820119_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qua

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{Tficiltky, Number1
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E{jEi,.,lil,,,lijil„r,ii(+ti,��,`Y##jjEl,i#I#,Y.t! D€vislon°af,Waterl Reso`u'Tc'es,
II - I'.. .I j
i� `�J� F �'I I) I� O Dlvislon of Soil an[i .Water Conservation `;^ {I
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,�C I�?,I��I� 1�1fdI F , : r' (,.OtherrAgency. 1 1:d -L1
Type of Visit: ompliance Inspection i5 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: ' p Departure Time: o County:Region:
Farm Name: 9,4f ,of,j,f- r-z:trI>K4 rAe- Owner Email: T'—
Owner Name: T�� ��� Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: 1060)#7 V-"— Phone:
f
Integrator: b ' r� f04
Onsite Representative:
Certified Operator: �r
Certification Number: 1$'0O3
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
1 j'i,i SII i Y;y r{ri ' { 11�'lll ,l'Ifil`, �Ili{p I,u• r ..I , - 111' Ir�i ��
ICU{ fiI rIei� +
- I Des�, g -I ,n . C. urre- nt
esign Curr
en
t
++ 'WPCi hPPop Cattle Capacity Pop• eICa acity I aopt ultrY { a acI`
�r tl
r• .
Wean to Finish
r?' ^
Layer I Dairy Cow
Nan La er —7airy Calf
` "'110i'i I ' ` 'I' r 'I '{' ' { Dai Heifer
i # sp,i i
Ill
Wean to Feeder
Feeder to Finish
,'`3'IxR''77f
��
Farrow to Wean
#�
;'{#,'�I"{�Ikll,i,y
�, :t i i I4'�I r r lr':" c
;IDleslgnlll Car"rent �y1�, D Cow
D` I,C'a aci P,q i Ir Non -Dai
Farrow to Feeder
;,:,;{�
IlPotiilt r.
yI:
Layers Beef Stocker
Non -Layers li���; Beef Feeder
Pullets "1'" Beef Brood Cow
]�
Turkeys
i Urke S-
Farrow to Finish
Giltsi;.
Boars
4.,
�,.�;
Other i11J1 �Il� GI, i.{,1:' i9 II �•1 �Yi�ir=�s.l.1. l.11i.�'� I I;li 1 { `,
TurkeyPoults ; II
Other
1 ,,1 .:
h
Ot er
,, ..,.1� ,,,..1>v,, ,•,Ii x..11 u 1 1,11. 1 �.�..,. � ., ,•. 1
Discharees and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 to [] NA ❑ N E
❑ Yes [] No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes �#a
[:]Yes Ti'`#o
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 2/4/2015 Continuer!

Eacili !Number: Date of Inspection: —
7 --
Waste Collection & Treatment
�+
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3 -Ko
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in): f' /9L
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
[] Yes
[�_'V1Vo
❑ 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
Q"INo
❑ 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
fTN-o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑-N-
❑ NA
D 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
0 --No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[] Yes
u 'Vo
❑ NA
❑ NE
maintenance or improvement?
1 1. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
ET<o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground , ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved
Area
12. Crop Type(s): �!� ZWil ,.,��
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
Q No
DNA
❑ 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? ❑ Yes ffNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes [YNo ❑ NA ❑ NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Ej-'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E3<o ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the propnate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard El 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 [31Vo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Ei No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection:
❑ Yes
M -No
❑ NA
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
/ No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
IBJ o
❑ NA ❑ NE
the appropriate box(es) below.
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative?
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
Q o
❑ NA
❑ NE
❑ Non-compliant sludge levels in any lagoon
D Yes
r.? iso
D NA
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
I <I "0
[:INA , ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[] No
❑ NA ❑ NE
Otherissues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes E3'go ❑ 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 E No D NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes [3'VU ❑ NA ❑ NE
permit? (Le., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
M -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
Q o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
D Yes
r.? iso
D NA
D NE
� Sa; L ri v=a rater To pwf + ►1 �r our Cre oi4
t1rL fl "a.3 brie''\, u o o,/l v- 7 -14 A 'rD V'e't_
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: `}1'D : &3n-2 j 4r1
Date: _ i*1d7- l 7 `/�
2/4/2015

