;question #) Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional ages as necessary).
Lb ""'t `8�, `r 7 `— 1
�
�c p - b 1 S o-. Y P-- Y b f � 3 .
Reviewer/Inspector name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
2/4120

Facility Number -
411 1 5
0Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: C. Regions {1
Farm Name: I +W T ,LA U &M& Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: C5 1C1✓`C,y t✓ Title:
Onsite Representative: 1�
Certified Operator: Sa VK ] ?i0e
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
Boars
Other
Other
Latitude:
Phone:
Integrator: P4(�
Certification Number: [' 7 0 q7(
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Nan -La er
ory rouitry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Discharees and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop,
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes E>6 --n NA ❑ NE
L
[]Yes
❑No
r:rNA
❑ NE
❑ Yes
[:]No
�i
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑'<A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [—]Yes [3 -No NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [�rNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

Facility Number: Date of Inspection: Ir-
v
Waste
r -
Waste Collection & Treatment
4, Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes -No NA[:]NE
a, If yes, is waste level into the structural Freeboard? ❑ Yes ❑ No 2 -NAS
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
[] NA
Identifier:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[A -lo
[3 NA
Spillway?:
Renuired Records & Documents
No
Designed Freeboard (in):
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[]
❑ NA
Observed Freeboard (in):
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E2'lo
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
fo
❑ 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
ED -N-6
❑ 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
[4-1 o
[] NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[],NV-
❑ 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
EE IC
❑ 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 [a'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? ❑ Yes ED -No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [El"5o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [ErNo ❑ NA 0 NE
acres determination'?
17. Does the facility lack adequate acreage for land application?
❑ Yes
L7 110
[] NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[A -lo
[3 NA
❑ NE
Renuired Records & Documents
No
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[]
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E2'lo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Docs record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking C] Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 01 o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ?NNo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 214/2011 Continued

Facility Number: jDate of ins ectlon:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [;Ko ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ YesNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [D 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)
❑ Yes CI'No ❑ NA ❑ NE
❑ Yes C]"No ❑ NA ❑ NE
[:]Yes [ErNo ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other;
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
T .29 J-( pltr
[fNNo ❑ NA ❑ NE
E] --No
E3No
F�No
Phone: "1�
Date:
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
3

µS
ivision ofater Quality
Faidlity Number - 0 Division of Soil and Water Conservation
Q Other Agency
Type of Visit:Zoutine
iance Inspection Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up O Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: I fl Arrival Time: Departure Time: County: i.! 1"( Regi
Farm Name: (�,/ i �� It.C,.11� rr l/G C _ Owner �Email:
Owner Name: Phone:
Mailing Address:
Physical Address: �JJ
Facility Contact: C//�ct L L Title: Phone:
Onsite Representative: Integrator: NIP
Certified Operator: a. u"'p Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
ury rounry
Layers
Non -Layers
Puilets
Turkeys
Turkey Poults
Other
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)?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dai Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes j2' o ❑ NA ❑ NE
❑ Yes
J ] No
En N
❑ NE
❑ Yes
❑ No
NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No [aNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes �o ❑ NA E] NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes �o ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 214/2011 Continued

Facili Number: - Date of Ins ection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes -Alt❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No Q-Nik' ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ' ❑ Yes E 1'�0 [ ] NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or eironmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 1 No-_❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ET<o ❑ NA ❑ NE—
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �1a` ❑ NA ❑ NE
maintenance or improvement?
Waste Apalication
10. Are there any required buffers, setbacks, or compliance alternatives that need 0 Yes rNo ❑ 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 ❑ AAp"p�lication Outside of Approved Area
12. Crop Type(s): f "s 4,.. cj7j��'l�f 5G o C _�
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Alb- ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes C j P o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [D.Nr ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[5,Ko—
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
E4 -<o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
4d"""
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
io
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and I" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�❑
Mo[:]NA
C] NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
;;I�OD
NA
❑ NE
Page 2 of 3
2/412011 Continued

Facility Number: Date of Ins ection:
24. 171d the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �] NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
[] Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
❑ 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 NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application) T
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below. ❑ Yes nNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes L_J N;:[—] NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes No [3 NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? F-1YesNo [] NA ❑ NE
Comments (refer toquestion:#} Eiplaln`i}ny YES answers and/or any additional recommendations or any other comments.
Use drawings''of.fiic'ility to hetter"ekplain situations'(use additional pages as necessary).
C
to , 6 1
,51 v 13
d
F �,7
Reviewer/Inspector Name:
Reviewer/Inspector Signature: �1j ( ��{,( Date:
Page 3 of 3
M
214120

i ype or visit: ty1 ompuance inspection v Lpperanon tceview %j niructure r.vatuation V i ecnntcat Assistance I
Reason for Visit: (4outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:( Arrival Time: O 't t-09 Departure Time: A County: p�AT Region: 'O
Farm Name: ��(�E FmyR ,M\„ Vz R'V6 Owner Email:
Owner name: mLo's Phone:
Mailing Address:
Physical Address:
Facility Contact: 'Title:
Phone:
Onsite Representative: isATrp— _ Integrator:iy1URo�� J�rQ01.j
Certified Operator: &Yet n I ?-I Hyo Certification Number: ^r % 81 4
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 ES3"N'o ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes E3No [S3/NA ❑ NE
b. Did the discharge reach waters of the State`? (If yes, notify DWQ) ❑ Yes ❑ No [gftA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system'? (If yes, notify DWQ)
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 ro
Yeso
E31NA
❑ NE
❑NA
❑NE
❑ NA
❑ NE
Page 1 of 3 2/4/2011 Continued

