820236_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

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I ype ol visit: (2Mompliance inspection %j Uperation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 0"koutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
A ro
Date of Visit: Arri'val Time: L7 Departure Time: County: 5:A V"_
Farm Name: t /17-51 Owner Email:
Owner Name: A �'!L44 Phone:
Mailing Address:
Physical Address:
Facility Contact:
Tide:
Onsite Representative:
k L
Certified Operator: It
Phone:
Regionzlr__/�
Integrator: "VACef-e—,
I
Certification Number- / j 3 7
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
es' n t Fff f5fie-n—AtM
t o EX0
Wean to Finish
er
Dairy C w
Dairy Calf
Wean to Feeder
on -Layer
Feeder to Finish
315S
t
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Dry Cow
Non -Dairy
F..
Farrow to Finish
rs
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Layers
u ets
Boars
e
Other
urkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? E] Yes O/No F] NA NE
Discharge originated at: F] Structure E] Application Field E30ther: / —
a. Was the conveyance man-made? Ej Yes [:]No NA NE
b. Did the discharge reach waters of the State? (if yes, notify DWR) [j Yes E] No gNA E] 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 DAa) Yes [:] No NA NE
2. Is there evidence of a past discharge from any part of the operation? Ej Yes &.1 NA NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters Yes YNo NA E] NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

lFacility Number: - a,3 0 Date of Inspection:
Waste Collection & Treatment
4� Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
D Yes
Q446_­D NA
D NE
a. If yes, is waste level into the structural freeboard?
Yes
[-]No
NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway'?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
D Yes
[3-No-
D NA
D 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
0 Yes
[;Ko
DNA
[:] NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
Yes
ZNo
NA
D NE
8. Do any of the structures lack adequate markers as required by the permit?
El Yes
LEI"No
NA
D NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
D<o
D NA
[:] NE
maintenance Or improvement?
Waste App1lication
10. Are there any required buffers, setbacks, or compliance alternatives that need
Yes
C]r No
[:] NA
0 NE
maintenance or improvement?
t t. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes Ea<o 0 NA ONE
[] Excessive Ponding [D Hydraulic Overload 0 Frozen Ground [:] Heavy Metals (Cu, Zn, etc,)
r_1 PAN 0 PAN > 10% or 10 tbs. Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
F-1 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): 15 r-P W�tA� (560
13. Soil Type(s): A G, V4 (P &.1
14. Do the receiving crops differ from those designated in the CAWMP? Yes - g�jNo D NA D NE
15 . Does the receiving crop and/or land application site need improvement? D Yes E3"N'o D NA D NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes E]�`No DNA D NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
D Yes ETNo DNA D NE
0 Yes [�3`No [:] NA D NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Ej Yes No [:] NA E] NE
20. Does the facility fail to have all components of the CAW MP readily available? If yes, check Yes 121"No D NA D NE
the appropriate box.
El W"UP 0 Cbecklists ODesign E]Maps E]Lease Agreements OOtber:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. D Yes 0"No D NA D NE
D Waste Application D Weekly Freeboard D Waste Analysis [:] Soil Analysis 0 Waste Transfers [:] Weather Code
DRainfall [3 StockingO Crop Yield 0120 Minute Inspections El Monthly and I " Rainfall Inspections El Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes ffNo [:] NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:] Yes [�j No 0 NA NE
Page 2 of 3 21412015 Continued

A 4
Facility Number: 'K
jDate of Inspection:
24.-Did the facility fail to calibrate waste application equipment as required by the permit? E) Yes g]-Iq-o D NA [—] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes [D-No— [:] NA Ej 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 �q NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Yes 6--No NA NE
Otherlssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes [�rNo 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 �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 Ql�o NA NE
permit? (i.e,, discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility9 If yes, check the appropriate box below. E] Yes
0 Application Field El Lagoon/Storage Pond M Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? D Yes
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? D Yes
34. Does the facility require a follow-up visit by the same agency9 D Yes
K
GUA 4 0 V0\
/ ) _0Z_3 - / -1
Reviewer/inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
O'No
DNA
ONE
ZNo
D NA
D NE
E�fNo
E] NA
NE
eNo
[] NA
NE
Phonc4­1,-) �) —,'-J --I
Date: A
21412015

1 Yh S tlf} KU
a 049000-f Water Resources
Facility Number � ivision of Soi[ and Water Conservation _
® Other Agency =
Type of visit: 71compliance 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 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: d'c - Owner Email:
Owner Name: �-CA Phone:
Mailing Address:
Physical Address:
Facility Contact ,�ju w- ( FD G�J"(,c) "" Title: Phone:
Onsite Representative: f Integrator:
Certified Operator: if Certification Number: ! O r L
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design CurrentDesign Current:
Swine Capacity Pap. Wet Poultry 'Capacity Pop
Wean to Finish
Design Current
Cat[le Capacity III
Pop.
�.:;.
Dai Cow
Wean to Feeder
,
al
Dair Calf
Feeder to Finish
.
Design Current
Dry P�o_ultrCa�`aci Po.�
La ers
Non -La ers
DairyHeifer
Farrow to Wean
D Cow
Non -Dairy
Beef Stocker
Farrow to Feeder
Farrow to Finish
Gilts
Beef Feeder
Boars
Pullets
Beef Brood Cow
Qther
Other
Turkeys
TurkeyPoults
- Y
Other
La per
Non -Layer
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (I f 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 [5- o ❑ NA ❑ NE
❑ Yes [:)No
❑ Yes ❑ No
❑ Yes ❑ No
[:]Yes Na
❑ Yes No
�NA ❑ NE
F,;r'NA ❑ NE
NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Page 1 of 2/4/201S Continued

lFacility ! Number: � 94 fD7ate of Inspection:
10 dV qn^. i t7
NN"aste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes E3<o D NA D NE
a. If yes, is waste level into the structural freeboard? D Yes E] No E3'NA D 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?
(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?
D Yes F.;�I�o D NA D NE
0 Yes eNo D NA D NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
'r 7. Do any of the structures need maintenance or improvement? Yes [? No D NA D NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes FeNo. DNA D NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require Yes EEY'No D NA E] NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance altematives that need Yes C!�No D NA [:] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes dNo [:] NA E] NE
F-1 Excessive Ponding [:] Hydraulic Overload [:] Frozen Ground [:] Heavy Metals (Cu, Zn, etc.)
F� PAN r-1 PAN > 10% or 10 lbs- E] Total Phosphorus [:] Failure to Incorporate Manure/Sludge into Bare Soil
F� Outside of Acceptable Crop Window D Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): k...J 8�_ 15- (. -'0
13. Soil Type(s):
TA
14. Do the receiving crops differ from those designated in the CJKWMP?
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 deten-nination?
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.
D Yes
DTNo
[:] NA
NE
D Yes
�No
D NA
NE
D Yes
E3"'No
[:] NA
D NE
0 Yes. EfNo E] NA 0: NE
[:] Yes [!fNo [DNA D NE
[:] Yes El"No C—] NA NE
0 Yes E�fNo DNA NE
WU P [:]Checklists [:]Design D Maps [:] Lease Agreements D Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. D Yes [E]"No
Waste Application Weekly Freeboard [:1 Waste Analysis [:] Soil Analysis E]Waste Transfers
Rainfall [:] Stocking Crop Yield D 120 Minute Inspections Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? 0 Yes E2(, o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes fNo
[:] NA ONE
D Weather Code
D Sludge Survey
NA E] NE
NA [—] N E
Page 2 of 3 21412015 Continued