viIst iiot-n'dfolllf3r W
t".!RI I r>.. 1 I ' ! 1 �
mbr �lIit�f i�;101]visoin46fSell
and Water,Conservat€on" 1
�l�Lli�i4�1l1 F f l�5 tl`€r1"IF
.111.1 L.€P 1�1..dr I{J L ar.... g ,,, T . -
I I Other A enc
Type of Visit: ompliance Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: > ne Q Complaint Q Fallow -up O Referral Q Emernency Q Other Q Denied Access
Date of Visit:/f / ] . Arrival Timer Departure Time: County: Region:
Farm Name: (/j �7/�7- !m_s �j9G, Owner Email:
Owner Name: _�+ — Phone:
Mailing Address:
Physical Address:
Facility Contact: _ U �hw 1� .r rA' Title: /-Vise""Pi -eel Phone:
Onsite Representative: �,_ Integrator: S,/yJ) 2r1d
Certified Operator: �� �r�� Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
1 11 13 fl II ]r ! „ 1]e
Current
S1vipe� 11 I� ; �„I I q; �t;,Ifk Capac�tya 11"`;�Pop� r�IIN.I. Yl l I; wet Poultry s 1.1 'Ca f
IEIIIY rh I:; ,lf. ,ari l �retYfw�li#ap l�i6lfl%E.tss,ll�lu�.'ll�l Il r, �r1��Y�0� 6thl;itf "'h:uEil:r i9�41kitiadel l;
Wean to Finish
14€
Layer
Wean to Feeder
l E
Non -Layer
Feeder to Finish 7 J (; po1
,.�1'oult `,P,(:!�iP€ Cat
Farrow to Wean
�V'�4„s;';I�Dr
Farrow to Feeder
Farrow to Finish
iV��i
Layers
Gilts_;
I ;a
Non -Layers
Boars
Y I "I�,` r IlirE ylklll,"II 'rH'!I �, I1,' ltl �:��hlllll�1€I�':;i1E 1� �n Ira IYI III3l
i`
l-
Pullets
Turkeys
TurkeyPoultsOthehr�
Other 1 11!44
lOther
DischarLwes and Stream Imoncts
Longitude:
Current I i Design Current
Cattle- Ca aci Po
ul Ah"l �; i
Dairy Cow
Dai Calf
Daia Heifer
My Cow
Non -Dairy
Beef Stocker
Beef Feeder
Be f Brood Cow
499.',Curirrenf
H
1. Is any discharge observed from any part of the operation?
❑ Yes
Jallo
❑ NA
❑ li
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
No
❑ NA
❑ NE
C. What is the estimated volume that reached waters of the State (gallons)?
�
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
[n NA
r
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[Z No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
RNo
[—]NA
0 NE
of the State other than from a discharge?
Page 1 of 3
2/4/2015 Continued

Facili Number: - Date of Ins ection:— f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
9ObseDesigned Freeboard (in): /9-
Observed
rved Freeboard (in): _ 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes P�A No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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 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 -9-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. 6 Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift R Application Outside of Approved Area
12. Crop Type(s): C�f%i!? 14V rrf � �-
13. Soil Type(s):
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 ®No ❑ NA ONE.
16. Did the facility fail to secure and/or operate per the irrigation design or wettable R Yes ❑ No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
I S. Is there a lack of properly operating waste application equipment?
❑ Yes ® No ❑ NA ❑ NE
2 -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 C&No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design ❑Maps ❑ Lease Agreements ❑Other:
2l. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EE1,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 IS No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Humber:- Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes €�S No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes allo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes allo ❑ NA ❑ NF,
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/lnspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes allo ❑ NA ❑ NE
❑ Yes .® No ❑ NA ❑ NE
❑ Yes allo D NA ❑ NE
❑ Yes E,No ❑ NA ❑ NE
❑ Yes
MNo
❑ NA
❑ NE
❑ Yes
[Z No
❑ NA
❑ NE
❑ Yes
EZ No
❑ NA
❑ NE
Coimmen" M.-fQelfer;to question #); Bola in'any, YFS Answers"and/or any additiaaal reeammendations orany, othei" comments.
I.d. i ,€ I I .. .i, la, y.,. € ,f .i' . i...
Use drawings, of.fac.iiity, tolbefter�explein situ'utions';(use;additionalpages as necessary);
/./..—�
!fid e7 �
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77K=
it �}� j�f�' l C.�.�C � ��S Q��✓1fh r.-� "` i[. / "-'e �r%r i �'�`-� p�-r r w .sir
lov � r ; }� c�S S
71,
Reviewer/Inspector Name:
Reviewer/inspector Signatui
Phone: Q'Q—OP3--04
Date:
Page 3 of 3 2/4/2015

(Type of Visit: Q�Com11 e 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 0 Denied Access
Date of Visit: / / Arrival Time: ; p Departure Time: ,' �" County: -. Region:
Farm Name: fig In- Ir_ n c. Owner Email:
Owner Name: r Phone:
Mailing Address:
Physical Address:
Facility Contact: U o h�� n�t �r✓'� Title: _ fb}-cy�L,r Phone:
Onsite Representative: J,_Z' Integrator: 5j;', J ,
Certified Operator: _i�� Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
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 �o ❑ NA ❑ NE
❑ Yes ❑ No
[-]Yes ❑ No
❑ Yes ❑ No
❑ Yes E. No
❑ Yes 2S.No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
E] NA E] NE
Page I of 3 2/412015 Continued
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design C►urrent
Cattle Capacity Pop.
Dai Cow
Wean to FeederFINon-Layer
Dai Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
7j�
Dr. P,oultr,
Design
Ca aci
Current
P.o
Dai Heifer
D Cow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
Gilts Non -Layers
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
TurkeyPoults
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 �o ❑ NA ❑ NE
❑ Yes ❑ No
[-]Yes ❑ No
❑ Yes ❑ No
❑ Yes E. No
❑ Yes 2S.No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
E] NA E] NE
Page I of 3 2/412015 Continued

Facility Number: Ff,�L_- j Date of Inspection:
�. Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes allo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): �2
Observed Freeboard (in): 1
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes RLNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes RNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes 0 No
❑ NA
❑ NE
8. 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 5�j No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes '21 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
Yes 9LNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s): C� r,-� �w�f �,,� /S'B�7h��•,. s
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes r[ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ,EgNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 5jNo ❑ 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 allo ❑ NA ❑ NE
❑ Yes ENo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the 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 [SJ_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 allo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes allo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EB -No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
[DNA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: - / 9_ I Date of Inspection: A- I
'r 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ 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 E?[ No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 81 No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA D NE
❑ Yes f7 No ❑ NA ❑ NE
❑ Yes g. No ❑ NA ❑ NE
❑ Yes S No ❑ NA ❑ NE
❑ Yes O No ❑ NA ❑ NE
❑ Yes
0,No
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
[:]Yes
PNo
❑ NA
❑ NE
Comments (refer to questiow#): Explaln any YES answers and/or ayny additional recammendations�or:,another comments •;.: � _ ,
Use drawings"of fac,llity,to better explain; situations (rise additional pales°:as neeessarY).,;
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone: /%P'—:343 196-1
Date:
21412015

