820071_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

t`
Type of Visit: PfCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: / Arrival Time: Departure Time: County:.�dR-- Region: yr���
Farm Name: Owner Email:
Owner Name: yea Phone:
Mailing Address:
Physical Address:
Facility Contact: p ✓I A'. -z:7 C06e Irejj_ Title:
Onsite Representative:
Certified Operator: /,
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: &"_4/
Certification Number:
Certification Number:
Longitude:
current^i Destgn
Design C**urrent
�g
iCurrent
p Swine Ca ty
Pa We t Poult
p ry Ca l
P.
K:::.
IFop.
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to FeederL
INon-Layer
I
Dairy Calf
Feeder to Finish
N
Dairy Heifer
Farrow to Wean
. .
Design Current
Pry Cow
Farrow to Feeder
P,o!i;,
Non -Dairy
Beef Stocker
Farrow to Finish
"' ` Layers
Non -Layers
Gilts
Beef Feeder
Boars
Pullets
Beef Brood Cow
Jill I
Turkeys
t
Oter�k'
Turkey Poults
Other
Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at. ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes allo ❑ NA ❑ NE
D Yes
❑ No
❑ NA
❑ NE
❑ Yes
[:]No
❑ NA
❑ NE
❑ Yes
❑ No
0 NA
❑ NE
❑ Yes
ER No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
Page I of 3
21412015 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
rt 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
E@-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: �L
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[0 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
[,M 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
® No
❑ NA
❑ NE
S. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E[ 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
RLNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
B No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes FNo ❑ NA ❑ NE
❑ Excessive Ponding [] Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindow %❑ Evidence of Wind Drift ❑: Application Outside of Approved Area
Cy /
12. Crop Type(s): �l1 / 11ilfr' /
13. Soil Type(s)= � ` / u. rl/���r., Zf'I r�l�s-cr
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
El No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[a No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
allo
❑ NA
❑ NE
Rgguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [ ] Yes (R 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 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes MNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Ins ection- ('
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [a Yes [allo
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 R No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [gNo
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?
Reviewer/Inspector Name:
Reviewer/Inspector 5ignatur
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑Yes F2z]No ❑NA ❑NE
❑ Yes [A -No ❑ NA ❑ NE
❑ Yes [E[No ❑ NA ❑ NE
❑ Yes [ o ❑ NA ❑ NE
❑ Yes R No
❑ Yes ® No
❑ Yes �allo
❑ NA ❑ N E
❑ NA ❑ NE
❑ NA ❑'NE
Phone:
Date:
21412015

Division pf-Water Resources
Facility Number ®- I l..i_____l Division of Soil and Water Conservation
- - OQ Other Agency
Cype of visit: OTompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0Moutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 2 Arrival Time: Departure Time: /, E5 County: ,g t+hf Region:
Farm Name: +��5}�'�` r� 1 "`-� Owner Email:
Owner Name: IA�e,,t Phone:
Mailing Address:
Physical Address:
Facility Contact: ,&LpL tti rj{) rC�tyc yn-i Title:
i(
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: V( S
Certification Number: d— t Isy
Certification Number:
Longitude:
Design��Current��-�� I
Design Current "' Design Current
Swine.
Capacity�_.'Pop Wet Poultry
Capaccity Pop.
Wean to Finish
w Layer
u Dai Cow
Wean to Feeder
Non-La er
Dai Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current ' "` D Cow
Farrow to Feeder
�
;4 ,." Dry Pooult ,
��F�
Ca act l'o -Dairy
Farrow to Finish
rh'' La ers
-r,
Beef Stocker
Gilts
Nan -La ers
A, Beef Feeder
Boars
Pullets
70fl 113eef Brood Cow
- - -
- - Turkeys
Y
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify D W R)
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 DW R)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes Q-1'ro— ❑ NA ❑ NE
❑ Yes
❑ No
E NA
❑ NE
❑ Yes
❑ No
E]�NA
❑ NE
❑ Yes
[:]No
dNA
❑ NE
[-]Yes
❑"No
❑ NA
❑ NE
0 Yes
dNo
❑ NA
❑ NE
Page I of 3 21412015 Continued

Facility Number: Z— Date of inspection:
Waste Collection & Treatment
4. IS storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�- oo
❑ NA
❑ NE
a. Ifyes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑KA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[�o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[]'�o
❑ 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 Efl"No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes dNo ❑ 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 [5"No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes �No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes Ef 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): �e✓ a — G'— G4cj(S
IJ,4
13. Soil Type(s): Ato 'r '
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes FWr o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 2 o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes [2'/No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes El"No
❑ Yes EerNo
❑ NA ❑ NE
❑ NA ❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes Eevo
❑ NA
❑ NE
20. Does the facility fail to have all components ofthe CAWMP readily available? Ifves, 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 EfNo
❑ 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 ZNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ;�No
❑ NA
❑ NE
Page 2 of-3 21412015 Continued

Facili umber: 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 [ fi o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [ o ❑ NA ONE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? D. Yes D<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 tite 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 [2e'rqo ❑ NA ❑ NE
❑ Yes [No
❑ Yes 2No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
ER o
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
2 No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better exulain situations (use additional Danes as necessarv).
C'G b at (0-1 "
Cl - (5 -1A
5a '& SLz 6rul - 1;, -1 -1�
Reviewer/Inspector Name:
Reviewer/Inspector Signatut
Page 3 of 3
or 3-7 .
(f-e)^L4.s
ce,d q10-3a9-41?5(
Phone: "[ J �--33 IV
Date: 3 t--j `
21412015

Fype of Visit: [�Cou�Hance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: JAY,
Farm Name: OSf—e ✓` F Owner Email:
Owner Name: (3,e,, dP W oevv e j Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: V'o Irh`C U) d7y1i Title: Phone:
Onsite Representative: �( Integrator: 3
Certified Operator: f Certification Number:
Sack -up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design
Current, Design Current =.
Design Current
Swine Capacity
..Pop , �,-,: Wet Poultry Capacity Pop
Cattle Capacity Pop.
Dairy Cow
Dai Calf
Wean to Finish
ILayer
Wean to Feeder
Non -La er
Dairy Heifer
Feeder to Finish`:''
Farrow to Wean
Design CurreutDry
Cow
Farrow to Feeder
D . Paul Ca aci Po .
Non-Dai
Farrow to Finish
Beef Stocker
Layers
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other �r
Turkey Poults
NJ
Other I
Other
Discharees and Stream Imnacts
1. Is any discharge observed from any part of the operation?
❑ Yes
i_7 Z
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[&NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
�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 DWR)
❑ Yes
❑ No
�A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Q No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
G2-lqo'
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

[Facility Number: Date of Inspection: LO
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[!IiM-
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
E3"1GA
❑ NE
Structure 1 Structure Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[?].No
❑ NA
[] NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[:]Yes
[�o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[E31q0
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
C]"No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[E No
❑ NA
❑ NE
maintenance or improvement?
Waste Anniication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[]'1CIo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Q 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): G PJvK q �Q %t Gu Alh�
13. Soil Type(s):
OV6 A U k*)a-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [E'No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [B'No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ®�No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[J-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[Ergo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑moo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[21IQo
❑ 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
E�Ao
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
O No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ErNo
❑ NA
❑ NE
Page 2 of 3
21412014 Continued

Facility Number: TT I Date of Inspection: 6
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 1. No ❑ NA ❑ NE
25. Is.theiacility out of compliance with permit conditions related to sludge? If yes, check [—]Yes [g-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? D Yes [j?&o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [Z"'No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ZNo [] NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes dNo ❑ 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 do'No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes &No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes Z(No ❑ NA ❑ NE
Comments (refer to question #). Explain any YES^answerssandlor,any addi�bonal recommendations or any othe�r��cornm_e A.
Use'drawmgs ©f'faciIcty to=letter. explata sitna#rons (useaddit,onal pgggs.4smecessAry).
i 1
b cJ r 044
b
r ,r
Reviewer/Inspector Name: >< �,/� Phone: `3� 3-33 3 1
Reviewer/Inspector Signature: Date: /Ql
Page 3 of 3 21412014

i
(Type of Visit: iErtliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance I
Reason for Visit: O.Routine O Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
_. A - 'D
Date of Visit: Arrival Time:Departure Time: County: Region: FJw
Farm Name:—F=0 S f ` oar/ +� Owner Email:
Owner Name: 6, 1� c Phone:
Mailing Address:
Physical Address:
Facility Contact: Kiliyt I e i�u cv� S Title: Phone:
Onsite Representative: t( Integrator:
Certified Operator: `t Certification Number: S3
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Gurreut
Design C►urreut
Swine
Capacity Pop.
Wet PoWtry
Eaparity
Pop.
Caftle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
INon-Layer
I
Dairy Calf
Feeder to Finish
p O
I
Dairy Heifer
Farrow to Wean
n
Dry Cow
Farrow to Feeder
Dr. P,oul
Ca aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
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 o ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes [:]No
[3"TA ❑ NE
D NA ❑ NE
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 [f No ❑ 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 I of 3 21412014 Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ig-N
!__I NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
Q-i A-
❑ NE
Structure 1 Stru�L Structure 3 Structure 4
Structure 5
Structure 6
Identifier: '
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): c� V
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
©'lgio
❑ 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
[3' oo
❑ 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
L3 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
J'No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
❑"Ro
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ONo
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes eNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 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): ���.� �j ✓'�t S'�7
13. Soil Type(s): c "�- 4 lu , U c
14. Do the receiving crops differ from those designated in th AWMP?
❑ Yes
Q f4o
❑ 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
[3 o
❑ NA
❑ NE
acres determination?
IT Does the facility lack adequate acreage for land application?
❑ Yes
[�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E3"N-o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[3No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[]'%
❑ 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"] o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [a"No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E�No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of Inspection -
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes CJ To ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes EJ-K° ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus foss 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.
A 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?
[�(`&"A tom ►•l j(- °` K
Reviewer/inspector Name: 1� �l
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
Cj-�o
❑ NA
❑ NE
❑ Yes
l21"°
❑ NA
❑ NE
❑ Yes
I? eo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
C140
❑ NA
❑ NE
❑ Yes
❑ N
❑ NA
❑ NE
❑ Yes IZ/ o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
0 Yes ❑ No ❑ NA [] NE
Phone: 43 -3' 3 3
Date:
21412014

