820207_INSPECTIONS_20171231

NORTH UAROLINA
Department of Environmental Qual

Type of V rsit: a Compliance inspection U Uperation Review V btructure Evaluation V 1'echnical Assistance
Reason for Visit: 46 Routine O Complaint O Follow-up O Referral 0 Emergency O Other O Denied Access
Date of Visit: 17/ Arrival Time: ! Oo--- Departure Time: D`j'30at County: atv
Farm Name: J ► Fa or rA& Owner Email:
Owner Name: �e� Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: T1 �'^ �"l�""f Title: Phone:
Onsite Representative: Integrator: � VU 1`4
Certified Operator: Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Discharizes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure p Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
❑ No
� NA
❑ NE
❑ Yes
❑ No
Design Current
❑ NE
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pap.
Wean to Finish
I I Layer
I
F=�
1DairyCow
Wean to Feeder
11 JNon-Layer
I
Dairy Calf
Feeder to Finish 3=vo L&DDairy
Heifer
Farrow to Wean
Design
Dry Cow
Farrow to Feeder
D . P.oui ,
Ca aci
P.o ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
-
Turkeys
Other Turkey Poults
Other
Other
Discharizes and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure p Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
❑ No
� NA
❑ NE
❑ Yes
❑ No
0 NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 2/4/2015 Continued

Facili Number: y - Date of inspection: 7 Z
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
Pg NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): J, H Zj2 y G
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[P 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 0 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 MNo E] NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes W No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes No [DNA ❑ 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 Windpri$ ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): 130 61 A114; UA6
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes Q3 No ❑ NA ❑ NE
❑ Yes [�j No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes [ t No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facility Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check
[] Yes
No
❑ NA
❑ NE
the appropriate box(es) below.
T
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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
C�j No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes[}�
No
E] NA
❑ NE
and report mortality rates that were higher than normal?
T
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
[P 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
[P No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or_ any other comments
Use drawings of facility to better explain situations (use additional pages as necessary).
=
-;
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: GL 1 �%
2/412011

IType of Visit: S Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: ID Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: (DD Departure Time: County Region: /gyp
Farm Name: 3-1 M . arm Owner Email:
Owner Name: �Q_ Mc LU,4 Ca-ep- Phone:
Mailing Address:
Physical Address:
Facility Contact: T (-M!►L M-4."44— t -4."4 Title: Phone:
I �
Onsite Representative: 6i Integrator:
w
Certified Operator: Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
❑ No
Feeder
Non -La er
[:]Yes
❑ No
Dai Calf
o Finish pp
Dai Heifer
o Wean
FGitts
Design
Current
Cow
o Feeder
Dr. Poul
Ca aci
P,o
Non -Dairy
o Finish
]Layers
Beef Stocker
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure. ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify 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?
El Yes
1PNo
DNA
❑NE
❑ Yes
❑ No
NA
❑ NE
[:]Yes
❑ No
NA
❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes No
t}NA ❑ NE
❑TTNA ❑ NE
❑ NA ❑ NE
Page I of 3 2/412015 Continued

u'acili .,Number: Date of Inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:_ Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 'Cto if j, t '30
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �p 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 0 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 ONo ❑ 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 [VNo ❑ 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 �rop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 1..CL'&'Vj 4&fA,,t ( (rJS'h�.Q f. �/yt. V"1'�11t'1 (Ji1�Q.✓S
Q�tJ
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes(
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
0 Yes
JZ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[�R No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design [:1 Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes NoNA ❑ NE
❑ Waste Application ❑ Weekly Freeboard El Waste Analysis ❑ Soil Analysis E] Waste Tra sfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes `NJ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 14 No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Ifpcility Number: 7 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes fONo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes CP+ No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 1� No
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 JA No
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 ❑ YesNo
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 �9 No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes (� No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes 1� No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes N No
❑ NA ❑ NE
[ ] NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #: Explain any.RYES answers andlor anyaddMoarecommendationsor any;other comments_
.�
Use drawings of i'acilityfo,better explain sduations (use adds onal pales a_stnecessary}:. a
Reviewer/Inspector Name:
wdReviewer/lnspeetor Signature: �_�/(�
Page 3 of 3
Phone: g�O t133�33ee
Date: e 0 ,b
2/4/2015