_-Z'Ll1-,q -,:zo r-0-4
CMIvision of Water Resources
r
4y Facility Number ®- 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit:QMOTpli nee 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 0 Denied Access
Date of Visit: a / Arrival Time: ,� Departure Time: County�9 ,9�-E Region:
Farm Name / f�
-G , ©&Y tins _ G. Owner Email: ��
Owner Name: _ V O f �v� LQ kLeda Phone:
Mailing Address:
Physical Address:
Facility Contact:
'V Title: Phone:
Onsite Representative: Integrator: Af_3
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
WL er
Non -Layer
Design Current
Nan -L
Pullets
I ITurkev Poults I I I
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ;g -No ❑ NA ❑ NE
[:]Yes ❑ No
[:]Yes ❑ No
❑ Yes ❑ No
❑ Yes 25 No
❑ Yes 91 No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 2/4/2014 Continued

Facilit 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:
Spillway?:
Designed Freeboard (in):
ZNo ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 6
Observed Freeboard (in): S` P-,5-
❑ Yes
EL No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
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.)
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
ZNo
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�No
E] NA [:]NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
®,bio
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
RLNo
❑ 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
5jNo
❑ 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 ZI No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [] Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus [] Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window
L [] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): G_O
❑ NE
i
13. Soil Type(s): �i(�D z�Z Gyc- /� a�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes rNo [3 NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
rte, ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ®.No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
[:]Yes 0,'No ❑ NA ❑ NE
❑ Yes 2 -No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
EL No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
RNo
❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists E] Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
ZNo
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield [3 120 Minute Inspections [] Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�No
E] NA [:]NE
23. If selected, did the facility fail to install and maintain minbreakers on irrigation equipment? ❑ Yes EL No ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

Facili Number: nL - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes UNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ES -No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [,_2 No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes RNo
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
[] Yes CK No ❑ NA ❑ NE
❑ Yes [a No ❑ NA ❑ NE
❑ Yes [gNo ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [R No
[:]Yes 2 No
❑ Yes Callo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or, any;otheu6mments
Use drawings of facility to better explain situations (use additional "ages as necessa ).
�r
'! 7
W z�a
Reviewer/Inspector Name:
Reviewer/Inspcctor Signature:
Page 3 of 3
Phone: 2 Xyz—.fit%
Date: 1,;7-
2/4/20]4

%E "Division of Water Resources
ti Facility Number - % / O Division of Soil and Water Conservation
A.
0 Other Agency
Type of Visit: ompliance Inspection n Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: CHIC56ine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: : 00 Departure Time: County: Region: Frt
Farm Name: w� 4t—�or_.re- ratzz., S Owner Emall:
Owner Name:K 33�„.,,�,� Phone:
Mailing Address:
Physical Address:
Facility Contact: V/ !!h v, cam e4o bl Title: / JK tom✓— Phone:
Onsite Representative:Integrator: /llyr, a i7e.eJ�'C-
Certified Operator: Certification Number: ,/003
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feede:
Farrow to Finish
Gilts
Boars
Other
Other
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
"Layer
Non -La er
Non -L
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1, Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes J�R No ❑ NA [D NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No
[:]Yes Callo
❑ Yes jz No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 3 2/4/2014 Continued

Facili Number: I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 9�-—
Observed Freeboard (in): 3 L
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes g No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [ 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 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 4! /&^ w ✓. .6 �-,��-..e
13. Soil Type(s): L
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 ER No ❑ NA [] NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes 10 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a tack 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 RL No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MNo ❑ NA ❑ NE
the appropriate box.
❑WUP [I Checklists E] Design E] Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [.] Yes [R"No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes � No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes J( No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 2/4/2014 Continued

Facili Number: jDateof Inspection: ./
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes No ❑ NA ❑ NE
• 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility.fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the 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
® No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
C] No
❑ NA
❑ NE
❑ Yes J&No ❑ NA ❑ NE
❑ Yes r No ❑ NA [D NE
❑ Yes ® No ❑ NA ❑ NE
[:]Yes Q No
❑ Yes k No
❑ Yes 0,No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to -question #) Explain any YES"answers and/or.any additional;recommendations or any, other- comments
Use drawings of facility to bettee ex laln;situations use additional; a es as necessary).
p �r r/� ��—�
Reviewer/Ins ector Name. a•-�Phone:.
Reviewer/Inspector Signature: Date:
Page 3 of 3 214/2014

