820299_INSPECTIONS_20171231

NORTH CAROLINA
Department of Envirenmental Qua
II

Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: �utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I Cj jFq5ffArrival Time: Departure Time: D County: Region:
Farm Name: f y p I'S -1—:2. F a,, n I ' � Owner Email:
Owner Name: a zi _ ► Phone:
Mailing Address:
Physical Address:
Facility Contact: 1 Title: r i
Onsite Representative:- S�
Certified Operator: /3$'y,�..� Ki n �
47
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: 174 191 d
Certification Number: f*
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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 g[ No [] NA C] NE
If
CD Yes ❑No ❑NA ❑NE
❑Yes ❑No []NA ❑NE
[:]Yes ❑ No
[::]Yes RNo
[—]Yes [0 No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 2/4/2011 Continued
Design Current. Design
Currents
Design Current
Swine
Capacity ,pop �W�et Poultry Capacity
.... Pop
Cattle Capacity Pop.
to Finish''
]Layer
Dai Cow
to Feeder
Non -L a er
Dai Calf
r to Finish
--o� �� " "
Dai Heifer
w to Wean
r
`''" Design
Centf
Cow
w to Feeder
aD _ 4PouI Po.� �:;Ca aci � .,
Non-Daiw
to Finish
La ers
Beef Stocker
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
F, .. Turkeys
Turkey Poults
Other
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 g[ No [] NA C] NE
If
CD Yes ❑No ❑NA ❑NE
❑Yes ❑No []NA ❑NE
[:]Yes ❑ No
[::]Yes RNo
[—]Yes [0 No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 2/4/2011 Continued

Facility Number: - Date of Inspection: —
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ® No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA D NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
13. Soil Type(s): 6hin 14
Spillway?:
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
Designed Freeboard (in): j 'T_
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
Observed Freeboard (in): .3L
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[] Yes
® No
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
E.No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
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?
Required Records & Documents
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 Annlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Ll�tet—�� my nc, Dulh / Egmek—ni
13. Soil Type(s): 6hin 14
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[] Yes
® No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® 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
RL No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
10 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 51 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 D�[No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [Z No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
DNA ❑NE
Page 2 of 3 2/4/2011 Continued

Facili Number: 113ate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes JZ No ❑ NA ❑ NE
i
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes jo No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey E] Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ Yes
[5� No
❑ NA
❑ NE
❑Yes
®No
❑NA
❑NE
❑ Yes
to No
❑ NA
❑ NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes 54 No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [:]Yes fL No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes &I No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes JE�No
r 6W fn I"Y & dj W -t'+- re vc-ew E-) &" P -- I -p'xO 13
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
[DNA ❑NE
[:3 NA ❑NE
Phone:'p._`(3�--37
Date:
�'' 214/2011

ivi"sion of Water Quality
Facility Number - ® ® Division of Soil and Wa#er Conservation
� Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (Z Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: —1-/ Arrival Time: / U : o Departure Time: j� Q C� County: �---- Region:
Farm Name: ;If L-2— Owner Email:
Owner Name: e. , — i 1� - Phone:
Mailing Address:
Physical Address:
Facility Contact: (7' �rY/ 40 197- z= Title: Phone:
Onsite Representative: sc �t� Z Integrator: jWtfry�y
Certified Operator: 'k T \ +^ Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current`
Design
Current
Design Current
r Ca aci Po
ne j. p ty p.`We#
� Poultry 'Capacity
P,op,
Cattle Capacity Pop.
Finish
Layer
Dai Cow
Feeder
Non -La er
Dai Calf
o Finish I-
r`
Dai Heifer
o Wean - Design Current
D Cow
o Feeder
EFarrow
13 . Poultr Ca 'aCi
P,o
Non -Dairy
o Finish
La ers
Beef Stocker
Non -La ers
Beef Feeder
Pullcts
Beef Brood Cow
Qther
Turkey Poults
Other
■Ye�N01YY�WY/..:GriY E_J-'9r".-iiW.:Jwi'.r:iL�'iaLiL4Gi1. _
Other
.. ::eEee.]Y'�c-MsLd-3' -,. �'.: idii-:iib'xi.. .
Dkchames 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 0 No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page I of 3 21412011 Continued

Facility ]dumber: - Date of Ins ection: Z� �—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a_ if yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure pian?
No ❑ NA ❑ NE
❑No E] NA ❑NE
Structure 5 Structure 6
❑ Yes � No [:]NA E] NE
❑ Yes [&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? Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? []Yes E&No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ®,No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E�t No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Cj�-No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �{jrn
r;
Z72"
13. Soil Type(s): l�il�r3 � Z Z72" ZN cZf4' -
14. Do the receiving crops differ from those designated in the CA WMP? ❑ 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 [3NA E:]NE
ILA
acres determination`?
17. Does the facility lack adequate acreage for land application?
❑ Yes
5� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
� No
E] NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
CaNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
P 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
[R No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
[] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[R No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
E] No
❑ NA
❑ NE
Page 2 of 3
2/4/2011 Continued

