820061_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

Type of Visit 8 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 I Date of visit: Su! Time:
Q Not Operational Q Below Threshold
M Permitted 13 Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
Farm Name: ............h.!^�"`�.......Pi v!........... rrar... '"^............................. County: ........
4.r..1pSon�...................... .......................
Owner Name:....... rn..G1^..' tGr.S.................. ``'^.'................................... Phone No:............ �tu........ `.Y3:.............I.....................
MailingAddress:........ 0........`..� ` ...... l.,r!..e{.......... .............................................................................................................................
FacilityContact:.............................................................................. Title:................................................................ Phone No:...................................................
Onsite Representative: .......... m.:.k'_ pe- Integrator: f7'J�'C'04�......... 6±atn � .......
Certified Operator: ...... .... rn.'.ke.. ........L......... .'-"...^ ............................ Operator Certification Number:.. �.....r.$�f.�1........
Location of Farm:
C3 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ` " Longitude • 4 41
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes 11 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Stricture 4 Structure 5
Identifier: ................ �........................._.....................................................
................................................................................................. .......
Freeboard (inches):
'06
'` yS "
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
Structure 6
12112103 Continued

Facility Number: K.2
Date of Inspection OI p
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type & r — a-Sa. a r a Z_<ce / 5 r--% I 1 IJ,r -6
❑ Yes (R No
❑ Yes M No
❑ Yes J No
❑ Yes No
0l 04�
❑ Yes No
❑ Yes No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes M No
16. Is there a lack of adequate waste application equipment? ❑ Yes �V No
Odor Issues
17, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes [ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes (� No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ® No
Air Quality representative immediately.
Field Copy ❑ Final Notes
IV
��t 4..1 H��Y 1 i 14 !i � i �� k•{ 11 9 ' � 1 d k44'1�'111 { i. 44� it,T[ y :F)�z 41 y'y
ReviewerflnspectorName � .I�"!se,`�V��,!'T.;E'Y.e!,,::.�.�u.;,riE.'.,,u�.��{�,'.;
Reviewer/Inspector Signature: Date:
12112103
Continued

Facility Number: Date of Inspection 09 a/ a
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes P No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes No
23. Does record keeping need improvement? I€ yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
OD No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
Yes
❑ No
31.
I€ selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
J No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
® No
❑ Stocking Form ❑ Crop Yield Form (:]Rainfall [:]Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

131A S E - Umc IR OU
D[vl"star of Water Resources
Facility Number - © Divlslon of Sail and Water Conservation
Q Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Cr Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ArrivalTlme:1 Departure Time: I MOD County: !IfthS&(2) Region:
Farm Name: /ir) 0 Owner Email:
Owner Name: i`G� G[ Y I e J f Phone:
Mailing Address:
Physical Address:
Facility Contact: C u- f i l l 3 ezy- J tx Title:
Onsite Representative:
tL
Certified Operator: aV�- rG ,a N e d r f'4
Back-up Operator:L /J fty
Location of Farm:
Latitude:
Phone:
Integrator: 14 (7 5`
Certification Number: StfS
Certification Number: as
Longitude:
Swine
Design' Current Dcaign Current
Capacity Pap. Wet_Poultry Capacity Pop.
Design
Cattle Capacity
Current
Pop:
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
A
Design Current
D . P,oult o Ga aci F.o
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Dairy Heifer
Dry Cow
Non -Dairy
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
10
Qthcr
Beef Stocker
Beef Feeder
Beef Brood Cow
OtherI
10ther
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?
❑ Yes ❑c -Ate ❑ NA ❑ NE
[:]Yes ❑ No ❑'1SA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No LTNA ❑ 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 [3'NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes �o 0 NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes E] No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: - Date of Ins ection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. if yes, is waste level into the structural freeboard'? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 97 1 _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ NA ❑ NE
❑No [ ❑NE
Structure 5 Structure 6
❑ Yes Imo' o ❑ NA ❑ NE
❑ Yes 0�No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate puhlic health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
�Io
❑ NA
❑ NE
S. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[D-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
[;>o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ 3�No
[] NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below.
❑ Yes
M�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
�y
12. Crop Type(s): C � P � f" s (r'D
13. Soil Type(s): f3l We, 14 & Tv
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
EfNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
F�6o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application'?
19. Is there a lack of properly operating waste application equipment?
Reouired Records & Documents
❑ Yes [2"'No
❑ Yes C2-No
❑NA ❑NE
❑NA ❑NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
ER* o
[] NA
❑ NE
20. Does the facility tail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E2,1<o
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement'? If yes, check the appropriate box below,
❑ Yes
[].No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
Ef"No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[J"No
❑ NA
❑ NE
Page 2 of'3 21412019 Continued

Facilit Number: - Date of Inspection: Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ILd"'"o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [a YesF!rNo ❑ 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 ®,N'o NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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 ` N ❑ NA ❑ NE
❑ Yes ®lq_o ❑ NA ❑ NE
❑ Yes C],W ❑ NA ❑ NE
❑ Yes [Er1qa ❑ NA ❑ NE
❑ Yes ❑-N-o
❑ Yes []"No
❑ Yes 0156—
❑ NA ❑ NE
DNA ONE
❑NA ❑NE
Comments (refer to ucstion #) Explain any.YES answers and/or anyadditional recommendations or'any other comments.
q:Y
Use`tlrawingsof fa'cility,to better"ex lalrn,situatinngh(use additional pages as necessary).
c (� 6 �a� r �-. g - z -3- sru� q-� s� rv-e-t It- ,7 47
Z S, 9'
Reviewer/Inspector Name: 5 ��A Phoner�
Reviewer/Inspector Signature: c Date: i O
Page 3 of 3 21412015

