820281_INSPECTIONS_20171231

NUH I H LAHULINA
Department of Environmental Quai

... �. . , ... .. � . v .. .. ; _ _ _ _ - fps-=✓` � .
n of Water Resources
r Facility Number - ® O Division of Soil and Water Conservation
Type of Visit: ompliance Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: D Departure Time: p O County:�f-- Region:
100,
Farm Name: A Owner Email:
Owner Name: S;� �-� f} Zk__ Phone:
Mailing Address:
Physical Address:
Facility Contact:Title: �vch
Onsite Representative:
Certified Operator:G�/j,U
Back-up Operator:
Location of Farm:
Latitude:
C;n�a' Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
DesignCurrent
Design Current
Swine'
Capacity E Pop.
Wet Poultry Eapaeityii 'Pop.
Cattle Capacity Pap.
Wean to Finish
Layer
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Dai Fleifer
Feeder to Finish
0
30
t; .°
Design. Curren`i '
IP,oul
Farrow to Wean
D Cow
Farrow to Feeder
Q , @a c Po
La ers
Non -Lavers
IPullets
Turkeys
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
Beef Feeder
Boars
Beef Brood Cow
Other
Turkey Poults'
Other
.. P.
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: W
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?
Page 1 of 3 1
[:]Yes fo ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes ❑ No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes
❑ No
[:]NA
❑ NE
❑ Yes
2lo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
21412015 Continued

<*acili Number: - Date of Ins ection:
Waste Collection & Treatment
t'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): f f
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2fo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
/
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[ 3<o
❑ NA
[] NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
E No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[-]Yes
10
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ET -No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): rr A961, _-:V ` zY�l
13. Soil Type(s): C -172 3 hn /f7 / Zet i rt. S
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E] o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑­1116 ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes e'7 o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes Ef No ❑ NA ❑ NE
❑ Yes [3'1�o ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �fo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [] No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other: ,..7774 AJD
21. Does record keeping need i v ent? If yes, check the appropriate box below. Yes o ❑ NA ❑ NE
❑ Waste Application eekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0'l fro ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0Ko ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection: Q
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
t 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes D No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes EJNoo ❑ 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
O N
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[T N
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ZNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ZrNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[E No
❑ NA
❑ NE
aim re�� /� �".cQ 7CLdr`z-nc ©� �d ; .•
j r ,`ll j ����tr',►>� /
r} i r7
r�` Nnc• Bu N eje a" 1c::-
74
Reviewer/Inspector Name:
Reviewer/Inspector Sipatui
Phone: �7 D 3113�D1�`j
Date: //;) Z�` *'
Page 3 of 3 21412015

ype of visit: V %.ompuance inspection v operation xeview kj ntruciure r,vaivanon L! iecnmcai Assistance
Reason for Visit outine O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: /� -j Arrival Time: p UZ7 I Departure Time: p ; 3a County: J�cx�t,- Region: %jam ti
Farm Name: G Owner Email: �"—
Owner Name: j Phone:
Mailing Address:
Physical Address:
Facility Contact: 6 /`t t� /yl�� Title:
Phone:
Onsite Representative: Integrator:
Certified Operator: �L�/�ZG� jAr�� Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Garrent
Wet Poultry Capacity Pop.
Layer
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Farrow to Wean
00
t?O )
Design Current
D , Foul Ga ci Flu.i 3Po p .
Layers
Dai Heifer
Dry Cow
Farrow to Feeder
Non-DaiTy
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Othe
Other
Turkeys
urkey Poults
Other
Discharges and Stream lmnacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
[:]Yes �jNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑Yes [:]No DNA ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes [:]No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes M No ❑ NA ❑ NE
3. Were 'there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes L?�No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

[Facility Number: - Ds action: p
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes LA -No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes L3.No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
allo
❑ 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
nNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
0 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
®,No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes KNo ❑ 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 Approved Area
12. Crop Type(s): Ar'­jW'Z'- ev �Oc. -✓� ��%
13. Soil Type(s): egp U'yode
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes t&No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Uj�_No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [g No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
[] NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
0 Yes FNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes IQ No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes allo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes MNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - ) Date of Inspection: p I
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [-No ❑ NA ❑ NE
f,
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes KNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26_ Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
Sc No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
F7 No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
?� d'-• / — -0 7
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
❑ Yes ® No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes Ni No ❑ NA ❑ NE
❑ Yes' ENo
❑ NA
❑ NE
❑ Yes I& No
❑ NA
❑ NE
❑ Yes RNo
❑ NA
❑ NE
❑ Yes CR.No
❑ NA
❑ NE
Phone:
Date:
21412015

a
L
of Visit: (Z3'Campfiance Inspection Q Operation Review O Struc#ure Evaluation Q Technical Assistance
n for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: d-- Arrival Time: �� 3 n Departure Time: County:sRegion:
Farm Name: Spy f r}— S� z�s l_ C _ Owner Email:
Owner Name: �p� / d'Sort� �L Phone:
Mailing Address:
Physical Address:
Facility Contact: �jrr-�,r %j�p�> Title: i t-c- �j 1, Phone:
Onsite Representative: Ste_ Integrator:
Certified Operator: ��/LIJDOd1 f'( Sir /I _ Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current ORR Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Finish
La er
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
C7
__
a
D , P,oul
Layers
Design Current
Ca aci Pao -
DairyHeifer
Farrow to Wean
D Cow
Farrow to Feeder
Non -Da'
Farrow to Finish
I
Beef Stocker
Gilts
ZEE
Non -Layers
I
Beef Feeder
Boars
-
Other
Other
Pullets
Beef Brood Caw
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes � No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes [—]No
❑ Yes [!I -No
❑ Yes gNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21417015 Continued