' i`vision of Water Quality
Facility NFY
umber =.A—IMI Division of Soil and Water Conservation
® Other AgS
Type of Visit: Com 'ante Inspection Operation Review p Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral p Emergency O Other O Denied Access
Date of Visit: 13 Arrival Time: Departure Time: dc7 County :�l Region: 1 UW
Farm Name: C.1 cc +�✓I.t Owner Email:
Owner Name: R ✓V- �{7 Phone:
Mailing Address: /
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: —P=,,A V'V, 4-� �t u a Integrator: rn19
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Desi
Current
Swine
Ca acl Po
P h' P•
W't :
efPoulry
Ca P aci
Po
"Cattle Ca aci Po .
-
Wean to Finish
Layer
Da Cow
Wean to Feeder
Non -La er
a
Da Calf
Feeder to Finish
0 4
"'
"
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D ,P,oult :
Ca aci
I?o P.
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I
113eef Brood Cow
Other
—.Turkeys
Turkey Poults
Other
Other
DiseharQes and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: `
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

03
FaciliNumber: Date of 1!!sj ection: O �C
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4 Structure 5
'��r f
Identifier: �j� b /
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3fo
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?
TT ❑ NA ❑ NE
❑ No Qom. ❑ NE
Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes [3<0 ❑ 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 Ej No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Qlq-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 []] No ❑ NA ❑ NE
maintenance or improvement?
_Waste Application
W. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ®No ❑ NA ❑ NE
maintenance or improvement?
1 I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑.kill ❑ 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):Lt (/J }d t�% !•�%
13. Soil Type(s): Wel /qt j4V'y1jr(�-e
14. Do the receiving crops differ from those designated in the CAWMP? i
❑ Yes
[jINo
❑ 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
o
❑ 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 Ul"No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[&W
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[ to
❑ NA
❑ NE
the appropriate box.
❑ WUP []Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? 1f yes, check the appropriate box below.
❑ Yes
[�t'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
Islo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[40
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Faedity Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA 0 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 EKO ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes EKO ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes < ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes to ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes [EKo ❑ 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
[3] No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ENo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
EE'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[2rNo
❑ NA
❑ NE
w�,��,w C
,5 lv�'C sc'l
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
e--3=4- R-3rS
11M
avN
Phone: W 0 q � 1 J
Date: 13J
V412014

Type of Visit: WCompliance Inspection n Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (]4outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: $ Arrival Time: / .�y Departure Time: /,'y County:�Sa Region: rR o
Farm Name: �C��-T� �� jZ{Y1 Owner Email:
Owner Name: ���RR�t7 �IJP`R{�_11� Phone:
Mailing Address: K z'!Z_Kari ROBE),
Physical Address:
Facility Contact: k V\M4. \3�\�XPoY6 Title: Phone:
Onsite Representative: �ptMF_ y
Certified Operator: �T W Vkg&'E1'1
Back-up Operator:
Location of Farm:
Latitude:
Integrator: K U ck!p $-\,4 � Oki
Certification Number:
Certification Number:
Longitude:
mm'
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Design Current
Capacity Pop.
40 p
� z � Design
Wet Poultry Capacity
La er
Non -La er
"`"
Design
D . P,oult , Ga aci
Layers
Non -Layers
Current
Pap.
Current
P.o
� Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dal
Beef Stocker
Beef Feeder
Boars
Other
Other
Pullets
Beef Brood Cow
Turke s
Turkex Poults
Other
Discharges and Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [g] No ❑ NA ❑ NE
❑ Yes
❑ No
[Q NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
m No
❑ NA
❑ NE
Page I of 3 21412011 Continued

J�
Facili Number: - Date of Inspection: Co7lV
L?
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
LW Yes
[:]No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
g) No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_!
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[4 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
W 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
[2a No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[] No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[] No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [M No ❑ NA ❑ NE
❑ Excessive Ponding 0 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): p t> ��st�sa PAs[U2 E, , 0 , Cs�Rf]� W)h £ -V ,_ 04b EAnS Zwfnm F't � IQ. Rk' POL64—
13. Soil Type(s): S2 �� 1i�c� d rq A R� L M_ l` r
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes rM No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes O No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [E No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ® No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes ® No ❑ NA ❑ NE
the appropriate box_
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes [0 No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
DNA ❑NE
Page 2 of 3 21412011 Continued

Facility Number: 82 711 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ro' No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes (4 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 M No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [A No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes q No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
[] NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[4 No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[0 No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
5Q No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: f Phone: 91U
n
Reviewer/Inspector Signature: Date: 6U511
Page 3 of 3 21412011

vli D INk 4 L3o
Type of Visit: 1�gr Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit: (2rRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: rqiTqi= Arrival Time: ,3D Departure Time: County: S01hVS01 Region: Q -
Farm Name: �(r�s }fir T'D!M Owner Email:
Owner Name: 6%2 k iNoffe/) T Phone:
Mailing Address:
Physical Address:
Facility Contact: �� �►rj j f/yt Title:
Onsite Representative: -Q 121,0 }tir llt'�t�
Certified Operator: U �Voffl n
Back-up Operator:
Location of Farm:
Phone:
Integrator: H B
Certification Number: �q�S
Certification Number:
Latitude: Longitude:
Z.
Design
j- Design Current
am Swine Capacity Pop. Wet Poultrv,� Capacity Pop.
Cattle Capacity Pop.
�ae r
F ., tee.,. .
Wean to Finish La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Dairy Heifer
Feeder to Finish
=
Farrow to Wean
Design Current
D Cow
Farrow to Feeder
D , �,PouId .
La ers
Ca aci P.o ,.
Non -Dairy
Farrow to Finish
Beef Stocker
Beef Feeder
Gilts
Non -La ets
Boars
Pullets
Beef Brood Cow
Turkeys
-
Qther
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[—]Yes ® No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
[:]Yes No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
Page I 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
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: C/�r� j/► ]
Spillway?:
Designed Freeboard (in): I Cf
Observed Freeboard (in): 33 �?
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
® No ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 6
❑ Yes CR No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes n No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes C No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [2 No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN n PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
UN No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check
❑ Yes
cnNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? []Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
UN
NA ❑ NE
Uil
Page 2 of 3 21412011 Continued

lFacility.Number: TZk - 71 IDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [51 No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes allo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No [�j 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 tilt drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes allo ❑ NA ❑ NE
❑ Yes [S No ❑ NA ❑ NE
❑ Yes [�j No ❑ NA ❑ NE
❑ Yes �3 No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [] Yes
[jNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss reviewtinspection with an on -site representative? ❑ Yes
6'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency'? ❑ Yes
No
❑ NA
❑ NE
�50n ,P- Iort QS cc - o, 9 & SI L ddyp�a-h p � th,p oMoh of - 0. q'sla e roVo, "if fy W-h wi 11 nc�(
1e&70Vf JAIJ+hl)l 0- -fie w y O/W fl t�s�
ISA -Cev -fi eldr hod hi h z j 1c I'eLets 01 the t o ' n ly r�l� S irs/e mar 9� r
-+hM aoaQ -2n T„d P, M- twe Yvef-e a -�I w bc-�f e:�7 l 000 aid aono, Coo) 1
OrR Un �nown, Sol I Say I Ivas do)e by a- pfof-ojlo►aI Coehpa 9.and FrtAe1--01 J
rilot ho �� h I h nvm ber1,
An by-� Ij Cam ��� y
�Ve mOjr1 4 W, -,(�l1>7 r
Reviewer/Inspector Name
Phone: `iwo-433-33ay&Q r)
Reviewer/Inspector Signature:
Page 3 of 3
Date: @o%
21412011