4-- 1=7
lFacifity Nurn—ber: 0 7' - IDate of Inspection: I jJAZ7 r 7 1
14 %_.0 V IV-
24. Did the facility fai I to calibrate waste application equipment as required by the permit? E] Yes P-11-o NA E] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes [;�Ko NA Ej NE
the appropriate box(es) below.
F] Failure to complete annual sludge survey Failure to develop a POA for sludge levels
F-1 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 1:�Ko NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes Ea -'go NA NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document 0 Yes �o DNA 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
ETlqo
D NA
NE
Ifyes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
0 Yes
[TNo
D NA
NE
pen -nit? (i.e... discharge, freeboard. problems, over -application)
3 1. Do subsurface tile drains exist at the facility9 If yes, check the appropriate box below.
Yes
L20"No
[:] NA
D NE
0 Application Field D Lagoon/Storage Pond El Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Ej Yes
C�T`No
D NA
F] NE
3' )� Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Yes
0"No
[:] NA
[—] NE
34, Does the facility require a follow-up visit by the same agency?
0 Yes
E2r'N'o
D NA
E] NE
- Z !!A
Reviewer/Inspector Signature: r?�&Lffl Date:
Page 3 of'3 21412015

i ype ox v isit: ic7 r—ompuance inspection %.,i tiperation Keview t,.j atructure Evaivation u i econiCal Assistance
Reason for Visit: (?rkoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: A County: 5AOf Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: I/
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
tntegrator:
Certification Number:
Certification Number:
Longitude:
S S *ne
Wean to Finish
U" U
er 5651 bi�P_2H 0
3 t 7rV_j
ILayer
it:y;
Desi orrent
C-1 RIV, opm
Mpa
Dairy Cow
Wean to Feeder
Feeder to Finish
Farrow to Wean
Warrow to Feeder
Farrow to inish
[Non -Layer
Dairy Calf
f
4VE—
urrent
P
r 'v �o
La
Layers
Dairy Heifer
Fer
ry ow
Non -Dairy
Beef Stocker
ker
Gilts
rTNon-Layers
Beef Feed, er
er
Boars
Pullets
Furkeys
Furkey Poults
)ther
Beef Brood Cow
LjOther
.7
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure E] Application Field Fj Other:
a. Was the conveyance man-made?
b. Did the discharge reach watm of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gailons)?
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?
Ej Yes D-1qo__ [:] NA E) NE
Yes [:]No
Yes E) No
0 Yes E] No
[3 Yes �0
[:]Yes ONo
[2NA [] NE
E�RA E] NE
[3<A
E] NE
NA
NE
NA
NE
Page I of 3 21412014 Condnued

Facili!x Number: Z Date of Inspection:
Waste Collection & Treatment
4. 19 storage capacity (strucwral plus storm storage plus heavy rainfall) less than adequate?
0 Yes
0-Na
0 NA
ONE
a. If yes, is waste level into the structural freeboard?
[-]Yes
[:]No
E�J-NA
0 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?
0 Yes
2<o
0 NA
0 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
0 Yes
fTNo
0 NA
[:] NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
[:]Yes
[QNo
NA
NE
8. Do any of the structures lack adequate markers as required by the permit?
Yes
P-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
0 Yes
[2-No
NA
0 NE
maintenance Or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance altematives that need
[:]Yes
[3--IVo
[DNA
I—] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes �o 0 NA 0 NE
Excessive Ponding 0 Hydraulic Overload [:] Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
PAN [-] PAN > 10% or 10 lbs. Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): 0 O'XA'k4--_� 15 G -2
13. Soil Type(s): a4e'l &, �� USe
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes [ONo NA ONE
IS. Does the receiving crop and/or land application site need improvement? [-]Yes �fNo NA NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable OYes gNo NA NE
acres determination?
17. Does the facility lack adequate acreage for land application?
0 Yes
0 No
0 NA
NE
18. Is there a lack of properly operating waste application equipment?
[:]Yes
[allo
0 NA
NE
Reguired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
EfNo
0 NA
0 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
[!I No
0 NA
[:] NE
the appropriate box.
[:]WUP [:]Checklists [:]Design 0 Maps 0 Lease Agreements OOther:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes [�TNo [DNA 0 NE
M Waste Application M Weekly Freeboard 0 Waste Analysis 0 Soil Analysis E] Waste Transfers 0 Weather Code
F1 Rainfall OStocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and V Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 yes o [:] NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes No 0 NA NE
Page 2 of 3 21412014 CondAmed

Facility �Number: !Z3C jDate of Inspecdon: "!Ej ' A
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes [A -No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check E] Yes C]rNo
the appropriate box(es) below.
Failure to complete annual sludge survey E] 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 �o
27. Did the facility fail to secure a phosphorus toss assessments (PLAT) certification? 0 Yes E�rNo
Other Issues
28. Did the facility fail to property dispose of dead animals with 24 hours and/or document
CD Yes
[2"N'o
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?
E:] Yes
[2fNo
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
E] Yes
[2No
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes
ETNo
E] Application Field 0 Lagoon/Storage Pond F1 Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAW'W?
E] Yes
E�rNo
33. Did the RevieweT/Inspector fail to discuss review/inspection with an on -site representative?
E] Yes
[ZrNo
34. Does the facility require a follow-up visit by the same agency?
[—] Yes
(Z"No
Reviewer/inspector Signature:
Page 3 of 3
NA NE
NA NE
NA NE
NA NE
[:] NA [—] NE
F] NA E] NE
[—] NA [:] NE
[] NA F] NE
F] NA ONE
E] NA NE
[—] NA NE
Date: m4m
t
21412014

