820224_INSPECTIONS_20171231

NORTH CAROLINA �
Department of Environmental Quai

Division of taster Resources
Gumber - Division of Soiland Water Conservation
Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 01 routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: [ Departure Time: County:Region: l I'Z-0
Farm Name: Ly nt1 f eta
Owner Name: tly} vi .1 e! E�j
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: CC--v` 1 1 5 DLL{ L(27 Title: Phone:
Onsite Representative: { Integrator:
Certified Operator: t! 4 nn 7' '�5tj Certification Number: ZW(c
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
IT,Swine
Wean to Finish
Design Currft
Capacity Popet
Design Current
Poultry Capacity Pop.
Cattle
Dai Cow
Design Current
Capacity Pap.
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
H
DairyCalf
l2`{� p�
Design Current
D , P,aultt. Ea aci P.e
Layers
Dai Heifer
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Beef Brood Cow
Boars
Pullets
Turkeys
Turkey Poutts
Qtber
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify D W R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify 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 g1gc, ❑ NA ❑ NE
❑ Yes [:]No
[:]Yes [-]No
[:]Yes [] No
D Yes 2-Kc,
[:]Yes [No
E3-NA ❑ NE
ffNA ❑ NE
ONA
❑ N E
❑NA
❑NE
❑NA
❑NE
Page 1 of 3 21412015 Continued

Facili Number: 2 - Z7- Date of Inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ej_TTo_ �0 NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No EEKX ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier -
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): — --
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 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 E[- o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
ao any of the structures need maintenance or improvement?
P<es l to
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes to
❑ 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 ❑-M
❑ 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 ❑ 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
rr ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �)-J-ok t� l Lj _S &-n C W 43
13. Soil Type(s): tiCt
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [g 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
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?
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes Eff'Ro ❑ NA ❑ NE
❑ Yes 0]"No ❑ NA ❑ NE
❑ Yes ['No ❑ NA ❑ NE
❑ Yes [JrNo ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [a'�o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes [3' o ❑ NA ❑ NE
[:]Yes FfNo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: jDate of Ins ection: I
24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes U3�No
25. Is the Zcility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes io
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:
❑ NA ❑ NE
❑NA ❑NE
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
Lg Ko
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[r' qo
❑ 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, aver -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes ❑-No ❑ NA ❑ NE
❑ Yes TNNo ❑ NA ❑ NE
❑ Yes ❑'No ❑ NA ❑ NE
❑ Yes ❑'NO ❑ NA ❑ NE
❑ Yes [3-No
❑ Yes [ o
❑ Yes [TNo
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional. pages as necessary).
te
S�
W
V0-3A-68-51
Reviewer/Inspector Name
ReviewertInspector Signature:
Page 3 of 3
Phone6q(r L} �
Date: V_M44b
21412 5

Divi"sion of Water Resources -
Facility Number - Division of Soil and Water Conservation
OO Other Agency
Type of Visit: Ppcompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q-Koutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ? Arrival Time: Departure Time: County: 9444t, Region:
Farm Name: ; L ywiyt Owner Email:
Owner Name: Ly ( i e� Phone:
Mailing Address:
Physical Address:
Facility Contact: rw4c S p e�Wd,`C; [ Title:
Onsite Representative: it
Certified Operator: L i e
Phone:
Integrator: fltf? 5
Certification Number: 2-7 q0 D
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Longitude:
lDP1 p
Desi n Curre 'gn urrent
Designer€CP rent
gb
Ant �"
Swine Ca aci P,o Wet Poultry Capacity Cttlye, Ea acity Pap.
P
Dairy Cow
DairyCalf
Feeder to Finish DairyHeifer
Farrow to Wean Design . Current�;Z D Cow
Farrow to Feeder D. . P,oultr. Capactty, Po Non -Dairy
Farrow to Finish La ers T+A Beef Stocker
Gilts Non -Layers Beef Feeder
Boars Pullets Beef Brood Cow
Turke s
,
Other TurkeyPoults �+F
Other Other.
Wean to Finish La er
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure ❑Application Field ❑Other:
❑ Yes �o' ❑ NA ❑ NE
a. Was the conveyance man-made? ❑Yes [] No ZNA ❑ NE
1
b_ Did the discharge reach waters of the State? (If yes, notify DWit) ❑Yes ❑ No ❑ 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 KNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation'? ❑Yes 'Ga5&o ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑Yes dNo ❑ NA ❑ NE
of the State other than from a discharge'?
Page 7 of 3 2/$/2015 Continued

Facilit Number: j1p jDate 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 [3 A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? 0 Yes Cj4,Nb ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) '
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [3"<o ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
'esOV
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? "`
❑ Yes
r=H�o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
�o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
0-5o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �Cit-al�c./ �' 'rid- f
13. Soil Type(s): W .9-
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[�o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ffNo
❑ 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
Flo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
EEJ�o
❑ 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
ENo
❑ NA
❑ NE
the appropriate box_
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[�No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [ff"No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E� No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection:'
I
2j. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [E'No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes B<O
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 3090
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑'1�To
I
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29_ At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ETNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes El No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? I ❑ Yes dNo ❑ 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).
/X f
-7 C, i)v ce— ,w_koo- A24
❑ NA ❑ NE
[DNA ❑ NE
❑NA ❑NE
[DNA ❑ NE
Reviewer/Inspector Name: ' -1 4 (4( '
❑ Yes
[�No
❑ NA
❑ NE
❑ Yes
dNo
❑ NA
0 NE
❑ Yes
dNo
❑ NA
❑ NE
❑ Yes
[/X No
❑ NA
❑ NE
c,ff-,vo- 30-0-5�' /
Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412015

Type of visit: ( Mom Iiance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other Denied Access
Date of Visit: Arrival Time: Departure Time: County: l�h� Region:
Farm Name: ; W
Owner Name: L
Mailing Address:
Physical Address:
Facility Contact: 6h4jt5 9,r`cv1,Title:
Onsite Representative: E[
Certified Operator: ,,, 1
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Phone:
Integrator: V11 9 S
Certification Number: �_7 f a *' _
Certification Number:
Latitude: Longitude:
- -
Design Current
Design
Current
Desigu Csurrent
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Dairy Calf
Wean to Feeder
i I '.rD
Non -Layer
Feeder to Finish
d INO
Dairy Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
D , Pool
Ca aci
Po P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Non -Layers
Boars
Pullets
Turke s
__
Qther
tern,
TurkeyPoults
Other
Other
Discharges and Stream_Imnacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes [j]A< ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No [g-%A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) [:]Yes ❑ No Ea*<A ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [:]Yes ❑ No A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 214No [] NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes e] No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