Type of Visit: 0 Compliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: • Routine O Complaint O Follow-up Q Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: ,'[ r q Departure Time:/ Q� County: _Zy"eJ4A) Region- /= Z0
Farm Name: -M f* '
Owner Name: Cjtc
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: w" /" c" Title: Phone:
Onsite Representative: r{ Integrator:^
N
Certified Operator: Certification Number: 1 7Q 0 !p
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Eff"n"Wo—Current
p
Design
Current
Design
Current
Swine Capacity... Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity
Pog.
Wean to Finish
11
Layer
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWR)
❑ Yes
Daig Cow
NA
Wean to Feeder
INon-Layer
I
DLitj Calf
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
Feeder to Finish
""
NA
❑ NE
Dairy Heifer
❑ Yes
Farrow to Wean
❑ NA
Design
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Ea Cow
rn No
Farrow to Feeder
D . Poul
Cap - i_
Po
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
? No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[t 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
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
rn No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/412014 Continued

Facility Number: -go Date of Ins ection: /U 2r
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 P9 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
��q T2
Observed Freeboard (in): / 3
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 EP No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes [j] No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 5d No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [�j 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 grop Window Evidence of Wind DrA q Application Outside of Approved Area
12. Crop Type(s): A, �Q 5
13. Soil Type(s): 1-�lo 61 YV Q
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes�j[
No
❑ NA
❑ NE
acres determination?
21. Does record keeping need improvement? If yes, check the appropriate box below.
TT``
�] No
[] NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
© No
❑ NA
❑ NE
18. Is there a lack of property operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E�3 No
❑ NA ❑ NE
the appropriate box.
E]WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
�] No
[] NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
® No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
T
❑ NA ❑ NE
Page 2 of 3
2/412014 Continued

FIcili Number: O Date of Inspection: Z(
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? ❑ Yes EpNo ❑ 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
[P 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?
❑ YesNo
❑ 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
❑ YesNo
❑ 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
[P No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer twquestion ft Explain any YES answers and/or any additional recommendations or anyother carameiii
Use drawings of facrl tyAwbetter explain situation's (use additional pages as necessary).`
3
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ! 10 - 33
Date: &j
2/4/2014

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: h Departure Time: FTr'_k'h" County: SB"1
Farm Name: :Lp Owner Email:
Owner Name: —11'e- C Phone:
Mailing Address:
Physical Address:
Region: r-4�740
Facility Contact: U 1 Air -L" Title: Phone:
Onsite Representative: Integrator:
If 01
Certified Operator: A Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
ign Current
❑ No
Design
Current
Design Current
❑ No
NA
Swine acity Pop.
Nall
Wet Poultry -
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish pO
Dai Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D . P,oul .'=
Capacity
Pio' .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
i'urke s_
Other
Turkey Poults
Other Other
Dischar es 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)?
[:]Yes PMNo ❑ NA ❑ NE
❑ Yes
❑ No
[ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No
❑ Yes ENo
❑ Yes $No
NA ❑ NE
❑NA ❑NE
❑NA ONE
Page 1 of 3 214/2011 Continued

Facili Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(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)
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
No
❑ NA
❑ NE
® No
❑ NA
❑ NE
1�1No
❑NA
❑NE
4 No
❑ NA
❑ NE
Comments (refer to question ff): Explaimany YES answers and/or any additional recommendations or any other comments._ N,
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: --
Date:
214%2011

FUcili PQumber.Z-2,0'7 DateoCIns inspection: 2- (�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [P No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No C4>NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 2— 13
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): J i7 l' N21
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 jS 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 EP No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No [—]NA [—]NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [] PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
}
12. Crop Type(s): (� �'SQivr_'S 5 (�
13. Soil Type(s): 171Ci�z7�rt fib. 10;'-4 t/!�- Nb �Ui W'tR►'�ZJ+^ 'G✓/D
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[:]Yes
M No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Q3 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
(;!�No
T®
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements [—]Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [P 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 T�No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 2/4/2011 Continued