• Facility Number: - Date of Inspection: /- J -
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �a No ❑ NA ❑ NE
' 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: _ % 0
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [B No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes allo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document []Yes TRNo ❑ 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 K No ❑ NA ❑ NE
[:]Yes El No ❑ NA ❑ NE
❑ Yes 4 No ❑ NA ❑ NE
❑ Yes L No
❑ Yes .] No
[::]Yes M -No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility io better explain situations (use additional pages as necessary).
I0 t,, --/,X a --7-a5 &.- tzz?Af-
Reviewer/Inspector Name:
Phone: W o --y93 33C'
Reviewer/Inspector Signature: Date: 110-A- / —/ -2- _
Page 3 of 3 2/4/2011

Date of Visit: Arrival Time: Departure Time: ! O County
Farm Name: K: h a roi Owner Email:
Owner Name: Ury PI � K; vt. Phone:
Mailing Address:
Region: f
Physical Address:
Facility Contact: &v -err YT Title: �r, Sir., Phone:
Onsite Representative: Integrator: r
Certified Operator: 21r Certification Number: /781y5L
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
l
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry CapacEty
Pop.
Cattle Capacity Pop.
a. Was the conveyance man-made?
❑ Yes
Wean to Finish
Lir
❑ NE
Dai Cow
Wean to Feeder
Non -La er
❑ NA
Dai Calf
Feeder to Finish L 3
-
Dairy Heifer
Farrow to Wean
_
r Desi
Current
Dry Cow
Farrow to Feeder
D , P,oultr w,aCa act At..' p.
Non -Dai
Farrow to Finish
Layers
❑ NA
Beef Stocker
Gilts
Non -Layers
® No
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other-�;:::, ; ;
Turke Poults
Other
OEher
Discharges and Stream Imaacts
1. Is any discharge observed from any part of the operation?
❑ Yes
0 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
R No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
® No
❑ NA
❑ NE
of the State other than from a discharge?
Page l of 3 2/4/2011 Continued

FaciliNumber: 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
[aNo
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
� 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?
aYes
[—]No
[] NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Ea No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
17. Does the facility lack adequate acreage for land application?
❑ Yes
[0 No
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[Z No
❑ NA
❑ NE
maintenance or improvement?
❑ NE
Required Records & Documents
Waste Application
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
� No
[:]NA
❑ NE
maintenance or improvement?
❑ NE
the appropriate box.
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [,No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. [] Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 650rpA �,•�/me>< �O�r
13. Soil Type(s): aC
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
� No
❑ NA
[:]NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[@ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
® No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[0 No
❑ NA
❑ NE
l$. 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?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
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
[,K No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
g No
❑ NA
❑ NE
Page 2 of 3
2/4/2011 Continued

Facility Number: I Date of Inspection: 114--1—ZZ
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
1, 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Eig Yes [-]No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
® Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes [�j 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
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
[:]Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
UNo
❑ NA
❑ NE
0 Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
5Q 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
[21 -No
❑ NA
❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
6X'`c stir -as 'o -p -L A--4
Phone: �jG�3jDb
Date:
214/2011

Type of Visit
ompliance Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
outine Q complaint
O Follow up 0 Referral O Emergency
O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure 1J Departure Time: t} County: Region:
Farm Name: �i ✓� a +''' r/f't— Owner Email:
Owner Name 1� r'�1 G-�— -_.. "` Phone:
Mailing Address:
Physical Address:
Facility Contact: r— K 1 Title:
Onsite Representative: _ „ ✓ iv �/ „ AtMY`r—
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Integrator: �? _
Operator Certification Number:
Back-up Certification Number:
Latitude: E=] e E=] ' = Longitude: = o [_—] , = u
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 Pa No ❑ NA ❑ NE
❑ Yes
Design Current
Wet Poultry Capacity Population
Design Current
Cattle Capacity Population
Swine
DesignCurren#
Capacity Papulation
❑ Wean to Finish
JEI Layer
❑ NE
❑ Daia Cow
❑ Wean to Feeder
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
❑ Dairy Calf
Dairy Heifer
❑ DIX Cow
❑ Non -Dairy
❑ Beef Stocker
❑Beef Feeder
❑ Beef Brood Cow
Number of Strue#ures:
Feeder to Finish q91-4
❑ Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
0,No
O#her
❑ Other
❑ Yes
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 Pa No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
0,No
❑ NA
❑ NE
❑ Yes
R9.No
❑ NA
❑ NE
Page 1 of 3 12/28/04 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes [9No ❑ 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): _ 32
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 ® 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?
S Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures tack adequate markers as required by the permit'?
❑ Yes 14 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 H No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes EjNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
[:]Yes ,KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) ! r-L /
13. Soil type(s)
14, Do the receiving crops differ from those designated in the CAWMP?
❑ Yes CR No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes [KNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ,Q No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes f.No ❑ NA ❑ NE
18_ Is there a lack of properly operating waste application equipment?
❑ Yes D3-No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional.pages as necessary):
-z-
4aS
tt %��5�`c'�. !��'l✓�; t �r7 d' cz /'res 1+1 N 1�? j %CS
el ^05;�-�-- E) 7,
l� �' 3 l --1 D
•�
ReviewerlInspector Name l�--�----
Phone: 33 a
ReviewerAnspector Signature:
Date: U
Page 2 of 3
12/28/04 Continued