'[Facility Number: jDate of Inspection: o..y
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a
Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
1�,- ❑ NA ❑ NE
❑ No �A ❑ NE
Structure 6
[:]Yes [;�4o ❑ NA ❑ NE
❑ Yes geNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public Health orYres
onmenta threat, notify DVWR
7: Do any of the structures need maintenance or improvement? No ❑ NA ❑ NE
r
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 [;I/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 [1No ❑ 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): �6
13. Soil Type(s): Lj-) Ic
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes @�JNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes lo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes dNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes o ❑ NA ❑ NE
[:]Yes 'No D NA ❑ NE
❑ Yes E2�No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes [;R'�o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes 12'IoNo ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
Page 2 of 3 2/4/2014 Condnued

f
Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? []Yes L-_t'r"" [DNA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes C3'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 [DAo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes io ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
C2 o
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
PTo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
T
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
[—]Yes
Q o
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
Ea<o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CD Aio
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
640
❑ 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:
Reviewerlinspector Signature:
Page 3 of 3
Phone:
Date:
21412011

,3, K g a- 5 s mac. C4 131b
Structure Evaluation Inspection
Facility Number: -- z-2 Dater 4(— I — 6 l
Time in: r �� Time out:
Farm Name: Lyvt-t tc—ty Farm 911 address:
Owner Name: Ei
Facility Contact:
LA
Onsite Representative:
Certified Operator:
cC
Is storage capacity less than adequate? Yes
n
Integrator: k�t
Cert. Number
N o
If yes is waste level into the structural freeboard? Yes No �C
Structure: 1 2 3 4 5
Identifier:
Spillway?
Designed Freeboard (in.):
Observed Freeboard (in.): �3
Are there any immediate threats to the integrity of any of the structures
observed? Yes No
0
Do any structures lack adequate markers as required by the permit? Yes _ No
Does any part of the waste management system need repair Yes No c/
Condition of field's
Condition of receiving crop eo as T��L
Comments:

i ype of visit: tN uompttance inspection U operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: (2'koudne O Complaint O Follow-up O Referral O Emergency Q Other O Denied Access
Date of Visit: r Arrival Time: Departure Timer County:---=-f-l==
Farm Name : z �.n y ' (ram �[s �.vy Owner Email:
Owner Name: �`�� Phone:
Mailing Address:
Physical Address:
Facility Contact: q Title: Phone:
OnsiteRepresentative: at41' I�L1 (/`Wf[.� Integrator: K(16
Certified Operator: �--TL Certification Number:
Back-up Operator
Location of Farm:
Latitude:
Region:"
Certification Number: o` 7 o d'
Longitude:
WORNgn.
Curren[
Design Current = _" r Design Current
5wi ne
#�
Eapac ty Prop
Wet Poultry
Capa ity Pop�Cattle Capacity Pop.
s,
Wean to Finish Layer Dairy Cow
Wean to Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design,Current
Cow
Farrow to Feeder
D . $oul
Ca act " 4"'
�Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
'
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes []2s - ❑ NA ❑ NE
❑ Yes
❑ No
�]-NA
❑ NE
❑ Yes
❑ No
�A
❑ NE
❑ Yes ❑ No
❑ Yes 13'1Vo
❑ Yes [!j-'No
ETNA
❑ NE
NA
❑ NE
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facili Number: - Date of Ins ection•
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):^
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
21go ❑ NA ❑ NE
❑ No �A ❑ NE
Structure 6
[:]Yes 0-96 DNA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
�o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
BYes
fi+3o
❑ NA
❑ NE
S. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q-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
Ej'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�10
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [P�N? ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): G C✓ l: so � C CA J
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CA WMP? [:]Yes dNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes dNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �10 ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes ENo
❑ Yes [�No
❑ NA ❑ NE
❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [:j"No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ffNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑ Maps [:]Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 6 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes dN 0
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

FaciliNumber: - Date of Ins ectio
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes CgK° ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes [Zl>e- ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? []Yes NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? []Yes o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes [ o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? [:]Yes M N-o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the [:]Yes �] ❑ 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 [}#o ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Q-No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 0-N5 ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes n V ❑ NA ❑ NE
C6mments (refer, to question-#} Explain any,;*YES answers and/or any additional: recommendations or any other comments:
Use draw
ings of facility to better explain.situatiiins (use additional pages as necessary) x
S U74 Sum`'(,,
O(9 (U 0
v l L { t7 4c) VV { �G C�
bail(
Reviewer/Inspector Name:
EA, 0 V'9L'� () L"
�C
Reviewer/Inspector Signature:
Page 3 of 3
L, � � �..
5
Phone:
Date:
21412014

t3
Type of Visit: 4D Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: OTtoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: YA(- \ Region:
Farm Name: I (Q w ryv Owner Email:
Owner Name: it Phone:
Mailing Address:
Physical Address:
Facility Contact: Cl U_
(,k'Ljyl _ Phone:
Onsite Representative: q Integrator: rm,
Certified Operator: Certification Number: %Q v
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Cftrrent
Pop.
.
Design Current
Cattle Capacity Pap.
Dairy Cow
Dairy Calf
Wean to Feeder
11 INon-Layer
Feeder to Finish
Farrow to Wean
D . P.ouI
Layers
Design
Ca aci
"''
Current
P,o
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Pullets
Beef Feeder
Boars
Beef Brood Cow
Other
Other
Turke s
Turkey Poults
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 DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes Q-3to---[:] NA ❑ NE
❑ Yes ❑ No 8-NA ❑ NE
[:]Yes [:]No ['_ NA ❑ NE
❑Yes ❑No
❑ Yes [ 1V
[:]Yes No
Ef '""
❑ NE
❑ NA
❑ NE
❑ NA
[] NE
Page 1 of 3 21412011 Continued