Ii ype of visit: W uompuance inspection u tpperanon meview u structure Evaivanon v reennicat Assistance I
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: lC 4 L Arrival Time: �Departure Time: B County: SAY N%/L/ Region: AZO
Farm Name: n Owner Email:
Owner Name: - -/`tG /4G Wrn Phone:
Mailing Address:
Physical Address:
Facility Contact: J_' Title: Phone:
Onsite Representative: 4 Integrator: �y,�p�,/{•�
Certified Operator: `� Certification Number: 1 9 0 4 9
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes [P No [[ NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
�"
❑ No
[P NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
n
Desi Curie nt
g
Design Current
Design Current
Swine
Capacity rPop.
Wet Poultry
CapacEtv��pop.
Ga le Capacity Pop.
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
(0 No
E] NA
E] NE
can to Finish
[:]Yes
La er
❑ NA
Dairy Cow
Wean to Feeder
Layer
Dairy Calf
Feeder to Finish
lyoO
Dai Heifer
Farrow to Wean
Design, purr
Dry Cow
Farrow to Feeder
D . P■oul
y
Ca aci. Po P.
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
I 113ecf Feeder
Boars
Pullets
91
113cef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes [P No [[ NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[P 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
G9 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
(0 No
E] NA
E] NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
taj No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Fa Number: Z - ZCQ Date of inspection Et 4 Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 50 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Va NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier: ' Z 3
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
Spillway?:
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
Designed Freeboard (in):
acres determination?
Z1 2S
Observed Freeboard (in): 33 23
17. Does the facility lack adequate acreage for land application?
❑ Yes
EP No
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ YesNo
❑ Yes
❑ NA
[:]NE
(i.e., large trees, severe erosion, seepage, etc.)
Required Records & Documents
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
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
§9 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 ARRlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below, ❑ Yes �@ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence ofWind Drift[:]Application Outside of Approved Area
4s-
12. Crop Type(s): Cpiyua4 0�4&7�'�'j 5;.r (;.✓ c Q
13, Soil Type(s): � Qom. 1c�y�, /l8-YrMI/5 —AiV �'J! ic�4 !2a& ,_ 4-4,47
14. Do the receiving crops differ from those designated in the CAWMP? v
[]Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
EP No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
EP No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[53 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists E] Design ❑ Maps ❑ Lease Agreements ❑Otber:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes G 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 [PNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

i'
Fad1ity Number: Date of Inspection: /Z
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? ❑ Yes `P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes []No [P NA E] NE
Other Issues T
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?
24. 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 file 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 CAWNW?
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 h No ❑ NA ❑ NE
❑ Yes �2 No ❑ NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes EP No
❑ Yes $ No
❑ Yes W No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer, to m
question#): Explain YES -answers and/or any additional recommendations or_any other comeents�
Use drawings of facility to better explain situations (use additional. pages as. necessary)..
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: a�G1' 360
Date: �Z
2/4/2011

Type of Visit: 9 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Timed M — Departure Time: County: Region
Farm Name: �1 ' \ .t^ /'� Owner Email:
Owner Name: 1 "--�R t ca� P Phone:
Mailing Address:
Physical Address:
Facility Contact: � ►�^ !_`c" Title:
Onsite Representative:
V
Certified Operator:
Back-up Operator:
Integrator
Phone:
W
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Cyr•.rent _
❑No
Design
Current
Design Current
Swine Capacity' . :Pop.
Wet P.oultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
INon-Layer
I
Dai Calf
Feeder to Finish
rp h''ri
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D".P©tiltrv'Ca
aci.
Pio
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
I 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)?
❑ Yes No ❑ NA ❑ NE
[:]Yes
❑No
NA
❑ NE
[:]Yes
[] No
NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [:]No
❑ Yes No
❑ Yes No
�NA
❑NE
❑NA
❑NE
❑NA
❑NE
Page I of 3 214/2011 Continued

Facili Number: Date of Ins ection: /'2
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 WA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: T
Spillway?:
Designed Freeboard (in): r
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes M 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 11,T No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement'?
Waste Application ,#,
10. Are there any required buffers, setbacks, or compliance alternatives that need E]Yes No [DNA F] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes N 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 D ' ❑ Application Outside of Approved Area
PType(s):
12. Cro G-4� Be,-" 5S C ,�ry.�2 l :�, `
- -
13. Soil Type(s):
G
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[1 No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[] WUP []Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 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 ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 2/412011 Continued

Facility Number: - an jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �l] No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes 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
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No
❑ Yes No
[l Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ONE
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 toYquestton:#): Explain any YES answers and/or any additionai'recommendatians or'anyothe rcomments.
Use: drawings of facdt to better expia6n as (use additional pages as necessary):`, 5,,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: r!O `% 3500
Date:
2/4/2011

Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: j') 0 Arrival Time: Departure Time: f7 ► County: '?f'1"r e� Region:
va
Farm Name: r �T I ' AAF' urrv, _ Owner Email:
IVI
Owner Name: bAryah /r��✓' Phone:
Mailing Address:
Physical Address:
Facility Contact: _ ' m rnC Title:
Onsite- Representative:
u
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number: 19 I
Back-up Certification Number:
Location of Farm: Latitude: = c =I
= " Longitude: = ° =I 0
Design Current
❑ Yes
Design Current
Design Current
Swine Capacity Population
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
Wet P.opltry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La el
❑ Da' Cow
❑ Yes
❑ Wean to Feeder
❑Non -La er
❑Dai Calf
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Feeder to Finish
❑ No
Dai Heifer
Farrow to Wean
D �Poult
❑ D Cow
❑ Farrow to Feeder
y�s� : _
-
El Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑ Pullets
❑ Beef Feeder
❑ Beef Brood Co
❑ Boars
-
❑ Turkeys
❑ NE
Other
❑ Turkey Poults
❑ Other
Number of Structures:
❑ Other
❑ NE
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
r, No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
0 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
P 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
12 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
'A No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [INo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 1//� NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 2—
Spillway?: Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3Ot u 2
S. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No
❑ NA EINE
(ie/ large trees, severe erosion, seepage, etc.)
❑ NE
15. Does the receiving crop and/or land application site need improvement?
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?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? E] Yes
® No
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
O No
[:INA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
[5 No
❑ NA
9. Does any part of the waste management system other than the waste structures require ❑ Yes
No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes
[ No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [:]Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
LQ 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? E] Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
PNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[5 No
❑ NA
❑ NE
Reviewer/inspector Name Phone:
Reviewer/Inspector Signature: Wjj I Date:
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ( No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desi n ❑ Maps b p [:1 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [P No ❑ NA EINE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
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
PNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[� No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
`P No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[� 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
1P No
❑ NA
❑ NE
Page 3 of 3 12/28/04

