820378_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quaa

aypx vi vIsii: d i.ompnance tnspecuon v tiperauon meview v orructure Evaivauon v recnnicai rvssisiance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: ,3orw Departure Time: p' County:
Farm Name: lA)aIhay I'm 5- Owner Email:
Owner Name: Lle4i n a WR lIP.g- Phone:
Mailing Address:
Physical Address: �^f
Facility Contact: V luc'1Q '.-. 144,-1 Title: Phone:
Onsite Renresentative: q Integrator• / -Y) M
Certified Operator: — bell h e i m f t I e -f
Region: %z,rip
Certification Number: / Cl 5 8S_
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Dischar es 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 y No ❑ NA ❑ NE
❑ Yes ❑ No 0 NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
Design
Current
1?41 NA
Design
Current
Design Current
Swine
Capacity
Pop:
Wet Poultry
Capacity
Pop.
Cattle Eapacity Pop.
Wean to Finish
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
Layer
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
Dai Cow
Wean to Feeder
❑ NA
❑ NE
of the State other than from a discharge?
Non -La er
Dai Calf
Feeder to Finish
!'
Dai Heifer
Farrow to Wean
t!(�
Design
Current
D Cow
Farrow to Feeder
D . P,oul
Ga a
P,a ,
Non-Datry
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
TurkeyFoults
Other
,_..._
_-
Other
Dischar es 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 y No ❑ NA ❑ NE
❑ Yes ❑ No 0 NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
1?41 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
Z NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
+] No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 2/411015 Continued

>Facili Number: 2_ 3 7 Date of Inspection: 3!
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No /V91 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
u 3 4
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes No [] NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA [] NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Aaalication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
0 No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
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.)
10 No
❑ NA ❑ NE
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Yes
❑ Outside of Acceptable Crop [] Evidence o Wind Drift^ ❑ Application Outside of Approved
Area
/W��,,i��ndow
12. Crop Type(s): Coos- ct� Ide+'i t?S 5.�, l.+�ci{4
13. Soil Type(s): AL)a A Min
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
❑ YesNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[)a No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
C No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box_
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [:)Stocking ❑ Crop Yield []1.20 Minute Inspections ❑ Monthly and 1 ° Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
10 No
❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EP No
❑ NA ❑ NE
Page 2 of 3 2/4/2015 Continued

Facility Number: - Date of Inspection:
,
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
No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA [] NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
P 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
�g No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
T�
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:/
Page 3 of 3
Phone: g1'0 —4A9 3'
Date: V3 //�
2/4/2015

i ype of visit: 0 Compliance inspection V operation meview V Ntructure Evaluation V lecnnical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ® Departure Time: ®County: Region:
Farm Name: i'n/a �lPir' S Owner Email:
Owner Name: An m 5 Phone:
Mailing Address:
Physical Address:
Facility Contact: �r&ylot ` � .11 Title: Phone:
Onsite Representative: Integrator:
Certified Operator: PelylI5 10'11,9- 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 Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [Q No ❑ NA ❑ NE
❑ Yes [] No
❑ Yes ❑ No
M NA ❑ NE
09 NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [] Yes ❑ No 0 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes No [] NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued
Design Current
Design
Current
Design Current
Swine
Capacity Pap.
Wet Poaltry
Capacity
Pop.
Cattle C•agacity P.
Finish
La er
Dai Cow
Feeder
Non -La er
Dai Calf
o Finish
Dai Heifer
to Wean
2
Design
Current
Cow
to Feeder
I;oul
Ca aci
P,o
Non-Da'to
Finish
Eee
La ers
Beef Stocker
Non -La ers
Beef Feeder
.
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [Q No ❑ NA ❑ NE
❑ Yes [] No
❑ Yes ❑ No
M NA ❑ NE
09 NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) [] Yes ❑ No 0 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes No [] NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

FaciliNumber: r Date of Ins ection:
Jr
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): G 7
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
No ❑ NA ❑ NE
❑No Q9NA ❑NE
Structure 6
❑ Yes No ❑ NA ❑ 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?
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 In No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes �No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require []Yes ® No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E� No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ® ❑ Evidence of Wined LDrift ❑ Application Outside of Approved Area
12. Crop Type(s): ` s +lam✓ iL�.. i. (� 45.5 t �Ts�.� �� ' 61-4-11O .,Q
13. Soil Type(s): /V o %t 1"W V"
14. Do the receiving crops differ from those designated in the CAWMP?
[]Yes
P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ YesNo
[—]NA
E]NE
acres determination?
17. Does the facility Iack adequate acreage for land application?
❑ Yes
[R No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E� No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
P No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Wo
❑ 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. ❑ YesNo
❑ Waste Application F]Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis ❑ Waste Tra sfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [P No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes M No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
E] NA ❑NE
❑NA C—] NE
Page 2 of 3 21412011 Continued