Facility Number: — Date of Inspection--�
' Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes allo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes P3.No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists
❑ Design El Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RNo ❑ 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 ❑ Wcather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
QNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
V] No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
JR No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
91 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
L.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
CD 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
[�l 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
'-1 No
❑ NA
El NE
33_
Does facility require a follow-up visit by same agency?
[.Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
3 Dtc..►Q w', f 1 F��� �u to
Page 3 of 3 12/28/04

BItAS iz -o9- zoos 9.R
Z9y
Type of Visit &fommpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 01routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: l Z -i►$ d �� Arrival Time: Departure Time: %'fS County: SQ' iso.., _ Region: F20
Farm Name: ae ^t Ki Arc, Fiirw• Owner Email:
Owner Name: Lae—,j�TN41 _ _ _ Phone:
Mailing Address:
Phvsical Address:
Facility Contact: Title:t P- Phone No:
Onsite Representative:Integrator:
T
Certified Operator: rN favi B' Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: =0 =1 ="
Longitude: = o =' E_—] a
Design Current
Swine Capacity Population
Design Current
Wet Ponitry Capacity Population
Design Current
Cattle Capacity Population
❑ Wean to Finish—L
ID Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -La er I I
❑ Dai Calf
_
eeder to Finish ,58 ate BOt7
a. Was the conveyance man-made?
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑Dry Cow
❑ Farrow to Feeder
❑ Yes
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑Beef Brood Co
❑ No
Tur
❑ke s
❑ NE
Other
❑ Turkey Poults
Hg
Ngo
ME -30 ther
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
["No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
El Yes
[_1 No
__,.,,//
LANA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
D<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
[B'I!'A
❑ NE
is there evidence of a past discharge from any part of the operation?
❑ Yes
Hg
Ngo
El NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
E] Yes
ETNo
❑ NA
EINE
other than from a discharge?
12/28/04
Continued

14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E NNo
Facility Dumber: gz —, qcj Date of Inspection W2 --o-SE-0
[INE
15. Does the receiving crop and/or land application site need improvement?
Waste Collection & Treatment
ER No
,��,�/
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[1 Yes
I� No ElNA ElNE
a. If yes, is waste level into the structural freeboard?
ElYes
Eo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 4-15 1
❑ NE
18. Is there a lack of properly operating waste application equipment?
Spillway?:
RN.
❑ NA
Designed Freeboard (in): J
Observed Freeboard (in): 10
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[3 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
06 ❑ 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
2<o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
LJ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
El Yes
[BNo [:1 NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
.❑ Yes
��
E o ❑ NA ❑ NE
mai ntenance/improvement?
It. is there evidence of incorrect application? 1 f yes, check the appropriate box below.
❑ Yes
L'J No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn,
etc.)
❑ PAN ❑ PAN > 10% or 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) 13e* -x t Kjc.,r (#4!2 S+&r, t l r: i ,.! ttJ S .) C�•'r itJ - W tltr
_ ,8
eA,?_j a -
13. Soil type(s) 6ULB
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E NNo
[:1NA
[INE
15. Does the receiving crop and/or land application site need improvement?
ElYes
ER No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
2,."'No
El NA
El NE
17. Does the facility lack adequate acreage for land application?
ElD Yes
o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
RN.
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answersand/or any recommendations or any other comments_
Use drawings of facility,46 better explain situations {use addittonalpages as necessary) j
_!� d,
Name , r te= Phone: j'.�3. 33�
Reviewer/Inspector
r
Reviewer/Inspector Signature: Date:
12/28/04 Continued