wj
lFacility Number: ga - �5t� Date of Inspection: 5-/h.31! �
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [3 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Al
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E?"'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 QNo ❑ 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 Callo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes E;rNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures
require ❑ Yes [!�No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance a]tematives that need
❑ Yes E2fNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box
below. ❑ Yes [E�No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure
to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 2 N ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes gNo . ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes gNo ❑ 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?
Reoulred Records & Documents
❑ Yes [2(No ❑ NA ❑ NE
[] Yes [Q"No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ffNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [YNo ❑ 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 2No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [(No ❑ NA [:]NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [KV4 ❑ NE
Page 2 of 3 2/4/2011 Continued

Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes DfNo [DNA ❑ NE
❑ Yes [►fNo ❑ NA ❑ NE
❑ Yes E�rNo ❑ NA ❑ NE
❑ Yes [2"'*No ❑ NA ❑ NE
❑ Yes [D'No
❑ Yes ffNo
❑ Yes [�KNo
[]NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments {refer to question #): Explain anyVES,answers and/or any additional recommendations or any other comments.
Use ,drawin s of facill to better:'ex ` lain situations (use additional° a es as necessary):
g ty g
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: SIU 3 OSS
Date: :R� 0-s\
2/4/2011
Facility Number: - Date of Inspection: S rna
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
[ErNo
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
dNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[:]No
E]�NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes DfNo [DNA ❑ NE
❑ Yes [►fNo ❑ NA ❑ NE
❑ Yes E�rNo ❑ NA ❑ NE
❑ Yes [2"'*No ❑ NA ❑ NE
❑ Yes [D'No
❑ Yes ffNo
❑ Yes [�KNo
[]NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments {refer to question #): Explain anyVES,answers and/or any additional recommendations or any other comments.
Use ,drawin s of facill to better:'ex ` lain situations (use additional° a es as necessary):
g ty g
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: SIU 3 OSS
Date: :R� 0-s\
2/4/2011

Its 2zi
(vision of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency 11
Type of Visit:Com lance Inspection 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: Z Arrival Time: '�� Departure Time: i QU County
Farm Name: Tr?St�1+� Owner Email:
Owner Name:fl:4.W�1riw1 d G• Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: C.t,t& L--cri'y LL Title: Phone:
Onsite Representative: 6G;<,4 --c_ Integrator:
Certified Operator: J Certification Number: /70
Sack -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.
La er
Non -Layer
Dry routtry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ]o ❑ NA ❑ NE
❑ Yes [] No
❑ Yes [:]No
[34A ❑ NE
[E�< ❑ NE
❑ Yes
❑ No
tom"
❑ NE
[:]Yes
(2'Ko
❑ NA
❑ NE
❑ Yes
LIS""
0 NA
0 NE
Page 1 of 3 2/4/2011 Continued

Facili Number: - Date of Inspection;
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �o [DNA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No E< ❑ 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 [Er1qo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
E?10
❑ 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
52-<o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�10
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑.Wo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
�o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): L,j
13. Soil Type(s): LL"i u Vv�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
glgo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑.Kb
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[].Ko
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
�lo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[;Ko
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
to
❑ 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 0'<o ❑ 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 [ o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 20<A ❑ NE
Page 2 of 3 2/4/2011 Continued

4
Facility Number: F07 - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E<O ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes Io ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA Ga-Kf�
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 To ❑ 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 [90<o ❑ 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 FCH<o❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes [D -Wo F� NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ®140 ❑ NA ❑ NE
Comments (refer to question ft ExplainanyYES answers and/or any additional recommendations or any other',comm.ents , :.
Use'drawings:of facility to.better explain situations (use additional pages as necessary). .
�c�ser c U -e-
f
�� �c� c�� t � �— cos ! �► �c.��� - 5 c�-� t s �-,
Reviewer/Inspector Name:
Reviewer/Inspector S
Page 3 of 3
Phone: 9,� 3•r3,��
Date:
/4/2011

Ivislon of Water Quality
Facility Number 8Z J"`� O Division of Soil and Watts Conservation
---- -- -- O Other Agency
Type of Visit O-C—om— pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ denied Access
Date of Visit: -/ 8—/O Arrival Time: d:/SA«- Departure Time: /O; �`� County: s6.�.as�ry _ Region: �"O
Farm Name: ape /Fd.rm,:La Co . 2N G Owner Email:
Owner Name: S0'" t -6e<. Phone:
Mailing Address:
Physical Address:
Facility Contact: u !_ $¢rr.Oj;kiC Title: T ?amu- # Phone No:
Onsite Representative: Cuvli'S ve.�i �� Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o =4
0 Longitude: = o = d =
it
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish 192 56
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
10 Other
❑ Layer
❑ Non -La er
Dry Poultry
_Layers
Non-LaXSrs
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?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Design Current
Capacity Population
Number of Structures: ED
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 2 N ❑ NA ❑ NE
❑ Yes
0 No
F±KA
❑ NE
❑ Yes
❑ No
[3IA
❑ NE
El- A
❑ NE
❑ Yes
❑ No
❑ Yes
B<
❑ NA
❑ NE
❑ Yes
B Na
❑ NA
❑ NE
12/28/04 Continued