�7
Facility Number: jDate of Inspection:
WasteCollection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes NA ❑ NE
ir a. If yes, is waste level into the structural freeboard? ❑ Yes [] No ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[;;] o NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
L7 1V V u 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?
Bles
❑ No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
UJ" o ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[]'No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
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 Dogo ❑ 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 0 Application Outside of Approved Area
12. Crop Type(s): c w 6 CUa S ej 4,V-4t f"A'-5-6 0 _
13. Soil Type(s): W4
14. Do the receiving crops differ&m 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?
ReJ[ uired Records & Documents
❑ Yes ❑.1do ❑ NA [] NE
❑ Yes L. !X ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes gN�o
NA ❑ NE
Yes ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑-#o`
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[3-NT--
❑ 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
Eq N-o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[:]Yes
[3*No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[]'I�o
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facility Number: n It., - Date of Inspection:
24. Did, the facility fail to calibrate waste application equipment as required by the permit?
' ❑ Yes
[!I o ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[1 1'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 to provide documentation of an actively certified operator in charge?
❑ Yes
To ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
io ❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
L T"°b ❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
Q-1 o� ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
❑ 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
0<0 ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No ❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
Yes
[ No ❑ NA
❑ NE
Comments (refer to questrou #): Explain any YES answers; and/or any additional recommendations or any other comments
Use:drawmk
f facility to better explain situations (use additional pages as necessary).
iw , r° ' ..
.. r
Cq'I t% 16 -J�— V,
o�y 7
to ood-
r Qa�l�n
�� �. �-0�00V\' Jt�z �p
55(Ov
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
� nU-�3- 3134
Dater 0
2/4/2 11

Type of Visit: (�MrRoutine
liance Inspection Q Operation Review p Structure Evaluation Q Technical Assistance I
Reason for Visit: Q Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Al►'\ Departure Time: County: �Arn l Region: IrAb
Farm Name_ _ 11 N 1 P.trJ r4A%T'%5 Owner Email:
Owner Name: �-•V Nam) �V N1LQ �F Phone:
Mailing Address:
Physical Address:
Facility Contact: CU(131-1-`) W-VC Q _Title:
Phone:
Onsite Representative: � Ni+ZP _ Integrator:
Certified Operator: o" z ��� T Certification Number: 1Lko'6
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Currents#AQ III
esign
Curreut -
Design Current
Swine
Capac y ,Pop.` Wet Poult
apacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
INon-Layer
DaiSZ Calf
Feeder to Finish
}.
'"''' �"
Daia Heifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
t;D
, Poult,
Ca aeity'
P%
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
`t
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes,. notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [!](No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
ff No
❑ Yes
EeNo
E�rNA ❑ NE
aNA ❑ NE
MINA
❑ NE
❑NA
❑NE
❑NA
❑NE
Page 1 of 3 21412011 Continued

Facility Number: -aaiA jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
O No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
E3"NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): i5
Observed Freeboard (in): 3a
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
E3"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
[;3No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[2rNo
❑ 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
dNo
❑ NA
❑ NE
maintenance or improvement?
Waste Anplication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2�No
❑ NA
❑ NE
maintenance or improvement?
1 L Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [Z'ONo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): C oRcN, t eNA V 1 D
13. Soil Type(s): ��� ��, p_, co
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes ff No ❑ NA ❑ NE
15_ Does the receiving crop and/or land application site need improvement? ❑ Yes [5No ❑ 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
[]'No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
allo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E]i No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[v7No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
E f 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
E�No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[B'NA
❑ NE
Page 2 of 3 21412011 Continued I,

Facility Number: - a Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �o
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ "No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? 0 Yes [ KNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
21NA ❑ NE
❑ Yes [9'lNo ❑ NA ❑ NE
❑ Yes E?rNo ❑ NA ❑ NE
❑ Yes E]�No ❑ NA ❑ NE
❑ Yes [�]/No ❑ NA ❑ NE
❑ Yes 3No
❑ Yes [dNo
[:]Yes [B/No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES.answers.and/or any additional recommendations -or any other comments:
Use dritwings of facility to better explain situations (use additional pales as necessary)..
C-CcAznvr 40 L, `r- Gn '00at '59M6 PRouhD Mtj.0 k0 p,00i2csb
RE EIS �Roc.s=h 5 can Ou+5TD E. GT- \ A� C W p1 s-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
/m-\ �o • !S F_ \fl5
Phone: q10' 30 r,)-Ls1SS 1 _
Date:
21412011

iyp�isit: p �70=tine
ce inspection V operation Keview V structure r vamation U recnnical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Arrival Time:
/�
Departure Time: U
County: Region:
Farm Name:
eq-1 5
Owner Email:
Owner Name: [ f-1A.1 V
Mailing Address:
Physical Address:
Facility Contact: ell -A, , ((L Title:
Onsite Representative: se,
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Integrator: NJ6
Certification Number:
Certification Number:
Longitude:
Design'Current
Design Current`s .,
Design Current
Swine Capacity Pop.
Wet Poultry CapacityPop
Cattle Capacity Pap.
Wean to Finish
Layer
DairyCow
Wean to Feeder
Da' Calf
Feeder to Finish Q
_ Y
, Da" Heifer
Farrow to Wean
Design Cu rent Dry Cow
Farrow to Feeder
Dry Idoult . Cam i Po= tj Non-Dai cry
Layers Beef Stocker
Farrow to Finish
Gilts
Non -Layers Beef Feeder
Pullets Beef Brood Cow
Boars
-:.
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes CRI<o ❑ NA ❑ NE
❑ Yes
❑ No
[B A
❑ NE
❑ Yes
❑ No
gA
❑ NE
❑ Yes
❑ No
2'�lA
❑ NE
[:]Yes
Lij<o
❑ NA
❑ NE
❑ Yes
]o
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facili •Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes L'_'J "o ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes [] No ®..1>— ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? [:]Yes �o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a [:]Yes L_'J 1fO ❑ 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 UJ-Ko
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes Q- To
❑ 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 Q-Ko
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes Q'1T'o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Vo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
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?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes &3 o
❑ Yes 01-Kc,
❑ Yes E�'<o
[] NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ Yes VNo
❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes Ej-<o ❑ NA ❑ NE
[—]Yes [a< ❑ NA ❑ NE
❑WUP ❑Checklists [] Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [a'IGo ❑ 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 []111o"_ ❑ NA ❑ NE
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No FEJ A ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ ` ❑ 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
Q-KA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
�o
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
D.Ko-
❑ 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
Erl o
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[.o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
D-Mo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[Ej�
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
l_`'1-Ko
❑ NA
❑ NE
Use ment`n s of facili st better ex lain any YES answers.and/or any additional recommendations or any other+'comments.'
g ty p
omments re er to gneshon .. ,) Exp
-'lain situations (use additional pages as necessaey). - *
Q
VC-1
Reviewer/Inspector Name:
Reviewer/Inspector
Page 3 of 3
Phone: '710 -03 — 3 i3
Date:
141201