Division of Water Quality
iFaciGty Numbex S�� 2Q`T 0 Division of Soil and Water Conservation
Other Agency
Type of Visit 0 Compliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: ® Departure Time: 10 . County: so�1 Region: i o
Farm Name: ��'fr I QL r,-% ii Owner Email:
TI)A_ Name: Acb Phone:
Mailing Address:
Physical Address:
Facility Contact: _.) i MM Y- Title: Phone No:
LI —
Onsite Representative: Integrator: rbo
Certified Operator: Operator Certification Number:
�9 1
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: ❑ o =4 = " Longitude: =0[=g
°❑g =
fg
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 1PNo ❑ NA ❑ NE
❑ Yes
❑ No
ERNA
❑ NE
❑ Yes
Design Current
SwineCapacity Population
Design Current
Wet Poultry Capacity PaFn_ ulationCattle
Design Current
Capacity Population
El Wean to Finish
❑ La er
❑Dai Caw
[�NA
❑ Wean to Feeder
❑Non -La er
Dry Poultry
❑ La ers
❑Non -La ers
❑Pullets
❑Turke s
❑ Turkey Poults
❑ Other
❑ Dairy Calf
❑ Dairy Heifer
❑Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Broad Cowi
!Number of Structures:
JQ Feeder to Finish Q
❑ Farrow to Wean
❑ Farrow to Feeder
E�No
❑ Farrow to Finish
❑ NE
Gilts
P_1Boars
Other
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
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 1PNo ❑ NA ❑ NE
❑ Yes
❑ No
ERNA
❑ NE
❑ Yes
❑ No
aNA
❑ NE
[�NA
❑ NE
❑ Yes
❑ No
❑ Yes
E�No
❑ NA
❑ NE
❑ Yes
5;bNo
❑ NA
❑ NE
12/28/04 Continued

Facility Number: Date of Inspection I!
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
FNo
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
'�INA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a ��
5_ Are there any inunediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA ❑ NE
(ic/ 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
Q No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
(P No
❑ NA EINE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes�No
[INA [j NE
mai ntenance/improvement?
IL . 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 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)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�No El NA 0 N
�No El NA 0 N
ED No ❑ NA ❑ NE
TNo ❑ NA ❑ NE
EoNo ❑ NA EINE
commentsR(refer tb question' #) Eg}�latn any YES answers and/or any=recommend atio`ns ar any other comments.
Use drawings of facility to better ezplatn situations. (use additional pages as necessary) _
Reviewer/Inspector Name Il b R Phone:
Reviewer/Inspector Signature: Date: N S
12/28/04 Continued

Facility Number: 02—gyp Date of Inspection 11 S
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Desi
gn El ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �d No [INA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
§0 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
EpNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
j 3 N
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
CpNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
`P No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�No
(�No
El NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
❑ 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
[ 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
EP No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[P No
❑ NA
❑ NE
Ajddifional�Comments antllor Drawrngs:
ki
12/2&/04