Facility Number:82 —
Date of Inspection __78-/0
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:
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 [ O ❑ NA ❑ NE
❑ Yes <o ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 31�Io ❑ NA ❑ NE
❑ Yes ElNo ❑ 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? [I Yes [?<o [] NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes L -Ko' ❑ 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 0 Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E3<o ❑ NA ❑ NE
maintenance/improvement? ,.
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 'lam' No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [:]Application Outside of Area
12. Crop type(,,) a,,rw, iW1/�w/ w /ryrN4q�f i4irG'4e— tCnwjt, $GYIs".LL�.� LA6 �. S�rt//(orr��/ lt?�5•�
13.
Soil type(s) WLR , FL GDA
Reviewer/Inspector Name 13 %G' itr �S :' — T � Phone: wo, 3433, 330 o
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
ErNo ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
E�T"NNo [INA
El NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
Ngo C1 NA
El NE
18.
Is there a lack of properly operating waste application equipment?
El Yes
,L_�,
L7No ❑ NA
❑ NE
�' ; 4 i i�� # r 'i a l _W 4"
Comtrir nts (refer to'questian'`#) Explain any YES answers andlor any recommendations or any other commentsi�f,�;�
Use drawmgsof facility to better explain situations (use:additrorial pages as necessary)i y; ; t; f ' k #„� n 7f
f. k�h
i
Reviewer/Inspector Name 13 %G' itr �S :' — T � Phone: wo, 3433, 330 o
Reviewer/inspector Signature-, Date: Z- Ig? -ZD/O
12/28/04 Continued

r r
Facility Number: o62 — 5"" Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ff No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes BNIo ❑ NA ❑ NE
the appropriate box. ❑ ATUp ❑ Checklists
❑ Design ❑Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
B No
❑ NA
❑ NE
No [:INA
❑ Waste Application ❑ Weekly Frecboard ❑ 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
'❑
[���]"bIo
[:1 NA
❑ NE
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EK23.
❑ NA
ON E
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
EK❑
NA
[:1NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
!!]Vo
❑ 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?
ElYes
B3No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3 No ❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No [:INA
❑ 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
0No ❑ 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
,�_,,��
L<No ❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
El Yes
,__,�
B No ❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA
❑ NE
12128/04

/O — O 2 — Z,00 r'!
'Division of Water Quality
r
Faciltty:.Numner j �f t O Drvtsion oftSoii and Water Conservation
�. `� .Q ether Agencys s r
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 0-01 —091 Arrivai Time: � Departure Time:�: /S County: SDscpsvi✓ Region: /C/�0
G
Farm Name: �� �Y'"''`me � ZN L Owner Email:
Owner Name: _ sQ k, Phone:
Mailing Address:
Physical Address:
Facility Contact: (2CLE N aQ,Yw'i C" Title: _ �`� .spm Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
100th er
Back-up Certification Number:
Latitude: [::] 0 0' 0" Longitude: =0=, 0 {1
Design,, Current Design Current
Capacity; Population Wet Poultry Capacity Population
❑
Layer
❑ Non -La et
ori
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
EFDry Cow
❑ Non -Dairy
❑ Beef Stockcr
❑ 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 ErNoo ❑ NA ❑ NE
❑ Yes
❑ No
EJ NNAA
❑ NE
❑ Yes
❑ No
EJ<A
'❑ NE
IA
❑ NE
❑ Yes
F1 No
El Yes
B<oo ❑ NA
❑ NE
❑ Yes
ENo
❑ NA
❑ NE
12/28/04 Continued

Facility Number:
10,91,9 ,9
Date of Inspection V010--o/'n fl
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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 6151 001
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 2<o El NA [:1NE
❑ Yes Mff❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes B o ❑ NA ❑ NE
❑ Yes C Io ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat otify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes I No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑Yes No C3 NA [__1 NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [r}'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application �,/
10.' Are there any required buffers, setbacks, or compliance alternatives that need El Yes o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes E— l o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Co ✓AI , 0,+ jA+- d i I , Se_cr e. (-6,,1_j RA41,1. 1,4— (g-,) S`.�c��(v rr+�'�r rid . S
13.
Soil type(s) w Fe. 6o4
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2 o
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[R<o
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
[__1 NA
[:1 NE
17.
Does the facility lack adequate acreage for land application?
Yes
ElL
,Ed'
1<
C3NA
[:1NE
18.
is there a lack of properly operating waste application equipment?
[:1D Yes
o
❑ NA
❑ NE
# --Al f
.'7 7 i.,v� �a _wlra"J 57wi r
( 'fer to ,question #)�°Explain anyrYESanswe'rs and/or an3,3recommendations or any other comments..
Comments re g y
7 - - {" f ik i t
Use dra`wings of facility d better,explatp situatlonsiadrydlttanal pages as,neccssary).
k I.. o, J .l
7
ReviewerllnspectorNameGKyn� Phone:
Reviewer/Inspector Signature: Date:
10 O I — L QO y
12/28104 Continued

. 1.
Facility Number: — 5 Date of Inspection F/5 -0 -1 -0 -fl
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes INo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes UWa ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists
❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ YesJo ❑ 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 ErNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ,_,., N'o [:1 NA El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:1E Yes o ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ETNo ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑Yes -- 0<0o E3 NA [I NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes 9 ❑ 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
;IN�o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
��
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
BNo
❑ 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
C3 Yes
,�/
L� No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
_,�
32. Did ReviewerAnspector fail to discuss review/inspection with an on-site representative?
❑ Yes
9 o
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ NA
❑ NE
12/28/04