1�s kr%y> g � 11
A. ;vision of Water Resources
� Division of Soil and Water Conservation Facility Number - Ibt
' Q Other Agency
Type of Visit: ommp�pliance Inspection Operation Review 0 Structure Evaluation p Technical Assistance
Zeason for Visit: 9<Outine O Complaint O Follow-up O Referral Q Emergency p Other p Deniers Accea,,•-
Date of Visit: 1 S IRA,, A Arrival Time: Departure Time:11VOW I County: &f`A4 Region:
—
Farm Name:: �t9 Ir_� +rVk Owner Email:
Owner Name: c'Aa J fl Phone:
Mailing Address:
Physical Address:
Facility Contact: CLctr cs -90_/'&Uy,e,( Titic:
Onsite Representative: L (
Certified Operator: G r/`1L
Back-up Operator:
Location of Farm: Latitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Lilts
Boars
Other
Other
Phone:
Integrator: W- 6 s
Certification Number: 6 5�
Certificatinn Number:
Design Current
Wet Poultry Capacity Pop.
i
aer
on -Layer
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharp-es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Fieid ❑ Other: -
a. Was the conveyance man-made?
b. Did the discharge reach waters ofthe State'? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR'
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge'?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Call'
Dairy Heifer
Da Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [ZoNiT- ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �o
❑ Yes CTNo
2-NA ❑ NE
[fr A ❑ NE
CE' ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Faci lity Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [;-Ntom❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �>A ❑ 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
ago
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
& No
❑ NA
❑ NE
waste management or closure plan`?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
©'17o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit'?
❑ Yes
3 "'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
❑'Rb
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
[�J
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0--No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Typc(s):6 ff
(o Sio >
13. Soil Type(s): -b YL LOU
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[ "No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement`?
❑ Yes
�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
C20'Ko
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
53"No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
0 Yes
C2rNo
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check
❑ Yes
�(No
❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box beiow.
❑ Yes
OeNo
❑ 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`?
❑ YesVNo
o
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment`?
❑ Yes
❑ NA ❑ NE
Page 2 of 3
21412015 Continued

Facili Number: 16A- Date of Inspection:
24 ;Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Elio
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes C!rNo
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 <o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Q No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
[DNA ❑ NE
❑ Yes Q o ❑ NA D NE
❑ Yes [ffNo ❑ NA ❑ NE
❑ Yes [ "'o ❑ NA ❑ NE
[:]Yes []-No [DNA ❑ NE
❑ Yes Q o
❑ Yes ZrNo
❑ Yes CL�Ao
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question.#); Explain any; YES, answers: and/or any additional recommendations or any other comments.
Use drawings of facility .to better ex lain situations:(use additlanal. P, ages as.necessar ). .
6,3
Key - P 4te- God
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
4 MCo r
cd{ q w 3 ok--6 &'.5 (
Phone: W0—g33 d It
Datc:EKoo 1-7
2/4/2 l S

iU*t
(Type of Visit: 0 CC Hance Inspection O Operation Review Q Structure Evaluation U Technical Assistance I
Reason for Visit: Routine O Com laint O Follow-uri Q Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: SOD Departure Time: County:
Farm Name: Owner Email:
Owner Name: Iod gevy Phone:
Mailing Address; 01
Physical Address:
Facility Contact: �.WK-fc j�'�� `- Title:
Onsite Representative:
Certified Operator: P4VAt.V.1
Back-up Operator:
Location of Farm:
Latitude:
t� Region:
Phone:
Integrator: A 6 '-5
Certification Number: 2 b S iJ
Certification Number:
Longitude:
'Design Current
Design
Current
Design Current
Swine
Capacity : Pop.
Wet Pouitry
Capacity
Pap.
Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -La er
I
Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
j
Design
Current
Dry Cow
Farrow to Feeder
D . I;oultr
Ca aci
P,o
Non-Dai
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turke Puults
Other
I
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [3 o ❑ NA ❑ NE
❑ Yes
[] No
[J<
❑ NE
[:]Yes
[:)No
2r<A
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
N ❑ NA
❑ 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 21412015 Continued

acili Number: - Date of Ins ection: AAS�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes J ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 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? EPs ❑ 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 D410,
❑ 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 t reat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes allo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? D Yes � ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes I_d 110 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes fo ❑ 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 > l0% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑aEvidence of Wind �Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 3��.�J`�[� i7 (- ,� •S' Vy
13. Soil Type(s): Ctk t 4 j U4 y
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�10
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
C:�&
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E2 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[2/No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
D34o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[ffNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? Ifyes, check the appropriate box below.
❑ Yes
13<0
❑ 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
ENo
❑ NA
❑ NE
Page 2 of 3 21412014 Continued

Facility umber: rL - Date of inspection:. t�
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes (D>o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [1 kNT- ❑ 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 dale of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes I21go' ❑ NA ❑ NE
❑ Yes 0-Iro ❑ NA ❑ NE
❑ Yes [a.�� ❑ NA ❑ NE
❑ Yes ❑'N`5" ❑ NA ❑ NE
❑ Yes [3<o ❑ NA 0 NE
❑ Yes No ❑ NA ❑ NE
Yes
U No ❑ NA ❑ NE
❑ Yes
Io [ ❑ NA ❑ NE
❑ Yes
❑
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings.iffaciHty to,better, explain situations (use additional pages as necessary).
4, .0 "' - (KQW
P -s.3
A 41 5.z
cC�ke
o� L91 ooK �2 -4 �0'e.-' a � s��QL,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
+I o 6.z
Bj�-silo 'F
CJ wsi L Phone:
Date:
21412011

Division of Water Quality
Facility Number - O Division of Soil and Water Conservation
Q Other Agency
type of Visit: omp ' nce inspection Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:Arrival Time: Departure Time: ' J County: `s1 1 144 Region:
Farm Name: _ KvtA Rite, F y wA Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ) Title:
Onsite Representative:
Certified Operator: r.rt
Phone:
Integrator: k'6
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Non-L
Pullets
Other
Poults
Design Current
Discharges and Stream impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ❑ NA ❑ NE
❑ Yes
[:]No
RIFA
❑ NE
[:]Yes
❑ No
[3-K�A
❑ NE
017
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes [:]No ,_NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes EYRo ❑ NA ❑ 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 21412011 Continued