►(L�(/�J
VOT
Facility No. ?)-It Farm Name FO ��'Il Date
Permit ✓ COC OIC NPDES (Rainbreaker
Pop.
Type
Design
Current
C,
Ir,'IiA DINO Emm
TOM, 7-
ofilf 1,1A
PLAT Annual Cert )
�•lIi!!l.'ti�ii•!! .
Ir
Lagoon
3
4
5
6
7
Spillway
Design freeboard
;
Observed freeboard in
Sludge Survey Date
Sludge Depth ft
,
Liquid Trt. Zone ft
L
^
Ratio Sludge to Treatment Volume
"
Calibration Date
1"
2
3
4
5
6
7
8
Design Flow
Actual Flow
Design Width
Actual Width
Soil Test Date
Wettable Acres ✓ RAIN GAUGE
pH Fields
53,.)r) ✓
WUP ✓ Dead box or incinerator
Lime Needed
3J3-33s'2�,
Weekly Freeboard �� Mortality Records
Lime Applied)
atG
1�ror(..4
1 in Inspections ✓
Cu-1 Zn-fe3
v
120 min Insp. -
Needs 15
Weather Codes ✓
Crop Yield
Transfer Sheets
Waste Analysis Date
0151
.� s.
Em
55=5. ... 1 v J
Verify PHONE NUMBERS and- iliaon
Date last WUP FRO Date last WUP at farm j 1�I10
FRO or Farm Records
Lagoon #
Top Dike
Stop Pump
Start Pump
Conversion- Cu-1 3000= 108 lblac; Zn-I 3000= 213 Ib/ac
App. Hardware
Reel
�ol;d �o -
�r f o �fsd
ln�
fi
So i I sanr fej -00-
a4oR `$ wife.
Uno vdilobIf- bI-#-
aoogQho
hod tone, yT,)v n,4&3
8f Sao atd 1OMPo)
a} leo; �,e > (Om I I4'+e-,
" �n 5o4f crea or 4ie
0 -Q -N00 iYlabr0
5040,14,1 ?Job

g-rAfs g -1 z - 2_01 t9
- Division of Water Quality
iFaCMM Number gZ d % j Division of Soil and Water Conservation
M Other Agency
Type of Visit ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 9,'Zfi7w. Departure Time: S-.`GiQ k. County: _ S' f� ��- Region: 111r�
Farm Name: sle, Owner Email:
Owner Name: �er402241 &JcLy3 f'Phone:
Mailing Address:
Physical Address:
Facility Contact: rJ �� W: lei �►� S Title~"` ` w.c Phone No:
OnsiteRepresentative: Integrator:u-�6
7
Certified Operator: R'*" Al J'e- - j4z 6-V!`7 L,.j 1, d!", S Operator Certification Number: zel`S'3
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = I = !i Longitude: = o = I = u
Design Current
Design Current
Design Current
Swine Capacity Population
Wet Poultryy Capacity Population
Cattle Capacity Population
to Finish
❑ Layer
❑ DairyCow
to Feeder
❑ Non -Layer
❑ DairyCalf
r to Finish
Q
El Dairy Heifer
Hw to Wean
Dry Poultry
❑ D Cow
w to Feeder
❑ Non -Dairy
EFarrow
w to Finish
La ers❑
Beef Stocker
Non -La ers❑
Beef Feeder
Pullets
❑ Beef Brood Cowl
❑ Turke s
❑ Turke Poults
❑ Other
Number of 5truetures: 2
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the 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 B NA
❑ NE
❑ Yes ❑ No . NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes +' No ❑ NA
❑ Yes YNo ❑ NA
❑ NE
❑ NE
Page 1 of 3 12128104 Continued

Facility Number:
t! Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Vix
Zo
El NA El NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 344
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 240 ❑ 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 tthh at, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes L"I No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Id 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 VNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers. setbacks, or compliance alternatives that need ❑ Yes VNo
NA ElNE
maintenance/improvement'?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 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 El Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �r+�. kpC�.- �G r� GJ S . %/ �nr�i`N t�0 • S , i Su�,k,,. s us:�! r A. .. �s _ Grhr-wL-- 8-
13. Soil type(s) 1VPA (,J 4-8
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ETNp ❑ NA ❑ NE
E No ❑ NA ElNE
No ❑ NA ❑ NE
L7 No ❑ NA ❑ NE
Io ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? ❑ yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
'::
Comments (referrto question #): Explain any YES answers;andlor anv recommendations or am other comments ,
.Use drawings of facilityto better explain situations (use additional pages as necessary:)7,,y
Reviewer/Inspector Name FPS - Rl. t - - Phone:
ReviewerAnspector Signature: Date: g - /U - Z.0/0
12128104 Continued

Facility Number: 2 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate 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 1"
Weather Code
Rain InspectionVNN9,
22.
Did the facility fail to install and maintain a rain gauge?
El YesEl
NA
[I NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
�/N4❑NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ElNA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
VNo,,[I NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
El NA
El 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 CAW -MP?
❑ Yes
No ❑ NA
El 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
ONo ❑ 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
EJ No ❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative'?
El Yes;NoE1
,��
No ❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
El Yes
NA
❑ NE
Comments and/or
Page 3 of 3 12128104

0
Type of Visit
ompliance Inspection
O Operation Review O Structure Evaluation
Q Technical Assistance
Reason for Visit
,/
f5 Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of visit: 11149roQ Arrival Time: /e:n0 Departure Time: 's.30 County: Sc±!.95 .✓ Region: /
/170
Farm Name: A-®5le.►— / -'' Owner Email:
Owner Name: as C =' 1c1 i^JC+.VP_iL Al Phone:
Mailing Address:
Physical Address:
Facility Contact: �NN.G t!t-fr'liiaN� S Title: _F�r'"`Sv Phone No:
Onsite Representative: �O"f"" `' Wl�/!F -`� S Integrator: 177"A?
Certified Operator: ���' �- �� �l' Q "� S Operator Certification Number:
Back-up Operator: 6f-rn Id. i�..lr_yyc,nJ Back-up Certification Number:
Location of Farm: Latitude: = 0 0 I = u Longitude: = o = , ="
Design Current
Swine Capacity Population
Design Current Design
We# Poultry Capacity Population Cattle Capacity
Current
Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
❑ Wean to Feeder
❑Non-I_a er
❑ DairyCalf
Feeder to Finish 7D
'i�2
El Dairy Heifer
Dry Poultry ❑ D Cow
El Non -Dairy
❑ Layers ❑ Beef Stocker
❑ Non -Layers
❑ Pullets El Beef Feeder
u❑ Beef Brood Co
❑ Turkeys
❑ Turkey Poults
❑ Other Number of Structures:
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Discharges & Stream Facts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No D*KA
❑ NE
ElYes ElE No NA
❑ NE
❑ Yes ❑ No Li'NA
❑ NE
❑ Yes G'lq'o ❑ NA
ElNE
[IYes Blgo' ❑ 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? El Yes ,[B<oo ❑ NA ❑ N1
a. If yes, is waste level into the structural freeboard? ElYes (3'10 ❑ NA ❑ NE
Structure I Structure Structure 3 Structure 4 Structure 5 Structure 6
Identifier. 4la r✓�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): jW 2 2-0-1
5. Are there any immediate threats to the integrity of any of the structures'observed? ❑ Yes 3 o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) �
6. Are there structures on -site which are not properly addressed and/or managed El Yes 3 o ❑ 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 o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ,�
9. Does any part of the waste management system other than the waste structures require ❑ Yes 2<0 ❑ NA ❑ NE
maintenance or improvement?
Waste Application _
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes L7No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes G vo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Totai Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop/ Window ❑ Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) u d _ r6 r-= ` ev . S . J
13. Soil type(s) /V'4
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. is there a lack of properly operating waste application equipment? ❑ Yes
2'Noo ❑ NA ElNE
0, 10 ❑ NA ❑ NE
L37 NNo ❑ NA ❑ NE
[3a "N�o ❑ NA ❑ NE
Ej1 o ❑ NA ❑ NE
ReviewerAnspector Name G/�,1�,1+�CeJ ey /S Phone y/a, f33. 33y c7
Reviewer/Inspector Signature: - Date: //-/9 .Z IF
dQ 3
I2'1261 4 LonUnuev

Facility Number: $Z — Date of Inspection
Required Records & Documents �,/
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes E No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes R No ❑ NA ❑ NE
the appropriate box. ❑ W1Jp ❑ Checklists ❑ Design El Maps El 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
❑ 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
ETNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E<o
[INA
ElNE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0<0
[INA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
ElB Yes
o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
B<o
❑ NA
❑ NE
27, Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
2<o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
B<o ❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[�4VQ ❑ 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
��--,, JJ
I<o ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 1 . Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
,��/
L_TNo ❑ 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
l2/28/04

e `' ,31ws
0 Division of Water Quality
Facility Number $Z j Q Division of Soil and Water Conservation
0 Other Agency 11
Type of Visit 9 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit (D Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
- ZI --o
Date of Visit: Arrival Time: p Departure Time: County: Region: it:71W
Farm Name:
Owner Name: 4!3exx►- 1 A W &vrr & .
Mailing Address:
Owner Email:
Phone:
Physical Address:
Facility Contact: �HNi �� t� w.S Title: Fc. IL%lr . Phone No:
Onsite Representative: F00nrni i e_ integrator
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = d = Longitude: = o [= d 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
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 Fleifei
❑
Dry Cow
❑
Non-Dai
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Ca
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
[0 No
❑ NA
❑ NE
❑ Yes
9(No
❑ NA
❑ NE
El NA
❑NE
El Yes
No
f�
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[dNo
❑ NA
❑ NE
12128104 Continued

F
J
Facility Number: FZ —% / Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 14 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes V No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): g Z T
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 [9No ❑ 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
91 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
0No
❑ 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
, �{
hI No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0 No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �fNo ❑ 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 yWindow El Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) 3eC U►+�tiw d oc. (C_�J_ _ Sw�ti� G,.;.!
13, Soil type(s) �t� /�- AA 0 uk
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [0 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement`? ❑ Yes +1 No ❑ NA ❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes 0 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes O No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 0 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 NameiC�(� �� �. g Phone: g/O. 5133. 3300
Re-viewer/Inspector Signature: Date: 12 - 2/ —200
12128104 Continued