Facili Number: R Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
allo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):!
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
®' No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
® Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
ENNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E�_No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [ o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop TYpe(s): �Aer�7I1l
13. Soil Type(s): r�FsfJflir�_ 'ZX/n5
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 I No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑.No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑-.No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
a No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[::]Yes
0 No
❑ NA
❑ NE
the appropriate box.
❑ WUP [I Checklists ❑ Design ❑ Maps [:]Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [. No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes �-No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes JE]-No
DNA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: 1 1 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes bl-No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes M-No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
Last 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 Eg-No [DNA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes M-No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes LB -No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29, At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ®No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail 'to notify the Regional Office of emergency situations as required by the
❑ Yes
Jallo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
6No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
7allo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
5g.Vo
❑ NA
❑ NE
Comments refer to. aestione E lout an YES answers and/or an addtttanal recommendations o any other comments.=,.
Use drawtngs_df facility to better eapiatn.situations'(use•sdditional pageseas necessa
rY)-' :.
3 Cs7— tom- i n—S o2v /L
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
Phone:%
Date:
21412015

�/g I, I A 1
for Visit: 0—Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I 11-10~A9I Arrival Time: 33 O Departure Time: 3', v c7 County ---• Region )
Farm Name: Snnd L,j v _�s L L Owner Email:
Owner Name: �, // S Z"s L L Phone:
Mailing Address:
Physical Address:
Facility Contact: 4=fir 2 agr-r_ Title:
Onsite Representative:
Certified Operator: ni icl ar3�rf }"Z ,Spr %
Back-up Operator:
7� Phone:
Integrator: �' ]ft� #1��� _
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity _ Pop.
Wean to Finish
Design Cnrrent
Wet Poultry Capacity Pop.
La er
Design
Gat#le Capacity
Dairy Cow
Current
Pop.
Wean to Feeder
-Layer
Dairy Calf
Feeder to Finish
Farrow to Wean
) Dp
Design Current
D . P,oult , Ca aci to
Layers
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Pullets
Beef Feeder
Beef Brood Cow
Boars
Other
Turkeys
Fu ey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [] No
❑ Yes ❑ No
❑ Yes 5INo
❑ Yes [El No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3
21412014 Continued

Facility Number: - f Date of Inspection:
�+ Waste Collection & Treatment
hi 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0—yes ff ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes allo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):_
Observed Freeboard (in): / `l
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes allo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes �No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ayes _ 1Vo
❑ NA
❑ NE
$. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [3 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 ZLNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [3,No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes F�LNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): B ,,—MyL A C/
13. Soil Type(s): ems; l o 6t7/ a - �3
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes MNo ❑ NA [] NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes RNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[—]Yes
allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
[—]Yes
Eg.No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[a No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
EJ-No
❑ NA
❑ NE
the appropriate box_
❑WUP ❑Checklists []Design []Maps ❑Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
[] Yes
[&No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[S No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
❑-No
❑ NA
❑ NE
Page 2 of 3
21412014 Continued

Facifi Number: - / Date of Ins action: — fl
}R24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[a -No DNA ❑ NE
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
[:]Yes
[,-No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
ELNo ❑ 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
ZjNo ❑ NA 0 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
[2�No ❑ NA ❑ NE
permit?. (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[gNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[-No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[-No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
® Yes
❑ No ❑ NA ❑ NE
Comments ,{refer to question #): Explarn any YE&answerrvand/or.any additional recommendations•or anyAafl*e7i:,ummeni
Use drawings of facility to better explam.sitaations:(use additional pages as necessary): _ -
Reviewer/inspector Name:
Reviewer/Inspector Signature
Page 3 of 3
Phone:
Date:
2142014

Ste" la- 7-/y
Type of Visit: E)rompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (2r1 outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ; Da Departure Time: ��County: Region: 1 / t
Farm Name: �� tl:-9S L L G
Owner Name: Ste! �f — •S f, L L G
Mailing Address:
Physical Address:
Facility Contact: e r —eo- M pD r r Title:
Onsite Representative:
Certified Operator
Back-up Operator:
Location of Farm:
ECMN�WFAWMV i
Owner Email:
Phone:
Phone:
Integrator: jyLurn
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capatity Pop. Wet Poultry Capacity Pop.
to Finish La er
f1Z PFeeder
Design Current
Cattle
Dai Cow
Dai Calf
to Feeder Non -La er
Pv to Finish
Farrow to Wean Design Current
Farrow to Feeder D Panl '• Ca aci �P,o
Farrow to Finish La ers
Gilts
Boars Pullets
Turkeys
Other Turkey Poults
Other Other
DairyHeifer
Cow
Non -Dairy
Beef Stocker
I Beef Feeder
Beef Brood Cow
El
Discharees and Stream Imnacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[K No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Q No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
10 No
❑ NA
❑ NE
of the State other than from a discharge?
Page l of 3 21412011 Continued