PAW
Type
for Visit: (2dioutine 0
0 Follow-up 0 Referral
(:) Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: j.4yx Regior_6��_
Farm Name: Owner Emaff:
Owner Name: C. F:iR J'A—j Phone:
Mailing Address:
Physical Address:
FacitityContact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone:
Integrator: 1prr-wv
Certification Number:
Certification Number:
Location of Farm- Latitude: Longitude;
Des-ign
i
I
t
Ev
:i
lWean to Finish
Layer
Dairy Cow
lWean to Feeder
INon-Layer
Dairy Calf
Weeder to Finish
141(1
Dairy Heifer
11'arrow to Wean
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
113eef
Boars
Pullets
Brood Cow
I UrKeYS
-Turkey Poults
er
I
L
Other
Discharges and Stream Impacts
I � Is any discharge observed from any part of the operation?
Discharge originated at- 0 Structure Application Field Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d, Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[-] Yes [�J� [—] NA [—] NE
[:]Yes [:]No
[:]Yes [:]No
[:]Yes [:]No
0 Yes ffNo
[:]Yes E-No
Ea-15A' 0 NE
Eq-15rA [:] NE
3<A
ONE
0 NA
0 NE
[:] NA
[:] NE
Page I of 3 21412014 Continued

jFaciIi!j Number; Date of Inspection: /A 7 11,21-1
Waste Collection & Treatment A
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [3 Yes Eg4ro" [:] NA 0 NE
a. If yes, is waste level into the structural freeboard? 0 Yes [:] No [D,?q'X E] 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?
(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?
[]Yes [�J� E] NA E] NE
yes NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? Yes � 0 NA NE
8. Do any of the structures lack adequate markers as required by the permit? Yes [!rlqo� 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
maintenance or improvement?
Waste ADDUCatiOn
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes �o E] NA 0 NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. Yes NA 0 NE
Excessive Ponding E] Hydraulic Overload [:] Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
PAN F1 PAN> 10% or 10 lbs. 0 Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
E] Outside of Acceptable Crop Window Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): )3 �5�—o
13. Soil Type(s): IN / U -t V-'r
14. Do the receiving crops differ from those designated in the CAAP?
0 Yes
ga-lqo
0 NA
E] NE
15. Does the receiving crop and/or land application site need improvement?
E] Yes
[�-<o
NA
0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
E] Yes
C],No-
NA
[:] NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[3 Yes
[2<o
NA
0 NE
18. Is there a lack of properly operating waste application equipment?
Yes
[2rNo
NA
0 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes [3-No E] NA [::] NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check Yes [3&o ONA ONE
the appropriate box,
[:] WUP Checklists E] Design 1:1 Maps 0 Lease Agreements Elother:
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes ffNo 0 NA M NE
0 Waste Application Weekly Freeboard Ej Waste Analysis E] Soil Analysis 0 Waste Transfers 0 Weather Code
M Rainfall E] Stocking Crop Yield E] 120 Minute Inspections 0 Monthly and I" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:]Yes dNo [:] NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? []Yes [;�rNo [DNA NE
Page 2 of 3 21412014 Condnued

Q-3 opo
lFacility Number: Date of Inspection:
24. Did the facility fail to -Librate"waste application equipment as required by the permit? 0 Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check F-1 Yes
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:
M_N_0� NA 0 NE
E3Xo'E] NA 0 NE
26. Did the facility fail provide documentation of an actively certified operator in charge?
[:]Yes
Ea<o
NA
NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[—]Yes
&<0'_
NA
NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
Yes
[R<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?
E—] Yes
B<o
0 NA
ONE
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
0 Yes
[3'1�o
0 NA
0 NE
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Yes
[2"No
0 NA
0 NE
[:] Application Field E] Lagoon/Storage Pond F-1 Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
ffN o
0 NA
0 NE
33. Did the Reviewer/Inspector fail to discuss. reviewlinspection with an on -site representative?
Yes
P�o
0 NA
0 NE
34. Does the facility require a follow-up visit by the same agency?
Yes
�VNo
0 NA
E] NE
Comments (refeuto question #): Explain any YES answers and/or any additional recommendaitions-'orsny other-comafen
lUse
drawings of flicilit _V to better explain situations (use additional pages as necessary).
C I I &—
Vj' 6 4 '-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Type of Visit: (LKompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (2D"Rioutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
4 A I I
Date of Visit: Arrival Time: Departure Time: County: Rcgion: mz�_.
Farm Name: Ca Owner Email:
Owner Name: Phone-
. IS24tu%5
Mailing Address:
Physical Address:
ld;�' Title:
Facility Contact: (,j(j [A) Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
S !He
Wean to Finish
Imesign I ent
I Wit
esign
cl
I
I
U. rent
0
I
Pill
ow
IL er
Wean to Feeder
I
jNon-Layer
alf
Feeder to Finish _14i4j
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Jill
IN
10ther
I_
I
I
I Layers
Non -Layers
Pullets
Turkeys
Turkey Poults.
Other
airy eifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure E] Application Field E] Other:
[—] Yes Q>l [—] NA [-] N E
a. Was the conveyance man-made? [:]Yes [:]No EnA [3 NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [—]Yes [:]No [B<A E] NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) E] Yes [3 No Ef 'NA E] NE
2. Is there evidence of a past discharge from any part of the operation? [-] Yes AEr"No F] NA NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [3-No [:] NA NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

03 a
Facility Number: (),J-- - d-1) 16 1 1 Date of Inspection -
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes
a. If yes, is waste level into the structural freeboard? Yes
Structure 1 Structure 2 Structure 3 Structure 4
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.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
Eq-Ko' D NA D NE
EW.' D NA D NE
Structure 5 Structure 6
E:] Yes [� E] NA D NE
El Yes EAI<o---[—] NA [—] NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
0 Yes
Calro
E] NA
E] NE
8. Do any of the structures lack adequate markers as required by the permit?
Yes
[;?<o
[:] NA
[—] NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[-]Yes
B-<o`
D NA
D NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
Yes
2��o
NA
[:] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes
[�Ko
NA
D NE
F1 Excessive Ponding D Hydraulic Overload E] Frozen Ground [:] Heavy Metals
(Cu, Zri, etc.)
M PAN F] PAN> 10% or 10 lbs. Total Phosphorus D Failure to incorporate
Manure/Sludge
into Bare Soil
F] Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): 6n" , 5-&0
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
Yes
�o
[:] NA
D NE
15. Does the receiving crop and/or land application site need improvement?
Yes
FC-4-110
0 NA
[] NE
16. Did the facility fail to secure andlor operate per the irrigation design or wettable
Yes
2r`N'o
Ej NA
E] NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
[ETNo
D NA
NE
18. Is there a lack of properly operating waste application equipment?
Yes
NA
NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
Ej'�N
D NA
NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
� �No
[:) NA
NE
the appropriate box.
E3WLJP E]Checklists DDesign 0 Maps DLease Agreements E]Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes GKNo D NA D NE
Waste Application Weekly Freeboard D Waste Analysis D Soil Analysis 0 Waste Transfers D Weather Code
Rainfall [:] Stocking Crop Yield [:] 120 Minute Inspections E:1 Monthly and I " Rainfall Inspections [:]Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? Yes D NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? L] Yes No DNA NE
Page 2 of 3 21412011 Conyinued

tFa ' — e_2 a L2 J / I 'y
dlitj Number- Date of Inspection: "A I
24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes 52-1qo E] NA D NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes F-rl-No" E] NA D NE
the appropriate box(es) below.
F] Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
F1 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? D Yes [D-<o D NA D NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? D Yes []Wo E] NA D NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
Yes
55Xo"
0 NA 0 NE
and report mortality rates that were higher than nor -mat?
29. At the time of the inspection did the facility pose an odor or air quality concern?
D Yes
[DXo
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
Ugl<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,
D Yes
[0"No
D NA NE
D Application Field [:] Lagoon/Storage Pond [:] Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? E] Yes �o DNA D NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? D Yes ��c NA E] NE
34. Does the facility require a follow-up visit by the same agency? [—]Yes [�Ko NA NE
Comments (referlo, question#): Explain any YES answers and/or any additional recommendations%or any, other, com: ments.,
Use drawines of &cilitv to better explain situations (use additional pap -es as necessar-0.
5(,Jo 5�� 7
t
a(�01 urtA
Reviewer/Inspector Name:
�D — 7�3
6 , I q,- I e)-,
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
Date:
21412011