Facility Number: S2 71 Date of inspection
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 R No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 11No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA
❑ NE
23.
1f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
V 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
VNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�3 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
ElNA
El NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
P 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
r70No
❑ 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 Drawings:
12128104

V
l ype of Visit QP Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit ®Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: O Arrival Time: ; ZQ Departure Time: i Q County: 52!NC Region: /0-4W
Farm Name: —a p t Owner Email:
Owner Name: t ea tr-L� L Phone:
Mailing Address:
Physical Address:
Facility Contact: �o t W i lUa► _t Title- Phone No:
Onsite Representative: rzo a raS Integrator: Przi,.4zr 1_ -5/d.
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [—] o F--] ' [::]" Longitude: =1 ° =1 = [I
Design Curren#
Design Current
Design
Current
Swine
Capacity Population
Wet Poultry
Capac�t�ty �Popuiation
C•attie Capacity
Population
to Finish
❑ La er
❑ DairyCow
to Feeder
❑Non -Laver
`« ; "::,:
❑ DairyCalf
Dairyheifer
r to Finish
7 w �, Z. �,,���
to Wean
Dry Poultry
;_
❑ D Cow
w to Feeder
ersw
Non -La ers
❑ Pullets
Turke soults
Non-DairyLa
Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
to Finish
FE
❑OtherI
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[XNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
9No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
%No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (Ifyes, notify DWQ)
❑ yes
Q�No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
(X No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
R No
❑ NA
❑ NE
other than from a discharge?
Page I of
12128104
Continued

i
. 1
Facility Number: $Z— %/
Date of Inspection 5 4
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?: LDS �� GE1
Designed Freeboard (in):
It /r
Observed Freeboard (in): 3(v _3
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 (� No ❑ NA ❑ NE
❑ Yes [� No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes Q2 No ❑ NA ❑ NE
❑ Yes �ff= 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 N No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes $0 No ❑ NA ❑ NE
maintenance/improvement?
. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [A No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift /❑ Application Outside of Area
12. Crop type(s) a� s S `1 Gva%�! C 0/S
13. Soil type(s) �QFj
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 acre determination ?
❑ Yes
No
❑ NA
❑ NE
IT Does the facility lack adequate acreage for land application?
❑ Yes
P4No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
I No
10
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other,comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name /�,� - — S ^ — — I Phone:(4/D —3330
Reviewer/Inspector Signature: 4"4:.-- Date: g ZS 74D6,
Page 2 of 3 12128104 Continued

d r
Facility Number: QZ —7 J Date of Inspection S S D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes D§ 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
0 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
M No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
V9 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
EN No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
O No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
P9 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[8 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
14 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
(� No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Page 3 of 3 12128104

r�
� Division of'w'ater Quality
?Facility Number 8� L� Division of Soil and WML ater Conservation 4
Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ORoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: CArrival Time: +7+ % S Departure Time: County: .�dMoo—sen _ _ Region: eO
Farm Name: _ F���L Fr Owner Email: '
Owner Name: Ce,,W1W W-,n Phone: 4/0 - S96 - rd'7L7 _
Mailing Address: ei 19• d1ar 2 /Ye,-Aw. Grote A/ 2A 3 G<i
Physical Address:
Facility Contact: R�/±�n��L+/.%/:u,.. s Title:
Onsite Representative: !t �Clir /w•��1 u�__
Certified Operator: Grid r'✓avr0n
Back-up Operator:
Location of Farm:
O
Latitude:
Phone No:
Integrator:*�+ ' 46
Operator Certification Number:
Back-up Certification Number:
="
Longitude: = o =' = u
Design Current Design ' Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
2feeder to Finish 1Y0170
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other: "
❑ Other f
F
La er
Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ 'Turke Pouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Co
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 [?5No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
2 NO
❑ NA
❑ NE
❑ Yes
Q'No
❑ NA
❑ NE
��
12128104 Continued

Facility Number: — 0 Date of Inspection » o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ONo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
2'No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: oml ` (r G a
Spillway?: Ao 010
Designed freeboard (in): /9 " y ''
Observed Freeboard (in): 3-f V
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑1 %o
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
ZNo
❑ 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
ZNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
9fio
❑ 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
,�/
L7 No
❑ NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
['No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
["No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of
Area
/- 3 .2 60 If-6 73�r sD
12. Croptype(s)
13. Soil type(s) /,/ rTo/I!_ ./� n�y%1� G✓ae..._.,
--
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
L-11"No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
allo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑
Yes
❑ No
❑ NA �E
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA [14E
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E3No
❑ NA ❑ NE
Qe s ,�, ro( Fiee6oa..1 G — Iy f, Za — 2 Lf.'AA •'s w,-;A /` l-
Reviewer/Inspector Name " �� y Phone: 17/0-z1W -ll y1 ew?30
Reviewer/Inspector Signature: Date: _2 .)J -O 5--
If z1z61U4 uonnnuea

Facility Number: —}j Date ol' Inspection - d
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Pennit readily available'? ❑ Yes 2No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Ej'go ❑ NA ❑ NE
the appropirate box. ❑ !� ❑ Ch fists 0 D� ❑ ❑ %
21. Does record keeping need improvement? If yes, check the appropriate box below. [Yes ❑ No ❑ NA ❑ NE
Erwaste Application ❑ d ❑ in s E. r' "ma,y5ia ❑ ❑Annual Certification
ElRrrirt'P3Tl- ❑ Crop Yield 20 Minute Inspections ns P�eather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment`?
24. Did the facility fail to calibrate waste application equipment as required by the permit'?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of -dead animals within 24 hours and/or document
and report the mortality rates that were hieher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional oil -ice of emergency situations as required by
General Permit'? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
E-5o.
❑ NA
❑ NE
❑ Yes
2No
❑ NA
❑ NE
❑ Yes
[2'No
❑ NA
❑ NE
❑ Yes
Ea No
❑ NA
❑ NE
❑ Yes
2�Jo
❑ NA
❑ NE
❑ Yes
2 o
❑ NA
❑ NE
❑ Yes
2f No
❑ NA
❑ NE
❑ Yes
ZNO
❑ NA
❑ NE
❑ Yes
ON
❑ NA
❑ NE
❑ Yes
[INo
❑ NA
❑ NE
❑ Yes
[; No
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
Additional Comments.and/or Drawings:
't# P%talc tip _-:t1fI7-/ cnc/ Clap Y/elof 4ornS,
12128104

Facility Number Date of Visit: A?� o Time: ! : 3
Q Not Operational Q Below Threshold
[3fermitted eCer ifiied [3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold : ..................
Farm Name: FO 64CA rurrn County:
Owner Name. am Phone No. C
':Mailing Address:...... PO :,00x� � ��......................._.. .. 61A—
Facility Contact.• �� ' 'a"^ t Q PhoneNo:
Onsite Representative: ......... Integrator: iAialxtvt I` iu-- �'F�.�
Certified Operator:.- w;��i�K- �....._.. .. Operator Certification Number: -?_4. ------
Location of Farm:
wine ❑ Poultry []Cattle ❑ Norse Latitude ` 4 o« Longitude • 1 44
Discharges & Stream Impacts ,,__,,,,((
I. Is any discharge observed from any part of the operation? ❑ Yes L!dtva
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 of the operation? ❑ Yes [Rlqo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes OKNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 9<0
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .... ----... ......._................------------
-"......
Freeboard (inches):
12112103 Continued

Facility Number:
Date of Inspection TA o µ
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 maintenancerunprovement?
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 Annlication
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 "I, S oca `
13- Do the receiving crops differ w th those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
fkA.; 4- rr"v*eJ ) Ad"fiv".1 W r-1149ed
' err do ;h )abI 0j",
ki—tie
❑ Yes E• No
❑ Yes [i(No
❑ Yes [+/No
❑ Yes E!(No
❑ Yes ['No
❑ Yes dNo
❑ Yes ►Q"No
❑ Yes [rNo
❑ Yes ErNo
❑ Yes fidN0
❑ Yes RrNo
❑ Yes YNo
❑ Yes 9No
❑ Yes [KFo
❑ Yes M40
❑ Yes [310
❑ Yes L<0
❑ Final Notes
tw'" j d:d V ta-1 jd.d ec"s
l
a nj!! 1 e44cAW-41 tar j ot it btpw$ir-'k
dker '"_0
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 2 O
I2112/03 Continued

Facility Number: Date of Inspection
Required Records & Document.
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
10'<i0
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Yes
Oe/ WUP, checklists, design, maps, etc.)
❑
[ago
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
(moo
❑ 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
[ -lqo
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
Rfio
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
(ie/ discharge, freeboard problems, over application)
❑
2140
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
C f4o
28. Does facility require a follow-up visit by same agency?
❑ Yes
B"No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
O No
i1PDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 3I-35) [94es ❑ No
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EfNo
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes [i}'fio
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes 19No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes [5&o
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes [KNo
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ I20 Minute Inspections ❑ Annual Certification Form
12112103