Facility Number: 82 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes B<o ❑ NA ❑ NE
20. Does the facility fail to have ail components of the CAWMP readily available? If yes, check ❑ Yes [�J< ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 2'110 ❑ 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? El Yes ,L`_7 No El NA El NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes [� ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes
1..4°No
❑ NA
❑ NE
❑ Yes
EiKo
❑ NA
❑ NE
❑ Yes
B -No
El NA
El NE
❑ Yes
El<o
❑ NA
❑ NE
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
(Additional Comments and/or Drawings:
❑ Yes
[2 o
❑ NA
❑ NE
❑ Yes
Mi io
❑ NA
❑ NE
❑ Yes
2N"o
❑ NA
❑ NE
❑ Yes
D— o
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104

- �Utvision of Water Quality
'Facility Number 72-9 Division of Soil and Water Conservation
Lether Agencv
Type of Visit 016ompliance 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: /�-p$- p$ Arrival Time: /Z: $' Departure Time: Off ; �O ,,� County: AWSOti/ Region:
Farm Name: k/,44 F�r�,.-- Owner Email: 'T
Owner Name: c2t, V I uct Phone:
Mailing Address:
Physical Address:
Facility Contact: lretlr Moa* �_ Title: !rot_ I Phone No:
Onsite Representative: G r�-t-��y' t— Integrator: tr to q Bkrwa
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [=O [=6 =44 Longitude: [� o [= g =66
t
Design Current Design Current
Design Furrent
Sw�e
Capacity PopulationWet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
JE1 Layer
❑ Dai Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
Feeder to Finish
Dairy Heifer
❑ Farrow to Weanper,
Poultry
❑ Cow
❑ Farrow to Feeder
- `' "
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
:: El Pullets
❑Beef Brood Co
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
„F aA ❑Turkeys
No
ElL�
Other
�, w :< ❑ Turkey Poults
2. Is there evidence of a past discharge from any part of the operation?
❑ Other
❑Other
Number of Structures:
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Discharges & Stream lm acts
1. Is any discharge observed from any part of the operation`?
❑ Yes
�,�
L71�fo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
"
L�����A
El NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
F-1Yes
El No
9<
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
El Yes
No
ElL�
,
<
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[<o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
3 o
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

Facility Number: 2 — 2-1
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2
Identifier:
Spillway?: A10
Designed Freeboard (in): I !
Observed Freeboard (in): S
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 B'90 ❑�
❑ Yes B'go ❑ 1
Structure 5 Struci
❑ Yes L'_TNo ❑ NA ►
❑ Yes 10 ❑ NA
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWt
7. Do any of the structures need maintenance or improvement? ❑ Yes EMo ❑ NA ❑ l
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes B Ido [I NA ❑ N.
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require E]Yes 2<o—[:INA EINE
maintenance or improvement?
Waste Application ,--,�
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes 2 o ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
❑^1Qo ❑ 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 �1�•ta�� G awl �,S-.�tl�esc.i"—BCG�•/S
13.
1
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
El NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement? El yes
,[�'1vo
L��,' oo El NA
El NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
[3 oo ❑ NA
El NE
17.
Does the facility lack adequate acreage for land application? El Yes
D4vo ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
�10 ❑ NA
[:1 NE
Reviewer/Inspector Namej�j �, e �f S Phone: 910. tj33 • ��'
Reviewer/Inspector Signature: Date:
Page 2 of 3 ]2/28/04 Continued

Facility Number: '1Z —Z-�]J'f Date of Inspection
Required Records & Documents �
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E1Vo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes BNo [:INA ❑NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design g El Maps [:1 Other ��
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes L7 1No ❑ 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 D o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes e'lqo ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes O'TVo ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑'lqo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
MrNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
L?1Go
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ET<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?
❑ Yes
9 -moo
❑ 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
U-110
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
El yes
,�_ ��
Ngo
El NA
❑ NE
33. Does facility require a follow-up visit by same agency?
[:1 Yes
,LZ,
vivo
❑ NA
❑ NE
Page 3 of 3 12/28/04

Division of Water Quality
r Facility Number --� O Division of Soil and Water Conservation jc, Ica
Q Other Agency n A 11
Type of Visit `compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 9111outine 0 Complaint O Follow up 0 Referral O EmergencyA Other ❑ Denied Access
Date of Visit: -1 Oi Arrival Time:Departure Time: ® County. Region:
`
V'A
Farm Name: • ^ �. i -OL rV111 Owner Email:
Owner Name: ' L 4 Yl Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Operator Certification Number: 7U
Back-up Certification Number:
Latitude: [=O =' Longitude: =o ❑ ` = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
_ ❑ Non -Layer
Dry Poultry
❑ Lavers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Pou its
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design .Current
Cattle Capacity Popula.fion :.
❑ Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow s
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: 71'
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 W,No ❑ NA ❑ NE
❑ Yes
❑ NoNA
[INE
❑ Yes
❑ No
NA
❑ NE
❑ No A�PNA
❑ NE
❑ Yes
❑ Yes
;4No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
12/28/04 Continued