Division of Watcr Quality
Facility Number �2 �07�1 0 Division ofSoil and Water Conservation
Q Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit • Routine O Complaint Q Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: [ -�24 Q� Arrival Time: Departure Time: d { County: ��fd'r' '1=�0� Region:
Farm Name: J . M nA ['"aryVA
-- I - Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address: JAW
_f
Facility Contact: SI�Mrn Ivl�1�LY�'p Title:
u
Onsite Representative:
Certified Operator: if
Sack -up Operator:
n�{
Phone No:
Integrator: MU'va 4 L &rws
Operator Certification Number: r 90L? _
Sack -up Certification Number:
Location of Farm: Latitude: = o = i = u Longitude: = o = f = u
Design Current
Design Current
Design Current
1�g_-apacgtnnWvMmMr,#_p@I_ation
Swine Capacity Population
Wet Poultry C&annri bpu� la ''on
Cattle
❑ an to Finish
10 Layer _ _
�
❑ Dairy Cow
a. Was the conveyance man-made?
❑ an to Feeder
10 Non -Layer I
[7P,4A
Dairy Calf
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Feeder to Finish 31100
❑ N�-
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
-
❑Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -La ers
❑Beef Feeder
❑ Boars
❑ Pullets
Beef Brood Co
❑ NE
❑ Turkeys
❑ Yes
Other
❑ Other
❑ Turkey Pou Its
❑ Other
Number of Structures:
other than from a discharge?
Discharses & Stream Impacts
I . Is any discharge observed from any part of the operation?
❑ Yes
[WNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[7P,4A
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ N�-
EONA
❑ 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
ONA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
['No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
0 No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128/04
Continued

Facility Number: Q
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Wo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No J�j NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: J
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a 30ee
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 10 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 f3No ❑ 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 PNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes J3 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 El Yes [gNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance altematives that need ❑ Yes P No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ 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
§3 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments {refer�`to q � t�ron�#)n Explain any YES answers anKi/gr gny recomm udabons or any other eomments.
Use drawutgs 2ofifacilztyfta better explain situations. {nse additional paglas necessary,):
Reviewer/Inspector Name Phone: j/o' S�33 �jn
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/04 Continued

Facility Number: —P0 Date of Inspection ! /
Required Records & Documents �No
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑NA [_3NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ElYes NNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps p ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 14 Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [jO 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
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
19 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
[ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[P 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
PNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
'RNo
❑ NA
❑ NE
Ad`dtponal Comments and/or Drawtn s �; - � :• r.
g_ .�.WAS,
-t -�
AL
Inv
Page 3 of 3 12128/04

i
0 Division of Water Quality
Facility Numberd`ai n d�� O Division of Soil and Water Conservation
0 Other Agency
Type of Visit i Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: If rArrival
Time: Departure Time: t'0 ;d County: Region: _
Farm Name:r + l!'GI�,,f►I Owner Email:
�Owner Name: 1ub lnn ip Phone: Ad 54 '__ "U
Mailing Address:
Physical Address:
Facility Contact: J I MFM C 'Title:
Onsite Representative: K
Integrator:
Phone No:
Certified Operator: V Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Latitude: =0
= = Longitude: [= o = g
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
[--]Layer
❑ Nan -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
EFDry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [P No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
NA
❑ NE
❑ Yes
❑ No
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
FNo
❑ NA
❑ NE
122/28/04 Continued

Facility Number: — Date of Inspection
❑ Yes
No
Waste Collection & Treatment
❑ NE
15. Does the receiving crop and/or land application site need improvement?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yesto
o El NA El NE
a. if es, is waste level into the structural freeboard?
Y
El Yes
A NA ElNE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: �-
P No
❑ NA
Spillway?:
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Designed Freeboard (in):
❑ NA
❑ NE
Observed Freeboard (in): .0.4
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
M 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
'g 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
§9 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
P9 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes]
No [:1NA E-1NE
maintenance/improvement`?
11. is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
P? No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ 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
R9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
59 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):
Reviewer/Inspector Name Phone: 0 Y10 Reviewer/Inspector Signature: Date:
12/28/04 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 13 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ff No ❑ NA ❑ NE
the appropirate box. ❑ wup ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA
[j NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
V] No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
PNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
1� No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
r 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
[jPNo
❑ 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)
JJ
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
�5 No
❑ NA
❑ NE
Comments and/or Drawings:
12/28/04

Division of Water Quality
Facility Number a ! aQ' O Division of Soil and Water Conservation
- O Other Agency
Date of Visit: r 3o Arrival Time: SOQM Departure Time: a; pn County:. 26! pL00 Region: P4>_0
Farm Name: 7, M, , m Owner Email:
Owner Name: Ld4 Phone:
Mailing Address:
Physical Address:
Facility Contact: Mt Lat�6 Title:
Onsite Representative: t I
Certified Operator: tN
Back-up Operator:
Location of Farm:
[Swine
Phone No:
Integrator: Y- n
Operator Certification Number-.
Back-up Certification Number:
Latitude: =0
=A
Longitude: = ° = =
Design Current,'
Capacity Population ..` Wet Poultry
Design Current
Capacity Population
❑
LJ Boars
,:,.Other
❑ Other
Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Cattle
❑ Dairy Cow
❑ Dairy Calf
❑ DaiEy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
z
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any pari 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 l of 3
m6 .. A
❑ Yes [ gNo ❑ NA ❑ NE
El Yes
El No
NA
E] NE
❑ Yes
❑ No
NA
❑ NE
NA
❑ NE
❑ Yes
❑ No
❑ Yes
9,No
❑ NA
❑ NE
❑ Yes PNo ❑ NA ❑ NE
12/28/04 Continued