,4
ivision of Water Quality�� Il
Facility Number O Division of Soil and Water Conservation-- j3
O Other Agency
Type of visit: ompliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: -13 Arrival Time: IQ! Z Departure Time: County: Region: E_RV
Farm Name: -,a �7�p �'� /-�roerp7, j ^Z::oVc.. Owner Email:
Owner Name: o.- 7l aa ehat✓d Phone:
Mailing Address:
Physical Address:
Facility Contact: //'qA"L.
Title: 0&0 t.p'-- Phone:
Onsite Representative: Integrator: /79-1-z�
dv
Certified Operator: sem_ Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer I T:::�
Non -La er
Pullets
Other
Poults
Design Current
Dischames and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes DE].No ❑ NA ❑ NE
[3 Yes [] No
[:]Yes ❑No
❑ Yes ❑ No
❑ Yes Z No
❑ Yes ® No
❑ NA ❑ NE
❑ NA ❑ NE
E] NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 214/2011 Continued

Facility Number: Z7 - I 14 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ® No ❑ NA ❑ NE
a. if yes, is waste level into the structural frecboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): C)
Observed Freeboard (in): �
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA
[ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes allo ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes a 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 �ANo ❑ 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): n"',_ /W/ "i �✓�B7�zra�r-.1
13. Soil Type(s): VU
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 51 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes RNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes MNo ❑ 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 Z[No ❑ NA ❑ NE
❑ Yes 3 No ❑ NA ❑ NE
Re wired 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 QjNo ❑ 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 jj4 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 XNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [S No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facili Number: 4a - Date of Inspection: `"
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C, No ❑ NA ❑ NE
i
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes CK No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[K No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
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
e, No
❑ NA
❑ NE
Comments (refer, to question ##): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better exulain situations (use additional gaaes as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:-tf33O�
Date: z
2/4/2011

ivision of Water Quality — f
Facility Number r �% l� 0 Division of Soil and Water Conservation rte,
0 Other Agency % �—/ 3
Type of Visit; mpliance 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 0 Denied Access
Date of Visit: rrival Time; V,'3 Departure Time: p County;�D—Region:
Farm Name: h C, Owner Email:
Owner Name: zax Phone:
Mailing Address;
Physical Address:
Facility Contact: C/ l�i�v� 73 c�/a� Title: j -rte,, y-✓ Phone:
Onsite Representative: Integrator:
Certified Operator: s em-- Certification Number: %pa
Back-up Operator: Certification Number:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Discharees and Stream ImnactS
Latitude:
❑ Yes
JR No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Wet Poultry
Design
Capacity
Current
Pop.
Layer
❑ NA
❑ NE
Non -La er
❑ Yes
❑ No
Design Current
Dry Poultry Capacity Pop.
Layers
c. What is the estimated volume that reached waters of the State (gallons)?
Non -Layers
Pullets
❑ Yes
❑ No
Turke s
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
Turkev Poults
No
❑ NA
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
L Is any discharge observed from any part of the operation?
❑ Yes
JR No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
J&No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

Facility Number: - Date of Inspection:
G — �—
❑ NA
❑ NE
�] Yes
Waste Collection & Treatment
❑ NA
❑ NE
;4 4, is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
CR No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure
4 Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 13
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ YesNo
❑ 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 heed maintenance or improvement?
❑ YesNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
I 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
Z[No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
V No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes KLNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil.
❑ Outside of Acceptable Crop Window /❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes IV9 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 [J� 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
(4 No
❑ NA
❑ NE
�] Yes
RZNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes CR No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PQ No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists []Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes ["No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'? [:]Yes "No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
E] NA E] NE
Page 2 of 3 21412011 Continued

• Facility Number: - Date of Inspection: --
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[gNo
❑ NA ❑ NE
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
J.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
J4 No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
®No
;k
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
jEg�'No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
L!INo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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 review/inspection with an on-site representative?
❑ Yes
IE�No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
_CZ -No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any. other comments.
Use'drawirtgs of facility to'better explain.situations(use additional pages'.asfnecessary} ' :. ; . ",
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: Z'�=(p
214/2011

F
ivision of Water Quality
13
Facility Number ��- - 0 Division of Soil and Water Conservation 0 - r Y— i I
0 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 0 Denied Access
Date of Visit: O O- Arrival Time: ,' Departure Time: ; D County:
Farm Name: UZ1,L C!r._ oC—_yeM Zae_ . Owner Email:
Owner Name: 0� _ _SOL,-- ay _ _ Phone:
Mailing Address:
Physical Address:
Facility Contact: _�A�-wg:vle
� Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
^Clam/, W --- Phone:
Latitude:
Region: 75-2-0
Integrator: AW -41
�-
00
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [a No ❑ NA ❑ NE
❑ Yes
[ ] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes ® No
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
Page I of 3 214/1011 Continued

Facility Number: Date of Inspection: y 07- /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):p�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Eff 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 rVf 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 K No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes gg 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?
I I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Types): _>�� 144 _4—
13. Soil Type(s): l,�j° `� '9 -e %Lys `k A-
14.
14. Do the receiving crops dAer from those designated in the CAWMP? ❑ Yes allo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes allo E] NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [ffNo ❑ NA ❑ NE
acres determination?
IT 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 3,No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ffj No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 21 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 5�]_No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Ejj.No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes allo
E] NA [D NE
0 Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facili Number: - Date of inspection: n ;Y /
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes JKNo ❑ 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 F1 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 CK No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [Z No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ® No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
J&No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
P,Yes
❑ No
❑ NA
❑ NE
J4 Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question fit); Explain any YES answers and/or any additional recommendations or any other comments R
Use drawings of facility to better explain situations (use additional pages as necessary).
..'®r 0
Aoi�
Reviewer/Inspector Name: ��W Phone: 3a D
Reviewer/Inspector Signature:
Page 3 of 3
Date:
V4/1011