1`
R1<S 0116 fl zoa S
Facility Number $L Jr
0bivision of Water Quality
O Division of Soil and Water Conservation71, �k
;Other Agency. '
Type of Vlsit ® Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit ®Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 1 ?:30 Departure Time: i00 iz• County: s*� Region: /'4
Farm Name: PoQwt_ Fr-rvw lloi —lq) Owner Email:
Owner Name: c C" F3S Phone:
Mailing Address:
Physical Address:
Facility Contact: fees, Title: ow/jg r - Phone No:
Onsite Representative: P0P Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
�o
Latitude:
Back-up Certification Number:
0 Longitude: ='=' =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La er
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 -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes R No ❑ NA ❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
7 No
❑ NA
❑ NE
❑ NA
EINE
❑ Yes
[;R No
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
P No
[INA
❑NE
12/28/04 Continued

. Facility Number: Date of Inspection is -2 -D7
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes []I No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes (9 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
[d No
Structure 6
Identifier: ka
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
Spillway?: d
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
❑ No
Designed Freeboard (in): 19
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Observed Freeboard (in): 39
r
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Pfl No
5. Are there any immediate threats to the integrity of any of the structures observed'?
❑ Yes
(7 No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
[I No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
Z No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[g No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
(] Yes
No
❑ NA ❑ NE
maintenance or improvement?
Waste Analication
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
WNo
❑ 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 Drifl ❑ 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
[d No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
M No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Pfl No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
ReviewerAnspector Name Rrc e. G%S Phone: 9/0,XM 3300
Reviewer/Inspector Signature: Date: !Z -2 T— Zoo -7
12/28/04 Cantiuued

Facility Number: Sz —SS! Date of Inspection /x -27-o7
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ED No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Z No ❑ NA EINE
❑ 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 �E No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
❑ Yes
[33 No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�D No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
E] Yes
PNo
❑ 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
WNo
❑ 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
XNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency`?
❑ Yes
0 No
❑ NA
❑ NE
Comments and/or Drawings:
12/28104

a
Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit ® Routine Q Complaint Q Follow up 0 Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: Arrival (Q Arrival Time: /O;UA Departure Time: ,3.40 County: Region:
Farm Name: P004?– 9,VbS M.; �, ��� –�9, Owner Email:
Owner Name: PDPz /�/a5_ Phone:
Mailing Address:
Physical Address:
T /V 90 -/370� i39Z,
Facility Contact: 'Tall RD
p Title: Phone No:
Onsite Representative: _5�+ Pop e— Integrator: �'f urD�, /Di"A s.//✓
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =0
=d =Sd Longitude: = 0 ='
0
i�
No
A."_'
signurrentDesgn#�, Current, Design �fi Current
zn'i 3r -++Ca aci Po ulation Wetltr v i F Y�p ty p y ? Capacity Populati6wt, C' ttle�Capacity Population
N. 11.;FfriidYEbS 51i�.�ii'�:i:a h 4 33h1 .!3'4 ':+ZY. i3i.�eh R.. .1SYit'.
❑ Wean to Finish ❑ La er
0 Dairy Cow
❑ Wean to Feeder on -Layer
I'' El Dairy Calf
Feeder to Finish Z Z ,�i`�' �`': ❑ Dairy Heifer
❑ Farrow to Wean aDry Poultry }° ` _� {' '; r# �`'r " ❑ Dry Cow �y
❑ Farrow to Feeder im[]
❑ La Non -Dai❑ ers Farrow to Finish Beef Stocker
❑ Gilts ElNon-La ersEl Pullets ❑Beef Feeder
❑ Boars Beef Brood Cow
❑ Turkeys
Other 10 urkey Poults
❑ Other ❑ Other I I j WNumblercont4_truitures:
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes
[ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
® No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[P No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
[�LNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
O No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
® No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

Facility Number: — S Date of Inspection
Soil type(s) 6✓8
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
INo
❑ 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:
❑ Yes
[� No
❑ NA
❑ NE
Spillway?.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
Designed Freeboard (in): ]9
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
Observed Freeboard (in): 3 rr
❑ 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.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
2� 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 99 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. 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 W No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [� No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop tYFe(s)vw/f-it/ cr n%a 1ffa.. —
13.
Soil type(s) 6✓8
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
R 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 #) . �Explajn' any YESanswers; and/or any: recommendations"or any other, comments
[Ise drawings of facility to better explain situahonsi (use addRhonal pages, as necessary):
Reviewer/Inspector Name-; ; "-'� Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/04 Continued

Facility Number: Sz —YV Date of Inspection g O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �1 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �8 No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists ED Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [$No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes XNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
UD No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit`?
❑ Yes
KP No
❑ NA
El NF
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
QNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[2[No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
5QNo
[INA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
r"No
❑ NA
El NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
E?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
XNo
❑ 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
El NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
NIo
❑ NA
❑ NE
�'f w.11�3M'e�lsN)„`i�aaYli`4 l7r_ �j�1Amy�dtn!pnit
12/28/04
12/28/04