Facility Number: �. ,� Date of Inspection �] V
Crop type(s) UA
C-10-015, j
Waste Collection & Treatment
13.
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 MNo
[--INA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Does the receiving crop and/or land application site need improvement'?
❑ Yes %No
Spillway?:
❑ NE
16.
Desigmed Freeboard (in):
❑ NA
❑ NE
Observed Freeboard (in):
Does the facility lack adequate acreage for land application?
❑ Yes KNo
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ YesNo
ElNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
❑ Yes kNo
❑ NA
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes A No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes JU 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 4 No
❑ NA ❑ NE
maintenance or improvement?
Waste Avolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
El [j NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes �&o
ElNA ElNE
ElExcessive Ponding ❑ Hydraulic Overload ElFrozen Ground ElHeavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or ] 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) UA
C-10-015, j
13.
Soil type(s) p
14.
Do the receiving crops differ froJ those designated in the CAWMP?
❑ Yes WNo
❑ 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 )kNo
❑ 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 kNo
❑ 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):
Reviewer/inspector Name C—BRIA�M m Phone: Li 10 11+63 339
Reviewer/Inspector Signature:Czkjl.,�_Date:
12/28/04 Continued

Facility Number:%za Mel Date of inspection
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 ❑ Design El Maps El Other
❑ Yes No ❑ NA ❑ NE
❑ Yes [ANo ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes _�bNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
4 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
ANA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
;RjN0
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26_
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
ANA
EINE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
-*o
ElNA
[:1NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElYes
Jb'No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
4 rl �"', Lie 'r o wt)- tc C '-, IDZU a4_e 4z Y10- t Y
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
RNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3l.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[kNo
❑ 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
-IKLNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
Yes
❑ No
❑ NA
❑ NE
Yi..
Additional Comments.and/or Drawings:
4-o
k_s_�
do Vcss u r . 1 esj-.�C erg i moved 00`.
No d : �Cj1Q5 at c&__�'4rs n-e_a.an . Q.reA rs (oardz red 6�-y
Sf ra_�'cl j_ 6-0-w Crv) 5a-+y.z- Erle- o S � Cj J n?
G { e" cc,1 : i,kd Lk lei rr -b tr""' &;yl�eP
d9ji2 n S t-, `7e 6h_SW e, So_ n W i 1 1 ! L�] i �� • ►.
4 rl �"', Lie 'r o wt)- tc C '-, IDZU a4_e 4z Y10- t Y
T
Page 3 of 3 12/28/04

Type of Visit G'Gromplia Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine © Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:d Arrival Time:
+1 Departure Time: 'I County:
Farm Name: i -t. ' R� ar Y�'"� Owner Email:
Owner Name: Phone -
Mailing Address:
Physical Address: n
Facilitv Contact: C, 'r � �f �— Title• 1 'eJ1
Onsite Representative: mmfC
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Region:
Operator Certification Number: I
Back-up Certification Number:
Location of Farm: Latitude: = o = I = `+ Longitude: =0=d = ,&
Swine
❑ Wean to Finish
❑ Wean to Feeder
Design Current
Capacity Population Wet Poultry
❑ La er
on—Layer
Design Current
Capacity Popula ik'
Cattle
❑Dai Cow
❑Dai Calf
Design Current
Capacity Papulation
Feeder to Finish3
Y $
'"M1
a{� ,
❑ Dai Heifer
El Farrow to Wean
❑ NE
❑ Yes
❑ Cow
❑ Yes
❑ Farrow to Feeder:
P ,
❑ Layers
❑ NE
❑ Non -Dairy
[9, o
❑ Farrow to Finish
❑ NE
❑ Beef Stocker
❑ Gilts
ElNon-Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
Other
M ElTurkeys
[] Turkey Poults
_
w.
❑ Other
�❑ Other
Number o#Structures:
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?
Page l of 3
❑ Yes 1!d'No ❑ NA ❑ NE
❑ Yes
❑ No
El NE
❑ Yes
❑ No
�9,'&A
E NA
❑ NE
❑' A
❑ NE
❑ Yes
No
❑ Yes
,❑
L?No
❑ NA
❑ NE
❑ Yes
[9, o
❑ NA
❑ NE
12/28/04 Continued