Faciliq Number: jr -7 Date of ins ection: 7
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes rp No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes EP No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey E] Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 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 Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
0 N ❑NE
❑ NA ❑ NE
❑ Yes
E�j No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
q, No
❑ NA
❑ NE
❑ Yes
`C" No
❑ NA
❑ NE
❑ Yes No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature: Date: 9 �7
Page 3 of 3 2/4/2011

1�,
(Type of Visit: 4D Compliance Inspection U Operation Review U Structure Evaluation Q Technical Assistance
'Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other,� p0 Denied Access
Date of Visit: rQ r Arrival Time: Departure Time:EK�� County: P`fa'-) Region:
Farm Name: �T /Jale-e- 6,'- f" s Owner Email:
Owner Name: In1, S Aj6d I CZ111 Phone:
Mailing Address:
Physical Address:
Facility Contact: G 0^0A ,,
Onsite Representative: to
Certified Operator:
Back-up Operator:
Location of Farm:
_(+I'O✓ Tide:
Latitude:
Integrator:
Phone:
�M
Certification Number:
Certification Number:
Longitude:
19 g5 -
s`r aC'urrent.
❑No
Desi
Current
Desi Current
e�
SwinWD
CapagtvP p
W,et Poultry
62 it ity
Pop.
Cattle Capacity Pop.
❑ NE
Finish
La er
Dai Cow
Feeder
Non -La er
Dai Calf
oFinish
Dai Heifer
o Wean
U
Z. bQ Lf
Design
Current
Cow
o Feeder
D , Poultry
@a aci
P.o _
Nan-Daio
Finish
La ers
Beef Stocker
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
r�
Turkey Poults
Other
Other
Dischar es and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: _
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
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?
Page I of 3
❑ Yes M No ❑ NA ❑ NE
[—]Yes
❑No
qNA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑Yes
❑No
®NA
❑NE
[:)Yes
M No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
2/4/2011 Continued

Facility Number: - Date of Inspection
Waste Callection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes VNo ❑ 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: Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2-5-
5.
"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 P No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ YesNo
❑ NA
E]NE
maintenance or improvement?
11. 1s there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
JV3 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 okWind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s):5
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWW?
❑ Yes
`i' No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
1PNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
P No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
'J No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
P No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design [:]Maps ❑Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �3 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ 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 21412015 Continued

Facili Number: - Date of Inspection: ( O k2 I
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 No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [�pNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes p No ❑ NA ❑ NE
Other Issues
2$. 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?
Comments (refer to'`uestton'##):.Ezplam any YES;answer-ani
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
additional recommends
!es as necessarv).
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes O No [DNA ❑ NE
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑NA F] NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Phone: 4 / 3 3 3-3 00
Date:
21412015

PP-,
Division ofWater Resources
FaciliDivision of Soil and Water Conservation
Q Other Agency
Type of Visit: 4D Compliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: *Routine O Complaint O Follow-up O Referral O Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: �'. Departure Time: I [a : County: Soi-j
Farm Name: �WQTI I ,-' FL,,%, $ C r Owner Email:
Owner Name: M t IP.r rte-✓ � �`Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: Jt-, r.d`925ia /[/ lle,, Title: Phone:
Onsite Representative: it Integrator: 72w
Certified Operator: 14i lle, 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 Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes N No ❑ NA ❑ NE
❑ Yes ❑ No [Z NA ❑ NE
❑ Yes ❑ No [5 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 (S NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes P No [] NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ® No E] NA ❑ NE
of the State other than from a discharge? TT
Page I of 3 2/4/2014 Continued
Design Cgrrent
=r
Design
Current
gig
Design Current
Swine
Capacity ...Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pnp.
r
Wean to Finish
La er
Da Cow
Wean to Feeder
Non -La er
Da Calf
Feeder to Finish
" a-
"
Da Heifer
Farrow to Wean
L pp
r
Design
Current
Cow
Farrow to Feeder
D . P.oul
@a aci
P,o
Non -D '
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Turkey Poults
Other
I 10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes N No ❑ NA ❑ NE
❑ Yes ❑ No [Z NA ❑ NE
❑ Yes ❑ No [5 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 (S NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes P No [] NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ® No E] NA ❑ NE
of the State other than from a discharge? TT
Page I of 3 2/4/2014 Continued

Facili Number: 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: Z
�No ❑NA ❑NE
❑ No NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
U t y
Observed Freeboard (in): AV
�d1V_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes V No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) T
6. Are there structures on-site which are not properly addressed and/or managed through a ❑ Yes 0 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [� No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �] No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [�3 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 nc
❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
[M
12. Crop Type(s): CS a "S$ 1 a 09 -V-
-
13. Soil Type(s): W
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
[—]Yes
5] No
❑ NA
❑ NE
[:]Yes
[] No
❑ NA
❑ NE
D Yes
No
❑ NA
❑ NE
❑ Yes [$] No ❑ NA ❑ NE
❑Yes � No ❑ NA ❑ NE
[-]Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑WLIP ❑Checklists ❑Design ❑ Maps [:]Lease Agreements ❑Other:
2l. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
0 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 [�] No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes LpNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 2/4/2014 Continued