I
Type of Visit QMompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine (9<o-mplaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: T'r7 Arrival Time: I 42,1Z)'D I Departure Time: County: P-- Region: ff Z)
Farm Name: _Ee e �rps. ra JL- S ._.e pie. Owner Email:
Owner Name: 212,0r al"t2s . Phone:
Mailing Address:
Physical Address:
Facility Contact: ��1 �fJl?G- Title•
Onsite Representative: •3 mss ---e
Certified Operator:
Back-up Operator:
Location of Farm:
/3 9d.
Phone No:
Integrator:
Operator Certification Number: /%�f�lr�
Back-up Certification Number:
Latitude: =0 =& Longitude: ❑ 0 0 1 0
Design Current Design Current
Swine' Capacity Population Wet Poultry Capacity Population
10 Wean to Finish
❑ Wean to Feeder
Feeder to Finish I
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Nan -La ei
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 ❑ Appiication Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity, Population
❑ Dairy 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 ycs, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
[]Yes BNo [INA ❑NE
❑ Yes
RNo
❑ NA
EINE
❑ Yes
M No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
®.No
❑ Yes
5?No
❑ NA
❑ NE
❑ Yes
,®,No
❑ NA
❑ NE
12128104 Continued

Facility Number-, —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3�e
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 allo ❑ NA ❑ NE
❑ Yes 14 No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 0 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 ❑ No ❑ NA jQ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
❑ No
❑ NA JZNE
(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 JZ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
❑ No
[INA E[NE
maintenance/improvement?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
❑ No
❑ NA ZINE
❑ 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 Drifl ❑ Application Outside of Area
12. Crop type(s) C�- r
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
ZNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
❑ No
❑ NA RN
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 ONE
O /-74 Cila e /" r,k c��i✓-• �N/s��1r' -
verve u�7'��,f !/Y11, ,�pa� l�/tlaj a -K S, �C dvr; �^ �urrt�; ►_
.�vr�y l`�ijtn�-�Chrpet=ray w�S 0t*C. �/
Reviewer/Inspector Name E` '' ` �..:°� , "i '�rk;.',.����'",�;z�"€ Phone: -tti�X
.3
Reviewer/inspector Signature: Date: 3 17— ro 7 U
12/28/04 Continued

( ..�
Facility Number: — Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EgNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ®,No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design g ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Z No ❑ NA ❑ NE
[:]Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
W NE
❑ Yes
XNo
❑ NA
q4
❑ Yes
❑ No
❑ NA
KNE
❑ Yes
❑ No
❑ NA
XNE
❑ Yes
[Z No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ® NE
❑ Yes
Z,No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
W NE
❑ Yes
❑ No
❑ NA
ONE
❑ Yes
❑ No
❑ NA
� NE
❑ Yes
❑ No
❑ NA
[KNE
❑ Yes
❑ No
❑ NA
rNE
12/28/04

W
Type of Visit • Compliance Inspection O Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up Q Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: 13:1 cr Departure Time: County: Region: �%Q
Farm Name: &,ae. &as. Owner Email:
Owner Name: P-0004 Bras Fa.•+.,1 . Z17e, Phone: .3o l/
Mailing Address: -S2EQ F -r- Xa c( %�wy C� �o� /1/CX83-2g
Physical Address:
Facility Contact: i a y eg4p Title:
Onsite Representative:.._
Certified Operator: ru
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Gilts
Boars
'Other
❑ Other
Phone No: 9 9?oma/010 / '5tz
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = = Longitude: = o =
Design Current Design Current
Capacity Population Wet Poultry Cgpacity Population
❑
Layer
li .❑.Non -Layer .. .
Dry Poultry
❑
Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharies & 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? (1f yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑
Dairy Calf
❑
Dairy l-leifei
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters or the State (gallons)?
Number of Structures: I
d. Does discharge bypass the waste management system'? (if yes, notify DWQ)
2. Is there evidence of a past discharge frons 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 D o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[�:1 No
[INA
El NE
❑ Yes
L�'1vo
❑ NA
❑ NE
❑ Yes
ENo
[:INA
❑ NE
12/28/04 Continued

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
r o
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
Date of Inspection -GS—
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
Facility Number: —
Waste Collection & Treatment
9. Does any part of the waste management system other than the waste structures require
2Io
❑"No
❑ NA
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ 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: .J
❑ NE
maintenance/improvement?
Spillway?: /TD
I]. Is there evidence of incorrect application`? If yes, check the appropriate box below.
El Yes
Bo
Designed Freeboard (in): /9 4,
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
Observed Freeboard (in):
❑ 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
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[✓rNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
❑' 4o
❑ NA
❑ NE
through a waste management or closure plan?
❑ 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
r o
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
ONo
❑ 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
El Yes
,_,/
L� No
❑ NA
❑ NE
maintenance/improvement?
I]. Is there evidence of incorrect application`? If yes, check the appropriate box below.
El Yes
Bo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of
Area
12. Croptype(s) ndell. "J. a e. r6fz�c/)T,
Su,.Bea.,C
,f...`//6�b."�
13. Soil type(s) - /,,, 6- ,Cr,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2090
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?es
❑ 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
ffNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
2*�o
❑ NA
❑ NE
16. CGU&,s 4a6l e4ien/ &werseed Cray? ulCrr Ser,v,vcia 6Wf 44C Rye VveeSe.el
S/orovIee t,/o, iraorvrer /o/uaS T'u CV� rye AA.'S U,0e
CouStcr/. �L'�z+1��it %j �rcShrl7` anc/
Reviewer/inspector Name �3 . ( Phone: yIc?'
Reviewer/Inspector Signature: Date:
12/28/04 Continued