Divisiou of Water Quallity
0 Division of Sail and Water Conservation b .
Other Agency �
Type of Visit Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other El Denied Access
Facility Number B Z "7� Date of Visit: ( Time:
10 Not Operational 0 Below Threshold
0 Permitted ecertified D Conditionally Certified Q Registered Date Last Operated or Above Threshold:
Farm Name: �'�5��� _ R�tvt -_ _ County: � 'A d t FF_QS
Owner Name:
Mailing Address:
Phone No:
Facility Contact: Title: Phone No: r
OnsiteRepresentative: -+.��� ln�• �-L-t� s Integrator: c.,IMAg-EN
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca nelty Population Cattle CaDacitv Po ulation ,
❑ Wean to Feeder I I #;�4 ❑ Layer I I Dairy
Feeder to Finish ❑ Non -Layer I on -Dairy
❑ Farrow to Wean -
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ILI Subsurface Drains Present IILJ Lagoon Area JU Spray Field Area I
Holding Ponds / Solid Traps ❑ No Li uid Waste Management System
Discharees & Stream Impacts
t. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
C. If discharge is observed, what is the estimated flow in galimin?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): 33 Zc
05103107
❑Yes ❑ No
❑ Yes 2r++No
El Yes LdNo
❑ Yes 4 No
❑ Yes XNo
❑ Yes :,C3'No
❑ Yes ZNo
Structure 6
Continued

Facility Number: Date of Inspection I R -5
5. Are there any immediate threats to the integrity of any of the structures observed? (fie6resevere 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 maintenancelimprovement?
I I . is there evidence of over application? ❑ Excessive Ponding
12. Crop type C_ _ A-- C_'
❑ PAN ❑ Hydraulic Overload
S_(-SO
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination? 6&=2 4tA
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment'?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other PermV readily available?
18. Does the facility fail to have all components of the Certified AAlmaf e Management Plan readily available?
(iel WUP, checklists, design, maps, etc_) L
19. Does record keeping need improvement? (ic/ irri tion, freebo!Ird, wlie anal sis & soil sample reports}
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes '0 No
❑ Yes VNo
❑ Yes
❑ Yes No
❑ Yes 0<o
El Yes o
❑ Yes No
❑ Yes U(No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes &]No
❑ Yes /No
❑ Yes ;R<o
❑ Y es JJ41
❑ Yes 1250
❑ Yes 7fNo
❑ Yes [Xo
❑ Yes �10
❑ Yes VNo
❑ Yes [�r
El Yes _/ No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Comments (refer to question : Explain any YES answers andtor any recommendations or any aUzi er ommentT
IJse drawings of facilityto better explain situations. (use additional pages as necessary): field Copy ❑ Final Notes
V__ sM A t _ TA-~XS A e{� 4 �� -T-4 �.,r a �w r.�c�- Tt4F_
St�Pti~. � _ `�"►t'� r�� ���� h L� � i �'T� � �'�, � � ��� .� 7 c_pt~ SP+*c1` lal,� S:
MY
Reviewer/Inspector Name
Reviewer/Inspector Signature: C— Date: 111 1-1
05103101 t Continued

Facility Number. Z — 7 Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes 0 No
❑ Yes No
❑ Yes No
❑ Yes ZNO
❑ Yes No
❑ Yes No
❑ Yes [�No
05103101

Type of Visit (R Compliance Inspection 0 Operation Review O Lagoon Evaluation d I
Reason for Visit Routine O Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number +7 Date of Visit: E
IM Permitted to Certified [3 Conditionally Certified Q Registered
Farm Name: 6,e5---''�v GcJcirfar, r—arm
Owner Name: er
-419
Mailing Address:
Facility Contact: V{QnA;e' �,i t.cmi Title:
Onsite Representative: 4� 20nn: i
Certified Operator: 60-_,f�
Location of Farm:
Time: /e
rO Not Ojoerational Q Below Threshold
Date Last Operated or Above Threshold:
County: Fi2c3
Phone No:
Phone No:
Integrator: ojc
Operator Certification Number:
WSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude a 4 a Longitude ' ° 0
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
No Liquid Waste
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes (9 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 gaUmin?
d. Does discharge bypass a lagoon system? (1 f yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes [SNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes M No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 00 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
OSIO3101 Continued

Facility Number: 53,E — Date of Inspection a t±
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
El Yes
Lp No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
M 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
M No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
[A No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
}�
elevation markings?
El Yes
[iY No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
% No
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
No
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
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
M No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20_ Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
M No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22 Fail to notify regional DWQ of emergency situations as rcq uired by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes [M No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [9 No
0 No violations or deficiencies were noted daring this visit. You will receive no further correspondence about this visit.
Field Copy LJ Final Notes
` F,-,,n k'_5 Q•c�t,"s :AAeqUiona.Q fJ 4L+ ,J1 %e Geld 4- fL lot,,P
6-1p ►nee' L1_1 4'p Ott -Ms ,
` f-Y'll�jc•r! �C-rMa�•�}Q., S�L'1� Laf�j JS I�YICTC_ IIX•43Ti/, ,rr'J.\ f'L•c+.sY�'1�
Reviewer/Inspector Name ��_����l��i
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: a rJl Date of Inspectiond a
Odor Is�os
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes $ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes %No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes M No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes M No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes [9 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additioital,Comments.;'and/or Drawings_
O5119310I

Type of Visit Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit ARoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: -- i ' d / Time:
'
O Not O rational Q Below Threshold
#Permitted 13 Certified © Conditionally Certified 0 Regi red Date Last Operated or Above Threshold: ...... _.
Farm Name: ��O` .U/ C? r ✓. �r�r/yL ... l " runty:...........5"..
Owner Name: 6¢ r e f ��
................�.> .................LI�.Q ............................................ Phone No:
Facility Contact: ........ (?fit n, r .... r.�Ll..r-�xr�r... Title:.... ela,..... llq .................... Phone No. .....W_..................
MailingAddress: ................................................------.._._._ _ .
Onsite Representative:.... 2..C11.. �` . l !Q-*� f ... Integrator:.............................._.................................................................
l
Certified Operator:,,,,,,,-�e r "jq... ''`e"'. Operator Certification Number:-_ �j`
i�S
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 44 Longitude . 0 6
Design . , Current
� - � I�'9nartty Pnnnlsfin*i
Wean to Feeder
Feeder to Finish
�a
El Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current Destgn Cum!
Poultry Ca aci Po elation Cattle: _ ° Ca ail -Po alatio
❑ Layer ❑ Dairy
❑ Non -Layer I I❑ Non -Dairy
Other
Total Design Capacity
:Total SSLW
' Number. of Lagoons ❑ Subsurface Drains Present Lagoon Area ❑Spray Field Area
Holding Pond§ ! SoKd:Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State? (if yes, notify DWQ)
c. if discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structurg I ucture 2 Structure 3
Identifier: ...... .... 41,lC.................. ..... ......!rl..............................................
AVR
Freeboard (inches):
5100
❑ Spillway
Structure 4 Structure 5
❑ Yes )kNo
❑ Yes No
❑ Yes No
❑ Yes qNo
❑ Yes No
❑ Yes o
❑ Yes 0 No
Structure 6
Continued on back

J,
Facility Number: — Date of inspection /
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWt)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancetimprovement?
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 maintenancelimprovernent?
11. Is there evidence of over awlication? ❑ Frxcessive Ponding ❑ PAN ❑ Hydraulic Overload ,
12. Crop type
13. Do the receiving crops differ with those designated i the Certified Animal Waste Management Pl (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Document
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
YKa iptis:oi dgficiet;ct s vv re po04 d4tr'tng this:visit; • Y:au witl >�ec iye o ui-thgr'
car'resi)ondence: abouti this visit: .::::....:::::..:::..:............ .
❑ Yes �No
❑ Yes A No
❑ Yes I`No
❑ Yes
T0
❑ Yes 9No
❑ Yes I�No
❑ Yes P(No
❑ Yes No
❑ Yes o
❑ Yes X
o
❑ Yes I+10
❑ Yes' P(No
❑ Yes MO
❑ Yes )No
❑ Yes 9No
❑ Yes *0
❑ Yes KNo
❑ Yes MNo
❑ Yes P(No
❑ Yes A�o
❑ Yes KNo
❑ Yes 04910
I&
Reviewer/Inspector Name
Reviewer/Inspector Signature: _ Date: IQ - � d/ 5!00

k
Facility Number: — Date of Inspection - 3
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes XNO
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes jlo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes PO
roads,roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes KNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ' `)J No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes KWO
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5/00

150b VtL*LT10%
6)
Ci
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Kerr T. Stevens, Director
May 31, 2001
MEMORAAIDUM
NCDENR
NORTH C4ROLINA DEPARTMENT OF
ENVIRONmem-r AND NA;ruRAL RES RCFS
To: Regional Water Quality Supervisor
From: Sonya Avant, Environmental Engineer AXa
Non -Discharge Compliance and Enforcement Unit
JUN 14D
Subject: Wettable Acre Determinations for Certified and Permitted Operations
Attached is a list of the facilities in your respective regions that have been selected to receive .
notification letters advising them that they have been flagged or pended for the month of June -
Each facility will be given written notice via certified mail. The notice will include a copy of the
certification form and a deadline for response.
I will also be sending copies of the final monthly list of selected facilities to the Division of Soil
and Water Conservation Operation Reviewers and Soil Water Conservation District Offices each
month along with an updated copy of all facilities in that county that have been either flagged or
pended. This will hopefully enable the Districts to be better able to schedule their workloads.
If you have any questions, please contact me at 733-5083 extension 571, or
sonya.avant @ncmail.net.
cc: Coleen Sullins
1617 Mail Service Center, Raleigh. -North Carolina 27699-1617 Telephone [phone] Fax [phone]M
An Equal Opportunity Affirmative Action Employer 50% recycted/10% post -consumer paper