Facility Number:Date of Inspection:
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
No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
[P No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
P No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes b No ❑ NA ❑ NE
❑ Yes 1�3 No ❑ NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
[–]Yes W No
❑Yes � No
[:]Yes ®No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Use�draiv e&of facihty to better exnlaln situationsYuse additional;navies as necessarvl:4 y _ Y comments:
_omme+n re er-to question : xplainiany YES answers and/or an additional recommendations or,an other 3
..
4 a
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 19 Il®' 133 3-3 &o
Date: 6411's-
21412014
4/�
2/4/2014

Type of Visit: (5 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Gekoutine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: W "% Owner Email:
Owner Name: { JJA_� Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: Aitle• SCC- Phone:
Onsite Representative: Integrator: " ' -
Certified Operator: , h {fl.� LU -e,� - Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Q'No ❑ NA ❑ NE
❑ Yes [:]No QUA ❑ NE
❑ Yes [:]No E NA ❑ NE
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 ONo Q NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes E�No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued
D s gn Cu rent
-
Design_Current g-`
Design Current
Swine
C£apactty ,p
Wet Poultry
S. city Pop.
Cap
Cattle Capacity Pop,
"_
La er
Da' Cow
eeder
Non -La er
Da Calf
FinishDa
Heifer
WeanPEE
DesignCurrent�i.
D Cow
Kinish
Feeder
Finish
D . Poul
La ers
Caact Po
Non -Dairy
Beef Stocker
Non -La ers
Beef Feede
Pullets
Beef Brood Cow
-
Turkeys
Other;
Turkey Poults
EL OtherOther
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Q'No ❑ NA ❑ NE
❑ Yes [:]No QUA ❑ NE
❑ Yes [:]No E NA ❑ NE
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 ONo Q NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes E�No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili Number: Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? [—]Yes ❑No S-+ ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
[j Yes K3 1Vo ❑ NA ❑ NE
❑ Yes ❑i'No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? es ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes I=1 To ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes To ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes NA ❑ NE
maintenance or improvement?
1 I . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [94'"' ❑ 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 ,Q ❑ Evidence
� o`ff Wind Drift ❑ ation Outside of Approved Area
12. Crop Type(s): V)eyA k tJYi'�-� ` 6 l7 V Oat,,�Z<
13. Soil Type(s): a
14. Do the receiving crops differ from those designated il the CAWMP?
❑ Yes
ENo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
g4o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Uk<o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
eNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
6/No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[] Yes
Q'i�o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E],Ato
❑ NA
❑ NE
the appropriate box.
[:IWUP ❑Checklists ❑Design E] Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 2 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 1� N
❑NA E] NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
No
❑NA ❑NE
Page 2 of 3 2/4/2011 Continued

Faclli Number: - Ds ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [Vivo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [j�j� ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ®'leo [DNA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes ❑'95- ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes E5<o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? [:]Yes <o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes Cr "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 10 ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 2<o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes VNo
❑ NA E] NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments
Use id ';wings of facility to better explain situations (use additional pages as necessary). R,
C104 t�4(1�3 V1
91cLJ)t Sutvj,
[1
OVA
4,�
1Yv��w< SI<_Ar��✓w5w �y00" 4'Q
Reviewer/inspector Name: VUV AW TPne
Reviewer/Inspector Signature: ll Date: ►f/V
Page 3 of 3 21412011

t -
� Divisi©n of Water Quality
Facility Number - �600HWEZAPKUHC. f Soil and Water Conservation
y
Type of Visit: Compliance Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Q<outine O Complaint 0 Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County Region
Farm Name: (;� L ��&' I Owner Email:
Owner Name: C. Phone:
Mailing Address:
Physical Address:
Facility Contact: 70
Onsite Representative: 1/1
Certified Operator: �'� �� W
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: !! CJ
Certification Number:
Certification Number:
Longitude:
Discharees and Stream Impacts
Design Curren1.t
Design
Current
. Design Current
Swine
C*apacity Pop. ,,,
WetPvultry__ Capacity
Pop Cattle - Capacity Pop.
Wean to Finish_'
La er Dairy Cow
Wean to Feeder
Non -Layer
a. Was the conveyance man-made?
Dairy Calf
❑ No
Feeder to Finish
" . Dairy Heifer
Farrow to Wean
b
❑ No
Design
Current'
Dry Cow
Farrow to Feeder
-
D . IP.o_ult : Ca aci
Pio
Non -Dai
eNA
Farrow to Finish
2. Is there evidence of a past discharge from any part of the operation?
Layers
Q-1 o
Beef Stocker
Gilts
"#
Non -Layers
Beef Feeder
Boars
of the State other than from a discharge?
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
Vo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
E NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
2'IqA
❑ NE
e_ 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
eNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Q-1 o
❑ NA
Q 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 I of 3 21412011 Continued
e