1('acili Number: I IDate of Ins ection:
—/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
IN 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?
D Yes
P2 No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[ANo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA
[] NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
WLNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
(K No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): / A gk ,••-_s
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [& No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes � No DNA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Eq No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Jallo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
4 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
g No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [19 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes C,No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes FM ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

FaciliNumber: ( Date of Ins ection: —/
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes ® No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes C,No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes MA No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes fo No ❑ NA ❑ NE
❑ Yes EkNo ❑ NA ❑ NE
❑ Yes C!kNo ❑ NA ❑ NE
❑ Yes ® No
❑ Yes No
❑ Yes ®. No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question i): Explain any YES answers and/or any additional recommendationsor.;any ather,camments a
Use drawings of facility to better explain situations (use additional pages as necessary). n'
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ��3=,33DO
Date: 5710--/Ar-/G/
V412011

Onsite Representative:
Certified Operator: Wood
Back-up Operator:
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Lam_ $ Arrival Time: Departure Time: County: Region: �
Farm Name: Owner . f Owner Email:
Owner Name: rjrpr CI �—. �� p ��� f Phone:
Mailing Address:
Physical Address:
Facility Contact: r�rZ►,..r` /rf�Dr`L— Title: -rc' 9je r
Integrator:
Certification Number: , g /Z
Phone:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Da Cow
Wean to Feeder
Non -Layer
Da Calf
Feeder to Finish
1 0
Da' Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D . Paoult .
Layers
Ca ac
Pia P.
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes JEJ No ❑ NA 0 NE
❑ Yes ❑ No
❑ Yes [] No
❑ NA ❑ NE
❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes [] No ❑ NA ❑ NE
1 Is there evidence of a past discharge from any part of the operation? [] Yes gNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes gNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Number: - 4&tl Date of inspection:
1
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
g#o
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
�q No
❑ NA
❑ NE
(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
allo
[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 DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
FANo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
a�_No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
J&No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 1!9-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s) ,,,htt� Zi�ve/
13. Soil Type(s): (ga /,JUD rp • f�Q : 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 5a No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [3 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes 21 No ❑ NA ❑ NE
❑ Yes Eg No ❑ NA ❑ NE
Required Records _& Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ® No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes M No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below_ ❑ Yes ®. No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: E2 - XW I Date of inspection: r—"/
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 No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 0 No
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?
24. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes QgNo ❑ NA ❑ NE
❑ Yes r® No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
L2 No
D NA
❑ NE
Comments: (refer to question ft Explain any YES answers and/or any additional recommendations or any other cowmen' W
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:y 3 3cp
Date: ^� ;I-a0
21412011

(Type of Visit: (_) Co m!Anance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: -/ Arrival Time: ; D?7 Departure Time: County: Region:
Farm Name: sye 11 oL -5 Owner Email: —
Owner Name: `� C a-- s &--L-S 1.._ L G Phone:
Mailing Address:
Physical Address:
Facility Contact: �1`GY.- /Alpy tor— Title: r- a, Phone:
Onsite Representative: w�{_ Integrator: yyw4 -_
�7
Certified Operator: T%s? / kj0D' f C S Certification Number: / 9/% }'
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design C rr nt
D f®r
Current
; Design Current
Swine F.r 0
Wet Poultry
Capacity
Rop
Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish (N po
La er
Non -Layer
` '
Dairy Cow
Dairy Calf
Dairy Heifer
Farrow to Wean
D`gu
Current
Dry Cow
Farrow to Feeder
D , P.oultr . Ga a i
Po
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
lBeef Feeder
Boars
Pullets
I Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes & No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
[DNA ❑NE
❑ NA [] NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Faeflity Number: - Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes allo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 43
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i_e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
0 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
(a No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
®. No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
C No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s). r ,G
13. Soil Type(s): rn21j5&C2 Z 421-1.15,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes P No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes � No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �0 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes $4 No ❑ NA ❑ NE
❑ Yes [F�No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes JZ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �SNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑Yes 14 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analy 2IWasst, Transfers
❑Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑Monthly and 1" RaIn
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Fa -No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facility Number: ;5rjDate of Inspection: /O-- O7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes j&No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes RA No
LOM
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes fNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [&No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑NA ❑NE
[DNA ❑ NE
❑NA ❑NE
❑ Yes MANo ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
[-]Yes [,g-No ❑ NA ❑ NE
❑ Yes [0 No ❑ NA ❑ NE
❑ Yes ® No
❑ Yes Callo
❑ Yes 10 No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question # ): Explain any YES answers and/or any additional. recommendations orkanytother�comments:OU
Use drawings of facility to better explain situations (use -additional pages as necessary). w;
n
O
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 2Zf --.32_0
Date:%�-
2/4/2011