Facility Number: Aa —S-!lDate of Inspection dS
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available'? ❑ Yes ON'. [INA ❑NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0-<o ❑ NA ❑ NE
the appropirate box. ❑ �xr3•fl5 ❑Che sts ❑ D tgn ❑ Nk6s' ❑ 0
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ e ❑ ❑ ❑ S -H 7k, t ys ❑ ❑_AnwmrI-eUrf=ion
❑'ftintil- ❑-S�❑ Gpop-f=ield ❑ ❑ to nspec tons ❑ -WzUhjr Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit'?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal`?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes M -<o ❑ NA ❑ NE
❑ Yes
9+ro
❑ NA
[IN E
❑ Yes
❑-fo
❑ NA
❑ NE
❑ Yes
E�Wo
❑ NA
❑ NE
❑ Yes
[l -<o
❑ NA
❑ NE
❑ Yes
PNo"""❑ NA
-
❑Yes 2fVo ❑NA ONE
❑ Yes �o ❑ NA ❑ NE
❑ Yes UNo ❑ NA ❑ NE
❑ Yes [j.;Ko ❑ NA ❑ NE
❑ Yes ❑No ❑ NA ❑ NE
❑ Yes Doo ❑ NA ❑ NE
A�tl'dtttonal`Catvments`undlor Drawingps !3 4
4 - b . . C - ! r, t
Mr. I��/OB A 44 Qc.E� iC9�.sP r / TO � Ci,e, / /1,e l� a�P
On
D jGddOi7 '
f/
b/i6 "d
.ej gfaSS C OVe,- is pPedtrn7 d?IOS,
12128/04

Type of Visit a Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for visit • Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number S Date or visit: G '� a Time: %d0 Rwr
rO Nat O erational C Below Threshold
13-rermitted M.ertified p13 Conditionally Certified © Registered Date Last Operated or Above Threshold: ..... .C......
Farm Name: ..... ...L..a f?c....... fig!« .. ?rs!... Sr.�.....�' ' .................. County:......s.9.s(PS&r.................................. 1...�{.d........
Tom s
Owner Name:....PG ..... CCtS..... 1',.. ...... :Ly ..................................................... Phone No:.....� �Q..:.S..`1?.`. 5..` .....................................
MailingAddress:......r......peckdr�.......... t w?6........... C Irn.ZQ'7.........M!! .........2.2 21 .......................... I............. .T ......................
aY{�
FacilityContact: ............... �l ; ........... P,owe ............................. Title :.............................................................. Phone No: lv,,3oI/.............
OnsiteRepresentative:..............] ;r .... 404 ............ I .................................................. Integrator: ....�x,r,aj .............................................. I..........
Certified Operator: ................. tf. .....................620..e ............................................. Operator Certification Number: ........ l.'PZ.*Vfk ............
Location of Farm:
.►
[wine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude • 4 6�
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑Yes Q'!vo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made'? ❑ Yes 0-56–
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes EKo–
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes [-Go
2. Is there evidence of past discharge from any part of the operation? ❑ Yes
MKo-
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes DWo
Waste Collection & Treatment �
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway El —
Yes �Q
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: ...............'..................
..........................................................................................................................................
r/
Freeboard (inches): y3
12112/03 Continued

4
Facility Number: —
Date of Inspection 6, �)
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 maintenancelimprovement?
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
❑ Yes Bl o
❑ Yes 9 -Ko
❑ Yes
❑ Yes [llo
❑ Yes 2 -Ko
❑ Yes
❑ Yes &?&o
12. Crop type (ft) 0 &,,m �,cla � Fesc,��
..fir_ C,1traT y� tar;
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes E; -d6
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor I.ssues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building 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
Air Quality representative immediately.
❑ Yes 9 Aio
❑ Yes Q -No-
❑ Yes❑- -Ido
❑ Yes © O
❑ Yes ❑-Alo
❑ Yes ❑ No
❑ Yes G,3 -W
❑ Yes QNo
❑ Yes Qom_
.��.r°4.J":91Yf 1Lp11 i,i,ii;i4Srr',:.1�i(fN?IH',&�:�if;l ".•"�,�k .1:�t,.,EnHfl._.6%..:»wC .3tkd ...lk „:.'..{U''�.L ftiAtElstGJga�lLi. .iFur'ii i..E ..�i.G , ., r.. Ik..<
iComments;(ire%rito!pAuesdo'ia'#): Eicplatn+any;YESratsswers anti/or!any,recommendatinns nr any�other
lH"`Y43i'H7 j,,.+r�:d�IN!f'i 4ij���VidlHdrSi$iikiN.^.N€ku 14M;:ltli !�k:it 1f` hiG?�i�E{1F:.f� �I..i{i l'u9i;li::I;s:il3f{�EIt:4Sa4:f{P;,ii?S�it!11114Y9 q
Use dr, i;G'j sjni'fadlity':to better:exptarrt stttxations'(use.addiltinrtal pages asjnecessary) i pield Copy Final Notes E.il! 'Ii'sj
u!I -' S -Iii If.f:7 iii Vi 1L, 1 IS'�.i -:6 x'1311 f �� pl 1 • 11�'I'f
}}L� Nn np tt r'�gy �i `!� p, ef�f { y� f E' 44rn
fi �.t r E1I. �.I.�IF', if��• 7 (V .l 1 , 1 N ry?Ni p tFi' '! 1M� if +t'.s'�M1 . rFEi 11. V } .1•! is € �. i' �i 1s .S� .1�1! , i i�1: i.'v':.
€.II��ti3;�.31:N!1riijilf ..Si�l—MVL�ttHHl;4�'iSIAI �VI�,�il.!Ir.1117r.Me� .�� a'lc.i �..
A6
! r
Reviewer/Inspector Name
,a 3, U"
Reviewer/Inspector Signature: Date: li _ 7 O
12112103 r Continued