Facili Number: - Date of Inspection:
Waste bollection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [S_Na__❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No E3-NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 91 -r
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 11Ld" o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
fNo
❑ 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 environment
hreat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
&0
❑ NA
[] NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Wo
❑ 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
fj No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Arc 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 0<0 ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window A ,❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): � le^V "`-4 - `s 6 �
13. Soil Type(s): 810 [A)-- jK A4 -lJ 71,1
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
n 1Vo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E No
❑ NA
❑ NE
lb. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
P3N
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
5Ko
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [:2�No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [_ ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements []Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes dNo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number': - Date of Inspection:
24. Bid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �'No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes —, No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes I MNo ❑ 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?
af 6"- U 4
157(
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes 14K° ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes F4KO ❑ NA ❑ NE
[:]Yes No ❑ NA [] NE
❑ Yes
❑-No
❑ NA
❑ NE
❑ Yes
❑'Ao
❑ NA
❑ NE
❑ Yes
[;J'�o
❑ NA
❑ NE
Phone: 3 '�` S J
Date:4 0 AM d-'
2/4/20 4

Facility Number
Type of Visit: (3Coeoutine
nee Inspection
Reason for Visit: O Compl;
S trf;t.l
O Division of Soil and Water Conservation
O Other Agency
Operation Review Q Structure Evaluation p Technical Assistance
O Follow-up O Referral 0 Emergency O Other O Denied Access
Date of Visit:ell
Arrival Time: Departure Time: County:
Farm Name: t1 `{ �,(A-e Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
r{;,b_�.�1'i� Mfg e"A Phone:
11
trf/t Title:
Certified Operator: M
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Discharges and Stream Imuacts
Integrator:
Phone:
Certification Number: r`zr V T S
Certification Number:
Latitude:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultr
Layers
Non -Layers
Pullets
Turkeys
Turkey Pou
Other
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation? ❑ Yes [a>T—❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[E'KA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[] No
QIIA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
r�Ko
❑ NA
❑ 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 I of 3 21412011 Candnued

Faciiit .slumber: b Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes []'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No EE j i�A ❑ NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): O� N
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 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
©'-No/
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[goo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
E? o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
2<o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes [�'lsio ❑ 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
Wind��00%w [3 Evidence of Wind Drift❑ Application Outside of Approved Area
12. Crop Type(s)- lgleol'ti[.�w- (Lewq 2>✓) Sr.
13. Soil Type(s): V
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
aco
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
[] Yes
[3,4
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application'?
❑ Yes
[314o_
❑ NA
❑ NE
18. is there a lack of property operating waste application equipment?
❑ Yes
E;'�o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [5<o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �No ❑ NA ❑ NE.
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 2<0 ❑ 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 [g N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ YesF2"NC ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No E],pd71 ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA [:IN E
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ YesE�I<o ❑ 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?
Ants refer,to question #) Explain any'YES answers and/or. any additional reco
swings of facility.to better explain srtu'ii"tions (use:additionnl pages as: necessnrv.
CrA.b.,.k�LH,
SIu.Q4hmLt
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
r` p`�+ 0
[�,- 3 C - 13
❑ Yes 5KO ❑ NA ❑ NE
❑ Yes [�o [DNA ❑ NE
❑ Yes EJ NNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ZNNo ❑ NA ❑ NE
❑ Yes do ❑ NA ❑ NE
❑ Yes ]o ❑ NA ❑ NE
nmendations or any other eomments
D 6C3
Phi©- `f33`3
Date:.//
2141011

Type of Visit: <D<ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q-Woutme 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: + qm Departure Time: County:
Farm Name: Owner Email:
Owner Name: {� E._ K4 (Z ZrS Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: Title: JEC,/Z(u� _4 t 2 O A & Phone:
Onsite Representative: Cy (L-tSS ' _P R.+���-IC Integrator: mo(kz n.I RR.0 LJN
Certified Operator: S11111=9NA pw� Certification Number: 4
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
�, ., it i
1 v:,
Swine
DCurrent
esig�
Capacity `Pop.
4,. Degtgn Current
Wet Poultry ` @ap`aci't1 ' P
4
Cattleq�;
Design Current
C pacify Fop.
�d;�
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
y
Dairy Calf
Feeder to Finish
ASS t<
35
t
Dairy Heifer
Farrow to Wean
Design'rrent x
Dry Cow
Farrow to Feeder
I . . P�oultr, Ca aci
Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Qther
Turkey Poults
Other
Other
Discharges and Stream Impacts
. Is any discharge observed from any part of the operation?
❑ Yes
E3/No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
VNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
P<A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
024NA
❑ NE
2. Is there evidence of a past discharge froth any part of the operation?
❑Yes
cgNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
&No
❑ NA
❑ NE
of the State other than from a discharge'?
Page 1 of 3 21412011 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �No ❑ NA ❑ NE
a, If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ©'NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:. ,k ,2
Spillway?:
Designed Freeboard (in): 19
Observed Freeboard (in):�_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ff No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
�No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7, Do any of the structures need maintenance or improvement?
❑ Yes
[Vo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[ "No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[2/No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2/No
❑ NA
❑ NE
maintenance or improvement? -
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E3"'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): � V_9,MU n 0, (rr eL�RpZ_!Z) � , C7,-
13. Soil Type(s): P&i>.}Sm_Q-S "_ Qc : I tRCt,V 4A ?^ La i
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [gNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [2"No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes �No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes [v'No ❑ 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 [3No ❑ 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 CyNo ❑ 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 ENA ❑ NE
Page 2 of 3 21412011 Continuer!

Facility Number; -I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [] Yes E�No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes eNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ❑ No giA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA [1Q<E
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No [2""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 ❑ No [DI"'NA ❑ NE
❑ Yes ❑ No []k<A ❑ NE
❑ Yes ❑ No [RNA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No E DNA ❑ NE
33. Did the Reviewcr/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No [ /NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ No [2"'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 pages as necessary).
P\l _OGF_ R CSR£SS V EJ�E_ ;000r� czra *Nh Yn Dr~ OF LpF y:onS -�3_ � a.
P1 E.�► S� c a,�sr.u� ko wo 9. O%N b Mz L_ va <Z_1LNS a tLo%.>'o t' A 5)Ocar's Z e 1
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: crjU'3C7�"Cosfsi
Date:
21412011

'7//V1 //
0
C:'Division of Water Quality
o Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit.:: 0 ttoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: !/'J / J/ Arrival Time: Departure Time: ! County:
Farm NamePtu'e_ r�Zw- Owner Email;
Owner Name: Phone:
Mailing Address:
Physical Address:
Region: �!TMO
Facility Contact: l._l.]—_)q,(-W i &Jj Title: Phone:
Onsite Representative: �J'lQ� Integrator:
L� _
Certified Operator: cg� �u P�A Kjc/ Certification Number: vS[�
Back-up Operator: Certification Number:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Design Current
Wet Poultry Capacity Pop.
La er
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Pouits
Other
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
to
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
�A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
LEA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
ET<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21417011 Continued