Facility Number: _D Date of Ins ection: C
❑ Yes
[] N
/No
❑ NA
❑ NE
Waste Collection & Treatment
❑ Yes
(
(DNA
❑ NE
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
CTlq—o
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
2-lgo-
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
❑ NE
Identifier:
❑ Waste Transfers
❑ Weather Code
Sludge Survey
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspectio;N�000j[:]
Spillway?:
❑ Yes
NA
❑ NE
Designed Freeboard (in):
❑ Yes
FE[N
❑ NA
❑ NE
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ZJNa—
❑ 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 DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
O -o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0o
❑ 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
To
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
,__,�
2fo
❑ NA
❑ NE
maintenance or improvement?
I I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes LB""" ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): _ C I
13. Soil Type(s):
❑ Yes
[] N
/No
❑ NA
❑ NE
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
(
(DNA
❑ NE
the appropriate box.
WNo
15. Does the receiving crop and/or land application site need improvement? ❑Yes ❑ 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 tack adequate acreage for land application? ❑ YesVN"o
NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑Yes ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[] N
/No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
I �l
❑ 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
©'1Vo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
Sludge Survey
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspectio;N�000j[:]
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
FE[N
❑ NA
❑ NE
Page 2 of 3 2/4/2011 Continued

Facility N umber L - Date of Inspection:
V9 V
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ®'�o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes � ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes E21 'o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes �] 1� _ ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes 0>a- ❑ 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 a 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 [2jNV—_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 [a>a' ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [DKb' ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? ❑ Yes [@416_' ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes Ej<o ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any. other,
- commen�s; e�9
Use drawings of facii ;to better "plain situations (use additional pages as necessary). '
'
�.r.
Reviewer/Inspector Name: .L3 11 1 k Y ' OL V%�
Reviewer/Inspector Signature:
Page 3 of 3
Phone
Date: 5 s4& �L --
2/4/2011

ME
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance;;,
Reason for Visit: (! Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: d l"+C1 Departure Time: County: Region:
Farm Name: 4,4410 FARnt5 _&C, Owner Email:
Owner Name: 1JA*R rAAM, j Tn1C_ Phone:
Mailing Address:
Pbysical Address:
Facility Contact:
Onsite Representative: C'jA in
Certified Operator: flt:ns UpLuf
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator: "rp Fv)
Certification Number: new
Certification Number:
Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? [::]Yes Q No —] NA ❑ NE
Discharge originated at: p Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? [::]Yes ❑No EfNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
L!f NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
Design
Current
❑ Yes
Design
Gnrrent
Design
Current
Swine
CapacityPopp
❑ NA
Wet Poultry
Capacity
Pop.
Cattle Capacity
Pop.
Wean to Finish
of the State other than from a discharge?
La er
airy Cow
Wean to Feeder
Non -Layer
airy Calf
Feeder to Finish
airy Heifer
Farrow to Wean
-IFMOD
aoub
Desigu
Current
Dry Cow
Farrow to Feeder
D . P.aultr,
Ga aci
P,o
Non -Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
her
�4
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? [::]Yes Q No —] NA ❑ NE
Discharge originated at: p Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? [::]Yes ❑No EfNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
L!f NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[�
�No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
°
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

Facili Number: -7 Date of Inspection: L$
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes yNNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [dNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ��l
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
t'0
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes
[—]Yes E?(No
�No[:]
❑ NE
[:]Yes
dNo
❑ 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 E?(No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes QNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
❑ NE
Required Records & Documents
9. Does any part of the waste management system other than the waste structures
require [:]Yes [2�No
[DNA
❑ NE
maintenance or improvement?
Z No
❑ NA
❑ NE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes [yNo
❑ NA
❑ NE
maintenance or improvement?
the appropriate box.
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes [g/No
❑ NA
❑ 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
p Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
C+;
6 UwC5
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 HNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes [ (No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[:]Yes
[j''io
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[�Io
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Z No
❑ 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.
❑VvW ❑Checklists ❑Design ❑ Maps p Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
❑ Yes Ea"No
❑ Yes ❑ No
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[] NA ❑ NE
�NA ❑ NE
Page 2 of 3 214/2011 Continued