Facility Number: - S-tl I Date of Inspection o
Renuired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes S -Mb
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WVF, c,hwJ fists, j e nn, m tc.) ❑ Yes Epitf
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [}Nu
❑_W-acW,A,pplit TtM oard ❑ S41-�Ing
Z/ -1G-~7 07.�j x'70-7 R. J, -/O -? 7.fT �-!o ,> .?,-2
24. Is facility not in compliance with any a¢plicable setback criteria in effect at the time of design? ❑ Yes 9N&-
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑-HO
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
SNO­
27.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
❑-Ne
28.
Does facility require a follow-up visit by same agency?
❑ Yes
Ugo-
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑-Ids
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
9-YCs
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
S -No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
gPio
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
ElNtr
34. Did the facility fail to calibrate waste application equipment? ❑ Yes 8-W
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. [its ❑ No
❑•Steckiz � [ <rrop Yield Form [Aainffl ❑ Ins2ae1 aAft=4.!Rain
❑• ❑
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
11i!?tlklidi�tlii!%oPrt;4, aItiliTlCoi7ifini1 t�Aefiil:fs.]l...Ail�ri j .. :e:•!r � ;j(1NNAC�`ri�#h��jl�illII�I!l�i'�ffj7{i�1��Q,it;•s;�,!I:��'1'1��j11f'4i6�I
.3f1��
9#195' Rev,•rwel� if 1-0/0 !1 ie FOr^,s 4" Jodi /�►'lr. �Pr
—
12112103

E]..
DSWC Anim
<;al Feedlot Operation Review �Mixg
$
:k DWQ Animal Feedlot Operation Site Inspection
Routine 0 Complaint 0 Follow-up of DWO inspection - 0 Follow-up of I)S%VC review 0 Other
Date of Inspection I 9-30
Facility Number 1
Time of Inspection 0 24 hr. (hh:mm)
© Registered 13 Certified 13 Applied for Permit 0 Permitted JE3 Not Operational Date Last Operated:....,., .....
..,..L..SR��lyep•'.s....a.......✓........................................Farm Name: ......... ..,..19"'.
..���? County ....
y
Owner Name:..........s/.Ap .�. �f.~14-I s~f.. �r�✓,C..............,......... Phone No:....,f..... S�9Z..'..���..L...........,......
/`�....^.. ` Q
Facility Contact : ...............s #-..! tn........�Q/K.......... .... Title: ....... Phone
3 0
Mailing Address: �. �(�.24 ..........................
.......... /........../..........p .............. f.........� �..... :z. �........,..................
sa ~Cg92
Onsite Representative:...................!.fo''i.....,,p",��............................. . Intel;r:rtor:...Lr.�i.:...
Certified Operator;...........r`'............f-¢,.pX............................................. Operator Certification Number...,J7.9. ell.........
Location of Farm:
AL
................................... ............................ .,.............................. ........................................ ......... I ......... I ....... I ...................... ......... ......................................... .....................
yr.......7el p�-.k-.....lilz�� ..el'. i64 .......`� ....Q. �.......Aip .... ................ .
Latitude • • " Longitude • 4 41
--Swine
❑ Wean to Feeder
2 Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current-
Capacity
urrent
Capacity Population
Design Current :`' Destgii` Current
Poultry Capacity Population Cattle -Capacity,- Population . '.
❑ Layer ❑ Dairy k
❑ Non -Layer I 1 10 Hon -Dairy
❑ Other
Total Design Capacity
_ Total SSLW
Number of Lagoons] Holding Ponds; ❑ Subsurface Drains Present ❑ Lal;oon Area 10 Spray Field Area
❑ No Liquid Waste Management System
General
I. Are there any buffers that need maintenance/improvement? ❑ Yes P No
2. Is any discharge observed from any part of the operation? ❑ Yes Pq No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. IF discharge is observed, was the conveyance man-made? ❑ Yes IRNo
b. li'discharge is observed, did it react] Surface Water'? (If yes, notify DWQ) El Yes 1A No
c, if discharge is observed, what is the estirnated flow in galhuin?
d. Does discharge bypass a lagoon system? (]f yes, notify DWQ)
❑ Yes
A No
3. is there evidence of past discharge from any part of the operation?
❑ Yes
V No
4. Were there any adverse impacts to the waters of the State other than from a discharge'?
❑ Yes
V No
5. Does any part of the waste management system (other than lagoonslhol4ing ponds) require
❑ Yes
IN No
maintenance/improvement?
6. Is facility not in compliance with tiny applicable setback criteria in effect at the time of design?
❑ Yes
NrNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
�4 No
7125197
Continued on back