Facility Number: 6;0Date of Inspection:
Aste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0;K ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No J2,i�A ❑ NE
Structure ! Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
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?
❑ Yes
&g-Ko
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[]Yes
❑ No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
U14o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
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
tG.iXo-
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
'U 'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ul ❑ 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the
MP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
[:]Yes rFwKo ❑ NA
❑ Yes [L_4410o ❑ NA
❑ Yes
[j;o `o
❑ NA
❑ Yes
(Ko
❑ NA
❑ Yes
19<0
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Ko ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Vo ❑ 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 Co ❑ 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? [3Yes No ❑ nAE]
NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No NE
Page 2 of 3 - 21412011 Continued

Facility Number: - Date of Inspection:
24Did the facility fail to calibrate waste application equipment as required by the permit?'l
❑ Yes
OB o ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
L.R4f CI 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
[[kNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No ❑ NA
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
g 10 ❑ 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
[DNd" ❑ 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
❑ Yeses
❑ 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
/�
[94o ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�T/o ' ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
/o
['NO ❑ 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.udditional pages as necessary).
'4pce�� n,-ou
4k, l
a�►-ass `-t' uu- 1-� D,io4k ase. �
Reviewer/Inspector
Reviewer/Inspector S
Page 3 of 3
Phone:�� 3' 33
Date:
41201

B54t C IO - 05'— 7.00 9
erl6iivislon of Water Quality
Facility Number 8,2 J ,y J Q Division of Soil and Water Conservation
— Q Other Agency
Type of Visit O'Co-mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 01105utine 0 Complaint 0 Follow up 0 Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: 9'�B'o4 Arrival Time: 2: 4 D Departure Time: County: _4Z! sue• SOfu Region:
Farm Name: KNa* Ai A/e_ Owner Email:
Owner Name: _ __M' KR- i�e irrl'r�� Phone:
Mailing Address:
Physical Address:
Facility Contact. G:� r �i" Br e&J C,1C Title: 7—e-e-4 Sr e-C- Phone No:
Onsite Representative: Integrator: W 6yie— F�yv s
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Operator Certification Number:
Back-up Certification Number:
Latitude:
=�
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wan to Feeder
ceder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
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?
Longitude: = ° = ' 0 "
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? (Il'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 D o El NA ❑NE
❑ Yes
❑ No
E�<
❑ NE
❑ Yes
❑ No
B<A
❑ NE
3-<A
❑ NE
❑ Yes
❑ No
❑ Yes
❑-Ko'
❑ NA
❑ NE
❑ Yes
�o
El 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 l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2 t� Z 7 "
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 E o ❑ NA ❑ NE
[:]Yes ]o ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes E<o ❑ NA ❑ NE
❑ Yes D-Ko ❑ 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 2<o❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ElYes ❑"1vo�❑ 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 Ly-tvo ❑ NA ❑ NE
maintenance or improvement?
Waste Application ,�
10. Are there any required buffers, setbacks, or compliance alternatives that need [I Yes 3-110 ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes L"`i< ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]'PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 3'LV $U% u< c� cti CG
13. Soil type(s) 80 R ,,.,,_,,``
14. Do the receiving crops differ from those designated in the CAWMP? [3 Yes [9 o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes DFIN"o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes [3-No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes 3<o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes [3 o ❑ NA ❑ NE
Reviewer/Inspector Name I i r� 7C'' eV.0 -s ' Phone: yl0• V33• 33 3
Reviewer/Inspector Signature: Date: 9— /8— ZOO?
Page 2 of 3 12128104 Continued

Facility Number: Z — Date of Inspection
Reaulred Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 09<o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ONo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[3'Ko'
❑ 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?
El Yes
�❑
[3 o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
0.,'I
El NA
[I NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
o
3 o
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
t -T o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ NA
ElNE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYes
�0-9
GJ'1vo
❑ NA
❑ NE
Other Issues ,�
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes G<o ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[3<o
❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ 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
LT No
❑ NA ❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
2<o
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
eKo_
❑ NA ❑ NE
12128104

13s lzls q--OS-4 8 Rk_
i �Ttalvision of Water Quality
Facility Number Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit &1150mpliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint Q Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: "/9`D8 1 Arrival Time: Z_: %S- �.. Departure Time: �.� f�SS County: Region: *"
Farm Name: Ne,� jjf� ,/5/alvc_ �`� �'"'� Owner Email:
/i'//& Ile
Owner Name: r/Y1 Nei Phone:
Mailing Address:
Physical Address: //oo
Facility Contact: C.KJ-�i*S S4Yk1/_c'-___Title: / ,+Phone No:
Onsite Representative: (_ dl S �y W r �,/C Integrator:
Certified Operator:
Sack -up Operator:
Location of Farm:
Swine
Operator Certification Number:
Hack -up Certification Number:
Latitude: = o = 1 Longitude: = ° = 4 = !f
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
El Farrow to Wean
I $ y
$25$ 2-
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Soars
Other
❑ Other J
Dry Poultry
❑ Layers
❑ Nan -La ers
❑ Pullets
❑ Turkeys
❑ Turkex 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 Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures: a]
ii
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑Yes B ❑NA ❑NE
❑ Yes
❑ No
2lA
❑ NE
❑ Yes
❑ No
D 11�A
❑ NE
S<A
Cl NE
❑ Yes
❑ No
❑ Yes
[3 o
❑ NA
❑ NE
❑ Yes
L_TNo
❑ NA
❑ NE
12128104 Continued

r�
Facility Number: SZ — & / I Date of Inspection 127 _/ -D
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,_oo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [I Yes 3 o ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in); Z49 Z
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [ 'go ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes El-mor ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 3-5—o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit'? ❑ Yes D-1173' ❑ 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 2-N-6 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 2<o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E `<u ❑ 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 [I Evidence off Wind Drifi [I Application OutsideofArea
d 12. Crop type(s) RerMai,— h1 *> y ;, r,c.J . Sm.11 �ra(40
.iu . S•J �1'ofP4c✓f Ab'mk✓ JNNac.1,
13. Soiltype(s) C7O45, A at✓ (V419
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[f No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ Flo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
D<o
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
KNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
2<
❑ 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):
i
Reviewer/Inspector Name Phone: 9/0, t%p33, 333 0
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: $Z — Cv l Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes , _�Io El NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ElED Yes ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes LTNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfalt ❑ 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
0<)
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
oo
❑ NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,R,
o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0<
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
0-Ko'
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[3'5'o
❑ NA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
,/
E No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
B<o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
D<o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[?go'
❑ 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
L�IVo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
Q'Na ❑ NA
❑ NE
Additional Comments and/or Drawings
Page 3 of 3 12128104