Facility Number. a D 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 [INE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: °� 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ YesNo
[__1NA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
14. Do the receiving crops differ from those designated in the CAWMP?
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
VPNo
❑ NA ❑ NE
through a waste management or closure plan?
15_ Does the receiving crop and/or land application site need improvement?
❑ Yes
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
WNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
® No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
17. Does the facility lack adequate acreage for land application?
❑ Yes
9. Does any part of the waste management system other than the waste structures require ❑ Yes
[&No
❑ NA ❑ NE
maintenance or improvement?
❑ Yes
25 No
Waste Application
❑ NE
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
[RNo
❑ NA EINE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
10 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or t0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of AcceptableCropWindowEl Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) eOQS�I � r -,--]j e Q4,7 , Sr"t , 6-r-, D
13. Soil type(s) g,131 A) o Q%
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
RNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[S No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
NNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
25 No
❑ NA
❑ NE
'Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):. . -i:
Reviewer/Inspector Name 1 Phone: ('I/ eV3 -3 3, 90
Reviewer/Inspector Signature: Date: /1234 %?agg
Page 2 of 3 12/28/04 Continued

Facility Number: !R;, `% Date of Inspection r�
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 I,No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes fpsNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
V1 No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
PNo
[:INA
❑NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
CM No
❑ NA
EINE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
El No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
P No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
MNo
❑ NA
❑ NE
Additional Comments. and/or Drawings.`.`
C©C r r. o� L4 Y' Pc av-',s,
1z
Page 3 of 3 12/28/04

.-- — � Division of Rater Quality �'�
(Facility Number $� _ -gyp O Division of Soil and Water Conservation
Other Agency S , rY�a
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:'
-!/� Arrival Time:p® Departure Time: County: 1�12Region: repo
Farm Name: T /,I, 6.7tc_" _ _ Owner Email:
Owner Name: _ /t7G�a,.,6 �or,00�Q 'ori Phone:
Mailing Address: ` e'
Physical Address:
/te+a
Facility Contact: ,�'..,.., , /�lrcLe...,!�_ "' !- Title:
Onsite Representative:
Certified Operator: 4 - p7cLa�, 4a
Back-up Operator:
Phone No:
Integrator:. uro A-10,14,
Operator Certification Number: / 90 `Zf
Back-up Certification Number:
Location of Farm: Latitude: =0
= =d Longitude: ❑ ° 0 I ❑ "
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ML a er
❑ Wean to Feeder ❑ Non -La et
P-reeder to Finish L270C J.koc,
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑
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
❑ Daia Cow
❑ Daia Calf
❑ Daia Heifer
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder s°
❑ Beef Brood Cow t
Number of Structures:
Design Current
Capacity Population.',
:i
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 Ej o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
NA
El NE
El Yes
r0_1
❑ NA
❑ NE
12128/04 Continued

Facility Number: — _-2 o
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �o ❑ 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?: �n D
Designed Freeboard (in): 4
Observed Freeboard (in): — _�2 g 3'
e Y S�pG�'S
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E54o
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
El Yes
,,.__,, //
Ek<o
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
�es
El No
ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit?
ElYes
LJ' 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
E20'No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes M'Ao ❑ NA ❑ NE
maintenance/improvement? B"
No Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes L"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 El Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) 26 r/.nVjoSn a #
13. Soil type(s)� (,tf� %� Qo 4 /Ha
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes EJ -<o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E54o' ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[] Yes ❑ No ❑ NA 3 NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ No ❑ NA QkKE
18. Is there a lack of properly operating waste application equipment? ❑ Yes EI No ❑ NA ❑ NE
Eomments�(iefer;ta question' #) Explailn sny YES�answers and/or any recommendations or any ocher comments.
r -- � y[ -
Use ilrswmgs o151, c�ty to better explain 4itiijit,ons. use additional pages.asinecessary)
r )"100 /eMO✓ei LVxrl,/ S�p�`,�gs �rvirr �49ao.7 04�KS.
Reviewer/Inspector Name _%)'1crK er _&�, • [���,,,k, rr t.. A �: •,. Phone:
LP�
Reviewer/Inspector Signature: 13 Date: S 11-0t:
12/28/44 Continued