Facility Number: t Z S VI
S. Are there lagoons or storage ponds on site which need to be properly closed?
Structures La oons 1oldin Ponds Flush Pits etc.'
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure i Structure 2 Structure 3
Identifier:
.fir.........,.
Freeboard (ft): �.� ..............
10, Is seepage observed from any of the structures?
❑ Yes A No
❑ Yes (XNo
Structure 4 Structure 5 Structure 6
...............................................................................................................................
❑ Yes T%No
11.
Is erosion, or any other threats to the integrity of any of the structures observed`?
❑ Yes
W No
12.
Do any of the structures need maintenance/improvement'?
❑ Yes
IANo
(if any of questions 9-12 was answered yes, and the situation poses
7125197
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
19 No
Waste Application
1.4,
Is there physical evidence of over application?
❑ Yes
($No
(If in excess ofWMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type !s��...'r�!.E
...C�/t'f .............. .... .................................... .... ........ .......................... ................... .......... .........
........ . ............
....................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the receiving crop need improvement?
j Yes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
OU No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative'?
❑ Yes
1)[No
22.
Does record keeping need improvement'?
❑ Yes
NO No
For Certified or Permitted Facilities Only V
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes RNo
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes( No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes No
No.violations,or. deficiencies were noted during this,visit. You.will receive no further ..
' corresporidebce about this.visit'.-"
Comments;('refer to question'#.}: lE; xplain any YES answers and/or aiij t ecommen attons;or any other comments.0 ,
Use`drawings of>facility4o better explain situations,{(use additional pages as -necessary) r Z
ye.
AF.'.�A !S iv �oa_ae+E-X� eve �24v,, /A� .A4✓� t�o ,c yam./,� a�✓.�
/ /
R
7125197
Reviewer/Inspector Name �.E,e� r �� 4�°W
.,.
Reviewer/Inspector Signature:�Date:

State of North Carolina
Department of Environment.
Health and Natural Resources = 4 •
Fayetteville Regional Office
— W
- James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
IDIF. H N R
Andrew McCall, Regional Manager
- DIVISION OF ENVIRONMENTAL MANAGEMENT
December 6, 1994
Pope Brothers
Route 4, Box 163
Clinton, NC 28326
SUBJECT: Compliance Inspection
Sampson County
- _ Dear Mr. Popes= .:-:..—T:__ .- -_:_. _ ._....:
-----"- On'December'I, 1994; -an' inspection'of your -animal'operation 'was performed -�
by the Fayetteville Regional Office (FRO). Please find enclosed•a,copy of our
Compliance Inspection Report for your information. It is the opinion of this
office that this facility is in compliance with 15A NCAC 2H, Part .0217, and
that Animal Waste Management is being properly performed.
Should you have any questions regarding this matter, feel free to contact
me at [phone].
Sincerely,
Mi D.
Environment 1 Technician
Enclosure
cc: Facility Compliance Group
Wachovia Wlding, SLAte 714, Foyettev49, North Caronna 26301-5043 Telephone 41a484�T541 FAX [phone]
An Equol Opportunity Affirmative Action Employer 6096 recycled/ 10% post-corwjyw paper

s• -
NORTH CAROLINA DEPART)mNT of ENVIRommm, HEALTH A NATURAL RESOURCES
DMSION OF ENVIROMWWTAL MANAGEMM
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
Brothers Farm
December 1. 1994 1 14-19
_........... - ...
.......... .. - .
Rt. 4 Box 163, Clinton, NC 28328 910 -592-3011 (Home) -
All questions answered negatively will be discussed in sufficient detail in
the Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
7SECTION I
Animal Operation lvpe:
Horses, cattle, swine, poultry, or sheep
ECTION II
1. Does the number and type of animal meet or exceed
the (.0217) attle (100 head),
horses (75)$'swine (250 sheep (1,000), and
poultry (30,0 with liquid waste
system)]
- 2. 'Does this facility meet criteria forte'"" "'
Animal Operation REGISTRATION?
3. Are animals confined fed or maintained
in this facility for a 12 -month period?
4. Does this facility have a CERTIFIED ANIMAL
WASTE MANAGEMMT PLAN?
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage with
specific cover crop)?
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc?
OEM,
mom

SECTION III
Field Site Management
1. Is animal waste stockpiled or lagoon
construction within 100 ft. of a USGS
Map Blue Line Stream?
2. Is animal waste land applied or spray
"
..irrigated within 25 ft. of a -USGS Map
- - Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application site have a
cover crop in accordnce with the
CERTIFICATION PLAN? • e o K -Aa - 4 - f -I e.)
5. Is animal waste discharged into waters of
—" --- the state..by man-made ditch, flushing.system, W
other.:similar. man-made 7.devices?_=----_�__
6. Does the animal waste management at this
farm adhere to Best Management Practices
(BMP) of the approved CERTIFICATION?
7. Does animal waste lagoon have sufficient
freeboard? How much? (Approximately 4� feet )
8. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SECTION_ IY
Comments
#5. Mr. Pope does not maintain waste management records but is aware of when,
where, and how much waste is applied. It was recommended that he begin to
keep written records of this information and a copy of a proposed log is
attached to this report.
The following are answers to questions asked by Mr. Pope:
' 1) Sample of lagoons should be taken at least once a year. Additional
sampling will provide a larger perspective of lagoon conditions.
2) There are no plans to change the type of piping used for systems.
Aluminum piping will suffice.
10
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SECTION_ IY
Comments
#5. Mr. Pope does not maintain waste management records but is aware of when,
where, and how much waste is applied. It was recommended that he begin to
keep written records of this information and a copy of a proposed log is
attached to this report.
The following are answers to questions asked by Mr. Pope:
' 1) Sample of lagoons should be taken at least once a year. Additional
sampling will provide a larger perspective of lagoon conditions.
2) There are no plans to change the type of piping used for systems.
Aluminum piping will suffice.
10