i ivision of Water Quality >ti�
Facility Number_ 0 Division of Soil and Water Conservation :512:
0 Other Agency
Type of Visit
omp[lance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
utine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: t jo-:? Arrival Time: C7 Departure Time: ! c7 County: Region:
Farm Name: k1ja — n o/Sz /�--S �L r� e • Owner Email:
Owner Name: _ iy, �` Phone:
Mailing Address:
Physical Address
Facility Contact: V�'7i'� / G� Title: z04e Phone No:
Onsite Representative: .5�— Integrator:
Certified Operator: Operator Certification Number: ZITQ2z
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
Back-up Certification Number:
Latitude:
n°
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑❑ La er—
Non -Layer
Other
❑ Other
Dry Poultry
❑ Layers
❑
Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Longitude: = o =' =
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑
Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: ©J
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ®.No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
9LNo
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
Page I of 3 12/28/04 Continued

Facility Number: Date of Inspection -tea
i
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _ 10
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes NNo ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes MNo ❑ 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 ZLNo ❑ 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 [3No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes rX3No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. [:]Yes ELNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13.
Soil type(s) l
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
0 No
❑ NA
1
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
J4 No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
&No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
E9.No
❑ NA
❑ NE
Comments (refer to question`#)c Explain any YES answers and7ot any'r.UVUmmetidations nr ariy"other comments' tea;
s t�
Use'drawEngs of face W to better explain situationsj(usc)addihonaplpag
,�es as ne{cessary):, �Va wwaes..n, + }
ti
•
ector Name
p Phone: p-yz
Reviewer/ins
Reviewer/inspector Signature: Date: 9.�'c) zP;Z-0/_p
Page 2 of 3 121A104 Continued

Facility Number: — Date of Inspection b
t
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 [R No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists
❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes (R No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield [:1120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
09 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
(9 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M 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
tR No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
®,No
❑ NA
❑ NE
Other Issues
2$.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EkNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ER No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
2 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
RNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
5No
❑ NA
❑ NE
Additional Comments and/or Drawings:' : 1 `'t.i,4P ',> ?,`vl
,` 3,
a
Page 3 of 3 12/28104

�I1
Type of Visit Z ompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: r D Departure Time: 112.�K . I County: Region:
Farm Name:17; fC -7:I1C Owner Email:
OwnerName: �� A/1s ¢Gt4C� 42eO/ _ Phone:
Mailing Address:
Physical Address:
Facility Contact: 0/ *L. JIL,4,x-+ & a/'44 Title: AWA 1,e ✓ Phone No:
Onsite Representative: SLE3t Integrator:
Certified Operator: ___.... .f =S. Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [=O =1 =61 Longitude: =o=,
o=,
Design
❑ Yes
Design Current
❑ NA
Design Current
-1urrent
Swine Capacity Population
Wet Poultry
•apacity Population
Cattle
Capacity Population
❑ Wean to Finish
10 Layer
JEJ Non -Layer___
❑ Dairy Cow
❑ Dai Calf
❑ Dairy Heifer
❑ Wean to Feeder
54 Feeder to Finish 173,41115-000
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Non -Dairy
❑ Farrow to Feeder
❑ Farrow to Finish
El Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
[) Beef Feeder
❑ Boars
❑ Pullets
L1 Beef Brood Cow
❑ NA
❑ Turkeys
2. Is there evidence of a past discharge from any part of the operation?
Other
❑ Other
urkey Poults
❑ Other
Number of Structuros:
❑ NE
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
JELNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
O.No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
ZNo
❑ NA
❑ NE
other than from a discharge?
12128/04
Continued

Facility Number: Date of Inspection
} Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy'rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes ERNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Identifier:
J
Spillway?:
7
Reviewer/Inspector Name �. ,
2 --ObDesigned Freeboard (in): 12 --
Reviewer/inspector Signature:
Date: D
Observed
served Freeboard (in): Y3
5. Are there any immediate threats to the integrity of any of the structures observed'?
❑ Yes
E4 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
C9 No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
9No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[Z 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
E9 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
RNo
❑ NA ❑ NE
mai ntenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate• Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of
Area
12. Crop hljklt�,�j
type(s) ajrrt
13. Soil type(s)G� I G A -
L
STP - -_ i..i...ii..._..i..ii.
14.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
54 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
0 No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
® No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
SNo
❑ NA ❑ NE
� .'�- . '. c s'�L`P `���T^z #N �-��X�t',
;Comments (refer ta: question;'#), llzplam any YFS;unswcrs andloi any recommendationsfaranlly, other comments,
Use drawings of facility to better cxplatn situations. (use addihonalpages,,as,necessary) �q VA p may.
J
7
Reviewer/Inspector Name �. ,
f '$ !Phone• �JQ y33", tea
Reviewer/inspector Signature:
Date: D
`" 0- 12/28/04 Continued