0 Division of Water Quality
Facility. Number �-,O Division of Soil and Water Conservation .�
QUther Agency
f,
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ denied Access
Date of Visit: /Q-L►3 -07 Arrival Time: 2: 20 Departure Time: Z.SD County: Sk* enJ
Farm Name: j6ft14u Pwe- F'm - Owner Email:
Owner Name: Ak kc- Phone:
Mailing Address:
Region• C'CD
Physical Address:
Facility Contact: dt-1 r, uc Title: Phone No:
Onsite Representative: Cor
p _Cu✓.'1-4y4 � r�x 4 � Integrator: o ►rl f- t-0A S
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 = 4 =61 Longitude: = ° = 4 = `l
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
T ❑ Non -La ei
Dry Poultry
Non-L
Pullets
I u1nl J
Other ❑ Turkc Poults
❑ Other El 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 I
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 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 [4 No ❑ NA ❑ NE
❑ Yes
[9 No
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[� No
❑ Yes
;3 No
❑ NA
❑ NE
❑ Yes
[;R No
❑ NA
❑ NE
12128104 Continued

Facility Number: SZ — is f I Date of Inspection /0-0--07
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ® No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 'Z r
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
® No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
1� No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
5] No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
qNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[� No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA [:IN E
❑ 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 Drill ElApplication Outside of Area
12. Croptype(s) 13emy- J... `Gw.-. Sr,,&a " rO.S.�
---
13. Soil type(s) [�p,p W [-8
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
EgNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
In No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑
Yes
[21No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
(3 No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
q No
❑ NA ❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name RZ,Y-4�,-VC)J Phone: 9/0. V33 .3300
Reviewer/Inspector Signature: .e_JL_ Date: /0 -03 - 2-007
12128104 Continued

Facility Number: gZ --(p/ Date of Inspection 0-03-07
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [$ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22, Did the facility fail to install and maintain a rain gauge? ❑ Yes [P No ❑ NA ❑ NE
23, If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[4 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
[3 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28,
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E� No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30,
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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
[M No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[� No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Comments and/or
1 Z/28/04

,—k—.h-. _/
de4-
j Type of Visit ® Compliance Inspection 0 Operation Review 0 Structure Evaluatlon 0 Technical Assistance I
I[ Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Dateof Visit: j_C�_ O Arrival/Time: :;0 Departure Time: County: 54*9Q^1 Region: �2d
Farm Name: ____lNtf�-, Ci'�ye �avn.i Owner Email:
Owner Name: 7Ila e 12� r'v, Phone:
Mailing Address:
Physical Address:
Facility Contact: Ak-4c, e_l lh!![.vri�z5 Title: Phone No:
Onsite Representative: _n1ek_1'_%_ U V W,, Integrator: �p_La-
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 0 t 06 Longitude: 0°= L=
tl
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish L!
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars f
, 'Other
❑ Other
❑ La er
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharp,es & 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'?
Design Current'
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Cowl
i
Number of Structures; 93
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
e. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [K No ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
R No
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

1
w
acility Number:
Date of Inspection $-• 2
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z
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 M No ❑ NA ❑ NE
❑ Yes 5A No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes N 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 [A No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
1� No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes]
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[: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 Drift ElApplication Outside of Area
12. Crop type(s) Se rM tAdc_ — q irQS! na Cry G m l nt
. T.
01
13. Soil type(s) Q/QA/-A OJU'nW dlni-Vt1AJ
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
[N No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination" [I Yes
[7No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
14 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
R No
❑ NA
❑ NE
Reviewer/Inspector Namey.'. ,; Phone: �110�Sta �Sy�
Reviewer/Inspector Signature: / ? ¢,,,,e,td. Date: 5 o 2- — z o o Cv
ll/27/U4 uonunuea

Facility Number: Z — Date of Inspection 5 D —
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ® No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes '® No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 59 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`?
❑ Yes
[ZNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
® No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit'?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[Z No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
®No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern'?
❑ Yes
® 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
R No
❑ NA
❑ NE
General Permit? (ie/ discharge, Freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
V No
[I NA
El NE
12128104

a
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine Q Complaint O Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: y1. Arrival Time: Departure'Hine: County: � "ytrAt—
Farm Name: n e [ [ �1 ? u Owner Email:
Owner Name: ev`k I 1k Phone:
Mailing Address:
Region: FRO
Physical Address: I
Facility Contact: i C. 4 a P. [ f-F �v&b i .... Title: Phone No:
Onsite Representative: M k 6aLe 6-le vtr �`�3 Integrator:
Certified Operator: Im 11c, LG sGyY� 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
Boars
Other
❑ Other
Back-up Certification Number:
❑o =' ❑� =o ❑1 ❑
Latitude: Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
I! 0 Non-Layet
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharizes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Daia 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 [No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes No ❑ NA ❑ NE
❑ Yes 0 ❑ NA ❑ NE
12/28/04 Continued

r :.-+
Facility Number:
Date of inspection —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 1 Structure 2 Structure 3 Structure 4
Identifier: ! 1
Spillway?:
Designed Freeboard (in): f �'
Observed Freeboard (in): 4 a
5. Are there any immediate threats to the integrity of any of the structures observed'?
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes [B No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes D o ❑ NA ❑ NE
❑ Yes UYNo ❑ 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 [9'No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes LT 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 ENo ❑ NA ❑ NE
maintenance or improvement?
Waste Application ,-,r
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes lld No ❑ NA ❑ NE
maintenance/improvement? ��//
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ L" Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
ElNA
ElNE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
,03
L--9,,,'��N""o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[]
Yes
[R/No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
2"No
❑ NA
[INE
18. Is there a lack of properly operating waste application equipment?
ElYes
P'Ni o
❑ NA
❑ NE
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone:
Date:
12128104
Ivy
Continued