Type of Visit (PTompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: �J� County: Region: jF:'_KQ
Farm Name: RiI✓� Owner Email:
Owner Name: Lv b vn-- ,._,,, _Fir~ t.li Phone:
Mailing Address:
Physical Address:
Facility Contact: L `4n n / e-Uj Title: Phone No:
Onsite Representative: Integrator:
Certified Operator: 1—;e & ti 1 �uJ _ Operator Certification Number: �;Z7 � Oe
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = I Ell, Longitude: = o = { = u
Swine
Design
Capacity
Current Design Current Design Current
Population Wet Poultry Capacity Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
on -Layer
❑ Dairy Calf
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
QajqlD
❑ Dairy Heifer
Dry Poultry ❑ Dry Cow
❑ Non -Dairy
❑ Layers
❑ Beef Stocker
❑ Non -Layers
❑ Pullets ❑Beef Feeder
ues
❑Beef Brood C4
❑ Turkeys
❑Tu-key Poults
❑ Other Number of Structures:
Other
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
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 [2ko ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
[&No
❑ NA
❑ NE
❑ Yes
2; No
❑ NA
❑ NE
Page I of 3 12128104 Continued

■r
Facility Number: Date of Inspection a
Waste Collection &'Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes KNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrrity of any of the structures observed?
❑ Yes
E9 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
RNo
❑ 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?
UYes
❑ 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, dr stacks and/or wet stacks),,u: :,
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
f9 No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below_ ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) e. /
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes (N No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes [9No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ® No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ®,No ❑ NA ❑ NE
❑ Yes [3 No ❑ NA ❑ NE
... � ...., ,, .: _ „ 1 ,�a ss'�r- •5 r' '�rt.'�'�r+'Y^�f 'rT9
Comments (refer to,question #): Explain any YES answer%and/or any recammendatians or'aay
Use drawmgs:of fac . ty -to better explain situations. (use additional pages as necessary).
-
other comments.
A.,.. 1 4•
maw i �.-c3S 7 0 7a , of�
!/ }s'jri-k `T a je, do-rr-
Reviewer/Inspector Name tC✓ " �` y ' "'
Phone:
Reviewer/Inspector Signature:
Date: a
Page 2 of 3
12128104 Continued

Facility Number: Date of Inspection /'D
' Required Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
f No
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWM P readily available? If yes, check
[--]Yes
ISNo
❑ NA
❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
L9 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ RainfalI ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
M-No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
54No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�3 No
❑ NA
❑ NE
_.. 25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
2�No
❑ NA
❑ NE
26.
Did the facility" fail to have an actively certified operator in charge?
❑ Yes
[3 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
®,No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E&No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ERNo
❑ 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
EA -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
D5 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
MNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
KYes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
33. � � G? �`. 11 ry t lwJ -- Lt p 6wt 7,�e__ !-rpo 1 r� �0 7�ti )v7v.
iitd/� d-sS uJ� E4alike Yr7cl T alp4'S F)I`Sec/�.�.Q /$/' r
0La++ ©n-wl' F rjv
Page 3 of 3 12128104

&T114S 12 -o Zorn? 2r�
msiou of Water
Facility Number g2 2 2 Q.Division of Soil and Water Conservstioa
Q OWer Agency _ r.__-..
Type of Visit compliance Inspection Q Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit (91 routine Q Complaint O Follow up Q Referral 0 Emergency 0 Other ❑ Denied Access
Dale of Visit: J2'a7-49 Arrival Time: Departure Time: County: Si1�Se�1 Region: Fes®
Farm Name: yNN GW �dr Owner Entail:
Owner Natne: NN TyN� 71W Phone:
Flailing Address:
Physical Address:
Facility Contact: Title:
Onsitc Representalive:
Certified Operator: a' ymq ' ' i eW
[lack -up Operator:
Location of Farm:
Integrator:
Phone No:
/14- i3i vwA)
Operator Certificalion Number: AOk—Z7df,0$
Back-up Certification Number:
Latitude: = o LL Longitude: a °
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish /2*0 /ZSfO
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood CoYA
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 9' No ❑ NA ❑ NE
❑ Yes ❑ No L�'J N/A
El NE
❑ Yes El No 1J NA
❑ NE
❑ Yes ❑ No ETNA
❑ NE
❑ Yes E t/vo ❑ NA
❑ NE
❑ Yes LT No ❑ NA
❑ NE
12128104 Continued

Facility Number: Q2-7Z2_+%
Date of Inspection !I -07- 09
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes E(NNo ElNA ElNE
a_ If yes, is waste level into the structural freeboard? ElB Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
�f
Observed Freeboard (in): 2- 41
5. Are there any immediate threats to the integrity of any of the structures observed?
❑Yes
[ No
[I NA
El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
E 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 thr at,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
l_�I tVo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
ONo
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
0 Yes
[5/No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[3 No
❑ NA
❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
l_J 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 Drifl ❑ Application Outside of Area
12.
Crop type(s) Be*-w."e,_ t !4°`y� Sw.ut�(s.-;,o (ovwrccC'aew--LAca..4 - EX&_aNS
13.
Soil type(s) w0. Ira k"'
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
El NA El NE
15.
Does the receiving crop and/or land application site need improvement? El Yes
['No
El"NNo
ElNA [INE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[:] Yes
NNo
ElNA ❑ NE
IT
Does the facility lack adequate acreage for land application? ElYes
�Eff
CJ`No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
L'J No
❑ NA ❑ NE
Reviewer/Inspector Name
Phone: 1101 &1-3-Y, 5300
Reviewer/Inspector Signature:
Date: 12-01-200q
12128104 Continued

Facility Number: 82. —2v Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EB No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes L?No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps ❑Other ,�%
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes L'� 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 [I
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
..�,,
1 �No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[�N�o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ETNo
El NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
E9 o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
L•`
ElNA
[INE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYes
�NNo
R No
❑ NA
❑ NE
Other Issues
2$. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
l_lNo
❑ 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?
ElYes
3No
❑ 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
E 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
CffNNo
❑ NA
El NE
33. Does facility require a follow-up visit by same agency?
El Yes
E No
❑ NA
❑ NE
Comments andlor Drawings:
122128104