Facility Ntimber: a —�0 Date of Inspection /
Required Records & Documents
19. Did the facility fail to have of Covera a &,Permit-rea ily available? ©-Kes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA,,��W,, MS�P readily available? If yes, check 0 -res ❑ NA El NE
the appropirate box. ElYk ElChe sts I_'-I'1)esign ❑ NJM<El Othdf`
21. Does record keeping need improvement? If yes, c eck the apro nate box below. V 'es ❑ No El NA C1 NE
�, 9� 3, 3 rs 7 I.G 1. G r� ivy I.L?
❑ 11Vast� 4 { ieet ❑ ❑ U S -°� ,...'��..-�� Waste Transfers
❑ wftd ❑ MMMMrinspeaLcas ❑ s �eather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
Q -Ko
❑ NA
❑ NE
❑ Yes
la<o
❑ NA
❑ NE
❑ Yes
El NA
El NE
El Yes
,Unfo
o
❑ NA
❑ NE
❑ Yes
UNb
❑ NA
❑ NE
❑ Yes
❑'10
❑ NA
❑ NE
❑ Yes U -No ❑ NA ❑ NE
❑ Yes [ o ❑ NA ❑ NE
❑ Yes ETNo ❑ NA ❑ NE
❑ Yes El"No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes O -Ko ❑ NA ❑ NE
Addi!tiona`l Comments and/dr Drawings:ii�m
'! +ne I)eaj �oe��;� 1$ Sle 6v9` T-�G i's no�
Z ns/aec a,- 6v"I1 M a ; l 46,1,
Cv Of �+ 1
,� ��� �
I Ps''f'1 rA r^ T'<< �il rie /pg ao� S
Gnc� Place +n "rLtr
Nesc c1<S,,9,n )10
I Please_ fll �n ��ie wec its "ale
12128104

W
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
LReason for Visit *Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: G`a - Time:
I
Facility Number .? O
.�� �.,` Not O erational Below Threshold1� Permitted L�t_.ertified ©Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: — T- /$I �. F.e.-� County: _ Sei t"s e.ft
Owner ?lame: < aam 12 C p 1; Phone No: -3 JW 5— G 7 1 �
Mailing Address: 3 8.7 - p, a, C -1-A e/l,c ht e-
/ ' 9'3 a �
Facility Contact: T I M.wv A4 4am%4 Title: Phone No:
Onsite Representative: %M y - M e- ��� Integrator: iy?v"c
Certified Operator: f �►+ 0")Operator Certification Number: /1701/
Location of Farm:
01,5�Wine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' z Longitude ' �• 0
Design Current
Swine rnnnritt' pnnnlatinn
❑ Wean to Feeder
weeder to Finish 71DU 1 .2?
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Foods / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Ca acity Po ulation
❑ Laver I I❑ Da'
❑ Non -Laver I I JE1 Non -Dain
❑ Other
Total Design Capacity
Total SSLW
I❑ Subsurface Drains Present ❑ La ooa Area 10SPrav Field Area
I❑ No Liquid Waste Management Svstem
Discharees & Stream Impacts
1, Is any discharge observed from any part of the operation?
Dischar,e originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discnarne is obsen ed. 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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1 :2
Freeboard (inches): f; .1 if �� .3 ! ��
05/03/01
❑ Yes Eallo
❑ Yes 91o
❑ Yes 9-180
❑ Yes
D-90
❑ Yes
D'90—
No❑Yes
EI yes
DN
❑ Yes
Iallo
Structure b
Conditued

Facility Number: —
Date of Inspection 3 -[,
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancerimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes Bi o
❑ Yes 9 NO
❑ Yes B-1
❑ Yes ONO
❑ Yes []-NG—
[]
]-No
❑ Yes 9-N
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes Iallo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
R 2 3&. �'rr­ ^! v g v
12_ Crop type ,],r...
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?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Usues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes GWO
❑ Yes Gwo
❑ Yes G NO
❑ Yes ❑ No
❑ Yes D-Nw
❑ Yes ❑ No
❑ Yes allo
❑ Yes BVo
❑ Yes [a --Mo
� Z .. s — s_t �.. r- x
Cpmukm (refer qu on Expl�un Tiny YES answers and/dr airy �recoiumendations or any at ttr comments. x n=�
Z
;Use drawusgs of #actTity to better explarntaatsoas. (ase addhonal pages as necessar9) [Meld COPY ❑ Ftnai Notes `
Plops e,I �e
Co✓1�inL{� kopk Drt
eras,,r sjoofs arav�.f' elt�9 on^ ta.a
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- r
Reviewer/Inspector Name . /Yltir. � _ �r►�- = ��'= �_- �- =� .�� -� "' �:R."
Reviewer/Inspector Signature: Date:
12112/03 Continued