Facilities Flagged/Pendell for June 1, 2001
Facility Flagged/Pending i.
Number Owner 1 Farm Name Address Status WA PAN�deticit WA Visit Date Integrator
FRO ;
09 — 82 Murphy Smith 19829 Hwy 131 South 111 2700 6/9/1999 Murphy Family Farms
Bladenboro NC 28320
Double S Farm
1
09 — 182 Tommy & Splawn 5056 Elizabethtown F2 1943 V.VI999 Carroll's Foods Inc
Karen Highway
Crooked Branch Farm
Roseboro NC 28382
E 82-2 Johnny Tyndall 3376 Howard (toad F4 1114.40 5/3/1999 Murphy Family Farms
.................................... Autryville, NC 28319
Tyndall & Sons Farm
82 — 40 William Powell 484 Tomahawk Highway F4 945 6/17/1999 AK Farms
Harrells NC 28444
William Powell Farm # 3
82 — 48 Perry Smith PO Box 68 F'4 1154 V27J1999 Carroll's roods, Inc.
Turkey NC 28393
Perry Smith Farm
82 52 McLamh M2 Pig Cradle Lane F4 1281 4/13/1999 Murphy Family Farms
Corporation Clinton NC 28328
A.M. Farm
f 82 — 53 F & W Farms 1557 Andrews Chapel F4 1250.493 3/23/1999 Carroll's Foods Inc
Road
F & W Farms / B - T Farm Rosehoro NC 28382

Facilities Flagged/Pended for June 1, 2001
Facility
Flagged/l'cnding
Number
Owner / Farm Name
Address
Status
WA PAN deficit
WA Visit Dale
Integrator
82 — 62
Earl Benny King
1746 Rowan Rd
1'3
1224
6/27JI999
Dogwood Farms
..............................
Clinton NC 28328
Earl Benny King Farm
82 —71
Gerald Warren
P.O. Box 233
F4
1004
6/14/1999
Warren Swine Forms
Newton Grove 28366
Gerald Warren Farm
82 — 89
George Thornton
1054 Sharceake Rd
F4
1059
4/27/1999
Prestage Farms
....................................
Clintop NC 28328
Gcorge Thoruton
82 99
Marshall Falatovich
410 Beaver Dam Drive
F4
1291.2
4/21119"
Prestage Farms
Clinton NC 28328
Falatovich Finishing #2
82 — 101
Joe Rose
481 Lassiler Rd
F4
1221.175
7/1/1999
TDM Farms, Inc.
Newton Grove 28366
Rose Swine Farms
82 — 103
Sue & James Buller
111444 N US 421 Highway
F4
914.9
4/27/1999
Murphy Family Farms
E1.
Clinton NC 28328
Sue Butler Farm
82 — 107
David Lockamy
1045 Hollerin (toad
113
1181.4
5/12/1999
Murphy Family Farms
Dunn NC 28334
L&L Farms
82 — 115
Robert .lackson
1494 Feed Mill Road
F4
951
5/10/1999
Murphy Family Farms
Rosehoro NC 28382
Across the Creek Farm

Facilities Flagged/Fended for June 1, 2001
Facility
Flagged./Pending
S'
Number
Owner I harm Name
Address
Status
WA PAN deCicil
WA Visit Date
Integrator
82 -- 171
Virgil Strickland
3500 Keener Rd.
P3
1073.5
4/29119"
Murphy Family Farms
Clinton NC 28328
Virgil Strickland Farm
82 — 179
Nelson & Butler
683 Odom Rd
F2
981
5/11/19"
Prestage Farms
Jerry
Clinton NC 28328
!
N&J Butler Pig Farm
82 — 246
Calvin Edwards
PO Box 472
FI
897
N10/1999
Murphy Family Farms
........... I .............
Rosehoro NC 28382
Calvin Edwards Farm
i82 — 260
Ronnie Smith
999 Moseley Ave
F4
974
3/22/19"
Murphy Family Farms
Clinton NC 28328
B&K Nursery I & 2
82 — 601
Billy Ray Daughtry
1960 Roanoke Rd
F4
1097
6130/19"
TDM Farms, Inc.
Clinton NC 28328
€
Billy Ray Daughtry
I
82 — 620
Thomas Ray McPhail
11020 Dunn Rd
PI
1004.45
5113/19"
Prestage Farms
Salemhurg NC 28385
I
I
McPhail Nursery Farm
82 — 653
i
Steed Farms, Inc.
2311 Keener Road
1`2
954
5/4/1999
Murphy Family Farms
„ ..................................
Clinton NC 28328
Thomas Steed Farm #2

D1V1S16n Of Water Quality
O Division of Soil and -Water Conservation'
OOth"ei Agency;:
Type of Visit Inspection O Operation Review O Lagoon Evaluation
,C.,ommpliance
Reason for Visit )O Routine O Complaint Q Follow up Q Emergency Notification O Other ❑ Denied Access
Date of Visit:
Cia "Time: 1 ; l� Printed on: 7/21/2000
Facility Number
-Operational
O Not 0 Below Threshold
J3 Permitted Certified 0 Conditionally Certified ❑ Registered
Date Last Operated or Above Threshold: .........................
Farm Name: w aCW.yEr.� EAQ-
County: ........I ..............
OwnerName: ................................................... ........................................................................
Phone No: .......................................................................................
Facility Contact: ..................................................... ...... ..... Title
. Phone No:
MailingAddress: .....................................................................................................................
..................................................................................... ..........................
Onsite Representative:-Y-4G�A' .k. .. `! .L �..! ! ^...........................................
Integrator:..._..INA. '` ....Sw �.nl ............................
Certified Operator:................................................................................................................
Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 O&s Longitude 0 ° 44
Wean to Feeder
Feeder to Finish
Farrow to can
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Ntm�betr of Ia
IkdmgPOnds S(
Design Current Design Current
7apacity Population Poultry Capacity, Population Cattle
❑ Layer I I JE1 Dairy
70 10 Non -Layer 1 10 Non -Dairy
❑ Other
Total Design Capacity
Dn5-_
f Traps
Total SSLW
Subsurface Drains Present 110 Lag-nn Area JE3 Spray Field Area
No Liquid Waste Management System
Discharges & Stream Iriipacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made"
b. if discharge is observed. did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/thin?
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 *tructure 2 Structurc ; Structurc 4 Structure S
Identifier: ..-+'i°`�`�`..........j...
Freeboard (inches): 3C6
5100
❑ Yes )3�0
❑ Yes�O''No
El yes;fNo
❑ Yes No
❑ Yes No
❑ Yes [114-0
❑ Yes Plo
Structurc 6
Continued on back

Facility Number: 1% L— 1 Date of Inspection t pa Printed op.• 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes /ij No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ZNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes P"ND
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes XNo
Waste Al2Rlication 1
10. Are there any buffers that need maintenance/improvement? ❑ Yes N
11. Is there evidence of over application? ❑ Excessive Ponding [I PAN [I Hydraulic Overload ❑ Yes �`-' No
12. Crop type B 4. F P-E,
13. Do the receiving crops differ with those desi ted in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 10CNo
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
I5. Does the receiving crop need improvement? ❑ Yes JZNo
16. Is there a lack of adequate waste application equipment? ❑ Yes J�rNo
Required Records & Documents t �e�Z��r1 s
17. Fail to have Certificate of Coverage & Gen al mit readily available? ❑ Yes ETNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ONo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, wa tAy
sis & soiltsaL Wreports) ❑ Yes P'1Go
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes Q"No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application) ❑ Yes J21 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'? ❑ Yes o
24. Does facility require a follow-up visit by same agency'? ❑ Yes �eNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 0410
1ci yiipl'atiQnjs:or defieiejtlrcies ry re npted during is:visit;ee�iye fid Mutther :
roriespoiideike a�aut this visit.
Comments (refer to., Lion #) Explain any YF,S answers and/or an recommendations or any other comet
ry ._ _ y w
Use;drawiagsFof facility Abetter explain situations. (use additional a es as nee
�_ P g._ Yf. -. .
i=�,-C.DX
ALoWG r rr c?r f�
Reviewer/Inspector Name 1 j, f j _ q� S_j j Vb c7
Reviewer/Inspector Signature: , _
Date:
5100

Facility Number: g Z 7-7 Date of I uspection 1 J - 41 !Tinted on.. 7121 /2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge aOor below ❑ Yes 'O"No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes INo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 'VfNo
roads, building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes /2!(No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e, broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes Id.,
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes VNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes F<O
J
5/00

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Gerald Warren
Gerald Warren Farris
P.O. Box 233
Newton Grove NC 28366
Dear Gerald Warren:
e��
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
December 30, 1999 DECEIVE,)
2000
FjYM-rEWLLE
FEG. OFr1
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 82-71
Sampson County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. IRR1, IRR2, DRY1, DRY2, DRY3, SLUR1, SL1JR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincerel
Kerr T. Stevens, Director
Division of Water Quality
cc: Fayetteville Regional Office
Sampson County Soil and Water Conservation District
Facility File
1617 ?Flail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