Facili Number: ed 117 k Date of Inspection:
[1 r<o
❑ NA
❑ NE
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
E�(No
❑ NA ❑ NE
the appropriate box(es) below.
E2/No
❑ NA
❑ NE
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
[0'*No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
❑ NA 5]�PE
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 emergy situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes G3"No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? [:]Yes [3"No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [RNo
Comments (refer to question ft Explain any YES answers and/or any additional. recommen_ dations or any other.
Use drawings of facility to better explain situations (use additional pages as necessary)..
CO+n'tanvtc �0 AAnR�SS t�Af�� �',rzF-'"'S �Ra�:��D 1~�•�oar�S
❑ Yes
[1 r<o
❑ NA
❑ NE
[]Yes
[D/No
❑ NA
❑ NE
❑ Yes
E3/No
❑ NA
❑ NE
❑ Yes
E2/No
❑ NA
❑ NE
60003 k-C-0aibs
r Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
"4
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Phone: "'0030%-UB51
Date:
2/4/2011

R
_ tIms VLOZ gyj-
tv "' of Water ,Quality
Facility NumberWj ' � - © Division of Son and Water Conservation
`�`�'^` ©Other Agency
Type of Visit: UzRmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q�utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: j Departure Time: Q County:
Farm Name: Owner Email:
Owner Name: _ �1 j f�C�L" �y�LS f jr _ Phone:
Mailing Address:
Region: I T2A
Physical Address:
Facility Contact: � �gI M111tor► Title: Phone:
Onsite Representative: Integrator: A4
Certified Operator: S�- Certification Number: !�!
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes B-I�o ❑ NA ❑ NE
[—]Yes
❑No
esign CurrentDestgn
TIN
❑ NE
Current Design Current
❑No
S2-
wine Ervjr�apak�SP,ap:E[Non-IL,ayer
❑ NE
t PoultryCap
ct Pop"
Cattle Capacity Pop.
Wean to Finish
er
Dai Cow
Wean to Feeder
Feeder to Finish
Farrow to Wean
„_ = �, =
- "*
Design''acCurrent¢
Da Calf
Da' Heifer
D Cow
Farrow to Feeder
D P,oultr.
�Ca act ` >Po__
Non -Dairy
Farrow to Finish
Gilts
La ers
Non -La ers
Beef Stocker
Beef Feeder
Boars
Pallets
Turkeys
Turkey Poults
Reef Brood Cow
Other
x--
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes B-I�o ❑ NA ❑ NE
[—]Yes
❑No
®-<A
❑ NE
[:]Yes
❑No
[P-�KX
❑ 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
2190
❑ Yes
P1<0
BITA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 2/4/2011 Continued

Fac Wty Number: I Date of Inspection: U
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [r No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [�A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:L
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _A5
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 F�r`No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 2<o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes E?4o ❑ 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 02-1Vo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes [t +lo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below_ ❑ Yes �o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [] PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13, Soil Type(s):
14. Do the receiving crops differ
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18_ Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
❑ Yes
I oo
2 "0
Ep- o
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ Yes E No ❑ NA ❑ NE
[:]Yes �No ❑ NA ❑ NE
Re uire_d Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes L / ❑ NA [:]NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [D Nd ❑ 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 Lle Ko ❑ NA ❑ NE
❑ Waste Application p Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑Yes o ❑ NA NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes fo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes F,l 15- [] 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 021No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA Q'iQ>s
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:
[:]Yes ®<o ❑ NA [] NE
❑ Yes [j2, ❑ NA ❑ NE
❑ Yes Ux-o-_'E] NA ❑ NE
❑ Yes to ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [:]Yes L:jAo ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on-site representative? ❑ Yes10 NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes o ❑ NA ❑ NE
'7L
�504�
Reviewer/Inspector Name:
ReviewerAnspector
Page 3 of 3
Phone: <o —
Date: leoll, ZZ4l
4!2011

VXIS 6.1-711 7,010
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit &I routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: j Arrival 'Time: 9a)O,t Departure Time• %Q,' County: . So
Farm Name: LAA l lel- Fa r wl :I"<- Owner Email:
Owner Name: dDG'JNi'S i'J0.11e_V` Phone:
Mailing Address:
Physical Address:
Region:
FacilityContact: Gu✓, ICrNAleatc, /J. N[d�."�Title: Phone No:
A4�°c
Onsite Representative: �^�a�G� Integrator: _ �, •_ p C
Certified Operator: ��^' N� Sct�{'r Operator Certification Number: j9�D J
Back-up Operator:
Back-up Certification Number:
Location of farm: Latitude: =0
=6
=,. Longitude: =1 ° =I =
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ErNo ❑ NA ❑ NE
❑ Yes
Design Current
Design Current.
Design Current
❑Yes
Swine
Capacity Population =Wet Poultry
CapacityPopAulattoa
Cattle Capacity Population
No/
❑ an to Finish
[INE
❑ Layer
[❑
LKo'
❑ Dairy Cow
❑ NE
❑Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
"'_
❑ Dairy Heifer
Farrow to Wean
2400
Dry Poultry
n A � ❑ D Cow
El Farrow to Feeder
_
`'
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑Beef Stocker
❑ Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑ pullets
❑Beef Brood Co
_ _ ❑ Turkeys
Other
❑ Other
❑ Turkey Poults
t I ElOther
Number of Structures
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ErNo ❑ NA ❑ NE
❑ Yes
❑ No
L Y,NA
❑ NE
❑Yes
0 N
L"fN'A
El NE
❑ Yes
No/
fA
[INE
El Yes
[❑
LKo'
❑ NA
❑ NE
El Yes 0.,K ❑NA [I NE
Page 1 of 3 12/28104 Continued