I 11MIJK@'NUDIVIS1051011 _'�onserxanon
rype of Visit: U?ompliance Inspection 0 Operation Review () Structure Evaluation 0 Technical Assistance
Reason for Visit: Qlroutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 Arrival Time: Departure Time: County: Region: r=9z o
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address -
Facility Contact: /�Zee�._s Title: I 6�
Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator: VO-�3zi� d
I J0,
Certification Number:
Certification Number:
Longitude:
Design
S c-
11
�ap ac
.1p
I oult
co-apaci
Ro:'.
lies,
OR
c a
a e ba aci olp
P,
to Finish
to Feeder
ger
Dairy Cow
Dairy Calf
on -La er
r to Finish
Farrow to Wean
en
Daia Heifer
DEy Cow
lFarrow to Feeder
I fir—YMO
Wwr�p___ae'
P.
Non -Dairy
Farrow to Finish
Gilts
Boars
Layers
Non -Layers
Pullets
Turkeys
Beef Stocker
Beef Feeder
Beef Brood Cow
Turkey Poults.
111LIOther
Discharges and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure El 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 C&No 0 NA 0 NE
Yes
No
NA
NE
Yes
No
NA.
NE
Ej Yes [:]No
[:]Yes No
E] Yes No
NA [:) NE
NA 0 NE
NA ONE
Page I of 3 21412011 Continued

[Facility Number: Fp—ateof inspection: 4--,7o—)_7
:j
Waste Collection & Treatment
4. Is storage capacity (structural plus storni storage plus heavy rainfall) less than adequate?
D Yes
Ig No
D NA
D NE
a. If yes, is waste level into the structural freeboard?
D Yes
[D No
D NA
D 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?
DYes
RNo
N A
[:] 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
[Z No
NA
D 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?
D Yes
EL No
[] NA
D NE
8. Do any of the structures lack adequate markers as required by the permit?
Yes
[4 No
DNA
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
D Yes
Z[ No
D NA
NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
Yes
No
D NA
NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. D Yes EELNo D NA D NE
Excessive Ponding [:] Hydraulic Overload D Frozen Ground [:] Heavy Metals (Cu, Zn, etc.)
PAN n PAN > 10% or 10 lbs. Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
n Outside of Acceptable Crop Window Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): A-'-M,'4 /
13, Soil Type(s): 2LV�-If� V; Me
14. Do the receiving crops dif�r from those designated in the CAWMP? D Yes 0,No D NA D NE
15. Does the receiving crop and/or land application site need improvement? D Yes M No D NA D NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable Yes K No D NA D NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
DYes (nNo D NA D NE
D Yes M No D NA D NE
UINL
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Yes " No NA D NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check D Yes rA-No NA [:] NE
the appropriate box.
D W1JP DChecklists. Cj Design D Maps D Lease Agreements DOther:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. [:] Yes VU1 No
El Waste Application El Weekly Freeboard Ej Waste Amalysis DSoiI Analysis D Waste Transfers
E]Rainfall DStockingD Crop Yield E3120 Minute Inspections Ej Monthly and I" Rainfall Inspections
22- Did the facility fail to install and maintain a rain gauge? D Yes E] No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? D Yes jrf"6::rNo
NA [:] NE
Weather Code
D Sludge Survey
[:] NA NE
D NA NE
Page 2 of 3 21412011 Condnued

f Facility Number: �� - ;;2 3 J,, I Date of Ins2ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes 10 No 0 NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes RNo 0 NA NE
the appropriate box(es) below.
Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
Non-comptiant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
Ej Application Field 0 Lagoon/Storage Pond 0 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?
OYesKNo
ONA
ONE
0 Yes
F41 No
U&---
0 NA
[:] NE
0 Yes
No
Ej NA
0 NE
0 Yes [&No 0 NA 0 NE
0 Yes Z_No 0 NA 0 NE
[—] Yes 5�[.No [—] NA [—] NE
Yes Ig No
Yes r04
IZ�l No
Yes MNo
r—
[:] NA [—] NE
0 NA E:] NE
0 NA [:] NE
i vther comm6iitg��L"'­
Comments (refer.Ito,question #): Explain any -YES answers and/or any additional recommendations or any-
Ne drawings of fieffity to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: Phone-, —3300
Reviewer/Inspector Signature:
Page 3 of 3
Date:
f_3
21412011

Ld
Type of Visit: Compliance Inspection O Operation Review p Structure Evaluation p Technical Assistance I
Reason for Visit: (Routine 0 Complaint Q Follow-up O Referral 0 Emergency O Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time- County: Region:
Farm Name: k rf�2m S I LC- I—t5 Owner Email:
Owner Name: _CO)TAt3IL F'A{ttRS Phone:
Mailing Address:
Physical Address:
Facility Contact: e,VR'R�1 NRj,&�Xe K Title: Phone:
Onsite Representative: A M 13 Integrator: PR Ed-4 -$1✓
Certified Operator: e,yfkkSS 2) A R WTr K Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design Current Design Current
601Swerve
Capacity Pop.
Ir
Wet Poultry Capacity Pop. Cattle Capacity Pap.
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -Layer
Dai Calf
"`
-- -
Design Current
Dr. Pooutt , Ca acity I;o
Feeder to Finish'
►dLtl'�
4
DairyHeifer
Farrow to Wean
D Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
i
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Broad Cow
Turke s
Qther
Turkey Poults
Other
Other
Discharges and Stream Impacts
I. 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
ff No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
&(No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑' No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
[� No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