0 Division of Soil and; Wate'r�Conservatxon.- Operation Rev_,ew
-
__
Division of Soiland Water Conservation `Compliance Inspection°
Division of Water QualEty Comphance Inspection _�
Other Agency O ei^ationgl;;eview
_
g_. y I?
Q Routine O Com faint Q Follow-up of DWQ inspection Q Follow -tip of DSWC review Q Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Permitted 0 Certified
`r E3 Conditionally Certified © Registered 0 Not Operational Date Last Operated: .............
Farm Name: ...... rwf,�L....WGfl7 .......�'..... ...> dt�... J County :........................... ................... ...-.... d..................
r I
Owner Name G f,G( Phone No
.................. ..ems ...........-- �---....................... .
Facility Contact: ........... &*Irlir....... 11l1 t.. [.�!. l'!'�, . Title: ............................ Phone No:
Flailing Address: ................. P- �� J t�if�...N ....... a F�ZG
................�41". �' �lJ � ..
Onsite Representative: ppOr i't ! ►'4 Integrator: f..?.......................:�-..............�
Certified Operator:........... G.f a� .... Operator Certification Number :..........................................
............ .............. ..... . .............. .............
Location of Farm:
Ak
........................................................................................................................... .................................. .............................. ..----------
Latitude Longitude �• ��
m `°
Design Current
Design. Current -
Design .Current
Swine
Capacity Po ulation POU14r7
capacity Po ulatiori Cattle
Capacity Po ulahon --
Wean to Feeder
Layer
❑ Dairy
Feeder to Finish
b %Q
PEI
Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
'
❑Farrow to Feeder
❑ Other
;'
❑ Farrow to Finish
=
Total De5x Cs a_cit
P
ElGilts
❑ Boars
r
TotalSSL W
-
Number of Lagoons ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
HoidmgPonds7 Solid Traps ❑ No Liquid Waste Management System _
Discharges & Stream Impacts
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 Stale? (If yes, notify DWQ) ❑ Yes { No
c. If discharge is observed, what is the estimated flow in gal/min'? AIM
d. Does 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 lb 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 6
Identifier: J� I *t a
Freeboard (inches): .............. °25............
... a?3 iI
................................ ..................................
5. Are there any immediate threats to the integrity of any of the structures observed'? (iel trees, severe erosion, ❑ Yes Eh No
seepage, etc.)
3/23/99 Continued on back

i
Facility [Number: Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7_ Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10, Are there any buffers that need maintenance/.improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAP
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
ra
ante Management Plan (CAWMP)?
Re uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all co nents of the Certified Animal Waste Management Plan readily available?
{ie/ WUP, ecsts, desig tl' ma , etc.)
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
. . .. violafio .s.ek iiel .... ies were ngted dirrrirtg thisMsit; • Voir :Will•feeeiye iio fufthof • : •
CO* ires0 onuence. about~ this :visit::. ::...... ' :::. ' ' ... ' .
❑ Yes ONo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes VNo
El Yes 6 No
❑ Yes No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 9 No
❑ Yes KNo
❑ Yes j1No
❑ Yes IgNo
❑ Yes J"No
❑ Yes [)(No
❑ Yes kNo
❑ Yes ❑ No
❑ Yes WNo
❑ Yes No
❑ Yes � No
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: / a3 —
3123/99

4
Facility Number. &2 — ? f)ate of Inspection
Odor issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
VNo
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
No
3/23/99

A
Division of Soil and Water Conservation ❑ Other Agency
0 Division of Water Quality
FO Routine O Complaint O Follow-un of DWO insnectinn 0 Follow-uu of DSWC review O Other
Date of Inspection
Facility' Number 'L �
Time of Inspection 24 hr. (hh:mm)
13 Registered M Certified © Applied for Permit Permitted, E3 Not Operational I Date Last Operated:
AeFarm Name. GZI e.4 A t`�e utr w�- Tt�r �a.�, county: ...... ........ 6'' '............... .......................
ih
Owner Name: .y .1..�Y c><rre� ... Phone No: .....
FacilityC.
ontact: True .... ..r...... Phone No:...................................................
Mailing Address: .....1... ......�...... 2�.. ............... .... e+�� 6ice .... !"..�'� ...... 3 �...................... ............... �.......
Onsite Representative:.. , n1 �.......1- , 1(,� �$.. Integrator:......---..oi
..................................
Certified Operator;.................a-�'�---- .. Operator Certification Number• ............................................................................_............_..._....__......
Location of Farm:
Latitude 0.0` = 11 Longitude =' ` 0"
"� 'Destgn Current
v Design Current" F Design C>1Rent'
• r .6k'Ft :Xab"} w; W _ ,. -, y .'zi ^�'�- .,�M . � -•: l O �5 ,,, ,,... T �. �..Capacity Populattorr 4"-.Poaltry `CaptaciEy Population Cattle Capac�tyr-Popalahon.,
airy
❑ Layer °FONon-D�ryj
❑ Non-Layer
*F £;
❑ Other y w °�
n
A Total Desigia Capacity p 7 p
v
s
' , Total SSLW'
.,a.... p...,.,.,
�'���"4(�{ns ! Holdm Ponds
❑ Subsurface Drains Present
❑ Lagoon Area
❑ Spray Feld Area
�IVifml�er'of
f^°f+
❑ No Liquid Waste Management System
r q ?finf Jv
< R
Wean to to Feeder
fiF
-�.
Feeder to Finish
D
h
❑Farrow to Wean
❑Farrow to Feeder
General
1. Are there any buffers that need maintenance/improvement? El Yes No
2. Is any discharge observed from any part of the operation? ❑Yes No
Discharge originated at: [I Lagoon ❑ Spray Field [I Other
a. If discharge is observed, was the conveyance man-made? Cl Yes ❑ No
b. If discharge is observed, did it reach Surface Water? (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
3. Is there evidence of past discharge from any part of the operation? ❑Yes �No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑Yes �No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑Yes h-erNo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑Yes 4No
7. Did the facility fail to have a certified operator in responsible charge? ❑Yes V�No
7/25l97

Facility Number:
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ YesA
No
Structures La ons oldie Ponds Flush Pits etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
�No
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: .......... ...A
. .........
Freeboard(ft}:........2 ..C ......../I .....................................................................................................................
-............. ....................
..............
10.
Is seepage observed from any of the structures?
❑ Yes
�No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
KNo
12.
Do any of the structures need maintenancelimprovement?
❑ Yes
No
'
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff ente ' g waters of the State, notify DWQ)
15. Crop type �- ' ................................................... .............................................................
16. Do the receiving crops differ with ose designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted, Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No.vitiIatioits:ar deitciencies were, noted,atiring this'visit. You:rvill i•ecei:ve_ttti:ftirtlier.::
corresO0hdek0. dtiout this:visit:-.
UVt-j cjdo� 1b���.ky
r- �ri-41 yp ram/c�s
❑ Yes )qNo
❑ Yes �No
❑ Yes UfNo
❑ Yes 9 No
❑ Yes No
❑ Yes11No
❑ Yes
❑ YesNo
El Yes
❑ Yes BYNO
❑ Yes 2No
❑ Yes ❑ No
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: 4z. /61 Date: le ' f

f. - .,.. - 1. - - - - .. ---
Status: TOW Time
Farm Name:-CoeraU Warree,- Lkrm County:--
—
Owner Name: --aerct-.11A t-,)arre^- Phone No: aio/201
MallingAddress: Cree-k-5ide- Dr_ �Jao+pv� igro(le, A)C- 09366
Onsiteltepresentad'. ae-r-alj wo--C-r-eA. Integrator � r re m 5c&) jt�.t ct r, &-,L
C.tffia Op,.W, — A ero-1 J� LJac Operator Certification Number 19 1
Location of Farm:
Latitude Longitude 69
10 Not qMrational Date Last Operated:
Type of Operation and Design Capacity
3
WUNJ'O
to Feeder
Fce&-T to Finish Dairy
UBeef
Farruw to Wean
FaMOW tDF
EgIlow to Finish 7
M
V 14
Q ft*t
�<v
her Type of Livestock
Wean
rmwew 'A
1. Are them any buffers that need maintenan 13 Yes No
I Is any discharge observed
E3 Yes 'ONO
a. If discharge is
nun -made? 13 Yes JRNG
b. If discharge is
0 Yes No
C. If discharge is
flow in PLWm?
d. Does discharge bypass a lagoon
E) Yes ONO
3. Is them andcnec of pas discharge from any part of
13 Yes ON6
4. Was there any adverse impacts to the waters. of the
Yes Q No
S. Does any part of the waste management system (other than lagoonsUldmg ponds) require Yes dNo
nuintenan it?
Condnaed on back
Number of Lagoons `l.Halding Ponds Subsurface Drains Present
ny>= - I.0 oon Arts spray Feld Area ;
from any part of the operation?
observed, was the conveyance
observed, did it reach Surface Watet? (If yes, notify DWG
observed, what is the estimated
ayst®? (if yes, W* DWG
the operation?
State other than from a discharge?
F- Facft Number Date of Inspection
Time of hqwtion 1 15:30 Use 24 br. time
Farm
(in hours) Spent onReview
=2—
or Inspection (includes travel and processing)
Number of Lagoons `l.Halding Ponds Subsurface Drains Present
ny>= - I.0 oon Arts spray Feld Area ;
from any part of the operation?
observed, was the conveyance
observed, did it reach Surface Watet? (If yes, notify DWG
observed, what is the estimated
ayst®? (if yes, W* DWG
the operation?
State other than from a discharge?
F- Facft Number Date of Inspection
Time of hqwtion 1 15:30 Use 24 br. time
Farm
(in hours) Spent onReview
=2—
or Inspection (includes travel and processing)