Facility Number: _ f Date of Inspectiong
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9No ❑ 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.
❑ WUF ❑Checklists [I Design El Maps [3 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes SNo ❑ 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 B No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ZNo ❑ 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
CS No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
C.No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
JSNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
RNo
❑ 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
59 No
❑ NA
❑ NE
Additional CommentsandlorDrawingst
12128/04
12128/04

r
vision of Water Quality SI 6 &,-
Facility
/Facility Number O Division of Soil and Water Conservation jI `, �►
Other Agency
Type of Visit Ola–ompilance 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:11 Arrival Time: 'Oo Departure Time: : D D County:
�'�Y► F~—
Farm Name: +']'e -IL oL ,r �t'"m S �i� Owner Email:
Owner Name: aha Phone:
Mailing Address:
Physical Address:
Facility Contact: j �+ / Title:
Onsite Representative:.
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
a
Latitude: =
Phone No:
Integrator:
Operator Certific ion Number:
Back-up Certification Number:
Region: C�
❑ " Longitude: 0 a ❑ , ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish 10 Layer
❑ Wean to Feeder ❑ Non -La er
Feeder to FinishL 7
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: El
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes &.No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes J.No [INA ❑ NE
❑ Yes ®No [INA ❑NE
12/28/04 Continued

a
Facility Number: — Date of Inspectionj2Z26 iT
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): / / 9"
Observed Freeboard (in): y
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes allo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑.No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Z1 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 [K No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes MNo ❑ NA ❑ NE
maintenance/improvement?
. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes LZ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) )eq
v
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
R[No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
allo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
allo
❑ NA
❑ NE
(rer to question #) Explain any 1'ES answers and/or any recommendations or any other comments.
sa t �� g�,�
CommenlgQQ!twfiette
IJac drawr eatplaln situations. {use addf ion al pages as necessary):
Reviewer/Inspector Name — - r. ----r �� Phone: i�"',�/- 33
Reviewer/Inspector Signature: Date: 10-1:119-1;206 J'
Page 2 of 3 1 12/28/04 Continued

Facility Number: — Date of Inspection D b
Renuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes UNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 9 -No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes C.No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ®.No [:INA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �0 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
O No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[4No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
t4No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
®,No
[INA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
5,No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
Yes
(0 No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
91 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
R No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
V,No
❑ NA
❑ NE
i,VdditionatlGommenls and or 40AM"s
w
Page 3 of 3 12/28/04

vision of Water Quality Aq j
Facility Number �--� 0 Division of Soil and Water Conservation Jr
0 Other Agency A
Type of Visit 0916ompliance
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: Departure Time: �County: Region:
Farm Name: FQ/'wtjjQl a j Owner Emaipl:
Owner Name: _ ._ � (H !'t �' Phone: # 0—"2 90
Mailing Address:
Physical Address:
Facility Contact:L,owtaceI'o -Title:
Onsite Representative: Sle-:-.x
Certified Operator:..
Phone No:
Integrator: Aelyd!!�
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Design: Current
Swine Capacity Population
10 Wean to Finish
❑ Wean to Feeder
Feeder to Finish I 'D
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other
Latitude: =0 =1
Longitude: =0=6 °=6
Design Current
Wet Poultry Capacity Population
❑ La er
❑ Non -La er
ury rouirry
La ers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
❑ Dairy Cow
❑ Dairy Calf
❑ Daia Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
Design Current _,
Capacity":population.."
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 0 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
JR No
❑ NA
❑ NE
❑ Yes
®.No
❑ NA
❑ NE
12128104 Continued

r,
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'?[:] Yes
Facility NumberDate of Inspection [D` 7
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
JO -No
rr.
ii
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
3..No
❑ NA
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
BNo
❑ NA
❑ NE
a. If yes, is waste level into the structural Freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): G%
Observed Freeboard (in): y
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
(3 No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
[.No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
I&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
CK No
❑ NA
❑ NE
maintenance or improvement?
WasteAppilication
10. Are there any required buffers, setbacks, or compl iance alternatives that need
❑ Yes
C�t No
❑ NA
❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes RNo ❑ NA EINE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [:]Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [:]Application Outside of Area
12. Crop type(s)
13. Soil type(s)��-sD
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 19No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'?[:] Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
JO -No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
3..No
❑ NA
❑ NE
Comments (refer to question ft 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):
IReviewerAnspector Name y� ,� Phone: ��D-- 3.3�fl
Reviewer/inspector Signature: Date:
12/28/04 Continued

i Facility Number: fa — Date of Inspection /D w l 7� 17
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ YeS [BNo ❑ NA [:INE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes f.No ❑ NA EINE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers Y Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [ No [INA ❑NE
23, if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes XNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�RNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
[9 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[9 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
Q 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
JRNo
❑ NA
❑ NE
General Permit'? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[9 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ZNo
❑ NA
❑ NE
al Comments and/or D
12/28/04

V
Type of Visit 41�"Eompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 � j10-jO(v jArrival Time: Departure Time: t 05 County —=<_!:! � 0--22__ Region: ,�_,_1. o
Farm Name: _%�!'i �))T i 4 D I"LSr EGtrr>25l c r Owner Email:
Owner Name: OH v1_ 31 -exit- ✓G� Phone:
Mailing Address: 1 u i~a ✓ O R d. who .a-Gt1 AJ C.
Physical Address: fJ
Facility Contact: t��L.(�r? chv��� Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator: r'
Operator Certification Number:
Back-up Certification Number:
Latitude: =' ❑ ' = Longitude: =o=, o=,
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑
Layer
❑ Non -La ei
Dry Poultry
❑
Layers
❑
Non -Layers
❑ Pullets
❑
Turkeys
❑
Turkey PoultS
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Daia Calf—J
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Caw
Number of Structures: ®,
b. Did the discharge reach waters of the Slate? (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 Callo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
CXNo
❑ NA
❑ NE
❑ Yes
10No
❑ NA
❑ NE
12/28/04 Continued