Facility Number: — ? Date of Inspection
Required Records & Documents ,,��,,!!
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes EPC ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes FjeKo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste4rH4&tioja- ❑ Week y r1—F'eeT a d ❑ Wa�igsis ❑ S&4*r,4ysis ❑ k ❑ Aranuds Pr► � -
❑ R-HinfeN ❑ Sww6 ❑ Cold ❑ 120 Ikliaus_Iw4)eet4ons ❑ Mo nd-l"R�ain-Inspections ❑ W4athw-Ce4e
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
E91No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'?
❑ Yes
allo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
CdNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No-
❑ NA
El NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,62
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[VNo
❑ NA
❑ NE
Other Issues
29,
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[]Yes
VNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal'?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
MfNo
❑ 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
9No
❑ 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
I �+ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JN o
❑ NA
❑ NE
AdE��� r Fi', ff Y #. L �? air .k lr -�: "�1"-Y - 4 a i 4 Z } t-P
ditional�Commenta and/or l?rttryrn#;sH a, r ,
v`G._ `� !'rt. i1�i1 %"i
12128104

of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification *Other ❑ Denied Access
Facility Number KZ blJ Dale of Visit: 3I1i/2004 Time- 9:30am
Not O erationxl Below Threshold
® Permitted ® Certified D Conditionally Certified []Registered Date mast Operated or Above Threshold: ..................
Farm Name: k iwilly-RimI: .a rim ..................... ......... County: S.aialpS0jn........................................... F.Ro .............
Owner Name: Mjj:ha.el.................................. Hvir.ratotg...................................................... Phone No: 9.1.0.161-C443............ ................................................
Mailing Address: I42R.JFxyg,.jl:idg95.R&.......................... ...
Facility Contact: ................................................... ......1`itie: .. Phone No:
Onsite Representative: Mjcba&RerrLng....................................................................... Integrator: i1: urpbY..Family-Earm.........................
Certified Operator : ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
From Clinton, take 421 N and go about 0.5 mile past US 421/701 split to first stop light, turn Lt. onto SR 1311, go 1.0 mile to
farm entrance on Lt.
® Swine ❑ Poultry ❑ Cattle ❑ Horse LatitudeF 35 'F 110 36 Longitude 78 • 22 00
Design; ° Current . ; ` ; Design Current Design Current
Swine Cif aci ': `Pa ulafion. Poultry. Ca acit Po ulapon.. Cattle , ` , Ca self Po ulation
p yp P y... P
❑ Wean to I ceder
® Feeder to Finish
4896
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Imuacts
1. is any discharge observed from any part ofthe operation'? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field []Other
a. If discharge is observed, was the conveyance man-made? El Yes ❑ No
b. If discharge is observed, did it reach Water ofthe State'? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. [hies discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes [:]No
2. Is there evidence of past discharge from any part of the operation'? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & 'Freattnent
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway [-]Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): zj 39
................................ .............................................................................................................................................................................
12112193 CanlinuPd

?acil' - Number: 82-'61 Date of Inspection 3/19/2004
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ❑ No
closure plan'?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? [:]Yes ❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination'?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
l5.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment'?
❑ Yes
❑ No
Odor Issues
17.
Does the discharge pipe from the confinement building to the storage pond or lagoon tail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18,
Are there any dead animals not disposed of properly within 24 hours'?
❑ Yes
❑ No
19.
is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
20.
At the time of the inspection did the facility pose an odor or air quality concern? II'yes, contact a regional
❑ Yes
❑ No
Air Quality representative immediately.
Comments refer t _,. U r. 4 r 3
(. o.questton #}z� E plain uriy YESansKers and/or any recommendptfons or,Any,other commen ts 4G
4 M �r5
Use drawingsrof,factitty to;better;explain�situatiotis '(ase addlhonal pages as necessaryj: ° � i
®t field Copy ❑Final Notes
i.. Y , } r 4 . % .
`3'.": •4. i C'a `' s^• t' _'f
tea, .r. ::�i"'• _. t... :4-
Visited farm at request of SWC to look at a pipe in the lagoon wall. Pipe appears to have been used as a possible pump supply line. Mr,
•
Herring removed the pipe with little effort and it is not a possible discharge route. Water or some other material coming up near the toe o
the dike will continue to be investigated and monitored.
Reviewer/Inspector Name Larry Baxley Dann} Edwards {
_, ...
ReviewerAnspector Signature: Date:

c
�sa+'�� '�i�'" ..._j�,�, -e,:" � ... l .r-°� �'f'3�.'•J'-"�y t.. p`' �„`�' i°`sr-�'��!"� -r'i� �.,� al.`�.�' �._..,n,-_
Be r
� r-�.�',A9��`x . 4 : s.'�` ,�;i' �"�t . _ ., .r ` s. :�� r �`�m -:Fd �.t. ...Si s.. �F .. x - ,_ -. , .., ,. E.aS 3_ •.'�'-- _ .'�: '�. � a '��s . ��i ..
Type of Visit .O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 3/79/2004 Time: 9:30am
Facility Number 82 61
5 Not operational Q Below Threshold
® Permitted ® Certified [] Conditionally Certified (] Registered Date Last Operated or Above Threshold: .......•....
Farm Name: Kl1.ARyTijltr..Form......................... County: S.AMjjS()M ........................................... FRO
Owner Name: MAciaajel.................................. J11ty.ring ...................................................... Phone No: 9.1.0-SG4769.43.................................
..........................
Mailing Address: 7.52.R.a:i.Y.g..8 dgt:t.Rd ..............................
FacilityContact:..............................................................................'l'itle:........._...._.............---................................. Phone No: ...................................................
Onsite Representative:,Mj,CjAgj.RgrXjAg..........................
Certified Operator: ................................................... ..........
Location of Farm:
— Integrator: Murphy-Fatmily..l;.ar t>rs.........................
.. Operator Certification Number:
7rom Clinton, take 421 N and go about 0.5 mile past US 421/701 split to first stop light, turn Lt. onto SR 1311, go 1.0 mile to A
arm entrance on Lt. .r
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =0 F 00 i 36 rb Longitude 7I3 • 22 00
Design . Current Design Current Design. Current
`Swine.....,..,.:Capacity .. f oultry .._ Capacity Population Cattle -A' Capacity','` Population ,
❑ Wean to Feeder
® Feeder to Finish
4896
❑ Farrow to Wean
❑ harrow to Feeder
❑ Darrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Im acts
1. Is any discharge observed from any part of the operation'? ❑ Yes ® No
Discharge originated at: [:]Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part ofthQ operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (Freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 0
Identifier:..................................................2................,........................................,......................................................................................................
Freeboard(inches): ...............2.1................ ...............32....................... I........................... .........................................................................................................
1211210.3 rantinuod