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 0 Denied Access
Date of Visit: Arrival Time: O ; Da I Departure Time: c7 County: ra. Region:
Farm Name: Owner Email:
Owner Name: .S ,�� jL�.s- /Ar- Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: '%r?i�, Phone:
Onsite Representative: ��� Integrator:
a -
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
DesignCu
D gn
Current
Design Current
Swine
w
Capactty �1'op
Wet Poultry
Capacity
Pop.
Cattle C►►specify Pap.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
f
Dairy Heifer
Farrow to Wean_,
Des'i'
Current
Cow
Farrow to Feeder
Farrow to Finish
D . _Foultry,yCa'
La ers
city
P.oP.
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
:.
:,.
Pullets
Turkeys
_
Beef Brood Cow
Other ,,b-
N
Turkey Poults
Other
Ill
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes KNo ❑ NA ❑ NE
[:]Yes [:]No
❑Yes [::]No
[:]Yes [::]No
[:]Yes C, No
❑ Yes fo No
❑ NA ❑ NE
❑NA ❑NE
❑NA [:3 NE
❑NA [:3 NE
❑NA ❑NE
Page I of 3 21412011 Continued

Facili Number: R7 Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [&No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E j No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[] Yes
O No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
® Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit`?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
_E
9. Does any part of the waste management system other than the waste structures require
❑ Yes
to No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes 01 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift /❑ Application Outside of Approved Area
12. Crop Type(s):t
13. Soil Type(s): IG6�
14. Do the receiving crops differ from those designated in the CAWMP? Co Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑Yes RA ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes KA- No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[:]Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
M No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
KNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Z No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Cbecklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
[—]Yes
® No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
6a No
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facili Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [K�No ❑ NA ❑ NE
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes M No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [ANo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [VlNo ❑ 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?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
.Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes [0 No ❑ NA ❑ NE
❑ Yes � No ❑ NA [3 NE
Yes o ❑NA ❑NE
❑ Yes RNo
❑ Yes No
[—]Yes ® No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
JComtnents (refer to question ft Explain any YES answers and/or any additional recommeadatio`ns or any other iiatinents.
Use drawutss df'facthty. fo better exvlain situations (use additional vases:'as necessary).-:,
v
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:�+��
Date:—�
21412011

I
J
� ivision of Water Quality
r==aCiHt,ymber Q'� 0 Division of Soil and Water Conservation
Q Other Apm __ — 0
Type of Visit &6ompliance
Inspection
Q Operation Review O Structure Evaluation
Q Technical Assistance
Reason for Visit
Q '<utine O Complaint
O Foliow up O Referral O Emergency
0 Other ❑ Denied Access
Date of Visit: / Arrival Time: ; 0 Departure Time: County: - Region:
Farm Name: '% �" e�it�� I L G Owner Email:
Owner Name: S�✓I 1 d- pS_ L_ L, c Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: jq tir% Phone No:
Onsite Representative: Lrrz!t r­ 14AC 3tr___ Integrator:
Certified Operator: idP pq _. �r Operator Certification umber:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: =] o [:�]' = u Longitude: =] o[—]'= u
Design Current
ine Capacity Population
Design C►urrent Design
Wet Poultry Capacity PopulationWean
Current
tto Finish
❑ Layer
❑ Non -Layer
❑ Da' Cow
❑ Wean to Feeder
❑ DairyCalf
Feeder to Finish 1OD
❑ Farrow to Wean
1 00
❑ DairyHeifer
Dry Poultry ❑ Dry Cow
❑ Non -Daily
El La ers
❑ Beef Stocker
❑Non -La Non -Layers
❑ Pullets ❑ Beef Feeder
El Turkeys ❑ Beef Brood Cowl
❑ Turkey Poults
❑ Other Number of Structures:
❑ Farrow to Feeder
ElFarrow to Finish
❑ Gilts
❑ Boars
I
Other.
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2, is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 1&No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
CgNo
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
Page I of 3
12128104 Continued

Facility Number: —
Date of Inspection `tt
3 Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes RNo
❑ Yes ❑ No
Structure 5
El NA El NE
❑ NA ❑ NE
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 59,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 JZ 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?
M Yes
❑ No
❑ NA
ElNE
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
JjD Yes
90o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
P No
❑ NA
❑ NE
maintenance/improvement?
1 I . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes V-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I O 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) /Nw�/< `©41-roej
Y
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 X No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 9 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes KNo ❑ NA ❑ NE
18. is there a lack of properly operating waste application equipment? ❑ Yes E,No ❑ NA ❑ NE
Comments refer to question # • Explain any YES answers and/or an xreeommendations or an other comments
Use draivzngs' of facility_ to better explain situations. (use additional pages as necessary)
. .}.-:-, -•.--. -'. _ - .F 9..�..+. ... '-,. . '- ._ ..3'i'� F=gam'. }. - _fr.S
1.
AL
Lc� -I
/ f ; C d.S ►�.-t t/� 'mow !�l/�/" f,6
Reviewer/Inspector Name-` s
Phone:
Reviewer/Inspector Signature:
Date: 4
Page 2 of 3 r r 12128104 Continued