6/
/-Da-09
[Z2
IType of Visit fl-Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit Er%foutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: %Z o9-p Arrival Time: 10!/S.F.- Departure Time: County: s s�•� Region: Fib
Farm Name: AJAJ / elt'J PO -VI", Owner Email:
Owner Name: L4 am r�'_i Phone:
Mailing Address:
Physical Address:
Facility Contact: _ < +-rTitle: }c�u�.. glae Phone No:
Onsite Representative: Integrator: M!v-n g a'-� r�1
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 e 0 [ 0 Longitude: = ° = & =
Swine
Desigrt"Currenf�. '
Cap�acityPnpulatron Wet Poultry
Design Current
Capacity Population
Design Current
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
ILINon-Layer I
Dairy Calf
Feeder to Finish
2 O
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
Gilts
El
Non -La ers❑El
Beef Feeder
PE]
Puliets
❑ Beef Brood Co
Other
❑ Turkeys
0 Turkey Poults
❑ Other
❑Other
Number of Structures:
s,,,
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 3 No ❑ NA ❑ NE
❑ Yes
❑ No
LJ rvA
❑ NE
❑ Yes
❑ No
B<A
❑ NE
[R A
❑ NE
❑ Yes
❑ No
❑ Yes
B[ oo
❑ NA
❑ NE
❑ Yes
3
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: S? - Z
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes CTNo ❑ NA ❑ NE
❑ Yes & o ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 �r
5. Are there any immediate threats to the integrity of any of the structures observed? [IE Yes
�/
lqo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
,/
E o
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
[B<o
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes
LS iVo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
[' No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes
��,�//
L7 No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
,�.,,��
LTNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) a j a u G `'j
-S
13, Soil type(s)
14, Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
B o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[3'<o
[3NA
[INE
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
13No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑<o
❑ NA
❑ NE
mRh' [ �'i:+:Si4s
meWV (refer to questtoA #) Ezplatn any�YES' answers ands itny recomrnendaIJons or, any�otherrcomments.
Use drawtttgs of faetl>ty tow6eLier explatn,sttuations (use addtttonal�pages as;necessary)
A.
Reviewer/Inspector Name �l.V
Phone: gl�. `F33.3330
Reviewer/Inspector Signature: _?
_
Date: 1.0-09-2-008
Page 2 of 3 12129104 Continued

Facility Number: $2 —22f Date of Inspection
R Quired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [f No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes[s3No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
IJ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections ❑
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
ZNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
3/NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
&TNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Z No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ff No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
1K 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
LJ 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?
El Yes
��
LJ 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
ffNo
❑ 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
ONo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
ONo
❑ NA
❑ NE
Page 3 of 3 12128104

11
Division of Water Quality •--
Facility Number T Division of Soil and Water Conservation �it lG
0 Other Agency
Type of Visit j}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: LfJ Departure Time: County:
Farm Name: YV1 �� V V74s fri.* Owner Email:
Owner Name Phone: _
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: E? rl
Back-up Operator:
Location of Farm:
Swine
�-� Phone No.
Integrator: P/B01 S
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: =0 0' E" Longitude: [�° [=' ="
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La et
❑
Wean to Finish
❑
Wean to Feeder
Feeder to Finish
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Soars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Dischars!es & 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)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non-Dai
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
c. What is the estimated volume that reached waters of -the State (gallons)?
Number of Structures:
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?
,J
❑ Yes] No ❑ NA ❑ NE
❑ Yes
❑ No
PA
❑ NE
❑ Yes
❑ No 'Aj-NA
❑ NE
❑ Yes
❑ No
;2tNA
❑ NE
❑ Yes
�&No
❑ NA
❑ NE
❑ Yes_J�hVo
❑ NA
❑ NE
12128104 Continued

11ac3iity Number: Date of Inspection d
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ONo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes P�yo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in): 19
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No El NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes /� No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes )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)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
❑ NA ❑ NE
JkNo
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes %No
❑ NA ❑ NE
maintenance/improvement?
l l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes A No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifi ❑ Application Outside of Area
12. Crop type(s) L4'Mg-4'4& �-+► d / U $ �rn
13. Soil type(s) IJQZ/
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
XNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
I�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
fallo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
N No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�,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):
�C� s � �c mid ►`s —�� � l . "�
Reviewer/Inspector Name / j (e nJ7`�f� Phone: -C�Y
Reviewer/Inspector Signature: Date:C%
I2128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes NNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Wo ❑ NA ❑ NE
the appropiate box. El❑ Design El El
WUP ❑ Checklists /
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 ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
❑ Yes
*o
❑ NA
❑ NE
❑ Yes
❑ No
I%NA
❑ NE
❑ Yes
P&.
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
❑ Yes
glo
❑ NA
❑ NE
❑ Yes
❑ No
[�fA
❑ NE
❑ Yes
;ONo
❑ NA
❑ NE
❑ Yes
%No
❑ NA
❑ NE
❑ Yes
Z No
❑ NA
❑ NE
❑ Yes
�] No
❑ NA
❑ NE
❑ Yes
hNo
❑ NA
❑ NE
❑ Yes
NJ No
❑ NA
❑ NE
12128104

7 1!:
Facility No. `-�Time In �'''` Time Out Date
Farm Name 10 n ��.v� _ Integrator
Owner Site Rep G r'CC. V
Operator _ Ul Y) v\ �1�+-� _ No. �-
Back-up No.
COC Circle: General or NPDES
Desi n
Current
Desi n
Current
Wean = Feed
Farrow - Feed
Wean -
Farrow - Finish
eed r
Farrow -
Gilts I Boars
Others
FREEBOARD: Design
S;uuye S►ii-Jey
Crop Yield r�
7�
Rain Gauge
Soil Test PLAT
Weekly Freeboard
Spray/Freeboard Drop A
Weather Codes
Daily Rainfall
120 min I
Waste Analysis:
Date Nitrogen (N)
Observed
Cali►bratlor!!GPM
Waste Transfers 1
Rain Breaker -1
Wettable Acres
1-in Inspections
s
Date Nitrogen (N)
Pull/Field Soil Crop Pan Window