Facility Number: Zq Date of Inspection
.Waste tollection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes
_,
b�'No
[] El NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
El No
_NS,�A
L_ ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
1
Designed Freeboard (in):
�I
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ao
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
El Yes
,,_,
P110
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental) thereat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
9' o
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
62'No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
El Yes
�,�
Lld No
❑ NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�,
Lid'lvo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
Yes
11P
,_ ,/
' o
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > ]0% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift El Application Outside of Area
12. Crop type(s)G /1 "V &, n t
13. Soil type(s) LJ4,, A 0 , �Q
14. Do the receiving crops differ from those designated in the CAWMP?
El Yes
/�'
N(No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
B o
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
ErNo
[:1 NA ❑ NE
17. Does the facility lack adequate acreage for land application?
11 Yes
E3'No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
2"'N.
❑ NA ❑ NE
4V /U'Uj A:-' 6a- V . f V" l(6'?,"
— pt."pt."; ve-
ria �n ta�U
Reviewer/Inspector Name � 7 iu� ' F�' �(JI � Picone: to f /,3,3 3.3 cx)
Reviewer/inspector Signature: Date: �%(10
Page 2 of 3 1212 /04 Continued

Facility Number: Date of Inspection
Required Records & Documents �
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ElE Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes B o ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q/o ❑ 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
9&o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
I✓J No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
01
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[? o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�o
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
El No
,.❑NA
E_,//A
❑ NE
Other Issues
28_
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
'L! No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
LjNo
❑ 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
OJ 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
2No
❑ 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
12/N
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
L7 No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12/28104

• Facility No. , - _ Time In,,� Time Out Date r
Farm Name yl�,(' Fafry,Integrator d
Owner
Operator
Back-up
COC
Site Rep
No. r
M
Circle: General or (N"
Design Current Design Current
Wean - Feed Farrow - Feed
We - Farrow - Finish
Gilts 1 Boars
Farrow - Wean Others
FREEBOARD: Design
Sludge Survey
Crop Yield
Observed /
Calibration/GPM ✓ 1 ,21 S
Waste Transfers
Rain Gauge Rain Breaker
Soil Test ✓ PLAT 1121y7'XIe41-1 Wettable Acres
Weekly Freeboard Daily Rainfall 1 -in Inspections
Spray/Freeboard Drop yY10'
Weather Codes 120 min Inspections
Waste Analysis:
Date Nitrogen (N)
D,Q .f:�
alp a.cl
Date Nitrogen (N)
C� - —
Pull/Field Soil Crop
Pan
Window
`2- urs
Q -T
3
1 — 9 0
�.�� �•
3 Y
, �-
2 1
— C,
• 9.�
3.A
w
�

A
p ® Division of Water Quality A. r
Factihty,�Turlrtber g a a y O Division of Soil and Water Conservation
_J Q Other Agenc s
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: IrP -/s,- OS Arrival "lime: f p' Departure'rime: County: t og�1�_ Region: !�U
Farm Name: +yIC� %(� �li/ m Owner Email:
New. r
Owner Name: Phone: Cf/d_ , —CIO
Mailing Address: 3'a(a /�L Sw]-G_ `�S C�.�_1_NG ? 8.3.Fe
Physical Address:
Facility Contact: Qta�If.',�g Title:_
Onsite Representative:%_,_.er_t,�r!5%%!/—T�jynrS%f�artC�en
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Cott
p Phone No: '//-Q-
Integrator:
/_Q-Integrator:
Operator Certification Number: L 7"*
Back-up Certification Number:
Latitude: ❑ ❑ ❑ Longitude: ❑ ❑ ❑
Design Current Design current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish ❑ Laver
❑ Wean to Feeder IE] Non -Laver
[ eeder to Finish 499(o j3tqa
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑
Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observcd from any part of the operation'?
Discharge ori,inated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current
Cattle Capacity Population
❑ Daia Cow
❑ Daia Calf
❑ Daia Heifer
❑ Dry Cow `
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ❑
d. Does discharge bypass the kNaste management system`? (Ifycs, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes P<o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
EINE
El Yes
❑No
El NA
❑NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
2—No
[:INA
❑ NE
❑ Yes
['Vo
❑ NA
❑ NF_
12/28/04 Continued

Facility Number: $.� Date of Inspection ,-/S 'a s•
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 [2No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i
Spillway?: I h
Designed Freeboard (in): _ / 1 ry
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [fNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes 2No ❑ 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 2No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
allo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[3'No
❑ 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
[R'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 Gyp Window ❑ Evidence of Wind Drift ❑ Application Outside of
Area
t V `/� `' `•
9a
12. Crop type(s) j6e,,r„.,r✓a
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
❑ Yes
2-&6
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Eno
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
0,&o
❑ NA ❑ NE
Pre.lrwer A'S Plfiynjh? T. I/IS/7N! I nelee j rdfMAl / �Oe &A4/ o'!
c0,,4u4e ,-a, a Herr,.,
Reviewer/inspector Name Ufa %( Phone: 710—"tA-TV e,f 730
Reviewer/Inspector Signature: Date: -2-p,-=off
12/28/04 Continued

1
1 '
Facility Number: $a —)q9 date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 20 ❑ NA ❑ NE
20. Does the facility fail to have all components of -the CAWMP readily available'? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropirate box. [1>41P ❑Checklists ❑ De
n ❑ ❑ gul ter
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ W pplication ❑ W e Darn ❑ W nalysis El So ysis ❑ W ❑ Annual Certification
❑ P,, I ❑die ffig ❑ C je d [:11 22 M ions ❑ Monthly a nspections ❑ W o e
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal'?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes. contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge. freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
�o
❑ NA
❑ NE
❑ Yes
Q'No
❑ NA
❑ NE
❑ Yes
[3`No
❑ NA
❑ NE
❑ Yes
["to
❑ NA
❑ NE
❑ Yes
ONo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
L2<
❑ Yes ONo ❑ NA ❑ NE
❑ Yes O"No ❑ NA ❑ NE
❑ Yes [ZNo ❑ NA ❑ NE
❑ Yes 9No ❑ NA ❑ NE
❑ Yes
RfNo
❑ NA
❑ NE
❑ Yes
ZNo
❑ NA
❑ NE
Additional. Comments and/or Drawings:' r`
L ;-ne rf vla,mEel l�'e /��rGi W�tr1 w 'T�Afr ff��ts.
I IeGSC COHdri1f/e fG G✓Orle
5 S .r aoJ rots fa e,71-
�fea erns.',,.
5 9
IN
12/28/04

(Type of Visit (y tCompliance Inspection O Operation Review O Lagoon Evaluation I
for Visit 000udine O Complaint O Follow up O Emergency Notification O Other [) Denied Access
Facility Number a Date of Visit: - O D Tune: S
0 NotOperational O Below Threshold
[31�ermitted Etl6erdfied 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ........... ....�.....
Farm Name.
.-p•----./.....................................................................I------- County: .. ._.__ ..... ..._... ....__.........
99
Owner Name: ........ .1!''.........._..... !�_�. Phone No: 59 as
Mailing Address: _ �.iLl ..... Mix - 91J. S w +
Facility Contact: 3. r"W ------ Title: Own, !�..._. Phone No:
Onsite Representative:.._ _. .. Integrator•,,,,
Certified Operator: •.............,, K � Operator Certification Number•
Location of Farm:
wine ❑ Pouttry ❑ Cattle ❑ Horse Latitude ' 4 && Longitude ' 6 t4
Discharges & Stream I_ mnacts
I _ Is any discharge observed from any part of the operation?
❑ Yes [>�To
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) 0 Yes ❑ No
c. If discharge is observed, what is the estimated flow in gallmin?
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 E(No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 9<0
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [+/No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:......................................................... .....-•••... ........ ...............
Freeboard (inches): 3.5"
12112103 Continued

FacilityNumber: iga — :.
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancerimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Appcation
10. Are there any buffers that need maintenanceltmprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type ( _rA&g, c j (_ ,p ?4 , bew5 . /'Tj 10 , No%kl f /t*4:, t
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14, a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes [y11;0
❑ Yes Mo
❑ Yes [s"No
❑ Yes [91l! 0
El Yes Q'1�10
❑ Yes ['No
❑ Yes jR�lo
❑ Yes B140
❑ Yes Bolo
❑ Yes MIN,
❑ Yes [v]'No
❑ Yes MrNo
❑ Yes 2fTo
❑ Yes Eq No
❑ Yes ETNo
❑ Yes [Rio
❑ Yes E914o
Coiaments (refer to q�eshnn #} E�lain siry�YFS_answe;s and/or arry ns or iiln otirei comments..:_
:Use drawrags of faetlitl► to benetr rxp'lYaun situah.�anss( txonal pages as wry} r geld Copy ❑ Ftnal Notes
si��Gr� 4�ss at ���► �-k
A.
1
A.
:o":eer/Inspector Name ,
er/inspector Signature: Date:
12112/03 1
Continued

Facility Number: �, — 4 Date of Inspection / D
Required Records & Documents
21. Fail to have Certificate of Coverage &. General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ 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?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
3I . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes dNo
❑ Yes B No
❑ Yes B'No
❑ Yes Q'fio
❑ Yes Q No
❑ Yes Bl� io
❑ Yes [3-90
❑ Yes Eo
❑ Yes 31<0
[9Yes ❑ No
❑ Yes [Kio
❑ Yes [�Ko
❑ Yes B'NO
❑ Yes O No
❑ Yes 2110
--
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit-
isit.
0
dd�L�ona1 Comments°and/or°Drawings
D
AO -t SIW4
-5vn
�AV-,
k4 4r
CL-T'
12112103

Site Requites Immediate Ate.'
F=Bhy No. SZ
DIVISION OF ENVIRONR+EMAL MANAGEMUff
ANWAL FEEDLOT OPERATIONS SITE VLSITA71ON RECORD
DA'T'E: August 2 1995 -
ifA1C: I 1.00
Farm Nom:K - K is iC
vas7ing Awress' �. ( a i -MIR
�y:_-';*=San
T
in �lp�:�Muh anvil Fa plm: 49]0) 7RQ-2110
Ot Site Ropre3etltadve: Dewey Carter, Munhy Farms -_ PbMe: (91Q) %70-I Aa7
Physical Afte sfUmdw -J fi
Type of Operation: Swire g Poultry .� Cattle
Design Capacity: I' AM (0 Number of Animals on Site:
DEM Certification Number: ACE- DEM Certification Number: ACNEW
Ltitude:_SA. • S2' R5" Longitude:l$ • ti, •_•
Circle Ya or No
Dees the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 how storm evert
(approximately 1 Foot + 7 inches) ( or No Actual Freeboard: %`-.Jk finches
Was any seepage observed from the lagoon(s)? Yea or No Was any erosion observed? Yes orweepage Not
Is.adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No Evaluated
Crop(s) being utilized:
Does tM facility meet SCS minimum setback criteria? 200 Feet from Dwellin & 4@ or No
100 Feet from Wells? or
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Scram? Yes or;
Is animal waste land applied or spray irrigated within 25 Fee of a USGS Map Blue Line: Ya or No No valuated
Is animal waste discharged into water of the state by man-made ditch, flushing system, or4dw
sinu'lar man-made devices? Yes oKq If Yes, Please Explain.
Does the fatuity maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No Not Evaluated
Additional CMMCltd:, this was a very breif inspection, a _more thorough inspection will b_r.__
conducted in the future.
11aformition
if you have smentions Xtgarding this jeporY_Rleajje cnntac_r�Paui Ravi a_ flrm water Q at "—
Section 8 [phone].
_4l} -ase rmitact nmshould any .landirlans arise that Vaqp _lmminpnr„daapor rn A=far'&
This fA= "s not, locatod on gag Topn map to Aerl�=4:00 "Allitsn
"Z�- 1 ZIL_ - __ -
Inspectat Nance Si jnt MM
= FwMty Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No. ra aq
DIVISION OF ENVIRONMENTAL MANAGFNIF.NT
ANDMIAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: August 2 , 1995
Time: IG 06
Farm NaMlO ner: 3nc_„ *- 13_ai ,;n k;ra 133'- KBR
Mailing Address: �ra 3anx C.kt­,Vs� TAC, %28 010) SU -1"119•—�
Integrator. Murphy Family Farms Phone: 1-910) 7RQ_9119
On Site Representative: Dewey Carter, MurRhy Farm&_ Phone: 191 n) sgs-i AR7
Physical Addresyl ocation:
Type of Operation: Swine -2— Poultry Cattle
Design capacity: -W 4 (g, Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: R.4 ` S8' _ta" Longitude:2-8 8 -
Circle Yes or No
Does the: Animal Waste Lagoon have sufficient frveborard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) (&or No Actual Freeboard: _% 11Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or(&)eePage Not
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No £Valuated
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwain s'r � or No
W
100 Feet from Wells? or o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No Noivaluated
Is animal waste discharged into water of the state by man-made ditch, flushing system, or -other
similar man-made devices? Yes o' o If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No Not Evaluated
Additional Comments: This was a very breif inspection, a more thorough inspection will b
conducted in the future.
Information noted on_thi,&insnection was_Qbtainpd fr= Mr - D_ eweX_C:artPr_
If you have guest ions rggardjng this report please contact Paul Rawl, DEM Warpr Y
Section @ [phone].
This farm was nor 1 nnnrPd on a USGR TOPQ_ map to derermine "Aline Mnp" eta ma_
"�Z� 1 Q'j�g
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.