Facility Number: — Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZgNo [:1 NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes R] No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design El Maps ❑Other
21. Does recoid 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 I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
Eff No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
54No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
IgNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ANo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
14 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
JO No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
KNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of [lead 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
El 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
R 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
[A No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency'?
❑ Yes
RNo
❑ NA
❑ NE
Additional Comments aridior Drawings:
(1j7_
r7�-�+--�
! u r K ro( %!'
U
% h %3 Aj b c(
Page 3 of 3 12128104

B,1 US IZ.-07-2-009 izRr
Type of Visit Q'com (lance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Z O%�9 Arrival Time: Departure Time: %Z,' j s County: S �
Farin flame: SOGII 4md SOWS LLC Owner Entail:
Owner Name: S�aII GNC saNS �-� Phone:
Mailing Address:
Region: ­0 5�0
Physical Address:
Facility Cantnct: 6rte-r M06rP1 Title: Tte t ��«• Phone No:
Onsite Representative: j Integrator: N-B>�wAI
Certified Operator: �t t�aa d S�el1 Operator Certification Number: ,4wA 91/ 9
Bark -up Operator: Back-up Certification Number:
Locatiou of Farm:
Swine
Latitude: ❑' ❑' ❑" Longitude: =0 0' ❑ u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish 13100
131 ao
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ PulIets
[I 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-madc?
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 -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood CovA
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: a]
d. Does discharge bypass the waste management system? Of 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 ON. ❑ NA ❑ NE
❑ Yes
❑ No
ETN"A
❑ NE
❑ Yes
❑ No
2-14A
❑ NE
❑ Yes
❑ No
DNA
❑ NE
❑ Yes
I�10
❑ NA
El NE,
❑ Yes
_,
2 o
❑ NA
❑ NE
12128/04 Continued

Facility Number: 82 —281
Date of Inspection 17-07-09
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I
Identifier: 12� /
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33
Structure 2 Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes'NO
❑ NA ❑ NE
❑ Yes ffNo
❑ NA ❑ NE
Structure 5
Structure 6
❑ NA ❑ NE
❑ Yes E No
❑ Yes E No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes LTNo ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ONNo ❑ 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 0 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [I No ❑ NA ❑ NE
main tenance/improvement?
It. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ETNo ❑ 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 Drifl ❑ Application Outside of Area
12. Croptype(s) $ea-,_uJ4 (Pds-4- C) .S,w✓161.v✓(0,s-1 U;a4w r' 5Q'Ppw-AA.Ar9/5
13_ Soil type(s) t5C Jd56ot"o RG{`N5
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, ❑ Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment'?
Reviewer/Inspector Name
❑ Yes
❑ Yes
EEKNo ❑ NA ❑ NE
E No ❑ NA ❑ NE
No ❑ NA ❑ NE
E No ❑ NA ❑ NE
BNo ❑ NA ❑ NE
Phone: 910. Y33.333 V
Reviewer/Inspector Signature: Ke�
Date:
12- 07-Z00 9
12128104, Continued

Facility Number: 82 —Zgl Date of Inspection
Required Records & Ducuments
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 ONo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other ,�,�
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes C� o ❑ 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
DNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
BN//o
❑ NA
El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
El yes
2 o
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
L�N�o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
NNoo
El NA
El NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
,L_7,
L0No
❑ NA
❑ NE
Ether Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWW?
❑ Yes
E o ❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ErNo ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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
EI 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
ErNo❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ NA
❑ NE
Comments and/or Drawings:
1228104

✓F �&zw.s
Type of Visit OrCo-mpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit e'er utine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: ; Or Departure Time: County: 5'd=s'a_g Region:
Farm Name: S�1 j Sant L , _ Owner Email:
Owner Name: D, Xa.IV A M5 S Phone:
Mailing Address:
Physical Address:
Facility Contact: G Title: ��+• Ux . Phone No:
Onsite Representative: -sirup IzZSY-�� Integrator: __ 1/\LLB L' L4 It ft-nmj
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o ='
= Longitude: = o = , 0
ig g Current
Des n Current`' - .- Deli n
-
Design
C*wrent
Swine
Capacity Population Poultry Capacity Populafion
- -- --
Cattle Cap�ty
Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
10Non-Layer
❑ Dairy Calf
Feeder to Finish
El Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
El Farrow to Finish
❑ Layers
El Stocker
❑ Gilts
El N ers
ElBeef Feeder
El
❑ Boars
Netsn-L
El Pullets
❑ Beef Brood Co
❑ Turke s
Outer
❑ Other
❑ Turkey Pou Its
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
8' o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
B<A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
OVA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
R<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ NA
El NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
Yes
[IL-T
,2<o
<o
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12178104
Continued