Facility Number: 82 — �f Date of Inspection lO '17�I0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ETNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes CrNo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. - i /-a " Z
�.�
Spillway?: )q
Designed Freeboard (in): q
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
13.
Soil type(s) 1166 , f a MQ� A
6. Are there structures on-site which are not properly addressed and/or managed ❑ Yes
b ❑ NA
❑ NE
through a waste management or closure plan?
Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
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 No ❑ NA
❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
BNo ❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
? ❑ Yes
9. Does any part of the waste management system other than the waste structures require El Yes
,�,"No�
L�❑ NA
❑ NE
maintenance or improvement?
El Yes
�NNo
l3No ❑ NA
Waste Anotication
18.
Is there a lack of properly operating waste application equipment?
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
D. o ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
Er5o L❑ 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 types)9Qrvti%k_d0_ { /Grrs�►r�b� _ Smg GEai+u to -.s.) ,
Cw-j-LjLt&+-sem.,bcqWS
13.
Soil type(s) 1166 , f a MQ� A
14.
Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
L7 No ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
2 Ngo ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
? ❑ Yes
2r[_1 NA
[j NE
17.
Does the facility lack adequate acreage for land application?
El Yes
�NNo
l3No ❑ NA
ElNE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
P o ❑ NA
❑ NE
ReviewerAnspector Name M
Reviewer/inspector Signature:
Page 2 of 3
Phone: 9b. x`-33 33o0
Date: G / -Z0/D
12128104 Continued

Facility Number: $2 —37 Date of Inspection
Re aired 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 B o ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 2<o [:] NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
Id'No [:1NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Blgo�❑ NA
❑ NE
24.
Did the facility fait to calibrate waste application equipment as required by the permit?
El Yes
ff off❑ NA
❑ NE
25_
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Piro'l❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
"13 NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
,EgIN
21lo ❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
9-<o ❑
9
[:3NA NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
algaff❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
_,
UN0 ❑ 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
�,
[a-iVo ❑ 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
BNo ❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
LTNo [:INA
❑ NE
Page 3 of 3 12/28104

-61►uS 11 -la -zoo?
Type of Visit (D -Compliance 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: /a</o -- 09 Arrival Time: 9. �� AM Departure Time: IO: D//�� County: ASo ^� Region: ��90
Farm Name: �4 �><e f4 v S Z�G Owner Email:
Owner Name: beNIJt S 41t-✓ Phone:
Mailing Address:
Physical Address: /
Facility Contact: 6GNTerO KetJA/C ��e_ Title: . SP G Phones No:
j
Onsite Representative: 0 �aN /�,/► .Il4' Integrator: Z)
Certified Operator: I) e-" ^f t � S W 6k I I <--✓' Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o [:] ' [—] Longitude: = ° =' = u
Design Current
Design Current
Ity
❑ NE
❑ Yes ❑ No F4'<A
Wepacity Population
Cattle CapaciPopulation
❑ NE
❑ Wean to Finish
❑ La er
❑ Da Cow
❑ Wean to Feeder
Laver
❑ Da' Calf
❑ Feeder to Finish
Dt;y Poultry
❑ Da' Heifer
❑ D Cow
❑ Non -Dairy
arrow to Wean D
0
❑ Farrow to Feeder
❑ Farrow to Finish
ers❑
FRL'a, n -La yers
Beef Stocker
Feeder
❑ Gilts
❑ Boars
❑ Pullets
❑ Beef Brood Co
El
❑ Turkeys
Other
❑ Other❑
❑ Turkey Poults il
Other
Number of 5truetures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ffNo ❑ NA ❑ NE
❑ Yes ❑ No LT NA
❑ NE
,
Yes ❑ No NA
ElB
❑ NE
❑ Yes ❑ No F4'<A
❑ NE
❑ Yes IJ No ❑ NA
❑ NE
❑ Yes B o ❑ NA ❑ NE
12/28/04 Continued

Facility Number: <g Z 3 ]S
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes LYNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 9KA_ ❑ NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 4a,4 2—
Spillway?:
Spillway?: /V O
Designed Freeboard (in): 42 / g
Observed Freeboard (in):
.2-7
5. Are there any immediate threats to the integrity of any of the structures observed? Yes ❑ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) �'
6. Are there structures on-site which are not properly addressed and/or managed El Yes M 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? ElYes O No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ���es ❑ 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 E!rNo ❑ NA EINE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [3 o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) _jV p A , ra-9 , Aka►-v�, ry , k ti /k
14. Do the receiving crops differ from those designated in the CAWMP?
l5. Does the receiving crop and/or land application site need improvement?
iv�O.S,�. Corm—WJ�—SPy6eAws
❑ Yes L'7 No ❑ NA ❑ NE
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
1$. Is there a lack of properly operating waste application equipment? ❑ Yes
R<o ❑ NA ❑ NE
E3"No ❑ NA ❑ NE
No ❑ NA ❑ NE
No [:INA ❑ NE
Cornments (referrto:question #): Explain anyf,YES answers andlor any recommendation`11s or aother comments.
�., N -M I. , „ n..
Use drawings of facility to better explain situattoas (use additional pages as necessary),
,-
5, Ph &J,.. C u !.lend7 p hew. •fs ► wc" 5
ons -0tx+s d d .__ S Ay C_ or
�
(aiAIC
i43era i>* I �a/d Side j / AW le-57.r4i..v S'
lu S • Pfc r t�-au c-. 5a, I 4 � -,0 ,,, A w�4�. s;�r
1 N �(�¢_ rvw lgfoo.J
Ipj 0erd��- e- I- a. �rac rGaa/r... a
Reviewer/Inspector Name
Phone 9/0. ,<33.3300
Reviewer/Inspector Signature:
Date:
12/28/04 Continued

Facility Number: $ 2 378 Date of Inspection F11--t-0710—Ti
Re uired 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 L'7No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ffNo ❑ 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
0 To
❑ 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
T
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
� �o
211o,
L`i'Zo
❑ NA
EINE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
R o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
//
o
El NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElD Yes
,B
o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
L31Vo
❑ 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?
ElYes
BNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
BNo
[__1 NA
❑ NE
iAddeiEonal C* omments�andlor Drawings : `%�+k
2�• Cali 6�-a-�#�,j ,�j s don�c -mss- z�oSs
•
NaJ
' �c G., (,' j4 ►� f v+-�
Witt ►.ro'f Iv 2. r—,* u l' r c... U_A, 7L-�/AID
T
]MV04

L -7-T LI.S 7-2/-07
�7 uivision of Water QaaGty
~Facility Number 9Z �7 g Division oiSoil and Water Conservation
Q Other Agency
Type of Visit (2Eompliance inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: '/7 `O$ Arrival Time: ,3� Departure Time: �� Q County: �a+�tPso�J Region: ���
Farm Name: L30A e r Fav ►..45. -Lt.. L • Owner Email:
Owner Name: w 0.�� F:7ZkV cS XM C- • Phone:
Mailing Address:
Physical Address:
Facility Contact: --Ao4CMA" AA tjw Title:
Onsite Representative: <aerNO Ke_.-tjudh _ Integrator:
Phone No:
Certified Operator: "Itj ti S W 0`kt c�1� _ Operator Certification Number: 1 g985
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [ 0 ='
0,4 Longitude: [----] o = , ="
Y.e
Des' n Curren~
tg
❑ Yes
g Design Current
Desi nn Current
Swine Gapty Popu n
Wet Poultry
Capacity Popu C1Q. Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑Non -La er
No
ElLI
❑ Dairy Calf
❑ Feeder to Finish
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ Dairy Heifer
Farrow to Wean Z SOD
Dry Poultry
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Dry Cow
❑ Farrow to Feeder
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
El Yes
❑ Non -Dai
❑ Farrow to Finish
❑ La ers
2. Is there evidence of a past discharge from any part of the operation?
❑ Beef Stocker
❑ Gilts
❑ Non -La ers
r
❑Beef Feeder
❑ Boars
El Pul
A
�❑ eef Brood Co
other than from a discharge?
El Turkeys
Other
❑ Turkey Poults
Number of Structures
❑ Other
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
E7 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
Was the conveyance man-made?
❑ Yes
No
ElLI
'A
NA
ETN"
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[3 A
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
El Yes
❑ No
���
Ej NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ YesNo
❑, NNAA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
❑ No
A
EINE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: Z,-379
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 I Structure 2 Structure 3 Structure 4
Identifier: { 2 -
Spillway?: Spillway?:
Designed Freeboard (in): ,S (9, 5
Observed Freeboard (in): Z 30
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 3,�,</o El NA El NE
El Yes 13<0 ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes B<o ❑ NA ❑ NE
❑ Yes D<o ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ET N/o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes D o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [3No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ElE7 Yes No ❑ NA El NE
maintenance/improvement? .,�
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes LTNo [INA ❑ 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) iNRy t Pof.; ..+-c_% Sw��G,r.;n1 to.S ,v - Sim%r .mss
13.
Soil type(s) A
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
[3<o
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
ff No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
[ No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Reviewer/Inspector Name I Re_ e_VeJ Phone: 9/0, 3. 333
Reviewer/Inspector Signature: Date: '7- ," 7— Z609
Page 2 of 3 12/28/04 Continued