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
Q�}
Date of Visit: Arrival Time: ® Departure Time: r County: -s� Region: ` )`''6�
Farm Name: ] �, n t'P'WJ Owner Email: CJ G
Owner Name: � "'I n n � '� Phone: 't IQ I ` 3/ y
Mailing Address:
Physical Address:
Facility Contact: � PJAr ` Title:
Onsite Representative: Or) ` ~
Certified Operator:
Back-up Operator:
Phone No: ���_ 0 / J
Operator Certification Number: �7 r " 0
Back-up Certification Number:
Location of Farm: Latitude: = u =1 = " Longitude: = o =, = "
Design Gurretit Design Current xDes' Current
Swine Capacity Population Wet Poultry Capty Population Cattl�e� �":' Capacity Population
❑ WeIN
an to Finish
❑ La er
Dairy Cow
Dairy Calf
❑ Wean to Feeder
❑Non -La er
Feeder to Finish
O 1
_ _
Dry, Paultry. s -,
El Dairy Heifer
❑ Farrow to Wean
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish ❑ La ers
❑ Gilts El❑Non-La ers
❑ Boars Pullets
❑ Turkeys
Other "F: El Turkey Poults`
❑ Other ❑ Other
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Numberof Struetures:
r
Discharges & 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
P NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
ONA
❑ 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
RNA
❑ 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
)jskNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12.128104
Continued

Facility Number: a Date of Inspection L•l1 J/ohs
" Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes JN No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ® No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes �q 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 [WNo
❑ 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 JgNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes I—Zj 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 -4No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes T%No
❑ NA ❑ NE
maintenance/improvement?
IL 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 > t0% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Man urelSludge
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
NNo
❑ NA
❑ NE
[:]Yes
1Z No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes I No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes 'KNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes YNo ❑ 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 addidonaFpages as necessary):
11 ! / /1
�OTe Nea�j� S(��� Yla�f i�
pia S�c
5 t4 swGi �D r
lnc1tm4Qdrcv" r��� P�h�4it�j7�
/�'10k11Itj/ t5 SVIf'LG(f �`/t
Q
Ccx�►, : ,� wee -JCS .
.�
Reviewer/Inspector NamePi STI- N p
Phone:
Reviewer/inspector Signature:
Date: vI tv
Page 2 of 3 12/28/0fj Continued

Facility Number: Date of Inspection Q
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 7No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 4No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and ] " Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
'M No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
WA
❑ 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
❑INA VNE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
'KNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
15(NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1KNo
❑ 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
kNo
❑ 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? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ONo
❑ NA
❑ NE
Page 3 of 3 12128104

Facility Number x 4
Owner L
Farm Name.: ��i 72A-A�
Date-7 Time IN "3�9
Out
o.1-C I)
I
C.O.C. Genera NPDS
Current
No.. 0 / 40
Wean to Finish Wean to Feeder
Feeder to Finish Farrow to Wean
Farrow to Feeder Farrow to Finish
Gilts Boars . .
Other -
Soil types
Crop Type
J.
Soil Test ' a( Plat
PanD
/7
2
2L
Design Current
Window 1/ — 3131
9,-3
3
Designed Freeboa Observed Freeboard .. //II
Rain gauge Rain breaker Daily Rainfall Waste Transfers K/,4
Calibration of spray equipment, G.P.M. --
Sludge Survey '� ° Crop Yield 120 Minute inspections
1 in. Rain inspections Weather code Weekly Freeboard
Pumping time
Waste Analysis % & Month I & _ .2• S
f /&- 3 � l
I0fy I'%
Comments

ri` iI Division of Water Qualltj
s 3 !
ivumber .2 e2.2 0 Division of 5oit and v� afer Conservation
n p _.�
Q Other Agency
Type of Visit 8 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: Time: Departure Time: County: r- Region: F jeD
Farm Name: Lv14 1 2w_. Fc2+ rr+ Owner Email:
Owner Name: L �t Nr t-4 W Phone: �9 t `� f
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: v /v ! cJ
Certified Operator: iv/-,f
Back-up Operator:
Location of Farm:
Swine
Title:
Phone No:
Integrator: P%e r'n i_r. m 5 t0.�sQo
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 c= 6 0 Longitude: = o❑ l
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Laver
❑ Wean to Finish
❑ Wean to Feeder
ER Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ barrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Pouhs
❑ Other
Discharges & Stream Facts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dai Cow
❑ Dai Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Nion-Dairy—
El Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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)?
Number of Structures:
d. Does dischar�ae bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
[:]Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
g No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection fie'
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes Fil No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
3 Identifier: /
Spillway?:
Designed Freeboard (in): of U
Observed Freeboard (in): S
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ® No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ® No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? [R] Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures Iack adequate markers as required by the permit? ❑ Yes [V 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 El 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 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) {J e4 n 4 S Q e- -L a
13. Soil type(s) (,vla
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[M 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 determinations❑
Yes
❑ No
❑ NA
ONE
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
- R e en a ,r X_ (_✓ e d dlf y s a jo I t +� y n. n 1 a&I e-'. �• b a y (c-5. to
Ickgaar. 1rja:G S(vt�,
Reviewer/Inspector Name �� Phone: 41S-1� _ 1,1—q1_
Reviewer/Inspector Signature: Date:
I1118104 Continued

Facility Number: V _ii— Date of Inspection Fi''�
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 CA'%VMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes. check the appropriate box below. r% 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
®'No
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
® NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit'?
❑ Yes
❑ No
❑ NA
® NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
[4 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
[ZNE
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
(M 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? (ic/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative'?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
AdditionaE`Corhments and/or -Drawings: n r }s�E �
.t �p y t �r t�;L 1r t o. � 0 P Lt CaT �� TG C r VL -, + �e� r �G ►- N..•
h'b r. { `: ri c.� r r G c C+ J cr� i-.: C o C P
r �. CD r c� � � c. V` rt_ t't - i
X, t> ., ►n-. 5
12128104

(Type of Visit ('Compliance inspection O Operation Review O Lagoon Evaluation i
Reason for Visit ®'Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: t* Tone: • O D
Facility Number �. -
O Not O erational O Below Threshold
Q�Permitted Q'Cerdfied 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ........... » . ..
Farm Name: L' on � atw County:.. „'l� ��P!^ .... _� _ _
................. `�.. ......... ... - --�. q
Owner Name:...__._L. , ........_ ._ ....._.._. Phone No: 5 / � - qb a�[�
Mailing Address: Q' � i�'-XS� A �- L..[ i w`bv� i� C A3X
�.._._._..... _. _ ..... _.. ... ,.
Facilitv Contact: ...!!^..---... !.....__. _ Title:.. ..�L�Z1Q ..�. Phone No:
Onsite Representative:.....-.... Y! ..._ .....� _ .W_ -- �.. -- - Integrator:..... w+ilc_-^.... :5%,. Ou wW
Certified Operator: Operator Certification Number:....
Location of Farm:
94-Ine ❑ Poultry ❑ Cattle ❑ Horse Latitude • & 044 Longitude • 4 "
Discharees & Stream impacts
1. Is any discharge observed from any part of the operation? ❑ Yes B3 10
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes M4
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 9.6
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes OW-0
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:..................I............... _..... .......... ......
Freeboard (inches):
12112103 Continue