Facility Number: gZ 2 g! Date of Inspection r2 T- 8
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: Arl I
❑ Yes 2N ❑ NA ❑ NE
❑ Yes L'TNo ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 25
5. Are there any immediate threats to the integrity of any of the structures observed'? ❑ Yes B lqo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ai-I ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes Q o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ 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 <o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ONo ❑ NA ❑ NE
maintenance/improvement?
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. Crop type(s) �j 1c,,, CG+r+;e_� �.�a1� G e�►i+.I CO.S. S�•.K�t ul'11/T`Y
13.
�
Soil type(s) GO A
r
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ETNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
2-no
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
�o
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
3<o
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
D<o
❑ NA
❑ NE
Comments (refer to quj on #) E p antlany YES answers anchor any recommendations or any outer comments.
�I
Use drawings of factlityto bettereaglatns�tnahons useladdthonal pages as necessary).
"`5;�„a;
Reviewer/Inspector Name iZ v [' Phone: 910, V33, 33"
Reviewer/Inspector Signature: Date: 12—pQ-2Q%2B
Page 2 of 3 `" I2128104 Continued

Facility Number: Date of Inspection Is-b9-0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 2<o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [3 o ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
UK
❑ 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
2*'Ko
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
!d"lVo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
El NA
El NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,<o
L!'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
9<
❑ NA
❑ NE
Other Issues ,�,�
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes LENo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[ <o
❑ 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
,—,
LYNo
❑ 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
2<oo
❑ 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
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[-i'1 oo
❑ NA
❑ NE
Additional Comments andlor Drawings;Imam
Page 3 of 3 12128104

Facility Number
0 Division of Water Quality uk 1
0 Division of Soil and Water Conservation ' II �l ��1{
0 Other Agency -1
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Fqllow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: joil 11 Jj)_j I Arrival Time: Departure Time: County`
Farm Name: Owner Email:
Owner Name 1 1 ��S �-/ ., „ Phone:
Mailing Address:
Physical Address:
Region: M
Facility Contact: , Title: Phone No �fl "'
Onsite Representative: C.� r )MCqCOUL Integrator:
Certified Operator: _ D__IL Sao e- t I Operator Certification Number: 9 1
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
eeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Back-up Certification Number:
Latitude: =e =' =" Longitude: =o
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
1 10 Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharses & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heife}
❑ Dry Cow
❑ Non -Dairy
❑ 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?
❑ Yes 'N No ❑ NA ❑ NE
❑ Yes ❑ No ANA ❑ NE
❑ Yes ❑ Noet§NA ❑ NE
❑ Yes ❑ No—)6 NA ❑ NE
❑ Yes 1 No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: 1 — Date of Inspection l
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes kNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes9-410 ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ yes KNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes PRNo ❑ 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? X Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes nNo ❑ 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 �eo ❑ 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 *o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
_�3No
❑ 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
Qj
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
(4)No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
_%No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
'
ReviewerA n specto r Name \, 20STWe' LP k Phone: -Ito
Reviewer/Inspector Signature: Ava Date: :�'73- 42�goj
1212810Y Continued

Facility Number: Z— Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes N No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes It No
❑ NA
❑ NE
the appropiate box. ❑ WUP ❑ Checklists ❑ Design ❑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 V
Rain Inspections ❑
Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
❑ YesQ1F)VLVA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
XrNA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes b4No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Ye OW
❑ NA-XN,E
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes , No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ❑ No
qNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes f4Vo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
bg)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
Wo
❑ 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
EANo
❑ NA
❑ NE
Additional Comments and/or Drawings:
'" �'rJfy�;ar `� yc 5��4�td !-1Sr�r � �f'o 4e �A�if�� �}"1 �-f-• `
- O
Y k� re_�atfs .
�. 4u_ver 4b bR acl- W 40 c {ate
12128104

Type of Visit OKom Lance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: d Arrival TTiime: Q= Departure Time: -ice County: Region: 1Tf Jb
Farm Name: + Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:Q1 V-Q.Q r fflctm _ Title:
Onsite Representative: GY-C& nmir`-,
Certified Operator:
Back-up Operator:
Phone:
c' Phone No:
Integrator: I-Irf-IrIn K_'_'1rtd %
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o ❑ ` ❑" Longitude: ❑ o ❑' ❑ "
Design Current
Design Current
Design Current
Swine Capacity Population
Wet PoWtry C►►apacity Population
Cattle Capacity Population
❑ Wean to Finish
10 Layer
airy Cow
❑ Wean to Feeder
10 Non -Layer
I
a Calf
eeder to Finish
Woo
Dry Poultry'
airy Heifer
❑ Dry Cow
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑Pullets
❑ Turkeys
❑ Beef Feeder
❑Beef Brood Cowl
❑ Boars
It e
❑ Other
10 Turkey Poults
10 Other
Numer of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ANo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
ElYes
*NNo
/NYhiA
❑ NA
ElNE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
ClYes
o
El
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number:15_ — Date of Inspection
Waste Collection &Treatment f '
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes
El NA [I NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 0 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): t"1 11
Observed Freeboard (in): 3(0 t
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 1ANo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes TgNo
❑ 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 JTo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes UNo
❑ 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 [l Yes b(No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �?JVo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes CTo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Wo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
P1 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
ElYes No
[I NA
El NE
IT Does the facility lack adequate acreage for land application?
❑ Yes
o
Zo
❑ NA
ElNE
18. Is there a lack of properly operating waste application equipment?
ElYes
❑ 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):14,
i
�1b,�t : Co j- PA'to rn4C1- flew- IAJ U is `
Reviewer/inspector Name Z f K AJTD T� Phone: [ /0 V.33 3300 Reviewer/Inspector Signature: Date: �d
Page 2 of 3 12 8/04 Continued