IFacility Number: Date of Inspection.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes [3/No NA NE
a. If Yes, is waste level into the structural freeboard? Yes Q,"No NA NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in): 19
Observed Freeboard (in): 310
5. Are there any immediate threats to the integrity of any of the structures observed?
D Yes [yNo
D NA
D 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
D Yes [3"No
DNA
D 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 [gNo
NA
NE
8. Do any of the structures lack adequate markers as required by the permit?
Yes [2 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
0 Yes Z No
D NA
NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, Or compliance alternatives that need
Yes [0 No
0 NA
E:] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
Yes d No
D NA
0 NE
Excessive Ponding D Hydraulic Overload [:] Frozen Ground D Heavy Metals (Cu, Zn, etc.)
PAN M PAN > 10% or 10 lbs. Total Phosphorus D Failure to Incorporate Manure/Sludge into
Bare Soil
Outside of Acceptable Crop Window D Evidence of Wind Drift [:] Application Outside of Approved Area
12. Crop Type(s), '�ItRff"LUDP (r.RfN7_f)
L —
13. Soil Type(s): Ro k Va�\j k a%kV_
14. Do the receiving crops differ �om those designated in the CAWMP? D Yes [a No D NA D NE
15. Does the receiving crop and/or land application site need improvement? D Yes [2 No E] NA D NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [—]Yes allo D NA D NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
D Yes [3"No DNA D N-E
[:] Yes n No D NA D NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
D Yes
[g'No
D NA
D NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
[Z No
D NA
D N"E
the appropriate box.
DWUP D Checklists 0 Design D Maps D Lease Agreements
F]Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
D Yes
[a No
[DNA
D NE
M Waste Application D Weekly Freeboard D Waste Analysis D Soil Analysis
D Waste Transfers
D Weather Code
DRainfall [D Stocking D Crop Yield D 120 Minute Inspections [:] Monthly and I " Rainf�ll Inspections
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
D Yes
[j No
NA
E) NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:] Yes
[2 No
NA
[:] NE
Page 2 of 3 21417011 Condnued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? E] Yes CONo 0 NA 0 NE
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check E] Yes F\-;rNo E] NA [:] N-E
the appropriate box(es) below.
n Failure to complete annual sludge survey E] Failure to develop a POA for sludge levels
E3Non-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 [;ZNo NA E] N E
27. Did the facility fall to secure a phosphorus loss assessments (PLAT) certification? Yes [Ff No NA [:] NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document Yes [2/No NA E3NE
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)
3 1. Do subsurface tile drains exist at the facility? If yes. check the appropriate box below
E] Application Field E] Lagoon/Storage Pond El Other.
32. Were any additional problems noted which cause non-comphance 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?
E] Yes g No E] NA E] NE
F] Yes FvTNO Ej NA [:] NE
E] Yes WNo [:] NA E:] NE
Yes 9No
Yes d No
El Yes [dNo
NA N E
NA NE
NA NE
Comments (refertd'que�stion ft Explain any YES answers and/or any Additional ret6mmendations:6-.Ir,a'n"Y'-�'o—t eQq�ofilifi�e7g
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name. zzo LN 0-S Phone: %b 44'b)
Reviewer/Inspector Signature: Date: NIr
Page 3 of 3 21412011

—1
1 yIIC UI V INEL: ;tj-l.UmpllallCe 1115PCCLIUU L! MPUCIMU11 l(eVleW t,J MFUCLUM C Va1UHLIUlI v 1 ecunlCal AssLSLaucr
Reason for Visit: ()-Rhine O Complaint O Follow-up O Referral O Emergency O Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:�j
Farm Name: _ �/�i'7ttS !L L� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: [ j4 y f`jS fl�ly[ e Title: Phone:
Onsite Representative: I v� Integrator: by �c
Certified Operator: ,( j.41 f1S ,t r[,u/�C� _ Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
�M� Design @urrrent Design Current
Swine Capacity Pop.
WetPaultry:'. Capacity Pop.. Cattle Capacity Pop.
Wean to Finish
Layer
DairyCow
Wean to Feeder
Non -Layer
DairyCalf
Feeder to Finish
¢rF n
DairyHeifer
D Caw
Farrow to Wean
Design Current
Farrow to Feeder
Non-DaiEy
DPoul Ca aci Po
La ers
Farrow to Finish
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other.
TurkeyPoults
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 Na
❑ Yes [—]No
❑ Yes [] No
❑NA ❑NE
OIA ❑ NE
B<A ❑ NE
❑ Yes
[] No
2lA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
P<o
❑ NA
❑ NE
Page I of 3 21412011 Continued

t
%cility Number:__ ;ra— 7� jDate of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? []Yes eEr<o EDNA E] NE
a. If yes, is waste level into the structural freeboard? E3Yes [D No 2'T;rA E] 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? El Yes Ej--N-o NA NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed andJor managed through a Yes 2'--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
2<0
NA
NE
8. Do any of the structures lack adequate markers as required by the permit?
Yes
&0"
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
E] Yes
[E�-<o
NA
Ej NE
maintenance or improvement?
Waste Application
10- Are there any required buffers, setbacks, or compliance alternatives that need
Yes
U;J�o
[3 NA
[:] NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
Yes
E],<o
NA
[D NE
F� Excessive Ponding E:] Hydraulic Overload 0 Frozen Ground E]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 Ej Application
Outside of Approved Area
12. Crop Type(s): 4
13. Soil Type(s): it Ile Ala-
14. Do the receiving crops ti*ffe in those designated in the CAWMP?
E] Yes
[B<O
[:3 NA
0 NE
15. Does the receiving crop and/or land application site need improvement?
Yes
p-&o
[:3 NA
I—] NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable
Yes
FL;V�o
E] NA
C] NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
L2rl�o
E] NA
E] NE
18. Is there a lack of properly operating waste application equipment?
Yes
[B'Ko
E] NA
E] NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
52'<o
M NA
[D NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Yes
ER<o
E] NA
E] NE
the appropriate box.
[:]WUP DChecklists Design E] Maps [:] Lease Agreements
F]Other:
2 1. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes [2<o E] NA E] NE
M Waste Application Weekly Freeboard 0 Waste Analysis E3SoiI Analysis 0 Waste Transfers 0 Weather Code
r-1 Rainfal I E] Stocking Crop Yield M 120 Minute Inspections E] Monthly and V Rainfall Inspections E3SIudge Survey
22. Did the facility fail to install and maintain a rain gauge? [:] Yes [:] NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:] Yes [jrNo C-] NA NE
Page 2 of 3 21412011 Condnued