• Facility Number: — Date of Inspection
Required„Records & Documents
' 14. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZLNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ZNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes K 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
JK No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[gNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
5INo
❑ 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
r-” No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ENo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
U[No
❑ NA
❑ NE
24.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
DdNo
❑ 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
RLNo
❑ 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
Dq 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
[Q No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JKNo
❑ NA
❑ NE
Additional Goniment�,;and/ornruwings
Kel"ev r
12/28/04

12. Crop type(s)
13.
Facility Number: — Date of Inspection
Waste Collection & Treatment
14.
' 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�9 No ❑ NA ❑ NE
a. If yes, is waste level into the stnietural freeboard?
❑ Yes
[ 4 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
❑ NE
16.
Spillway?:
❑ Yes
® No
Designed Freeboard (in):
❑ NE
17.
Observed Freeboard (in):
❑ Yes
M No
❑ NA
❑ NE
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0 N ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
❑ NA
❑ NE
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
[Z No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
Yes
❑ No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[VNo ❑ NA ❑ NE
UY
(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
JZ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
allo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13.
Soil type(s) /,{Jp Z
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Z No
❑ NA
❑ NE
15,
Does the receiving crop and/or land application site need improvement?
❑ Yes
rM No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'
❑ Yes
® No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application'?
❑ Yes
M No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
®.No
❑ NA
❑ NE
I-.7,PD"1-
Reviewer/inspector Name T .r sv . j, , � µ , ` Phone:
Reviewer/inspector Signature: Date: -- !a Dlo
12/28/04 Continued

V/
:zri�: HA: ,r, � c �N� �4 '. �� !� 4 �t�+►a.r .?-�:[lAr • 'Nn-' . r w "i' t r aC 2 •"'r „s i r r ! '�..} T � . ,
?� G� . Dlyisitan Oi+'8ter nali
`?n.:.x.. Q s - �4,��' t r S 1,4 • r w J.
"s�EE`hC 7 d W.-
• .
.,�t'� q�i`.h' "*5�' [},,I�� jj(d� �•-'+3,1'M�Q,DiVtsion-o!'Soil.aad Water Ganservatlon,_ , ,; ,... _ �' `.,'
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit *Routine O Complaint O Follow up 0 Emergency Notification Q Other ❑ Denied Access
Dote of Visit: a'0 Time: q, .7D '
Facility• Number
,,,,,
`` Not Operational Below Threshold
afermitted Certified I ❑ Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: �I%h. h A le C11 &Y, An c .rite . County: S C�lL
Owner Name: T0411 Q&. 4.2 a / Phone No: 9/d -Mailing Address: 9� Car/' a �/� 0 _ _ g _
Facility Contact: +T'A'M /arc( Title: Phone No: y�U 550— ��
Onsite Representative: Taff.__ _�J �G rtie��- Intecrator: OY'atua,
Certified Operator: j;AM Alght_AACZ Operator Certification Dumber: ay?
Location of Farm:
M-iwine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 1 0. Longitude `
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder I ❑ Laver I ❑ Dai
911�e'eder to Finish ❑ Non -Layer I I Non -Dairy
❑ Farrow to Wean
El Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons
:,,Holding Ponds / Solid Traps
❑ Subsurface Drains Present
❑ La Doty Area5 ray Field Area
❑ No Liquid Waste Mana ement Svstem
Discharges & Stream lingacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ LaQoon ❑ 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? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1 1
Freeboard (inches):
05/03101
❑ Yes Ly'ly o
❑ Yes 91,11
❑ Yes 0'No
❑ Yes ,D' qo'
❑ Yes L3<o
❑ Yes 91<0
❑ Yes L/No
Structure 6
Conderued

Facility Number: — q Date of Inspection ®d
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 2N -'o
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or ❑ Yes [ to
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
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes QKo
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 0.90
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes UN0
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Ccfrn , wi,-I t-. Srn,„i .,. e
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
2No
b) Does the facility need a wettable acre determination?
❑ Yes
GNo
,a
c) This facility is pended for a wettable acre determination?
❑ Yes
SRO
15.
Does the receiving crop need improvement?
❑ Yes
QWo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
UNb
Odor Issues
17.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18.
Are there any dead animals not disposed of properly within 24 hours? '
❑ Yes
E3'15o
19.
Is there any evidence of wind drift during land application? (Le. residue on neighboring vegetation, asphalt,
❑ Yes
Q -W
roads, building structure, and/or public property)
20.
At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
GNo
Air Quality representative immediately.
„ Y4 'sk'y 11�. RW!t..tCl "Et
„Comments refer to q6estiion #)* 1FplaYn,aayYrES�an srveirs ar►dlar any; recomrnendatiotis or anyatlercogdmets
Use,drswiag5s Eovalt;pay�g- es`ai sEi ne, c, 'e € s!,sarplauisttuatinas"{ue;additin£eldi Copy
U d:i FiI�E❑ Final Notes te+.sy
1w ��E eia frLd .4Sr4Fj .tN
�✓�s a Pon 4,7.5 ioen v/oc1alerl iv J44, w,, RjewS
f(,m1o.'„ 9
hi
t 3 :P • I,yN �y�; !
� F99'f' 14 t
Reviewer/Inspector Name iU!irx%H €€:!' „1 '�: 3fyr E31€:,u°tl�
,a
Reviewer/Inspector Signature: Date: 7- q -p
12/12/03 Continued