' Facility Number: —Q Date of Inspection 1)
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes VNo
❑ Yes ANo
❑ NA ❑ NE
El NA El NE
❑ 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31 _ Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ic/ 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
PNo
❑ NA
❑ NE
❑ Yes
D;bNo
❑ NA
❑ NE
❑ Yesk!No
El NA
❑ NE
❑ Yes
No
El NA
El NE
El Yes
No
ElNA
[INE
ElYes
ANo
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
Elo
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
` o
❑ NA
❑ NE
Additional Comments and/or Drawings:
CAKXJ --+'1� 11�.� �-�:. C�ir1�p �L Q V. OLV !� j 17 a Ck k? a A 40
Lt'rostc"') • 0. 1VrlS d `- n 'J i b GiG t t t
1X�a 4"� Qe'OD_t.5 40 Ir t' a C'k S a_4C'e.c
.ben l,'f C.P &I U .
Page 3 of 3 12/2&104

Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit If Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ?i !O Arrival Time: Departure Time: County:
Farm Name:-- _S ��// __ Owner Email:
Owner Name: b V._GoeA( ��..ti ?a _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: G,2rewr Magoa~e-
Certified Operator: bV, _ _ _ _ fir._
Back-up Operator: �`� S 17A
If
Location of Farm:
Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
Z
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Integrator:
Phone No:
PST=7
Region: fiao
Operator Certification Number: Z9—(0 jq
Back-up Certification Number: ilt 1 t
Latitude: 0 0= 1= Longitude: = o= 6 0
is
'Design Current
Wet Poultry ' 'Capacity Population
❑ La er
❑ Non -La et
Dry Poultry
❑
Layers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Cattle
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non-DaiLy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
h. 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 RNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
PSNo
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
12128104 Continued

Y'acility Number: Z ytj j Date of inspection a 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes iZ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: E ,
Spillway?: Nd
Designed Freeboard (in):
Observed Freeboard (in): 7J
5- Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
RNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
Wo
❑ 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?
C.Yes
❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[y�No
❑ NA
El 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
4.No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
El Yes
n No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
EANo
❑ 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
So, too
1-4
(So
12. Crop type(s) P�-a1ti�t.. s�M . 4 �clt +ti 0 S nl Q 6 $ jN►,'
e_+
�+
TeSGA)2.
13. Soiltype(s) Go050i0 I- t'r �
1'.� i►1
---
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
KLNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Eallo
❑ NA
❑ NE
L67.
W ec k:. ►� ke ► w�rr�ve_ �e st�.r� lei al ales w�� c4to
Reviewer/Inspector Name Phone: /
Reviewer/Inspector Signature: Date: 7�
12128104 Continued

facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes LKNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes U&No ❑ NA ❑ NE
the appropirate box. ❑ Wu,. ❑ Checklists✓❑ Desig r ❑ Mapes ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [KNo ❑ NA ❑ NE
❑ Waste Applicatioff ❑Weekly Freeboare❑ Waste Analysil"❑ Soil Analysiffoo..'❑ Waste Transfers ❑ Annual Certification✓
❑ RainfaR' ❑ Stocking#"❑ Crop Yield/ ❑ 120 Minute lnspection+*"'❑ Monthly and 1" Rain Inspections' ❑ Weather Cod!✓
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the faciiity fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (iel 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
J0 No
❑ NA
❑ NE
❑ Yes
(X No
❑ NA
❑ NE
❑ Yes
HNo
❑ NA
❑ NE
[]Yes
R No
❑ NA
❑ N E
❑ Yes
IRNo
❑ NA
❑ NE
❑ Yes Z No ❑ NA ❑ NE
Adfldrhonal Co iiments aad/oi<Drawings
&PAL
(A)*.s — A&A..- _14 S z(t t ro5- . K A(r lot( 2.3
a /is loK z.z s / tl fo 1 2-
-} /,-t [a-( G . 8S
❑ Yes MNo ❑ NA ❑ NE
❑ Yes & No ❑ NA ❑ NE
El Yes ER No ❑NA ❑NE
❑ Yes [A No ❑ NA ❑ NE
❑ Yes [KNo ❑ NA ❑ NE
❑Yes L&No ❑NA ONE
OF
-b 1 + sery t "L; Sao'.,
I2(28/04

(Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit (,1toutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 9 Time: b
Facility Number i•
Q Not O erational O Below Threshold
[3 Permitted [3Certified D Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ... ._
Farm Name: _..W .! !Gd .. J -`~ -- —___— __ .wW County:
Owner Name:-----�� ... Phone No:.....-.1..�.
14ailing Address:..°.
j Facility Contact: ---- ---- �� ...� 1-- �-I Title:.. �'wtQ_ W . � � — - -- Phone No:
Onsite Representative: ..... tLN_bv _ _ S fl� ....._.. _._ _ _ .. Integrator: .. l .M•i i �?` !!� ...___,�._......--
Certified O erator: _ �S O rator Certification Number. `oZs6�
p _....... ' � 1.1 !P+� _.... .. _._ ....... Pe ... .
Location of Farm:
Me6w"i'ne ❑ Poultry ❑ Cattle ❑ Horse Latitude • ` " Longitude • 4 6z
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes B'No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. if discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes [3Vo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [!(No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 63'&o
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Idenuffer: l..... ..... I .... ....... ...... _.........
Freeboard (inches):
12112103 Confinu qd

Facility Number: — 21d I Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
B-f4o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
�10
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
ErNo
8. Does any part of the waste management system other than waste structures require maintenancerimprovement?
❑ Yes
2 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
[214o
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
[R"No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
[�No
❑ Excessive Ponding ❑ PAN ❑ Hydrrraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type et' 1l ;
13. Do the receiving crops differ with these desit1ted in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
['No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
[l"No
b) Does the facility need a wettable acre determination?
❑ Yes
[;?rNo
c) This facility is pended for a wettable acre determination?
❑ Yes
[�No
15. Does the receiving crop need improvement?
❑ Yes
9No
I6. Is there a lack of adequate waste application equipment?
❑ Yes
GYNo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
❑ Yes
["No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
[RrNo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
9No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
Q'No
Air Quality representative immediately.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
Final Notes
12112103 /l Continued

Facility Number: Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes dNo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes 0; No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Bl o
❑ 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 [Ko
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes 91ro
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes Q'/o
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes B<O
28. Does facility require a follow-up visit by same agency? ❑ Yes 2"No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 044.
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ["Yes Cl No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Cleo
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes [TNo
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes [R'go
34. Did the facility fail to calibrate waste application equipment? ❑ Yes B"N'o
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below_ ❑ Yes �io
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12/l2103

State of North Carolina
Department of Environment,
Health and Natural Resources •
Fayetteville Regional Office
James B. Hunt, Jr., Governor p � H N R
Jonathan B. Howes, Secretary
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
Water Quality Section
August 2, 1995
Mr. Carl Little
Dogwood Farms, Inc.
Post Office Box 49
Clinton, N.C. 28328
Subject: Concentrated Animal Feeding
Operation Inspections
Dogwood Farms, Inc. Facilities
Sampson County
Dear Mr. Little:
Thank you for interrupting your busy schedule to assist in the
inspections of the Dogwood Farms, Inc. swine facilities in Sampson
County August 1, 1995.
Attached please find a copy of the inspection forms for the
facilities visited. We ask that you forward a copy of the forms to
the appropriate growers with the thanks of this office for allowing
timely access to their farms.
Again, thank you and Mr. Brian Spell for assisting in the
inspection process. If you have questions or comments concerning
the inspections please do not hesitate to contact me at (910) 486-
1541.
Sincerely,
( 9� I
Paul E. Rawls
Environmental Specialist
cc: DEM Facility Assessment Unit
Wachovia BUlding, Sulte 714, Fayetteville, North Carolina 28301-5043 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 5M recycled/ 10% post -consumer paper

Site Requires Immediate Attention:
Facility No. R a - a S I
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: August 1 , 1995
Time:
:Farm NawMwner:
`Mailing Address: NCW6jUj-'-.Z742
'COunty: Sa=snn
:IntigTator_ Dogwood Farms, Inc. Phone: [phone] ext. 316
-On Site Representative: rar1 T.itt1a niygunnA TPgrmc Phone
,Physical Address/Location: On t q x S6 Nr In 11 rwr-L. o., n E SQ 14 3L �- &3 �
Type of Operation. Swine x Poultry Cattle
Design Capacity: R430 Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 7 Longitude: ° c99' 49
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
.(approximately 1 Foot + 7 inches) Qor No y Freeboard:,�Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or ` o as any erosion observed? Yes or
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No (Not Evaluated)
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? (fj�br No
100 Feet from Wells?(JfsDor No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes mQp
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No (Not
Is animal waste discharged into water of the state by man-made ditch, flushing system, or -other Evaluates
similar man-made devices? Yes No) If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,(Not Evaluated)
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments: This was a very breif incgpctinn. a mare, thnrn,.ah inspertion will he_
-_ conducted in th@ future.
- Information noted on this inspection was obtained_ from the intergrator Qx DEM file-q-
If you have questions regarding this report Tease contact Paul Rawls_ DE iWatPr Quality
Section at [phone].
A �rey4ftm LAf Waste M-Q-rye p�nt Dlnn wn� not cGRAurta "-
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.