6. Is facility not in oomphz= with say applicable ■edmk criteria?
7. Did the amity fail to have a certified operator in responsible chmrp (f itrspecdon after VIM)?
L Are there lagoons or storage ponds on site which need to be properly closed?
trrretures MA cons and/or Holdin____Z P a
9. Is struchual f wbmird less than adequate?
Freeboard (Rr ,Lagoon 1 lagoon 2 Lagoon 3
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the shuctu= observed?.
12. Do any of the swxmuw need
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
.13. Do any of the structures lack adgaate slackers to identify start and stop pumping levels?
R'aste Aoallcation '
14. Is there physical evidence of over application?
_(If in access of WMP, or runoff entering waters of the State, notify DWQ)
15. Drop type
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adoquate acreage for land application?
I S. Does the cover crop need imprvvemknt?
19 Is there a lack of available irrigation equipment?
Eer Certified Facilities Only
20. Does the f rZiityy fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waite Management Plan in any way?
22. Does t+ecm keeping need improvem mt?
23. Does facility require a follow-up visit by same agency!
24. Did Revwwerllnsptctor fail to discuss reviewlmspection with owner or operator in charge?
eiits (refer Eo_qussticny :4F.xpiaia airy YES answers a ndforniiyIecoai
13. 5+ekr+—sop P"n p markers 4z be-
Reviewer/Inspector Name
Yes AN'O
CI Yes qNo,
CI Yes JKNo
❑ Yes ANo
Lagoon 4
❑ Yes RjNo
❑ Yes allo
❑ Yes ONo
ALYes ❑ No
❑ Yes 0No-
[] Yes MLNo
❑ Yes 0,,No
❑ Yes %No
❑ Yes Flo
❑ Yes E3 No
❑ Yes ❑ No
13 Yes ❑ No
13 Yes ❑ No
0 Yes ❑ No
Reviwer/inspector Signature:
Date: L Zq-9 7
tG Division of Water Quality, Oater Quality Secxion, Facfl V Assessment Unit 11/14/96

State of North Carolina
HetadNERouHeaih naturral Environment,
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Gerald Warren
P. O. Box 223
Newton Grove, NC 28366
Dear Mr. Warren:
M?WA
1DEEHNFZ.
DrVMION OF WATER QUALITY
April 25, 1997
SUBJECT: Annual Compliance Inspection
Warren Swine Farm, Inc
Gerald Warren Farm
Registration No. 82-13, 82-71, Nursery
Sampson County
On April 24, 1997, staff from the Fayetteville Regional Office of the Division of Water
Quality inspected the subject swine facility. Please find enclosed a copy of our Compliance
Inspection Report for your information. It is the opinion of this office based on the
information provided and observations made during the inspection that the facility was in
compliance with 15A NCAC 2H, Part.0217 at the time of the inspection. Please refer to the
comments section on the rear of the inspection form for information regarding your facility.
Please be aware that all swine facilities with a liquid waste collection system designed for
a minimum of 250 hogs must have a certified waste management plan on or before December
31, 1997. The district NRCS office, Agriculture Extension office, or the Division of Soil and
Water have specialist available to assist you with upgrading of existing facilities and
certification.
If You have any questions concerning this matter, please call John Hasty at (910) 486-
1541.
RC
sty, Jr.
Environmental Specialist
cc: Operations Branch
Central Files
Audry Oxendine - FRO DSW
Wilson Spencer - Sampson Co. NRCS
Wachovia Building, Sufte 714, Fayettevltle FAX [phone]
North Carolina 28301-5043 N%4)C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

-11
Fiemty Nrtmbrr Z lerin-IPPH
ate of °n - 2 9
Time of a S;3o meUhr. dM
Farm Ste ��
s4rej TOW Tim na lbonm) spent GAVATIM
ters+ ,_�� aa ftdoda ftrd sad procedao Z
Farm xatrI : e rickk AL W a rr e riii FetryK CMMtr. r SA-m Ps ow
owiwNsma: —� . , .!�i4 rear. tio�e xo• I `�i�� .' l7o 1 -
•CI
) Creekside br. m rove NC. 28� 3Q
oasite RepremMim G era d W a er re V L u re ►+ Sw t•- Ea r►%
CnrBfied pp ;_ /.,7 r'a- War ,2-•- ppesator Ga on Namber:. 191427
Location ofFarm:
Not Operational
or Operation and Design
Date Last Operated:
Other Type of Livestock
1. Am there any buffers that need awintenancehmprove�?
2 h any discharge observed fim any pert of the opendm?
a. if discharge is observed, was the convcyaace man-made?
b. 1f discharge is observed, did it reach Surface Water? (If yes. notify DWQ)
e. Vidischarge is observed, what is fe estimi fbw is pMmda?
& Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. 1s there evidence of past discharge from any part of the op m an?
1. Was there any adverse impacts to the waters of the State other than fevm a dischwgdi ,
S. Does nay part of the waste management system (other than IssoonsJholdieg ponds) require
=aintie�oeJmrgr+avam�ent?
p Yea No
pYes 'JONo
D Yes Wo .
0 Yes No
D Yes IffNo
E3 Ya ,MNo
p Yes ,6Qib"
13 Yes gbvo
C&A AUrxed an bark

PIP
L hcWtY Mt in ooa�piimoe with aqy sew tea? - 13 Yes ANo - •
7. Did the: fstaity fig to hm a ad operator fa nVomsle dwr Cif m=emm aAas 1I MM 17 Ya �No
L Are &n lagoons or sterrage pmh an site w hieb and b be poQerly eloaed? D Ya R A
$trot tarn ff.ae►mns aWgr flgMnS&M
9. 1s structural buboard less tmm adequate?
Freeboard (ftk .L oa I I,am= 2
. � , Z•
10. Is saepage observed Am any of do strut4ra+ O
© Yes ANo
'r mmm 3 LaS+oom 4
`] L Is emm im of any other tbnas; b the integrity of any of the =acm= amv ed? -
u. Do nay of the am== used . .
(if any of questions 9-12 was astme!red yes, and the situation poses an
immediate public health or environmental dmwtk ratify DWQ)
.U. Do say of the strueftaa lack adquatr makers to identify start and stop pumping k ds?
3aste Aoaiicstioa
M. is these physical evidence of ova appliemtioa?
.(If in excess of WW, or runoff entering waters of the Stele. m ify DWQ)
15. Crop type.
X Do the active crops differ with those daWsated in the Animal Waste Management Plaa?
17. Does the facility have a lack of adequate acreage fw land application?
IS. Dues the covar crop need impresveofte
19 is that a lack of available irrigation equipment?
Certified FacUltksMIX
20. Does the hefty &H to have a aW ofthe Aaamsl Waste Management Plea taffy available?
21. Does the fimility fill to comply with the Animal Waste Ma 4pmemt Plan in nay wralf!
22. Dote r wal keeping nerd iraproveaxnt?
M. Does facility requ> m a follow-np visit by same agcacy?
34. Did Rcwkwedhapecter fail to discuss reviewAnspecdon with owner or operstor is
Yes ONo
13 Yes allo
13Ya No
J Ym 0 No
fl Yea OINo-
0 Ya R,No
13 Yes QNo
© Yes Flo
13 Yes Wo,
D Yea E3 No
13 Yes 13 No
© Yea E3 No
D Yea 13No
D Yea 0 No
C6tiane� (refer tc gwmicm A).: YExplam am .YES answirs'abWorany i+e seardations rr aay.btl r coa:rnsatsr5 � . *
Uu�,.dr:�8�od'fat�+.to bearer explain._._ut�as..i!e�es�dii�.P,aBss
# 13. 5+ixe+—s' op p,cn�p 1na,kers -fb be ins tiwd.
�Qrr.,- fS it, 5bod $��e
ReviewerBnspec for Name
4OW/Inspector Signaare:
""Sion of W mar Q79af ty, water pvaffty Sertrm Feciay Assesxnerrt Unk _ -

Site Requires Immediate Attention: rJo
Facility No. -? I
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: Z: ZO
Farm Name/Owner:
.Mailing Address: P.O. [lox 213 m9agh 1 _ Grove k1 L 28 36
County: SGL'^jSay1
Integrator: Phone: (9 to) 50K -17 0 /
-On Site Representative:_ mara-U- - Phone:
Physical Address/Location: f;-on Cl 4bn on 1+4104 Z-1 - +00,070r
Type of Operation: Swine
Design Capacity: 190 -P:%
DEM Certification Number:
Poultry Cattle
Number of Animals on Site: 9;D 4-40
DEM Certification Number: ACNEW
Latitude: Longitude• "
Circle Yes or No
Does the Animal Waste Lagoon h ve sufficient freeboard of 1 Foot + 25 year 24 hour storm. event
(approximately I Foot + 7 inches) or No Actual Freeboard:��Ft. Inches
Was any seepage observed from the la oon(s)? Yes oi3Pb Was any erosion observed? Yes or
Is adequate land available for spry ? e or No Is the cover crop adequate? (!Ej�)or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback cnteria? 200 Feet from Dwellings? �e ►or No
100 Feet from Wells? �fj) or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or(sp
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes oreo
Is animal waste discharged into water of�e state by man-made ditch, flushing system, or other
similar man-made devices? Yes or If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or® fir9W_ "W
Additional Comments: Cwr4.red -«,. - W,ll be. ce-fliAW soon ' wa,tc,=M W/ NRc�
Z
7
1 r reGpr 0r e' an rt!
ki �Il1E? LS
Cd 13u C- h w+y- ci�i ai�:�
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

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