I+aciiity Number: 82-61
Date of Inspection 3/19/2004
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste ADnliC51t1on
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? if yes, check the appropriate box below,
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination'?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment'?
❑ Yes
❑ No
Odor Issues
17,
Does the discharge pipe from the confinement building to the storage pond or lagoon tail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18.
Are there any dead animals not disposed of properly within 24 hours'?
❑ Yes
❑ No
19.
Is there any evidence of wind drill during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
20,
At the time of the inspection did the facility pose an odor or air quality concern'? If yes, contact a regional
❑ Yes
❑ No
Air Quality representative immediately,
ac r7 a nzer
fCor�ments,(refcr1laqucstionz#f) L�Expiatn aieyYEB answers andl�r any�recommendations or atiy other comments°
u
lJse drawtngsyyyyof4faCitityfto better explain s�tuat<oni3 (u�� acldiponal pages as necessary): ' E ®f ieid Copy ❑ 1 tnal Notes
,.,yc 4. *'} - � 7ri � �; � ti _ =.�db ,. uE � r 3 5f,�, ,�
1 >> re pp
h3 -��'. `L txil :r,:.w E n_ L�. �. K �4 ��'Y �. �.. .,Y�.-..� r • w �rr. S ��.-�.� .. $.' .. � E .. r: A ... t _.:_x`,k ..:;f �.
Visited farm at request of SWC to look at a pipe in the lagoon wail. Pipe appears to have been used as a possible pump supply line. Mr.
Herring removed the pipe with little effort and it is not a possible discharge route. Water or some other material coming up near the toe o
the dike will continue to be investigated and monitored.
Reviewer/Inspector ]Name r.a
LarryBaxley, Danny Edwards; E a
Reviewer/inspector Signature: Date:

Rodtlne O Complaint O Follow-up of DWQ Inspection O Follow-up of LISWC review O Other
Facility Number ` Date of Inspection 2
Time of Inspection- Use 24 hr. time
Farm Status: ^�� , , r , , Total Time (in hours) Spent onReview
or Inspection (includes travel and processing)
Farm Name: %w/ / %�✓ County:
Owner Name: c1 . - - Phone No:
Mailing Address: 3 �1 r ,Da� �,�... s�-� �[ os4� ��-✓�i.J� /�/
OnsiteRep resentative: '�'¢"'� Integrator.�����"-�
Certified Operator-.— ��'''�yr�.... Operator Certification Number...�`�D
Location of Farm:
Latitude �•�� r-�� Longitude �• 0` 0�
1.7 Not -operational Date Last Operated:
Type of Operation and Design Capacity
<'a.. t w'. ,Fw''�r� sxd3i!M
n , �� ¢chi '& "' 6R 'A�e ..s-'`n,�'.^, a� 'R
Swine, . .. ro :°�:Numberx� „ Paul�'�.r�. ;� 4 Catt1C r ,
fy, Numbers �..��Iumlie 017
EF2ider
eeder ❑ La er ° ' ❑ DFinish 9l Non -La BeefD Wean�
er Finish ❑Other Type of Livestock
s
r yz,�i{ t'r° a fork ,,
r .i fi t^s. ='�� �• ;m> &�.'����:�?°, .Fw'<Si'��'�+5.•h.1 e�"„��K .P; [ kT,�:.r?..e:
Y ;,;xr"*b4�e:'6 X.SM - ,.y..� �'^�•�"•0-s+'t�s4 - .£' x;
Number of Lagoons'/Holding Ponds ❑ Subsurface Drains Present01
. -'
�j . ,
�r � �• �„� ��° � �.� - � �z����� . ❑Lagoon Area n� ❑Spray Field Area
1. Am tl e= any buffers that need maintenanWimprovement?
❑ Yes ANo
2. Is any discharge observed from any part of the operation?
❑ Yes
® No
a. If discharge is observed, was the conveyance man-made?
❑ Yes
® No
b. if discharge is observed, did it reach Surface Water? (If yes, notify DWQ
❑ Yes
f9 No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yea
K] No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
IN No
4. Was there any adverse impacts to the waters of the;State other than from a discharge?
❑ Yes
® No
S. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
® No
maintenance improvement?
Continued an back

6. Is facility not in compliance with any applicable setback criteria? ❑ Yes 55 No
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/l/97)? ❑ Yes 10 No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ® No
Structures(Laeoons and/or folding Ponds}
9. Is struchual freeboard less than adequate? ❑ Yes jR No
Freeboard (ft): —���� Lagoon Lagoon 3 Lagoon 4
10. is seepage observed from any of the structures? ❑ Yes W No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes IN No
12. Do any of the structures need maintenance/improvement? IN Yes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels? ❑ Yes A No
Waste Application
14. Is there physical evidence of over application? ❑ Yes J3 No -
.(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type
16. Do the active crops differ with those designated in the Animal Waste Management Plan? ❑ Yes No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes No
18. Does the cover crop need improvement? ❑ Yes ® No
19. Is there a lack of available irrigation equipment? ❑ Yes ® No
For Certified Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes ❑ No
21. Does the facility fail to comply with the Animal Waste Management Plan in any way? ❑ Yes ❑ No
22. Does record keeping need improvement? ❑ Yes ❑ No
23. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
24. Did Reviewer/Inspector fail to discuss review/mspection with owner or operator in charge? ❑ Yes ❑ No
e,✓ / ,� Al.%s ,fie
Reviewer/Inspector Name r'
Reviwer/Inspector Signature: _ _ Date:
cc: Division of Water Oualltv. Water Ouality Section. Facilitv Assessment Unit 11/14/96