Facility Number. 19,2— Date of Inspection ---�-�-L�
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes GKNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes EKO
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [�io
8. Does any part of the waste management system other than waste structures require maintenancerimprovement? ❑ Yes EJKo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes Mo
elevation markings?
Waste Application
10. Are there any buffers that need maintenancerimprovement? ❑ Yes QKo
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes [ lf4o
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type ij� q (_co.s fA-) q ( i
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
GR"No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
[lio
b) Does the facility need a wettable acre determination?
❑ Yes
❑�No
c) This facility is pended for a wettable acre determination?
❑ Yes
3-f4o
15. Does the receiving crop need improvement?
❑ Yes
[flo
16. Is there a lack of adequate waste application equipment?
❑ Yes
0"No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
2�40
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
E3,No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
[aNo
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
/
[! No
Air Quality representative immediately.
CQiEIIDegL4 {�r t0 q;uestean �) EXpi8lYt any �ES��svers and/or �: reCOlnffiend9bOaS 4I' atky�t�lE[�OwO[R�eIIt�S.T � -_°,�..�
Use drawsngs of sty to better explain satnatrobs' {use addattonal pages as necessary? -., field Copy ❑Final Notes
- _ - _.. _.. _
WVW 6) /T;1 bks .
Reviewer/InspectorName I"s+d �- •W �f `^`' --- _ _ _ -
Reviewer/Inspector Signature:y Date
12112103 _I-r- Continued

• Facility Number: Date of inspection p�
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
g No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
['(o
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
Rgo
[3Vaste Application [Freeboard ❑ Waste Analysis [j'Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
Q-No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
[0,No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
E2rNo
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
B So
28. Does facility require a follow-up visit by same agency?
❑ Yes
M-Wo
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
BoNo
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes E3- o
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Rodtine O Complaint O Follow-up of DWO Inspection Q Follow-up of DSWC review O Other
L_ Facility Number 2 2
l�1 111 1 i1.iY��YIi�YII
��11
\
Farm Status: cc: r41 9-i ��..._....._
Date of Inspection s 2 M
Time of Inspection 0 Use 24 hr. time
ITotal Time (in hours) Spent ouReview
or Inspection (includes travel and processing)
Farm Name: L�j n h j e County:._.. .2
Owner Name: L�j n A eW Phone No:
Mailing Address: 266 1J.-.A--rar-jkeQA C ]; n4o h 1u c.
Onsite Representative: Qr+ sad I Integrator... bQQQ.4 Fx-mis
Certified Operator.. a / e Operator Certification Number.
Location of Farm:
Latitude Longitude �•Q<0•
❑ not Operational Date Last Operated:
Type of operation and Design Capacity
i M� t2.
sy 5b1a?
Swine �` �� Number t�Poultry ,: ��Nainber„�Csttle Numlier�
Dairy
Wean to Feeder
Feeder to Finish q� ❑ Non Beef
g �<
Farrow to Wean '� � � 'A 1 * 4 �.
z ��
Farrow to Feeder ' wy A� rar'�
Farrow t0 Finish I ❑ Other Type of Livestock a
Xs '.'=„"q`9y"? "" rs.z+'`„-'::�. �'". x�.i`c`n .'i.,.-i^`„: ..s". -,^✓� ,ky,-he%, a„'r.
il-11110111�1
❑ Subsurface Drains PresentN.
rea .t,t� 0 Lagoon ASway Field Area
� - W
r tl xis x u. M .
General
I . Are there any buffers that need maintenanmAm4 rovement?
2. Is any discharge observed from any part of the operation?
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. Was there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenancelunpr ovcmeat?
❑ Yes ANo
❑ Yes 9No
❑ Yes gNo
❑ Yes FNo
❑ Yes �(No
❑ Yes No
❑ Yes j4 No
0 Yes qNo
Condnmed on bark

6. Is facility not in compliance with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge ('if inspection after ln/97)?
S. Are there lagoons or storage ponds on site which need to be properly closed?
Structures a ooLns and/or HoldingPonds
9. T. i:."w.ai uecYO$iuUj- ►adt4unter
Freeboard (ft): rn I - Lagoon 2
❑ Yes *'o •
❑ Yes %,No
❑ Yes F(No
Yes P No
Lagoon 3 Lagoon 4
I0. Is seepage observed from any of the structures? ❑ Yes P No
11. Is erosion, or any other threats to the integrity of any of the stuchm observed? ❑ Yes ,RNo
12. Do any of the structures need maintenance/improvement? ❑ Yes JkNo
(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 sbuct= lack adquate markers to identify start and stop pumping levels? jEkyes ❑ No
Waste Atiolication
14. Is there physical evidence of over application? ❑ Yes O'No.
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type
16. Do the active crops differ with those designated in the Animal Waste Management Plan? ❑ Yes ONo
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes gNo
IS. Does the cover crop need improvement? ❑ Yes UNo
19. Is there a lack of available irrigation equipment? ❑ Yes E�No
For Certified Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes 0,No
21. Does the facility fail to comply with the Animal Waste Management Plan in any way? ❑ Yes WO
22. Does record keeping need improvement? ❑ Yes ANo
23. Does facility require a follow-up visit by same agency? ❑ Yes Jallo
24. Did Reviewer/bnpector fail to discuss reviewimspection with owner or operator in charge? XYes ❑ No
Co meats'(refer to queshan #� `Fx ,. zri az y YES answers arsdJoran Trcommeadations onau comments]
tv r z4 r s �«. h- a' 1,...t- _ 1 r'a^ wru `�.w,+s' 4•.-.'^. S•,a ,< -Y,.
:Use drawmgs�of facdity to better srtuatuaas Kuseraddionalpa a gesas;ec�ssaij�
r_
a mctrtcer n42et s 4v be
13 s�� / wp '
2�• DcDner- wa-s ne+ o_uc i ktbic. t.JvAe Marwcame + Parso,,orf -PrDalwav4
8
Reviewer/Inspector Names it �`. ..,: �� F
Reviwer/Inspector Signature: Date:
cc. Division of if"ter Quality, ter Quality Section, Farrlity.4ssessment Unit 11/14/96