Facili Number: - Date of lns ection: 17
24. Did the facility fail to calibrate waste application equipment as required by the permit? [—]Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes I: 1VO
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 H-1<0
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? ❑ Yes 2 M18 ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? [:]Yes E34o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes No ❑ NA ❑ NE
Comments (refer to question.ft, Explaiwany YES answers and/or any additional -recommendations or any:othericommen#s:
Use drawings of facility to better explain situations (use additional pasties as necessarvl:
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ©-lam'
Reviewer/Inspector N
Reviewer/Inspector
Page 3 of 3
❑ Yes 2- ❑ NA ❑ NE
[:]Yes �o ❑ NA ❑ NE
❑ Yes 2 ivu ❑ NA ❑ NE
❑ Yes ICJ 1"e ❑ NA ❑ NE
Phone:
Date:
214/2 11

r
BTW-5 /-22 -2-o/0
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit C7Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: .3:I5 m I County: ��` Pam'✓ Region: 'CXO
Farm Name: C S Owner Email:
Owner Name: Cc ka"i t-- Phone:
Mailing Address:
Physical Address:
Facility Contact: Cu+'� t5 �J i c-i� Title: Phone No:
Onsite Representative: Integrator: CrIk4l), L-
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = = it Longitude: = o = 1 = "
IIIDesign
NCapacity
Current Design
Current Design Current
Swine
Population Wet Poultry Capacity
Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
I IE]Non-Layer I
❑ Dairy Calf
❑ Dairy Heifer
® Feeder to Finish
1 :200V
1 /200
❑ Farrow to Wean
Dry Poultry
E]DryCow
Farrow to Feeder
&2-
41 Z S"
La ers
❑ Non -Dairy
Farrow to Finish
El❑
❑Non -La ers
El Beef Stocker
Gilts
El Beef Feeder
PE]Boars
El Pullets
El Beef Brood Co
❑ Turkeys
Other
❑ Turkey Poults
Number of Stnsctures:
❑ Other
❑ Other
Discharees & 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
��
9 A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
LS NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (If yes, notify DWQ)
El Yes
❑ No
��/
LJ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
B o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

f
r
f,
( Facility Number: 02-2 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
NNoo
El NA
❑ NE
a. If yes, is waste level into the structural freeboard?
0,
❑ Yes IJ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 0No
❑ NA
❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ErNo
❑ 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
L1 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
L`SNo
❑ 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
21 o
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
L Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
BNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindow ❑ Evidence of Wind Drift ElApplication Outside of Area
12. Crop type(s) & *A ,4 " 4g'.3'f) �'i�cu!! ✓a f`n1 �O 5.
13. Soil type(s)u-`Y
e(s) A4 u i t ns d & I czoN-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
ONo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
2<o
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
L_.,
❑ NA El NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
��No
G o
ElNA ❑ NE
18. Is there a lack of properly operating waste application equipment? ElB Yes
❑ NA ❑ NE
Comments (reki,to`question #) ExOlamjjany YES answers and/or any recommendations or any other comments
gs o P.
lam srtuattons: {use additional pages as necessary): Use draKtn faciltty to better ex , , ._-
Reviewerllnspector Name ck tVE-iS Phone: r'ia 5�33. 333
Reviewer/inspector Signature: Date: /-2/-2d/19
12,128104 Continued

/ -Z/ -zo/ D
Facility Number: +g2 —23(a Date of Inspection
Required Records & Documents ,,_,,�,,//
19. Did the facility fail to have Certificate of Coverage & Permit readily available? [IL7
Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes B o ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps El Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crap Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspectionss/O Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes B 'No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
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
❑ Yes
B No
❑ NA
❑ NE
❑Yes
No
❑NA
❑NE
❑ Yes
N��oNo
❑ NA
❑ NE
❑ Yes
�Q
L31vo
❑ NA
❑ NE
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?
❑ Yes
[31N'o
❑ NA
❑ NE
❑ Yes
' No
❑ NA
❑ NE
❑ Yes
BNo
❑ NA
❑ NE
❑ Yes Q No ❑ NA ❑ NE
❑ Yes B ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104

tBxms 10 - 6 8 - zoay
Facility Number
O'bivision of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit a-Compf nce Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit our
0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: _0 I Arrival Time: %QS®S Departure Time: %�,� Z sJ County: Region:
Farm Name: _'7 Owner Email:
Owner Name: Ca Goa V I Phone:
Mailing Address:
Physical Address:
Facility Contact: cup' gcYW C Title: I ��-� 0 5�r-� - //_�� Phone No:
Onsite Representative: Integrator: L.L)A'Ar,Vi� e
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: = o = 6 Longitude: = ° 0 0 u
.Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
❑ Wean to Finish
❑ Wfan to Feeder
Feeder to Finish
d
❑ F ow to Wean
[ErFarrow to Feeder
Sp
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design -Current;
Cattle Capacity;; Populaf11
tn
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
'
❑ Non-DaIly
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
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?
r:
r
❑ Yes Mi-To�E] NA ❑ NE
❑ Yes ❑ No [J NSA ❑E N
❑ Yes [I No E NA ❑ NE
❑ Yes ,❑_, Noo TNA ❑ NE
ElLT Yes No ❑ NA ❑ NE
❑ Yes [J^I�o NA ❑ NE
12128104 Continued

. Facility Number: $`Z-Date of Inspection d
Waste Collection & Treatment ,/
4. Is storage capacity (structural plus storm storage plus heavy rainfalt) less than adequate? ElE Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 5 7
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes aN-o ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 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? ElJ w
Yes Lo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes D o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes U-N-o— ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:)Yes 011'o__ ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑-Ko' ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ FAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable CropWindow El Evidence
`of Wind Drifi [:]Application Outside of Area 1
12. Crop type(s) CAR ✓'u . r ds. ( v"1�— J �� ►tea �.�� f s
/ r
13. Soil type(s) �Q+i snli l�G ex
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
L�J No
ElNA
[INE
15. Does the receiving crop and/or land application site need improvement?
ElENo
Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
ff'NNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
ErNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name j L /<ewf_ Phone: 1C/99 • PY?S.�33y
Reviewer/inspector Signature: Date: % j�_ zUy9
121-16/U4 Continued

.. . e0- 230 9 fo 09
Facility Number: T7 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [�'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0o ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists El Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes R< ❑ 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
EKo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
B-9-o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
B<o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ErNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ETNo
❑ 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?
ElQ Yes
,—,.�
rio
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
Ei-o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 I.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
0-N—o—
❑ 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
El+i r ❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
afN0
❑ NA
❑ NE
Comments and/or Drawings:
12128104

i3t1us �-o / -08 ,
Type of Visit (Drtompliance Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Comp#aint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ;45� Departure Time: idd County:
Farm Name: tp t,0- C.�/541 !2!1 G'-" Sr Owner Email:
Owner Name: n t-ay i c- 40!i r_j - Phone:
Mailing Address:
Physical Address:
Region: A2V
Facility Contact: Cu V -A S Title: l �i� . 74e-e—Ir Phone No:
Onsite Representative: Integrator: CQl1lQY/'� ✓ti--�
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Operator Certification Number:
Back-up Certification Number:
Latitude: = o ❑ u Longitude: = o ❑ . ❑ u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish
ZDQO
Z100
❑ Farrow to Wean
Farrow to Feeder
60V
6,63
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
Layers
Non-L
Pullets
Turke
Turke
Other
Discharges & Stream Impacts
I _ Is any discharge observed from any part of the operation'?
Discharge originated at: El Structure El Application Field El 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-DaiTy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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'?
E
r
❑ Yes 6o ❑ NA ❑ NE
❑ Yes ❑ No 7NA
� ❑ NE
❑ Yes ❑ No ❑ NE
,❑ Yes ❑ IJ NA ❑ NE
❑ Yes VNE]
❑NA ❑ NE
ElYes NA ❑ NE
12128104 Continued

Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1
Identifier:
Structure 2 Structure 3 Structure 4
❑ Yes B o U NA ❑ NE
❑ Yes BNo ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
i
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes L'l No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) ,�
6. Are there structures on -site which are not properly addressed and/or managed El Yes 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) thereat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes LEA, NNoo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes B 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 +lo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes B o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Croptype(s)
13. Soil type(s) /Y !A. S.0
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
B—No
❑ NA
❑ NE
to
❑ NA
❑ NE
to
❑ NA
❑ NE
No
❑ NA
❑ NE
2'No ❑ NA ❑ NE
Comments)(refer to gneshon #} Explamkany, YES answe andlor any recoinruendattons�orany othei comments Rq.
•UseidraWlIIgs�o'f facility to,better,explatn sttuatlonsi (use"addrttonal,pages�as necessary, :
L
T
Reviewer/Inspector Name �R i G K V �.5
Phone:/0,3.3,33 3 fl
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12178104 Continued

Facility Number: ?— Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ElNA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes EJ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Ch kl' is ❑ D ❑ Ma s ❑ Oth
ec is es�gn p er
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections ❑ Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
ONo ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
I� N ❑ NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Ye
o ❑ NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
No ❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[ffNo ❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
M< ❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No ❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No NA
El
require
33. Does facility require afollow-up visit by same agency?
es
No ❑ NA
❑ NE
Page 3 of 3 12128104

rAl-S
Facility Number
® Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit ® 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: -/3 - 49 71 Arrival Time: is /O 4m I Departure Time: 9 :30, County: ru' �/r� Region: A20
Farm Name: C`5 Owner Email:
�O
Owner Name: C_ c&e-v i c— Phone:
Mailing Address:
Physical Address:
Facility Contact: l �4vPG� Title: Phone No:
Onsite Representative: Integrator: �D ►' �—YS
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = 1 F--I 64 Longitude: 0 ° = I ❑ u
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La er
F ---
❑ Wean to Finish
❑ Wean to Feeder
09 Feeder to Finish
ZO 00
22-91
❑ Farrow to Wean
Farrow to Feeder
Z
fA 2
Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other... ... _
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge.observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design
Cattle Capacity ,I
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: ( `'
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [WNo ❑ NA ❑ NE
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
[9PNo
❑ NA
❑ NE
❑ NA
El NE
❑ Yes
[7lNo
❑ Yes
W No
❑ NA
❑ NE
❑ Yes
P3 No
❑ NA
❑ NE
12128104 Continued

1'
Facility Number: 8'Z-2- Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes
M No
❑ NA
[I NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
RNo
❑ 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
QNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
P No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
P 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
Cl NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
[;@ No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
0No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 'VC �dc i�'te cv{rive'-0tre"""Zi
13_ Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
[ No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
ro No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
JA No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
JO No
El 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):
rr
ReviewerAnspector Name s Phone:
Reviewer/Inspector Signature: Date: q-i3-2407
12128104 Continued

Facility Number: F7, —2-36Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ICI No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 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
10 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
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
X No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
� No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
W 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
jo No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,,k
A No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Type of Visit ® Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: 7'ZrQ Arrival Time: /i'�0 ,Q Departure Time: county: Region: �2o
Farm Name: � �``4Y' S Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Cr6 j S jzC41' .J t L 1L Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 c 0 = Longitude: = 0 0` 0"
Design Current Design Current
Capacih, Population Wet Poultry Capacity Population
❑ Layer
�I ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges R Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Col
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 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 W No ❑ NA ❑ NE
El Yes
®No
❑NA
El NE
❑ Yes
f� No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[29 No
❑ Yes
fA No
❑ NA
❑ NE
❑ Yes
[ 1No
❑ NA
❑ NE
12128104 Continued

r •
Facility Number: ? Date of Inspection Z —Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. if yes, is waste level into the structural freeboard?
_Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): f 9
Observed Freeboard (in):
❑ Yes L� No ❑ NA ❑ NE
❑ Yes 09 No ❑ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
16 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
[jNo
❑ 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
Q9 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[P 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
QTNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
Q9 No
❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
(�j No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop tYPe(s) L_5 f-vw. &,-.1 e,— (G Va-. �-) S lyt4C/ 6). it c.t-Sc
13.
Soil type(s) /�n/7� It/ _
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ZNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[9 No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination:
❑ Yes
%No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
(A No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
N] No
❑ NA
❑ NE
Comments (refer to gnesbon #) Eaplatn4ay YES"answervand/or, any recommendations or any other comments.
Use drawutgs�of facity ta,better explain situations: (nse additional'pagesasnecessary)-t
�.�z.4 �H. k�
Reviewer/Inspector Name
�L^� +J�U1 :{ 3 M Y Phone: q/D — s�
Reviewer/Inspector Signature:
�.•--P.�t� Date: = 74 (o
12128104 Continued

Facility Number: gz-- 23 (p Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Mo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes (9 No ❑ NA ❑ NE
the appropiate box. ❑ WUp ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [`No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
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
QrNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[pNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
VNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
5 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
[ffNo
❑ 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
[5j 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
W No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[;?No
❑ NA
❑ NE
AdAii nalxCoiniments�andlor=Drawings
12128104

r.
Type of Visit 0 Compliance Inspection O Operation Review () Structure Evaluation O Technical Assistance
Reason for Visit * Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ��-r��� Arrival Time: Departure Time: County: sQ^+� -� Region: F,020
Farm Name:. Co a %� „ems �'t. C ' S~ Owner Email:
Owner Name:
Phone:
Mailing Address: 3Ao "cr.*
Physical Address: 49",A'., ,-,'aQ� _ �aP. __ � �•-� ���
Facility Contact: Title:
Onsite Representative: �4� n6;-, , c 1�
Certified Operator: �•�.� s 13 ti a _
Back-up Operator:
Location of Farm:
Swine
Phone No:
Integrator: elx'a #_.,or -
Operator Certification Number: "" A83.v 7
Back-up Certification Number:
Latitude: = o =1 = Longitude: = ° =, [=] ,,
Design - Current. Design Current
Capacity Population .Wet Poultry Capacity Population
o Finish ❑ La er
o Feeder ❑ Non -Layer
❑ Wean t
El Wean t
MI Feeder to Finish
Dv-
/ .2
El Farrow to Wean
Farrow to Feeder
6.2
S
El Farrow to Finish
® Gilts
/26
Boars
Other
❑ Other
I
Dry Poultry
ElLayers
ElNon-Layers
❑ Pullets
❑ Turkeys
❑ TurkeyPoults
El Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
Cattle
Design
Capacity
,.-•______:ice: i
❑ Dai Cow
El Dairy Calf
El Dairy Heifei
El Dry Cow
ElNon-Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Coid
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation`?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
12128104 Continued

Facib Number: $,a — -Z?C Date of Inspection /J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ® No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ® No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes M No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes R No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [] No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) f n,� ova /�u f,-� v rl/�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination:❑
Yes
® No
❑ NA
❑ NE
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
rK1 No
❑ NA
❑ NE
Reviewer/inspector Name Phone:
Reviewer/Inspector Signature: Date: p? //.f/dS�
12128104 Continued