` State of North Carolina 'T
Department of Environment,
Health and Natural Resources •
Fayetteville Regional Office
James B. Hunt, Jr., Governor C)aHNFZ
Jonathan B. Howes, Secretary
DIVISION OF WATER QUALITY
April 24, 1997
Mr. Randy Autry
3515 Bud Johnson Road
Clinton, NC 28328
SUBJECT: Annual Compliance inspection
Knotty Pine Swine Farm
Registration No. 82-61
Sampson County
Dear Mr. Autry:
On April 22, 1997, staff from the Fayetteville Regional Office of the Division of Water
Quality inspected the subject swine facility. Please find enclosed a copy of our Compliance
Inspection Report for your information. It is the opinion of this office based on the
information provided and observations made during the inspection that the facility was in
compliance with 15A NCAC 2H, Part.0217 at the time of the inspection. Please refer to the
comments section on the rear of the inspection form for information regarding your facility.
Please be aware that all swine facilities with a liquid waste collection system designed for
a minimum of 250 hogs must have a certified waste management plan on or before December
31, 1997. The district NRCS office, Agriculture Extension office, or the Division of Soil
and Water have specialist available to assist you with upgrading of existing facilities and
certification.
If You have any questions concerning this matter, please call Robert Heath at (910) 486-
1541.
Sincerely,
Robert F. Heath
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine - FRO DSW
Wilson Spencer - Sampson Co. NRCS
Wachovia Building, Suite 714, Fayetteville FAX [phone]
North Carolina 28301-5043 NQC An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10°% post -consumer paper

• Rootine O Com hint O Follow-u of DW is ection -a-Follow-up of DSWC review O Other
Facility Number Date of Inspection
Time of Inspection - .PO Use 24hr. time
� ir/�E Total Thu (in boars) Spent *Ocvkw
Farm Status:. or Inspection (Includes travel and processing)
Farm Name: 1f!"""A, f� - — - sty: .5Zebvo_.,.,,.._
t?+raer Name: - . L0z— 4 Phone No:or
..�
]��/{s/■�■ Addreess: 3.�ir �u� �,��,,a..� o� C/,.✓�,.� IV 6
MsEliag..�w...wt.M1i�...��1�.F�M ,n�........�
Onsite Representative: R±:2 y '7�zti hftrator: 4... .,Z-� all'
Certified Operator: �*"�� T`''T Operetar Certification Number.-Jrjj!O C
Location of Farm:
Ladtade • 61..�...ta Longitude • 1 ■
03 Not Operational JDate jut Operated:
Type of Operation and Design Capacity
-swim: � 3r Number ToRiltry u Number attk r MNumber >
Wean to Feeder €
Feeder to Finish k tiz140 Non- ,� Beefow
fg Feeder
x+�,
Farrow le Eind 1 s ❑ Other Type ofilveatocic
�`ir'rx .�- �W"•,`.^'� . ew �f. .;,,fit* �'°;Y��a�.'=:: Sr.i�,"'�'>'� X�',�`�;';t:`- .,;'�ri,� ,���y�!°r�*�;, :"'{ "�„ `.,�+ -4 !r-:.. y �,� �w�,��r�' 4�
�"�Namber afLagooni !Holding Pond: r�: Subsurface Drains Present
Lagoon Area S r fWd Area .
SIR
1. Are there any buffers that need maainteaao❑ Yee JKNo
2. Is nary discharge observed fam any part of the ooperadon? ❑ Yes ® No
a. If discharge is observed, was the conveyance man-made? ❑ Yes ® No
b. If discharge is observed, did it teach Sm face Wam? (If yes, notify DWQ) 0 Yes ® No
c. If discharge is observed, what is the estimated flow in gal/nain?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) 13 Yes Si No
3. Is there evidence of past discharge from any part ofthe opetadov? 13 Yes 99 No
4. Was there any adverse impacts to the waters of the State other than, $om a discharge? 0 Yes It No
S. Doe any put of the waste management system (other than IagoonsUlding ponds) inquire ❑ Yes ❑ No
maintenanoelmt?

6. Is Sdiity not in ooamplium with any applicable setback afte ia? 13 Yes jq No
7. Did the ficility 60 to brie a artified operator in respondble charge (if won aRer 1/IAM? n Yes 0 No
S. Am there lagoons or storage ponds on du which need to be property closed? 13 Yes 8 No
9. Is structural frxboard less than adequate? 0 Yes Ig No
Freeboard (>}): ia600 V Lagoon 2 iagooa 3 lagoon 4
�.AA
10. Is seepage observed 5gm any of the struchaW
11. Is erosion. or any other tlereats to the integrity of my of the Muctin a observed?
12. Do any of the strufturx need '
(If say of questions 9-12 was answered yes, and the situation poses an
Immediate public health or environmental threat, soft DWQ)
13. Do any of the structures lack adquaue markers to identify serf and stop pumping levels?
Waits ARPTICRUDD
14. Is there physical evidence of over &WHcWon?
.(If in excess of WMP, or runoff entering waters of the State, no* DWQ)
15. Crop type �' r
16. Do the active craps differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
IS. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For QW&d Facilhle L an}v
20. Does the ficrlity fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
IL Does record keeping need improvemcnt? .
23. Does facility require a follow-up visit by same agency?
24. Did Revie wAnspmor fail to discuss seviewlinspection with owner or operator in charge?
13 Yea M'No
Yes IR No
12 Yes ❑ No
(3 Yes J21 No
13 Yes JR No-
13 Yes H No
p Yes 9 No
13 Yes ® No
13 Yes ® No
E3 Yes 13 No
13 Yes ❑ No
El Yes 13 No
13Yes 13 No
O Yes ❑ No
t:orsimeats (refer to questron #) Explain u►yYYES answCa IMPd raay rerommcadabans or s othei ob rma { ;�- r
... .:..
13se draavings !af facility to better explain situations. fuse addipoit pages as _ces�a%y .;,,r«' ``
�v�,� elf
�d.�/•�.loE eat d„
ReviewerAnspwor Name
ReAwer/inspeetor Signature: ^_!w Z.vv Date: