820329_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

I %A 1 f n n A
I a ri
Type of Visit: Q Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit: �_ `R/outine Q Complaint Q Follow-up 0 Referral 0 Emergency O Other O Denied Access
Date of Visit: I e Arrival Time: Departure Time: (��',5 . County: �'1t Region•
l`�
Farm Name: _ Dar -e,/C r« twt /- g Owner Email:
Owner Name: �,ti.� V i� �/'� -,-, Phone:
Mailing Address:
Physical Address:
Facility Contact: C4 A 1 3 il4,k-,ft; tC Title: Phone:
Onsite Representative: 1� Integrator: P I -r4
Certified Operator: [ ��`a.Y`!� Certification Number:'
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application f=ield ❑ Other:
❑ Yes ED_>_ --E] NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No E3 -NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DW R) ❑ Yes ❑ No ENA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes [ -f4o ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes EINo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued
Design Current
Design
Curreat
Design Current
Swine
Capacity Pop.
Wek Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
I I Layer
I
IDairyCow
Wean to Feeder
I JNon-Layer
I
Dairy Calf
Feeder to Finish
. 2so v
Dairy Heifer
Farrow to Wean
Design
Current
—DryCow
Farrow to Feeder
D . I;oul
Ca aci
P,o
Non -Dairy
Farrow to Finish
I Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
I Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application f=ield ❑ Other:
❑ Yes ED_>_ --E] NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No E3 -NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DW R) ❑ Yes ❑ No ENA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes [ -f4o ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes EINo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

I
lFacility Number: fl)", - Date of Inspection: &40 //-,o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [G] -I D NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No � ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 v 39
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [ 160 ❑ 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 ❑ 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
[ZkNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
r0' o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ Yes
[21,4o
❑ NA
❑ NE
9. Does any part of the waste management system other than the waste structures require
❑ Yes
Q ­No
❑ NA
❑ NE
maintenance or improvement?
❑ Yes
[]] No
❑ NA
❑ NE
Waste Application
❑ Yes
dNo
❑ NA
❑ NE
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ffNo
❑ NA
❑ NE
maintenance or improvement?
❑ Yes
[ "No
❑ NA
❑ NE
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 p 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
c0
12. Crop Type(s): Ca-wC eLdert E /3 i
13. Soil Type(s): 6L)'. N" G V
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
EfNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[9-<o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[21,4o
❑ NA
❑ NE
acres determination?
IT 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
dNo
❑ 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
DNo
❑ 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 ETNo
❑NA [:3 NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
DNA ❑NE
Page 2 of 3 2/4/2015 Continued

Facili Number; - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0>c, ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Eg-<__ ❑ 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 fust survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ YesN/o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ©'No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface 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?
O Yes [3'9—o 0 NA ❑ NE
❑ Yes Q'llo ❑ NA ❑ NE
❑ Yes [:J'No ❑ NA ❑ NE
❑ Yes El"No ❑ NA ❑ NE
❑ Yes [] No
❑ Yes [No
❑ Yes dNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question-# reXxplain any YES answers and/or,any add�honalsrecommendahons or°any other correii encs. r
Use drawings'ofacilrtyto,be re expfa n situations.,{u additional pagesas necessary)
-C� lml t V'' ' l`' - �_s �
Reviewer/Inspector Name: �J t
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:" �L' •�`i.� l
2/4 Ol5

—
� �� „ya pau 'K-0. �rc.5� P i. ,. / a _ti -,c wv'li=� 4 �� _,4 s eF .::' � b �m ��� '� ^�.;•.'� j '���, "y —
.rF
r
ypeofVisit: ompliance Inspection Operation Review O Structure Evaluation O Technical Assistance
eason for Visit: QrRoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time:County: r
Farm Name: ^ Z)a tl 4&1r_4 If A^5 Owner Email:
Owner
Owner Name: lA w�k�_ `rtat+� Phone:
Mailing Address:
Physical Address:
Facility Contact: 1� garcvTitle:
Onsite Representative:
Certified Operator: G`ti
Back-up Operator:
Phone:
Region:
Integrator: e{`r5
Certification Number: !
Certification Number:
Location of Farm: Latitude: Longitude:
Discharees and Stream ImnaCts
1. Is any discharge observed from any part of the operation?
❑ Yes]
.
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Dest n Current
g
Destgn Current
117
Design Current
S
Ca act Pa
ty,�: p•.....
W.et Poult Ca act Po
,�•y _ P _ tY. P•
Cattle C+a aei Po
�
Wean to Finish
❑ Yes
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
❑ Yes
-
Dairy Heifer
Farrow to Wean
❑ Yes
, Design Current
Dt. Po_ult - Caacit" a P,o
Layers
Dry Cow
Non -Dairy
Beef Stocker
Farrow to Feeder
Farrow to Finish
Gilts
❑ NE
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
mill,
ivt�r . ...
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream ImnaCts
1. Is any discharge observed from any part of the operation?
❑ Yes]
NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
[:]No [9 -NA
❑ NE
b. Did the discharge reach waters of the State'? (If yes, notify DWR)
❑ Yes
❑ No ETNA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
C24(o EgINA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
' ❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Dumber: Date of inspection: TP
❑ Yes
No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
[ "No
❑ NA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
s o
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[EH6
❑ NE
Structure 1 Structure 2 Structure; 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
Spillway?:
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[j� No
❑ NA
Designed Freeboard (in):
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'?
❑ Yes
@�!rNo
❑ NA
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[Z,,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
[3'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[i]'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
dNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[fNo
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes Ea"No DNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload p 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): ey 6 G v Ct;v$
13, Soil Type(s): �fj� /Va cc,
14. Do the receiving crops diger from those designated in the CAWMP? ❑ Yes ETNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [ffNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes [R -No ❑ NA ❑ NE
❑ Yes [�No ❑ NA ❑ NE
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 El Checklists ❑ Design [—]Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[3No
❑ 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
[j� No
❑ NA
❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'?
❑ Yes
@�!rNo
❑ NA
❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: g Date of Inspection: d
24., Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q.tclo
25aIs the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes D o
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes �lo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 2-1&0
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA .0 N
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
E2No
❑ 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
dNo
❑ 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 the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[.allo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[:]Yes
ETNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
ff No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
[:]Yes
VErNo
❑ NA
❑ NE
Comments (refer to question Explain an . ,answers and/or an additional recommeadattons or,an pother com menu:
9 )• � y�
n .4 . / y . YT •ommili • 3' r
_.._,
• _ .
Use drawin¢s 6flfacility to better:ewlain sittiations..[nse,addEhonal napes as necessarsvi-
r.
ter,
CrO %0 -,309:f -sr
Reviewer/Inspector Name: a Z 0 464 Phone: D,3D$' 661
Reviewer/Inspector Signature: c Date:9(6—q33 333
Page 3 of 3 21412015

- a
vis �5
(Type of Visit: {Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emersencv O Other 0 Denied Access
Date of Visit:�j�, Arrival Time: Departure Time: County:
Farm Name: 1✓lL�l 'vraJw�� Owner Email:
Owner Name: A46 C q4' . af/`+ fx_ Phone:
u�
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Phone:
Region:
Integrator: tyre,
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Im�actsand Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes [&Nl r— ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No �A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [] Yes [] No A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes BNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [�No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2014 Continued
Design Current
Design Current
Design Current
Swine
Capacity .Pop.
Wet Poultry
Capacity Pop.
Cattle Capacity Pop.
Wean to Finish
I
I Dairy Cow
Wean to Feeder
-Layer
A
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
D . P,ou1
Ca "aci Pio
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Im�actsand Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes [&Nl r— ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No �A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [] Yes [] No A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes BNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes [�No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2014 Continued

• 1~acili Number: 67:7-73- jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): Y t%
5. Are there any immediate threats to the integrity of any off the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ NA ❑ NE
❑No [ lJ r❑NE
Structure 6
❑ Yes EEK ❑ NA ❑ NE
❑ YesNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
[:]Yes
�o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Io
❑ NA
D NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
[:]Yes
�o
❑ NA
❑ NE
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
E<No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ONIO000
❑ 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 Windown ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 0 ect4" c5.6 0 C [,E
13. Soil Type(s): W'l, D
14. Do the receiving crops differ from those designated in the CAWMP? []Yes g -No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Ea'fio ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [aXo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[]Yes
[3No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[go<o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
�o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[—]Yes
<o
❑ 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 [3To
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ff��FNO o
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 2/4/2014 Continued

acility Number: Arok - Date of Inspection: y
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes O'iJo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes Eer<o
the appropriate box(es) below.
Failure to complete annual sludge survey Failure to develop a POA for sludge levels
E] 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 hio
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes hlo
F]NA [:]NE
F]NA EjNE
NA [] NE
NA NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
C] Yes
O/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
dNo 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
E!rNo ❑ 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
dNo E] NA NE
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
ZNo ❑ NA NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[?rNo E] NA C] NE
34. Does the facility require a follow-up visit by the same agency?
E] Yes
E�No ❑ NA ❑ NE
Comments (refer. to question ft Explain any YES answers and/or any additional recommendations or any other comments
Use drawings of facility to better explain situations (use additional`' pages as necessary) " __
� Z 4• 3.� f -�S
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 43 Las 3
Date:
11
2/4/2014

W
(Type of Visit: 45rCom Hance 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: Krrival Time: ""o Departure Time: County:
Farm Name: b.,' ' V_Aj Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: CCW Title:
Onsite Representative:
Certified Operator: 4 4 -u L
Region: Pso
Phone:
Integrator: Prla4l9v
Certification Number: f 3 +fi"'
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Discharges and Stream Im�actsand Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes E3-150— ❑ NA ❑ NE
[:]Yes
❑No
=A
❑ NE
❑ Yes
❑ No
Desiga Current
❑ NE
[:]Yes
Design Current
e
Capacity Pop.
MDEesR'j'nCurrent
Wet Pouty
a Pop.
Cattle Capacity P.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -Layer
Dai Calf
Feeder to Finish
Dai Heifer
D Cow
Farrow to Wean DesignCur'rent
Farrow to Feeder
D , P,oul
:.
Ca aci Po
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
--
r
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Im�actsand Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes E3-150— ❑ NA ❑ NE
[:]Yes
❑No
=A
❑ NE
❑ Yes
❑ No
[:j'NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any pan 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
[D<A
❑ NE
❑ Yes
e No
❑ NA
❑ NE
[:]Yes
2-N—o
[DNA
❑ NE
Page 1 of 3 2/4/2011 Continued

Facility Number: - Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [9-No—O NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:]Yes [] No � ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
❑ NA
Identifier:
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ l o
❑ NA
Spillway?:
acres determination?
Designed Freeboard (in):
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ iT9
❑ NA
Observed Freeboard (in): /27 -
18. is there a lack of properly operating waste application equipment'?
❑ Yes
�Xo
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[Zlo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[Z�No
[] NA
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[3.Aio
❑ NA
0 NE
waste management or closure plan?
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
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
S. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
❑ale-
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
[] Yes
[]�'No
❑ NA
❑ NE
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[-Qo
❑ NA
❑ NE
maintenance or improvement?
2/412014 Continued
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[lr`o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes [3No ❑ 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 pp❑ Application Outside of Approved Area
12. Crop Type(s):"�`
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes EJ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑0Ro
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ l o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ iT9
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment'?
❑ Yes
�Xo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[ FNo
❑ 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 ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[ 'No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections.
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[] Yes
[]�'No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[�No
❑ NA
❑ NE
Page 2 of 3
2/412014 Continued

Facility Number: - Date of Inspection: h7#0k 7:1
24. bid the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes Cg.W- ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes [g44o ❑ 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 -Ka ❑ 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 [ZLjbIer ❑ 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 10 ❑ 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 [D -I o' ❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes NA
❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes QKc ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes d' o ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes Wo ❑ NA
❑ NE
Comments (refer to a '
ft Explain any YES answers and/or any add`tional recommendations oranyott ercomi<uents
Use drawings of facility to better explain situatig s (use additional ges asuestion
neeessary)
0-3-5- l ~ 1
Z 0-39
Reviewer/Inspector Name: b41VjAV
Phone:
Reviewer/Inspector Signature:
Date: 5
Page 3 of 3
21411011

wk S'
Type of Visit: CTCompliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: (2 Routine 0 Complaint 0 Fallow -up 0 Referral Q Emergency 0 Other 0 Denied Access
Date of Visit:rrival Time: Departure Time: County: Region:
Farm Name:
Owner Name
Mailing Address:
Physical Address:
UJ'.'4 Owner Email:
Phone:
Facility Contact: �j ,J�. r � a_ j/Title: Phone:
41
Onsite Representative: l Integrator: S .-2
677jC
Certified Operator: Certification Number:
4,Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes io ❑ NA ❑ NE
❑ Yes [:]No [�- A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Designs Curren#
n
Design Current;
Design Curren#
Swine
CapacityPop.
WetPoultry
Catyp
Cattle Capacity Pop.
Wean to Finish
❑ Yes
La er
NA
Dai Cow
Wean to Feeder
❑ Yes
on -Layer
❑ NA
Dai Calf
Feeder to Finish
-_
Dai Heifer
Farrow to Wean
[—]Yes
V
Wesign Gu n# :..
Cow
Farrow to Feeder
D , P.ouIt
Ca acY
Non -Dai
Farrow to Finish
La ers
Beef Stocker
Gilts
Nan -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
_
Turkex Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes io ❑ NA ❑ NE
❑ Yes [:]No [�- A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
Q 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
dNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[—]Yes
V
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili Number: - Date of Inspection.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. if yes, is waste level into the structural freeboard? ❑ Yes
Structure l 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.)
[l -Ko- ❑ NA ❑ NE
❑ No [T NA ❑ NE
Structure 5 Structure 6
❑ Yes III �Noo ❑ NE
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?
❑ Yes
eNo
❑ 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
2 0
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E3rN' o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
E(N o
❑ NA
❑ NE
acres determination?
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[301�o
❑ NA
❑ NE
maintenance or improvement?
�o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
Waste Application
wo
❑ NA
❑ NE
Required Records Documents
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[Z'No
❑ NA
❑ NE
maintenance or improvement?
[3,Ko-
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [rNo [DNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > t0% 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): &�) 9
13. Soil Type(s):
f
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
eNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[a'?qo
0 NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E(N o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?❑Yes
�o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
wo
❑ NA
❑ NE
Required Records Documents
_&
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[3,Ko-
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
[ "o
❑ 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 C3'�o
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22_ Did the facility fail to install and maintain a rain gauge? ❑ Yes dNo
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes Q�No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 2/412011 Continued

Facili Number: Date of Ins ection:
1< 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [Z[>o-- ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes �'Q_XA ❑ 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 l d'i"O ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑>6- ❑ 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?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑'No ❑ NA ❑ NE
❑ Yes 0?° ❑ NA ❑ NE
❑ Yes �o r ❑ NA ❑ NE
❑ Yes
Po
❑ NA
❑ NE
❑ Yes
L0'I"e
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ WE
Comments (refer to question ,#): ): Explain any YES answers and/or any additional recommendations or:anyFother comments
Use'draw nes of facility to tietter explain situations (use additional pages as necessary).
s(µ�y� 5 Vwy 3
Reviewer/Inspector Name:
- �O --' � 0 - 3,. X___
Reviewer/Inspector Signature: Date:
Page 3 of 3
I

+k
Date of Visit: —13 Arrival Time: Departure Time: i7 County: V_ Region: j�w G
Farm Name-_ ���YrL pQriy,
Owner Name:,j�Q �- V rt✓
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact:�j rl�► �j¢ rw +` Title: y� e- _ G , Phone:
PF
Onsite Representative: integrator: r a.
Certified Operator: �` j �,-� y ��,r�Y,t Certification Number: �( Ar3 70
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharses and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
[:]Yes Q . o ❑ NA ❑ NE
❑ Yes
Design Current
1111
Design
Current
Design Current
Swine
Capacity Pap.
Wet Pou1t'ry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
-Layer
Dai Calf
eeder to Finish
Dai Heifer
Farrow to Wean
Design
Current
Cow
Farrow to Feeder
D Eoultry .
' :Ca aci
P,o
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non-Laye
Beef Feeder
Boars
Pullets
Beef Brood Cow
ig
Turkeys
Other
TurkeyPoults
Other
Other
Discharses and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
[:]Yes Q . o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [:]No
[:]Yes 0 No
[:]Yes Eg-No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 2/4/2011 Continued

fFne—Wty Number: - 9' Date of Inspection: ��a
—
No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
Waste Collection & Treatment
No
[DNA ❑ NE
the appropriate box.
' 4, Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[:]Yes
ZI 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
❑ Weather Code
Identifier:
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
Spillway?:
❑ NA ❑ NE
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[. No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
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 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 pen-nit?
❑ Yes
M 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
[2�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): cs S -,� r� U-4-
13. Soil Type(s): LU Z & D $ , l, -a I-5
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [21� No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes P,No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes Q 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?
Required Records & Documents
❑Yes �No ❑ NA ❑ WE
❑ Yes No ❑ NA ❑ NE
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
[DNA ❑ 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
KNo
❑ 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
Q No
❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes 5�j.No ❑ NA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes (LNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 2 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 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?
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 Reviewerl nspector 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
DNA ❑ NE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes Q No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes Callo ❑ NA ❑ NE
❑ Yes
FO No
E] NA
❑ NE
❑ Yes
JEL No
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or:any other comments __
Use drawings of facility to better explain situations (use additional pales as necessary).
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone:()
Date: �
2/412011

Type of Visit: (°f 7outine
liance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance I
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Arrival Time:
Departure Time: :p nrl
County: SpN Region: - Rd
Farm Name: bo -W02 --m
�tlrRt'
Owner Email:
Capacity Pop.
Owner Name: 0&t4 Phone:
Mailing Address:
Physical Address:
Facility Contact: UjA{'"amCy' Title: Phone:
Onsite Representative: %*1 Am Q Integrator: P
Certified Operator: Anmk.e rt -�j �qr� Q� Certification Number: 1531©
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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 ffrNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
El NA ❑ NE
[DNA ❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) []Yes ❑No VNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes E f No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes (&No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued
Design C■urrent
Design
Current
Current
Capacity Pop.
VVet Poultry
Capacity
Pop.
gsign
Cattle pacity Pop.
Wean to Finish
MITLayer
Dai Caw
Wean to Feeder
al....
I
JNon-Layer
I
Dairy Calf
Feeder to Finish
5,,6 V yC9­67
Dai Keifer
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr, P,oultry
Ca ,acity
Po ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow-
owTurke
Turkeys
s
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes ffrNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
El NA ❑ NE
[DNA ❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) []Yes ❑No VNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes E f No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes (&No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �o DNA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑'�o ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): nn
Observed Freeboard (in): �al
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [gNo ❑ 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
[rNo
❑ NA
❑ NE
waste management or closure plan?
❑ Yes
Eno
❑ 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
[vrNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[E" io
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NA
❑ NE
the appropriate box.
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[Z No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[BNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes 2 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❑j Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): glt[n U0 A HA -I 1 S.Ci, b
^srr
13. Soil Type(s): I�c�� . N CJ3t1J. l� d zo
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 [TNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [2"No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[SEfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Eno
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
F -M
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
E2No
❑ 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 E] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes gNo
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 3 214/2011 Continued

r
Facili Number: �, - �'a Date of Inspection: LA y �
❑ Yes
Ej No
❑ NA
24. Did the facility fail to calibrate waste application equipment as required by the permit'?
❑ Yes
Cg"No
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
ff) No
❑ NA ❑ NE
the appropriate box(es) below.
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
❑ Failure to complete annual sludge survey ❑ Fai lure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
CEfNo
List structure(s) and date of first survey indicating non-compliance:
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
CErNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[:]No
[ffNA ❑ NE
Other Issues
❑ Yes
[B"No
❑ NA
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?
❑ NE
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
Ej 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
[yNo
❑ 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
CEfNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
[B"No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Et No
❑ NA
❑ NE
lComme€tts (refer to question #): Explain any °;YES answers':and/or any additional recommendationsy-oany otltmcornments.
UseArawinpas of facility to better explain situation .(use additional pages as necessary).:
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
2/4/2011

Type of Visit: ��7outine
' nee Inspection () Operation Review U Structure Evaluation O Technical Assistance
Reason for Visit: O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: LtL Departure Time: ® County:
Farm Name: ` _ rp Vs__13 n5 Owner Email:
Owner Name: "tAUA Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: (20..i`CiS L.X�VZ.�f� Title: Phone:
Onsite Representative: 04A_V S Integrator: " -1
Certified Operator: _ �c�r�eL Certification Number: Z23 r%()
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 02 T1oo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No 02'<A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Designs Current
Design Current
❑ NE
Swine Capacity' Pop.
Wet Poultry-�, Capacity . Pop.
Cattle Capacity Pop.
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
[:]Yes
❑ No
Wean to Finish
La er
Da' Cow
❑ Yes
Wean to Feeder
Layer
Da Calf
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Feeder to Finish
Farrow to Wean
Design... Current
Da' Heifer
D Cow
❑ NE
of the State other than from a discharge?
Farrow to Feeder
D , P,ault 4 Ca aci I;o ,
Non -Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Boars
Non -Layers
Pullets
Beef Feeder
Beef Brood Cow
Turkeys
Other a
TurkeyPoults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 02 T1oo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No 02'<A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[:)No
hlA
❑ 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
2<A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[�o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
E3090
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 2/4/2011 Continued

FaciliNumber: jDatcof Inspection-
Waste
ns ection:Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes dNo ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No [2'�4A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:V z
Spillway?:
❑ Yes Io
❑ NA
❑ NE
maintenance or improvement?
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes
[D'o
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
/'
❑ Yes E3'No
❑ NA
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[D-Iqo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes Io
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy
6. Are there structures on-site which are not properly addressed and/or managed through a
❑ Yes
[✓r No
❑ NA
❑ NE
waste management or closure plan?
❑ Outside of Acceptable Crop Window ❑ Evi ence of Wind Drift ❑ Application Outside of Approved Area
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
l2. Crop Type(s): .S , C 0 ,
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
�lo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
]o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ Yes 5-1.4
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
9. Does any pan of the waste management system other than the waste structures require
❑ Yes Io
❑ NA
❑ NE
maintenance or improvement?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[D'o
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
/'
❑ Yes E3'No
❑ NA
❑ NE
maintenance or improvement?
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
11. is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes Io
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy
Metals (Cu, Zn, etc.)
No
❑ NA
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Waste Transfers
❑ Outside of Acceptable Crop Window ❑ Evi ence of Wind Drift ❑ Application Outside of Approved Area
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
l2. Crop Type(s): .S , C 0 ,
CcM^-S W.�
[:]Yes
No
13_ Soil Type(s):
❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes 2<o
D NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 5-1.4
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes U34o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes fo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 02<o
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[rNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[D'o
❑ 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
No
❑ NA
❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
L'J NA
❑ NE
Page 2 of 3 2/412011 Continued

Facili umber: XL jDate of Inspection: 921
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [!'No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes io ❑ 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 EIK ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [] No IA [3 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?
,--,�
E] Yes LJ 1"O ❑ NA ❑ NE
❑ Yes E 1` o ❑ NA ❑ NE
❑ Yes NA ❑ NE
❑ Yes Lig, ❑ NA ❑ NE
❑ Yes ❑X5' ❑ NA ❑ NE
❑ Yes Q 10 ❑ NA ❑ NE
❑ Yes 0-401 ❑ NA ❑ NE
mmen.'"
Explain any; YES answers and/or any additional recomdations or. any oth'e-d ts
Comments (refer to question #) men
U drawings of facility to lbetter explain;situstions (use sdd�ho.nal pages. as necessary). --*,j,-
LL 44e cC S 1 5
Av-
Reviewer/Inspector Name: QA-
Phone: L 0 + 3 -3=
Reviewer/Inspector Signature:
Date:
Page 3 of 3
26affil

Type of Visit O'Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit tTRoutine O Complaint 0 Follow up 0 Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: z -Zs %(a Arrival Time: Departure Time: County: waist sow Region: -0�1f'0
Farm Name: jbaV- e -/J / ` v r"' Owner Email:
Owner Name: Aa d� bdydr_ ^t Phone:
Mailing Address:
Physical Address:
Facility Contact:/4Add b�I'de^1r1 _Title: Dr�w�v�Tcc4' s�� Phone No:
Onsite Representative: 'Qy iaf Integrator:
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o =I
=" Longitude: = o =I = "
Design Current
Cap�ac�i�ty Population
MiiDesign C►urreut
Wet Poultry C►opacity Population
Design C►urrent
Eattle Capacity Population
Finish
rWean
1. Is any discharge observed from any part of the operation?
Feeder
No
❑ NA
Feeder to Finish 3�$Q
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
❑ Da' Heifer
❑ Farrow to Wean
pn Poultry
❑ D Cow
❑ Farrow to Feeder
-
❑ Non -Dai
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Yes
Non -La ers
❑ Beef Feeder
FEJGilts
Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ TurkeyPoults
❑Other
I�tumlaer of Structures:
��
15 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Layer El Dairy Cow
❑ Non -Layer ❑ D ' Calf
�3.TMs 707/zG/zoo 2/"
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
EINE
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
:ETNA
❑ 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
��
15 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[� �Io
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Comments (refer to question #) Eaplainsany YES answers and/or any recommendations�or a�ny�other comments
Use drawmgs.bf facility to better expla�n1situataons. (use addthonal pages as.necessaty,)
Reviewer/inspector Name I r w4 -S Phone:
a-4'33.33oa
Reviewer/Inspector Signature: Date: Z -2-5,- 2010
12/28/04 Continued
Facility Number: Z-329 Date of Inspection 2-25- Jv
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
EKo ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
�o ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): %�r•-�oN�.��>
Observed Freeboard (in): Z Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
D No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
El Yes
,�/
[3 o ❑ NA
❑ NE
through a waste management or closure plan'?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[7f No ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
To ❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
El2 Yes
�
o ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ffNo ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
E<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) �rt.ty�e� � ,�, Sw,� La' Gtr.."� �t7 S ., M pr�.r -
('JL�s��- So y l ca�u-
—
13. Soil type(s) C bA NaL9 W4_8
14. Do the receiving crops differ from those designated in the CAWMP?
ElL`7 Yes
,�/
No ❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2<o ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
0�-,�"'NNo [:1 NA
El NE
17. Does the facility lack adequate acreage for land application?
El Yes
L 7 X o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[11 ❑ NA
❑ NE
Comments (refer to question #) Eaplainsany YES answers and/or any recommendations�or a�ny�other comments
Use drawmgs.bf facility to better expla�n1situataons. (use addthonal pages as.necessaty,)
Reviewer/inspector Name I r w4 -S Phone:
a-4'33.33oa
Reviewer/Inspector Signature: Date: Z -2-5,- 2010
12/28/04 Continued

.
61
Facility Number: 82 -3,24 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Q Io ❑ NA ❑ NE
the appropriate box.
❑ WUP [3 Checklists [:1 Design [:1 Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Io ❑ 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 [B<o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes to ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ NA
El NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
[:1 Yes
,01110
LE,i'1�t�o ❑ NA
[INE
26. Did the facility fail to have an actively certified operator in charge?
[I Yes
❑ NA
El NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
,[311
L 71vo ❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes R No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
L] Ivo
❑ 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
ElL7
�,�
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
To
❑ NA
❑ NE
General Pem-iit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
ETNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
io
❑ NA
❑ NE
12/28/04

i3ro(S e_.'4 P -CL /0 -0z -"a-'7
(Y15i_v_ision of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visitompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit & outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: /4-4/-09 Arrival Time: Departure Time: /2:34 County:"`so iOnJ
Farm Name: ���GN f`4 �' S Owner Email:
Owner Name: — /4i./et�c� �� ✓d �^� Phone:
Mailing Address:
Region:
Physical Address:
Facility Contact: ._ �N d G+ ! 6 V J -e-n! Title: � � kl^JC-4-'- ,. -_,_ Phone No:
Onsite Representative: PQ u C b0.V d11C_ N Integrator: Lcs,s A 4
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: L:]' [—] ' [--] Longitude: =] o =]' = "
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish j 10 Layer
❑ Wean to Feeder ILI Non -La et
eederto Finish g Q
❑ 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 Im acts
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
❑ DaiEy Cow
❑ Daia Calf
❑ Daia Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: h
4 ;
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No LEJ'5AA ❑ NE
El Yes ElL
No S11A ❑ NE
❑ Yes ❑ NogLINA ❑ NE
El Yes 2 oo 0 N El NE
❑ Yes NA ❑ NE
11/18104 Continued

Facility Number: 62 — 3 Z4
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. if yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: 1_4.$ 1 Lis Z
Spillway?:
Designed Freeboard (in): - /17
Observed Freeboard (in): o
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 o ❑ NA ❑ NE
Structure 5 Structure 6
[]Yes [ No ❑ NA EINE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental thre votify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes E No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ghlo ❑ 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 10 ❑ NA ❑ NE
maintenance or improvement?
Waste Aanlication
Commen(�referto uestron {F7rlarn n1'ESa§ns ers andloranrame dations or SII Ot1ieC COmmeRt5
q Y Y
Use drawiRgs�of¢facti�ty to�better eaplaiR sEtnat,ons.�(use a ry y
dditional;pages ash ecessa , ):
URL
L
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
3<0- ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
01115 ❑ 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 ElEvidence of Wind Drift ElApplication Outside of Area
!
12. Crop type(s) t3e-yM 4t j o,. i / +f Ss.4/l G ✓e��,.r (Q..S �Ai�AI -- �.Ji1t4
13. Soil type(s) Na S GcJOLE
14. Do the receiving crops differ from those designated in the CAWMP? ElL�
Yes
,
'IVo ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
-1G__ El NA
[INE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
,L
El NA
El NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
,Dg%ro
d
I�.,'No❑ NA
EINE
18. Is there a lack of properly operating waste application equipment? El Yes
Lq'lao�❑ NA
❑ NE
Commen(�referto uestron {F7rlarn n1'ESa§ns ers andloranrame dations or SII Ot1ieC COmmeRt5
q Y Y
Use drawiRgs�of¢facti�ty to�better eaplaiR sEtnat,ons.�(use a ry y
dditional;pages ash ecessa , ):
URL
L
Reviewer/InspectorName r— cj ... RerVe_l.S Phone: 910.4,/33, 333
Reviewer/Inspector Signature:Date: /0-0/-4017
Page 2 of 3 12/28/04 Continued
zUn '�

l A.
Facility Number: SZ—.3ZDate 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 ❑ Maps p ❑Other
❑ Yes
El No
❑ NA
❑ NE
❑ Yes
B o
❑ NA
❑ NE
Other Issues
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
io ❑ 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 Inspectionss, ❑//Weather
Code
22. Did the facility fail to install and maintain a rain gauge?
[I0_ Yes
o ❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
� ❑ NA
❑ NE
ElYes
B"" ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
BNo ❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
1o�❑ NA
El NE
32. Did Reviewer/inspector fail to discuss review/inspection with an on-site representative?
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
B<o ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
B o [INA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�
o�❑ NA
[INE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
,B
LTNo ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
�
30. At the time of the inspection did the facility pose an odor or air quality concern?
ElYes
B"" ❑ 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
Q< ❑ 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
L"l'No ❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
L_f"No ❑ NA
❑ NE
A�dditonaiomrnents and/_or DmwA
12128/04
12128/04

13rms 9-oS,-09 Rrz -- - -
Type of Visit &Cbmpliance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit &Voutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: %2: 3d County: -s '�'dn/ Region: /
Farm Name: D6L VC11eAJ J"'::121 -111,S - (!'rn.;$4�.vs Owner Email:
Owner Name: 4 &25�,y hxf, dbt—Je v Phone:
Mailing Address:
Physical Address:
Facility Contact: AAI - A ow y bay Je-n! Title:
Onsite Representative: CU + t w �+►! ��
Certified Operator:
Phone No:
Integrator: Pre S /Q!Q z <__
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: [=O
=4
=64 Longitude: =0=1 =
11
Swine Ca l Po- Matto .., -
Design Current' �' Design .Current Design Current
pty p s -a Wet 1?opltry,Capac�fyf,Popuiation CattleJICapacity Papulation
❑ Wean to Finish
❑ La er
❑ Dai Cow
❑ Wean to Feeder
❑Non -La er
❑ Dai Calf
❑ NA
Feeder to Finish
SS a""� :.a
❑ Dai Heifer
❑ Farrow to Wean
� ' � z;
❑ D Cow
❑ Farrow to Feeder
�-`
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Boars°
Other ..n
❑ Other
❑Non -La ers
❑ Pullets
t. El Turkeys
0Turkey Points
❑ Otherum
_
❑ Beef Feeder
El Beef Brood Co
ber of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑Yes
ko
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
EJ'IqA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
E3<A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
L.
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[I No No
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
31 o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
2<o
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12/28/04
Continued

c
Facility Number: S2 -- 32-7
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 37
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 E No
❑ Yes �a
Structure 5
El NA C1 NE
❑ NA ❑ NE
Structure 6
❑ Yes ETN. ❑ NA ❑ NE
❑ Yes L_TNo ❑ 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 LT No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [❑ Yes D No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes 2<o ❑ NA ❑ NE
maintenance or improvement?
Waste Aonlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes B<o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? 1f yes, check the appropriate box below. ❑ Yes BNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [:]Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �i. 'w't'icZ /�r� $•••oi� �r:�i.v 66, S 6rN,t w4,c-.;,-4�so:they-c
13. Soil type(s) A)a.g AlO$ GOA
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ETON' o
No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes IO N"o [INA [INE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre deterTnination?❑ Yes 1]� oo El NA [:1 NE
17. Does the facility lack adequate acreage for land application? El Yes ,E Ngo F-1NA El NE
18. Is there a lack of properly operating waste application equipment? El Yes B IVo ❑ NA ❑ NE
Reviewer/Inspector Name lei' isI�tvc Phone: 91n 033.333
Reviewer/Inspector Signature: ,cc� rArz-' .1 Date: f- Z $ - ZO 47 PJ
Page 2 of 3 12/28104 Continued

Facility Number: Date of Inspection
Required Records & Documents El"
No Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes L7 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes D o ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ ❑ Maps Design g p El Other r�
21. Does record keeping need improvement? if yes, check the appropriate box below. ElN
Yes !� o ❑ 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
[3"1Clo
❑ NA
❑ NE
23.
If selected, did the facility fait to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[2'1to
❑ NA
EINE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑-No
❑ NA
❑ NE
25.
Did the facility fait to conduct a sludge survey as required by the permit?
❑ Yes
[bio
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Q<o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
2<o
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EJI�o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑<
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[3 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
Dlo
❑ 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
E o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
E3Vo
❑ NA
❑ NE
Add�tionalComm�entsand%or Diawtngs 'R"r M5tlM
Page 3 of 3 12/28/04
Page 3 of 3 12/28/04

ivision of Water Qualitys¢f6 .,
FFacilityNumber �- 3p2 O Division of Soil and Water Conservation
O Other Agency
Type of Visit ompliance 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: I 'r0 Arrival Time: r D Departure Time: :J [i I County: Region: D
Farm Name: -PPA-- Fa/ -41 s / Owner Email:
%} e�
Owner Name: / t� ewe. s1_ Phone:
Mailing Address:
Physical Address: � /
Facility Contact: ///��7`n Dg, _��Gt/`�IPy" Title:
Phone No:
Onsite Representative: Integrator:
Certified Operator: S'•� Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Latitude: =0 =1 ❑ « Longitude: =0=1 = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ l a er
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discbarses & Stream Impacts
1.1. 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 HeifeF
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ®,
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes W No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
ElYes
❑ No
❑ Yes [NNo ❑ NA ❑ NE
❑ Yes f gNO ❑ NA ❑ NE
12/28/04 Continued

Facility Number: — 3 Date of Inspection �d?
i
' Waste Collection & Treatment
Reviewer/Inspector [Name Phone: p�
Reviewer/Inspector Signature: Date: l o
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
N 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): - 3g9-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
"M No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
2.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
D4 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
KNo
[:INA ❑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
JR No
❑ NA ❑ NE
maintenance or improvement?
Waste Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
M No
❑ NA EINE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
&No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Window ❑ Evidence off Drift ❑ Application Outside of Area
/Crop -Wind
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ yes
® No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
;-No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
C.No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
NNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E -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):
Reviewer/Inspector [Name Phone: p�
Reviewer/Inspector Signature: Date: l o
12/28/04 Continued

Facility Number: -3 Date of Inspection 7
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ®.No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ®,No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists
❑ Design [:1 Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes CgNo ❑ 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 KNo ❑ NA EINE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes XNo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
'9 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
CgNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
1jj No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
9KNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
E No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
OlNo
❑ 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
UNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[&No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
C&No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
'Wo
❑ NA
❑ NE
Comments and/or Drawings:
12/28/04

Type of Visit 01,00mmpliance Inspection O Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit U Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: S 3�rrival Time: C . d D Departure Time:� . Vj County: jn— Region:
Farm Name: ,0At'__d erL F,!:;r rm. S f Owner Email:
Owner Name: " sa r'd & Phone:
Mailing Address:
Physical Address:
Facility Contact: A -Q Ll 16 Od A- Title: Phone No:
Onsite Representative: S G Integrator:rr{�v
Certified Operator: -54'0+2'C Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = 0 0 I = u Longitude: = ° 0 I = u
Discharp_es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Design Current.
';Design Current
Design Current
❑ NE
Swine
Capacity Populr tion
Wet Ponitryt ap�actyopulation
~
Cattle C►specify Population
a. Was the conveyance man-made?
❑ Wean to Finish ❑ La er
❑ Dai Cow
❑Wean to Feeder
❑ NE
❑Non -La er
❑ Yes
❑ Dai Calf
❑ NA
Feeder to Finish D t7
❑ Farrow to Wean ~ ` k r'
Dai Heifer
❑ Cow
�=
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Farrow to Feeder
No
:.::�, :.
❑ Non-Daity
2. Is there evidence of a past discharge from any part of the operation?
❑ Farrow to Finish
No
❑ Layers
❑ Beef Stocker
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Gilts
No
Non -Layers
❑Non -La ers
❑Beef Feeder
other than from a discharge?
❑ Boars
❑ Pullets
❑ Beef Brood Cowl I
Page 1 of 3
` i
Continued
❑ Turkeys
Other ❑ Turkey Poults
❑ Other ❑ Other
Number of Structures:
Discharp_es & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
XNo
❑ 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 discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: — Date of Inspection 3 D4
Waste Collection & Treatment
i. 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,V No El NA EINE
a. If yes, is waste level into the structural freeboard? ❑ Yes NNo ❑ NA ❑ NE
�Stritcture 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 9No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes KNo ❑ 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 KNo ❑ NA EINE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ,q No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes J!j No ❑ NA ❑ NE
maintenance or improvement`?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes KNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes N -No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10%ori 0 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
KNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
N 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
KNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
Reviewer/Inspector Name w` `.� Phone: �— / S- 21""
Reviewer/inspector Signature: Date: �Dfl
12128104 Continued

Facility Number: — Date of Inspection (17
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ®,No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E.No ❑ NA ❑ NE
the appropirate box.
❑ WUP [I Checklists [I Design El Maps C1 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Wo ❑ 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
NNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
( No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
'[K\
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
9LNo
❑ NA
❑ NE
29_
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ YesNo
IN
[:1NA
[:1NE
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
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
[gNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PqNo
❑ NA
❑ NE
aidditionaE Comments'andlor Drawings
12128/04

® Division of Water Quality
�,CflityNU
rtiber O Division of Soil and Water Conservation}
O Other Agency ���
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: (o 2/ ° Arrival Time: Departure Time: County: 5 aw.pso+-1 Region:
Farm Name: Owner Email:
Owner Name: 12 a�• �GY��t�s Phone: (qIO� S53- !117�
Mailing Address:
Physical Address: 17
Facility Contact:
Title:
Phone No:
Onsite Representative: Ya n k- a r nl Integrator: �r c s4 -n
Certified Operator: Iq I'\ Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =0 ❑ 1 ❑ 1{ Longitude: ❑ o = j ❑
ds
Swine
Design Current Design Current Design Current
Capacity Population Wet Poultry Capacity Population Cat -tic Capacity Population
❑ Wean to Finish 10 Layer ❑ D;3iry Cow
❑ Wean to Feeder JEI Non -Layer I I Dairy Calf
Feeder to Finish SBD 7d
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Lams
❑ Non -Layers
❑ Pullets
❑ Turkevs
❑ Turkev 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 roan -made?
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
U Beef Feeder
❑ Beef Brood Cowl
Number of Structures: ®�
J
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 P0 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
[:]'NA,
❑ NE
❑ Yes
❑ No
❑ NA
' ❑ NE
❑ Yes
[9 No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA,
❑ NE
12/28/04 Continued

Y �
Facility Number: $2 — 3.2? Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes R1 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 W 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 [0 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [!9 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 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 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) lqe rm gr /i a .S G — ds / in c,. C rn.o ®Qfr'
13. Sail type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
M No
"[INA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® Nc
[] NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
i ❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
2 No
[INA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: 61-z �% a_rl'
12/28/04 Continued

Facility Number: f{2 — 3a? Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? V] Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑ Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the apppropriate box below. ❑ Yes [A No ❑ NA ❑ NE
1,1 3.1
El 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
®No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
® Yes
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
V] No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[K No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[Z No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
No
❑ NA
❑ NE
.
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
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
Q9 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
M No
❑ NA
❑ NE
A'ddrtional�Cdinmentsl�a'ndlorDt`aw1 ings {, F
m l
mr, �a�0'-tom ar rs.)
1'_
�ci'��1.CG Cep. C. iL�rA�.� �JrG� mow.--% CkyA�."wQ
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V r%o +i ►� � � 1�•�
CO(L
a Gb Y
Cal
p�ae_e %-k• a h ��` C
/t
arC• n, cGa•c�s.
`f
S e Ct_r, c. ck- Gb pu c c a 1. b r ca��cS �3 S •1 c� F `a c c- 3+
r
1 f�
re-c_orS-4,
12/28/04

n
Type of Visit 10 Compliance inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Date of Visit: Time: ' . Q ,fM
Facility Number .1 .�
=Not erational 0 Below Threshold
UPermitted Oertified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: __Delglen Fzrreh 5 County:-i4cWjon f—Wo
Owner Name: _ tl a Aa rix jog ,/e,7 Phone No: !%O - r4 I/ L 3G j
illailingAddress: 4, !e f��,'. �f. Cl,,,QVC _P 3_7
Facility Contact:i� ___ Q4reh'g _ . _Title: Phone No: 9�V' s lt'-
Onsite Representative: �9'�f� b r Integrator: Per.
Certified Operator: 1417%tAdg4. Operator Certification Number: 18370
Location of Farm:
iy'swine ❑ Poultry ❑ Cattle ❑ Fiorse Latitude Longitude C�' �•
Design Current
Swine Canneit Ponula6nn
❑ Wean to Feeder
E3fe_eder Finish I V S D o
❑ Farrow t0 Wean
❑ FwTow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultrti Capacity Population Cattle Capacity Population
❑ Laver I I IF—] Dairy
❑ Non -Laver I I ILI Non -Dain
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons a JL7 Subsurface Drains Present��❑ E agoon area J❑ Spray Field Area
Holding Ponds / Solid Traps ❑ 1\o Liquid Waste Mana ement-Svstem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge orirrinated at. ❑ Lagoon ❑ Sprav Field ❑ Other
a. if discharge is obsen ed, was the conveyance man-made?
b. If discharse is observed, did it reach Water of the State? (if yes, notifi' DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system' (If ves. notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes IKtvo
❑ Yes D 1 0
❑ Yes �o
_rte
❑ Yes 21 -No
❑ Yes ONO
3. Were there ant' adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 01No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 0'15-o—
Structure I Stmcrare ? Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 ?
Freeboard (inches): .3 t% 41 D
05/03/01 Continued

Facility Number: S-7 —32 1 Date of Inspection y .�
Required Records & Documents
2). 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 Analysisr❑ 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 Facileties
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. 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 NPDBS required forms need improvement? If yes, check the appropriate box below
❑ Stocking Forut✓❑ Crop Yield Form ❑ Rainfall Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
RY- s ❑ No
❑ Yes B-lTo
❑ Yes B -No
❑ Yes &No
❑ Yes [-io
❑ Yes [9 -No
❑ Yes Bwo
❑ Yes L3Po
❑ Yes B -No
0 -Yes ❑ No
B'Yes ❑ No
❑ Yes ©-No
❑ Yes [ago
❑ Yes 9 -Mo
❑ Yes �o
E3 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ddittoaal Cotnrnenu and/or:Dravvtngs F 4 ,� - _j
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12112103

I lFacility Number: 92 — 3J r
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 maintenancelimprovement?
❑ Yes ❑-Nb
❑ Yes Q Ko
❑ Yes ❑.No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes B No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes -Ido
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes U -N6
11 _ Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes B No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type o. dery,,14 ,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWIVIP)? ❑ Yes ®-No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes Q�No
b) Does the facility need a wettable acre determination? ❑ Yes [g -No
c) This facility is pended for a wettable acre determination? ❑ Yes [9 -No
15. Does the receiving crop need improvement? ❑ Yes ❑-110-
16. Is there a lack of adequate waste application equipment? ❑ Yes �o
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or 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 0-N-6
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 9 -No
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
Air Quality representative immediately_
Caxntmeats infer Ra aeshan p lata an YE$ ahswers sudor an recommet;datfifins or an other commentc.� ;
( } y y _
=Use dxawtngs of Jl c 'y t+o better exp�latn�s�tuat�ans. (use addrtianal pages ss ne sary) wield COPY El Final Notes
= -T - -.
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Reviewer/Inspector Name %tinfK-a.,
Reviewer/Inspector Signature: Date: 41. 6-t7LI
12112103 Continued

Farm Name/Owner:
Site Requires Immediate Attention:
Facility No. -:- 3"x -t
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE:J ✓ 1 1995
Time: 2 = 30' ?:3 -Al
1-4
7`- 39.x' A
Mailing Address: ;;?2L —1 -73-ox /77— f3 C L iry TaA,7 AJ Cl
County:
Integrator: Phone: 9/v —.s9z —577/
On Site Representative:.� ,eb a,✓ a xo- Phone:_
Physical Address/Location: a -r 0 ,-Nn a W--- _k / 7S S . , 4rN6r.sZ- �rC��P� X -Oa/,
N '9- o A G//N 2 _
Type of Operation: Swine x. Poultry Cattle
Design Capacity: Zf#v Number of Animals on Site: Z9
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude:"
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
{approximately 1 Foot + 7 inches} Q or No Actual Freeboard: If Ft. Inches
Was any seepage observed from the lagoon(s)? 'Yes orS Was any erosion observed? Yes oi�R
Is adequate land available for spray? (�r No Is the cover crop adequate? �Oor No
Crop(s) being utilized:PS
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? es i
100 Feet from Wells?es or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes oz0
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line:
Yes o(K)
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes oro 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 Nn
Additional Comments:
r<1aFW Alaw I7�C _
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.