• Facility Number: g.;2 —_20 P7 Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[g -W
22. Does the facility fail to have all com nents of the Certified Animal Waste Management Plan readily available?
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
(ie/ W�, c��ec Sts, W s, etc.)
❑ Yes
[}?4o
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑090-
❑ Waste Application ❑ ebmM [I)Vaste Analysis [I&OH Sampling-�
Did the facility fail to conduct an annual sludge survey?
❑ Yes
w -G ->V . '07 t
24. Is facility not in compliance 2 any applicable setback criteria in effect at the time of design?
❑ Yes
[•}
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
Lallo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
U -No
(ie/ discharge, freeboard problems, over application)
❑ Yes
allo
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
[;N6
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[}Ido
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)es
$,.,e les f411.5 fall Far ctt! 4
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
9 -NO
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
Dft
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
x] N6
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
g -Ko
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
U -No
❑ swekia� ❑4K*ieid..FetM ❑1bainfau ❑
❑ s ❑
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ddsti<onal Comments and/ar;Drawrngs� = -; -
$,.,e les f411.5 fall Far ctt! 4
A.
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12112103

E3 Division of Soil and Water Conservation E3 Other Agency
*Division of Water Quality
Facility Number
® Registered [3 Certified O Applied for Permit E3 Permitted
review
Date of Inspection
Time of Inspection L__j 24 hr. (hh:mm)
10 Not Operational (Date Last Operated: ..........................
FarmName: ............. 5%../%L..... /¢.R.................................................................. County:........:'f+'......JID-.........................................................
Owner Name:......�FL1...........e'`J................................... Phone No:...L./C/D,
....
Facility Contact: .......✓../..o". .._% c�� /�...... Title:................................................................ Phone No:...................................................
Mailing Address:..../Z. _� 15l, . ..1�. . ;i....5 ..'.�J /(j(( 2P7z?
........................................................................................... ..............
Onsite Representative:...... .l...t'^.." y...%tf+!�5_....................................... Integrator:..... .......... ................
Certified Operator ............�J.
...................................... Operator Certification Number:.........................................
Latitude =0=1=11 Longitude =• =` ="
Design " Current; Design Current < Design Current .,
Somme Capacity"Population Poultry CapacRy',Populatwn Cattle ; Capacity Populaticm. --
a _.
a. ❑ Wean to Feeder `":. ❑Layer .r ❑Dairy
-- ❑Feeder to Finish ..` ❑Non -Layer ❑Non-Dairy.�
❑ Farrow to Weal)
.. ❑ Other
❑ Farrow to Feeder
■ Farrow to Finish 294 Total Design Capacity
❑ Gilts a 4 '-Z
Total SSLW
'
..<, ❑Boars
;Number of Lagoons / Iioldmg Ponds ©$ ❑ Subsurface No -Liquid Waste Mn ans eemennt ❑t System JOS
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (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)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any pan of the waste management system (other than lagoons/holding ponds) require
mai ntenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes ® No
❑ Yes ® No
[]Yes 8 No
❑ Yes ® No
it//A
❑ Yes IR No
❑ Yes JN No
❑ Yes ,® No
❑ Yes ® No
❑ Yes DI No
❑ Yes �9 No
Continued on back

Facility Number: z —207
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laigoons.Holding': Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (ft): ... .3.7........z,�- ... ......3 .( .0 /... R;7.,�.r;�✓...
...... ............
10. Is seepage observed from any of the structures?
11. is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes ® No
❑ Yes [, No
Structure 5 Structure 6
❑ Yes W.,No
❑ Yes ® No
12. Do any of the structures need maintenance/improvement? Yes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes No
Waste Application
14. Is there physical evidence of over application? (L - No
(If in excess of /WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type
f..............................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes KNo
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes XNo
18- Does the receiving crop need improvement? Yes ❑ No
19. Is there a lack of available waste application equipment.) ❑ Yes ,® No
20. Does facility require a follow-up visit by same agency? ❑ Yes IN No
21, Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? ❑ Yes •1KNo
,,
22. Does record keeping need improvement? Yes ❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? El Yes ❑ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes ❑ No
0 No.violations or. delieieRcies.were-noted during this visit.- You.rvill receive no fttrtlier
Oeresp6tidence ah'ant this. visit::::
Cort[ments {refei to question #): Eaplatn any�YES answers and/ar any recominendattons or any other comments °
Use clrairings"of facility to'better explain situationsadditional pages as';necessarv)
,. T, „may
--
acz.� � 2 !1-�'f�' .�.�r.� /��yrs�.,J v-✓ , ,,,ac,�.r�yv,,E. '�.s�O��p �r��
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Xr 7/25/97
Reviewer/inspector Name r
Reviewer/Inspector Signature: `� Date: /O—�p`
v