-,
Faci ty Number: k-Z — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes X] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes RI No ❑ NA ❑ NE
the appropriate box_ ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X 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
r(I No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
9 NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[R No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
❑ Yes
❑ No
O NA
® NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
91 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31 _
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[3 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
itionai Comments and/or.Drawin s A"kd'd
12128104
12128104

Type of Visit (�.&mplianee Inspection O Operation Review O Lagoon Evaluation
Reason for Visit autine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number ? Date of Visit: G Tune: : O G
0 Not Operational Q Below Threshold
"etted 0<e-rified 13 ConditionyHy Certified 0 Registered Date Last Operated r Above Threshold-
Farm Name: G S
Owner Name. [pNQi t L Fjvws Phone Na: S92 - //a
__ .. .........................
1VlailingAddress: 50o WeS'fav[A Rol. ..._.......__........ ....__..._.....x......�C..............�..��......3.....�................�.�.-.-----...
Facility Contact: Cwe S 13keW i G k �+"�
------ -Title: 2'r- Phone No:
Onsite Representative:.. '_5 '._ k Integrator•
Certified Operator:........... S-
.........____.............__..............................._..._................ Operator Certification Number:....._................. ....... -....�....
Location of Farm:
QAIrwine ❑ Poultry ❑ Cattle ❑ Horse Latitude �4 " Longitude �• �� ��s
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 95-Mo-
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/rain?
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 Eyco
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 019-6-
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4
❑ Yes [awff—
Structure 5 Structure 6
Identifier: ........... ........ - .................................... ...... ... -................
Freeboard (inches):
12112103 Continued

Facility Number: — J►3(o Date of Inspection 6
1. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes E40
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes 42 No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes [ #6
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes 2To
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ' No
elevation markings?
Waste Anulication
10. Are there any buffers that need maintenance/improvement? ❑ Yes EKO
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes E No
❑ ExcessiveP�o�ndiing ❑ PAN ❑ Hydraulic Overload [I Frozen Ground El Copper and/or Zinc
/
12. Crop type C. "-141 9er r" 5mm 11 ¢Y,i ^
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
14 is Ar,', . YVJ &V%1.OL. Of Crv('s w re" .
Reviewer/Inspector Name
Reviewer/Inspector Signature:
❑ Yes ['lqo
❑ Yes [-Ko'
❑ Yes 0<0
❑ Yes ld<0
❑ Yes M<0
❑ Yes WO
❑ Yes .la -No
❑ Yes
❑ YesVTN_o
❑ Yes ❑ No
Copy ❑ Final Notes
.121.12103 1/ / Continued

Facility Number: - Date of Inspection .gib d
Required Records & Document~
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
W,Q
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
,�
(ie/ WUP, checklists, design, maps, etc.)
[I Yes
[310
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
0140
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
L/ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
91 CO
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
2r1e4o
27. Did Reviewer/Inspector fail to discuss review/mspection with on -site representative?
❑ Yes
240
28. Does facility require a follow-up visit by same agency?
❑ Yes
[�To
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes plo
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

W.
Site Requires Immediate Attention: /t/G
Facility No. . z--f
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: J I .In , 1995
Time: 1 'S (y
Farm Name/Owner: C 6 �1 a r j If c On -5
Mailing Address: 19, o , x I.1, -tin
County:_ �5 6 '--1 �25 d n
Integrator: _ if 0k C" - ; C _ _ _ _ Phone:— `2 Lv 529A _— d_ J,
On Site Representative: C o r Phone:
Physical Address/Location: M
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: , " Longitude: 0 , "
Circle Yes or No
Does the Animal Waste Lagoon hav sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) e or No Actual Freeboard: —Ft. _Inches
Was any seepage observed from the la oon(s)? Yes or (& Was any erosion observed? Yes or i�o
Is adequate land available for spray? es or No Is the cover crop adequate? D or No
Crop(s) being utilized: r a G 5 t c:,_ 4 !3 e_r r►-1 U d <-
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? I&or No
100 Feet from Wells? &e or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or&
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or&
Is animal waste discharged into water ofAe state by man-made ditch, flushing system, or other
similar man-made devices? Yes or o If Yes, Please Explain. A
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? 45or No
Additional Comments:
�L (o�
Inspector Nige
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention: IV40
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: d
lv�! 5 ot+r
Farm Name/Owner: _ -_ ��S rx Ce.Q-I L�anaa _ - _ esWo F• per �,
Mailing Address: v -
County:
Integrator: Phone:
On Site Representative: Phone:
Physical Address/lAxation:_, ._ . - _ _ - •- • •- _ _ • -- .- - ^�, _
Type of Operation: Swine _� Poultry Cattle
Design Capacity: _ y � - Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number:
Latitude:— ° Longitude: "
Circle Yes or No
ACNEW
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) es r No
Was any seepage observed from thblapon(s)?
Is adequate land available for prayor N
Crop(s) being utilized:
Actual Freeboard: .^Ft. _Inches
Yes or &>Vas any erosion ob ed? Yes or&
Is the cover crop adequate? kes r No
Does the facility meet SCS minimum setback criteria?
Feet from Dwellin 9 Ye or No
100 Feet from Wells? Vaor No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or Q
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or1fo) If Yes, Please Explain.
Does the facility maintain adequate waste management reco s (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)?(Y-es-jDr No
Additional Comments:
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

REGISTRATION FORM FOR ANIMAL F=EDLOT OPERATIONS
Department of Environment, Health and Natural Resources
Division of Environmental Management
Water Quality Section
if the animal waste management system
for your feedlot operation
is
designed to serve more than or
equal to 100 head
of cattle,
75
hoses, 250 swine, 1,000 sheen, or 30,000 birds that
are served
by
a. liquid waste system, then this
form must be filled
out and mailed
by December 31, 1993 pursuant to
15A NCAC 2H.0217(c)
in order to
be
deemed permitted by DEM. Please
print clearly.
Farm Name:_ (/".p A ��­^-, s _ tt [-S
Mailing Address:
County: Phone No �Fy�-lia?
Owner(s) Name:
Manager(s) Name:.W._Ilr:
Lessee Name: /rn
Fart Location (Be as specific as possible: road names, direction,
milepost, etc.) k,' 11-01 red s� /.21G Z/.
Latitude/Longitude if known:
Design capacity of animal waste management system (Number and type
cf confined animal (s) } 4 '�c" sa. ��r�e� f, 4- A 5
Average animal population an the farm (Number and type of animal (s)
-raised) _�?.5! S.W4 4-A,.._s a oaa
Year Production Began: yZ ASCS Tract No.
Type of waste Management System Used: /tea
Acres Available for Land Application14,�!,aste:
Owner (s) Signature (s) : A A' DATE:
`J v� DATE:

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