Facility Number: S� _ q Date of Inspection
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
g- fes
❑ No
7 - _741.0 y
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Re
uired Records& Documents
Did the facility fail to install and maintain a rain gauge?
❑ Yes
21.
Fail to have Certificate of Coverage & Genera! Permit or other Permit readily available?
❑ Yes
m,Al0-
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Did the facility fail to calibrate waste application equipment?
❑ Yes
[Ro
(ie/ 4ee tts, Aa4grr�psags etc.)
❑ Yes
E;W
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
U.I+d6
❑ W p ication ❑IFrsebem --fl V*ft-A[n ysisis ❑ ping
—notfn
24.
Is ct t y comp] ance ith any applica le setback criteria in effect at the time of design?
❑Yes
Q#u
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ d e, free ,problems, oyxralrpHcation)
❑ Yes
[3.ND
27.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
B -No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
GNo
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑-Ado
NPI)ES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
g- fes
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
®-No'
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
G -Ado
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
R fO
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
[Ro
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
Q.N v
[3Steeking-Fern: ❑ Crop Yield Form ❑Jkdrrfff- ❑ I
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
dLil�t%6IIa1 C8 �1�1en ia�tl�d/�orI�raWln S �1�`..si:..;.�..z�`_ ���1 �!� .�.,, vee � � �! 1 ::. '� r .r h
lin 1..
3 Aev,'ewrl 6t,
lolet se G+d M 07_ P �7 0I,/ fPe&l 14 600, S 01 }raur /plJoo+ss•
Pleas mo711or flare
9ec�1 �Or e/'O,f,j�
r �IGr�C Q/an71f�.
110
12112103

r.
F �j
II�1{'i�{ Site Requires immediate Attention:
Facility No.IZA-itci
DMSION OF FNVOtONUMNtAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS srm Y1SRAnoN RECORD
DATE: Auauat z , im
Tim: _.11;x:5._
Farm NUM Owner:ws & e1+ ncllna�
Valling Address: c 1.1. ail -
bjegM1or:_Muj2hy yamuxjarmsPhone: (gin) 980_4119
On Site Representative: Dewey Carter. MurRhu Earms ^ phone:, (910) r99 -1A82
Physical AddruO., cation:
Type of Operation: Swire g Poultry Cattle
Design Opacity: ?.�_ Number of Animals on Site:
DEM Certification Number: ACE. DEM Certification Number: ACNEW
Ltitvde:�' �$' �` Longitude:i8 • meg• s�s•
Circle Yes or No
Does The Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm evert
(approximately I Foot + 7 inches) Yes or No Actual Freeboard: t 4 Ft. finches
Was any seepage observed from the lagoon(s)? AW-orft Was any erosion observed? Yes p�Seepage Not
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or. No Evaluated
Crops) being utilized:
Does the facility, meet SCS minimum setback criteria? 200 Feet from DwelIin s? I&or No
100 Feet from Wells. org)
1s the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No NoEvaluated
Is animal waste discharged into water of the state by man-made ditch, flushing system, or -ether
similar man-made devices? Yes oro If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure. land applied,
spray irrigated on specific acreage with Dover tarp)? Yes or No Not Evaluated
Additional C;oM ents: This Was a -very breif inspection, a more thorough inspection will be�
conducted -in&he future.
Lnformalion__noted an this ineaection was obtained from Mr_ Daway Carter_ _
If You b -t auestiona regarding this rappzt please t,antAr,t Paui Rawls- 1DEM_ttator us1iLF-_
Section C [phone].
-Plea-0 #+1j"tert DEK should AM Condi inns Anile thAt noun imminent Auger to surface wax& n.
This fAn was ngt lnratad gn A URGS TORO min tq determine ""lite T.in^'! AzArus_
Inspector Name Signature - -----
cc: Facility Assessment Unit Use Attachments if Needed.

�J
Site Requires Immediate Attention:
Fatality No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANDoIAL FEEDLOT OPERATIONS STTE VISITAinoN RECORD
DATE: August 2 _ , IM
Farm NwWOwner:-a1k��. �.tm'A t .. mow. Qio�+j_ _
webs Address:., 3qo sera„ reds �serlT��sdu� els.. z ��. _15IO 4
Qmty: Samnann - - - -- - - — - —�
Integrator: MurRhv Family Farms - Phone: (gin) 7Aa_')t t 4
On Site Representative: Dewey CArter, murRhY_yOM91 Phone:_ (Q 1 n) spa_, AR, -
Physical Addresvl=ation•
Type of Operation: Swine _j_ Poultry Cawe
DesiSn Capacity: 34M Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Ladtude:, h- •,M' ,Q" LonSitude:.Jt • -91, X•
Circle Yes or No
Does dK Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No - Actual Freeboard: ^ _2_Ft. Inches
Was any seepage observed from the lagoon(:)? Yes or No Was any erosion observed? Yes o<96eepage Not
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No Evaluated
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? mor No
100 Feet from Wells? mor No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes ojQjE) S:k met. 10 ow s
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No Noivaluated
Is animal waste discharged into water of the state by man-made ditch, flushing system, orbther
similar man-made devices? Yes or No 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 No Not Evaluated
Additional COme This was a very_ breif insQection� a more thorogj h inst,ectio will be_
conducted i the future, -
irInfo
_IfyoujjP_,y Questions regi#;dingy this retort ,please contact Paul Rawls- nEK Watier Qjialit;
Section @ [phone]. __-
3�', k ym QL%
Inspector Nm
Signature
cc: Facility Assessment Unit Use Attachments if Needed.