State of North Carolina
Department of Environment,
Health and Natural Resources
FayettevlRe Regional Oice
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Lynn Tew
200 W. Arrowhead Rd.
Clinton, NC 28328
Dear Mr. Tew:
1DEF-HNFz
DIVISION OF WATER QUALITY
May 5, 1997
SUBJECT: Annual Compliance Inspection
Lynn Tew Farm
Registration No. 82-224
Sampson County
On May 2, 1997, staff from the Fayetteville Regional Office of the Division of Water
Quality inspected the subject swine facility. Please find enclosed a copy of our Compliance
Inspection Report for your information. It is the opinion of this office based on the
information provided and observations made during the inspection that the facility was in
compliance with 15A NCAC 2H, Part.0217 at the time of the inspection. Please refer to the
comments section on the rear of the inspection form for information regarding your facility.
Please be aware that all swine facilities with a liquid waste collection system designed for
a minimum of 250 hogs must have a certified waste management plan on or before December
31, 1997. The district NRCS office, Agriculture Extension office, or the Division of Soil and
Water have specialist available to assist you with upgrading of existing facilities and
certification.
If You have any questions concerning this matter, please call John Hasty at (910) 486-
1541.
Sincerely,
r
Aohn C. Hasty, Jr.
ironmental Specialist
cc: Operations Branch
Central Files
Audry Oxendine - FRO DSW
Wilson Spencer - Sampson Co. NRCS
Wachovia Building, Suite 714, Fayetteville 10 FAX [phone]
North Carolina 28301-5043 N & C An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/ 10% post -consumer paper

Faeiilty Ntmtber 2
Fast Staters: �
Farm Name: L a n r, Te t,.3
of
Date of bgeetion1:1---Z-A?7 j
nme of Itt:peedm t' Use U hr. Mme
Told nme an bona) Spent oaR evtew
or Inspection (indudes travel and proceubW
owaerNsm= L e PhmNo:
WwHng Address: _-zco uj- Aroo..
onsite Repre entatiwt: SDejI l &=I
CardBed Opaotor. Qperator CertiHcat<on Nmaber:
Loentlan of Farm:
rsT.l. �l
MM s
Latkude 0 4 C".�� a Loosgitude • a
Not Operational Date Last operate:
Type of operation aad Design Capathy
,.h ,�r.-�x'"�,�,,rti s�,n�•� .�"�Ar saF ��, a:�. -;�; :axl a%srr ,,,sp. ��.
-�l17ne v = z' jQ f�" �l�i• �oDi�y .- " 4--
Wean to Feeder :sELrya Dairy
Feeder to Finish b Nast- Beef
to
Feeft
arrow to Ftnish MNW.."
13 Other Type of Ii vestim* �
..Number afL -goons in', 13 Subsurface Drains Present
-Fu lAgoon rea
I. Are 6= any buffers that need .
2 B spy discharge observed 5nm my part of the opmdon?
a. If duch wV is ob= v cd, was the conveyance man -mu&?
b. If discharge is observed, did it reach Susie Watdl (If Yam. notify DW%
c If discha is observed, what is the estimated flow in galftk?
d. Does discharge bypass a lagoon system? (If ycs, notify DWi )
I h there evidence of past discharge from any part of the opadiata?
4. Was there my adverse bupuu to the waters of the State outer than Sam a diwbwp?
S. Does any part of the wam =magemenr symm (other than Lgooadholdmg ponds) reTm
fl Yea ANO
13 Yes gNo
0 Yes PfNo
E3 Yes RNa
D Yes ;�No
El Yea �qb
E3 Yes )4 No
n Yea KNo

& L Wility not in comglisnce with any applicable x bsclt c ritn'is? 13 Yes Wr,'O
% Did the sty fig to bava a cadfied operator is ropomabk Chur (Rf i necdom saw 1AIM? Q Yes +p'
& Art there bWooms or storage ponds an ate wbicb need to bo ptaparly cloned? Q Yes U(No
fte-M own' snd/Qt Holding Potad3?
9. b wucnuW fieebaand less thee adagwte? L7 Ya jjjj[,jt44j0
Freeboard M I ]Lagooaa 2 Lsgooa 3 Lagoon 4
10. Is Beeper obsaved ft m any ofthe sbvdtaa?
I I. Is a9dM er mY other threats to the integrity of Say cf the Sbuftm obsowd?
12. Do any of the sauctrues need '
(if any of questions 9-12 was answered yes, and the sitttadon posy an
Immediate public bealt or mvironmeuW threat, notify DWQ)
_13. Do any of the sum mzs lack sdgnaeee marloer to ide ntiisy start end stop l , g 'ng levels?
Waste AjdLeatin
14. h there physical evidence of ova applicatian?
. (If m ezeess of WMP, or tuaoff waters of the State, notify DWQ)
15. 4og type a tip
I & Do the active cis differ with those designated in the Animal Waste Management Plea?
17. Doss the facility have a lack ofadequate a tcage far load application?
It Does the cover crap need improveorait
19. Is there a lack of available irrigation equipment?
r Cerfiftd Facilities
20. Does the facWty fail to have a eM of the Animas Waste Management Plan readrly Svariable?
21. Does the facility fail to comply with the Animal Waste Managcnw= Plan in my way?
2L Does record kupmg nerd impao i?
23. Doss fadHty require a hollow -up visit by same agency?
24. Did ReviewedbLipecmr fafl to d'ssaw seviewfinspwtion with owns or operatar in charge?
QYea 14No
Mee JR No
Q Yes RNo
IkYes ❑ No
Q Yes PkNa
Q Yes ON*
© Ya 9Na
Q Yea WNo
Q Yes *No
E3 Yes 00
[] Yes STo
Q Yes RLNo
Q Yes VLNo
Yes Q No
Commeaf s (refer to _giits;ioa #cplana nay Y15 sos+eis alai mayTtcm=cadatzans _drr �tty othcc cotaeat.� r
Ust�,draw>ngs: of fac.ilitY: ttabetter rx�laia _-_a�tuat�ns .��e:ad�tiaflal:PgB� � . ;. �� '�'� '� �?��•'�� ,;�� • =
� !3..Sft��s�P �f;►.(} �++�, leer �►�# s � l,f` � r►.s�a�l e�.
� t+i. Oe.� eu r •� n ahj�cwai � c. ta►�as'�'e �a..ta►c� a n.u.�` P�rybwr� � �ra� D�f+.oaed
F&LrPLS wo's
ReviewtOnspector Name !_:
RrOwerfinspector Signature:
tt: Ddvwon of MAW Quality. wzw Qualify Sec don, F&C#4 :40ss MCM unit
Dom ��� :97