Facility Number: Sz —37 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 O No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklistsgn
❑Desi El Maps E] Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
EJ No
❑ NA
❑ NE
❑ yes
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ NE
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 "
Rain Inspections El
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
LTJ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
ETN'
LET o
[:1 NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
LE�JJ N//o
❑ NA
E] NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
[:1 NA
[:1 NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
�L'No
LQNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
LJ No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
E3<o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[2 o
❑ 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
El Yes
��
LJJ No
❑ NA
❑ NE
General Pen -nit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
Ko
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
LI No
❑ NA
❑ NE
Additional) Comments and/or. Drawings;°,,:. = . ;.. :' . � u .
Page 3 of 3 12/28/04

� Ikj IDID110
Lacility
- V Division of Water Quality 11
11 1 Number Q Division of Soil and Water Conservation
O Other Agency
Type of Visit $ Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arri,al Time: Departure Time: County: �n Regior�Q
Farm Name: wA-� �•i�_ mS L 1'� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: O vahngh --Title:—( tc C_ Phone No:
Onsite Representative: Lam ► Integrator: PUPI- 1 S4 c t ' —6
Certified Operator: LJC X11fL S _ _ VCS' Operator Certification Number: IS9
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
,1=arrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Back-up Certification Number:
Longitude:
Latitude: =0
=,
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_I ❑ La er
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation`?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
m
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy 1-leife;
❑ Dry Cow
❑ Non -Dai
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Humber of Structures.
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d- Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes *N. ❑ NA ❑ NE
❑ Yes
❑ No X NA
❑ NE
[-]Yes
❑No IQNA
EINE
❑ NoJVNA
❑ NE
❑ Yes
[:]Yes
.jNo ❑ NA
❑ NE
❑ Yes
❑ No jj�3A
❑ NE
12/28/04 Continued

Facility Number_19___Date of Inspection D
r
❑ Yes
ENo
Waste Collection & Treatment
❑ NE
15. Does the receiving crop and/or land application site need improvement?
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
6 No ❑ NA EINE
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: 2
RNo
❑ NA
Spillway?:
Designed Freeboard (in): !�-� 1 q
18. Is there a lack of properly operating waste application equipment?
❑ Yes
&PNo
Observed Freeboard (in): 3
❑ NE
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
�YNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed
❑ Yes
14 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?
/6 Yes
❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
RINo ❑ 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
[j 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
Wo ❑ 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 El Application Outside of Area
12. Crop type(s)✓ X rr1() H 4 P, �b2 Cr 04 _t Q_— L4j~ S
_
13. Soil type(s)
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
(",No
❑ NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
RNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
&PNo
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): '
reff
`fo t?54z6AA S441Ld ,
l� �f
Re-dewer/Inspector Name � ME N t Q Phone: `-t 33 3&DD
ReviewerllnspectorSignature: Date:'l.JCL. f�
12/28/04 Continued

r
Facility Kumber: ,�_ —3 Date of Inspection Y
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes "MNo ❑ 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 ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes 14No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
❑ 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
N No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
00 NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
O[No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
RNo
❑ 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
M NA
❑ NE
Other issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ANo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
j3No
El NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
kNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
O 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
k No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
*No
❑ NA
❑ NE
Comments and/or Drawings:
12/28/04

cla
Facility No.1�nTime Out
Time In �JU
Farm Name Wx Fa-� rl S f 1)L. _ Integrator
Owner b -k 6 h _ _5 � V1C___ ___ Site Rep
Operator
No.
Back-up No. _
COC V Circle: enera or NPDES
o'7
FREEBOARD: Design
Sludge Survey
Crop Yield
Rain Gauge
Soil Test ✓ ix L Wettable Acres
Weekly Freeboard
Spray/Freeboard D
Weather Codes
Waste Analysis:
Daily Rainfall L-1---
-11
�u t 4C4
120 min Inspections
Date Nitrogen (N)
L
z.%
34
Observed 3
Calibration/GR7 ! %it
Waste Transfers
Rain Breaker
PLAT
1 -in Inspections ✓
Date Nitrogen (N)
Ws Z. Z .(
Pull/Field Soil Crop Pan Window
CY a Y
OV l�
ftxy
'30 ,, —
t o o
010
t 4 y ()P -e
-- YY)G-L s
r 37
l� Z
Design Current Design Current
Wean - Feed
Farrow - Feed
Wean - Finish
Farrow - Finish
-Finish
Gilts 1 Boars
Farrow -
Others
FREEBOARD: Design
Sludge Survey
Crop Yield
Rain Gauge
Soil Test ✓ ix L Wettable Acres
Weekly Freeboard
Spray/Freeboard D
Weather Codes
Waste Analysis:
Daily Rainfall L-1---
-11
�u t 4C4
120 min Inspections
Date Nitrogen (N)
L
z.%
34
Observed 3
Calibration/GR7 ! %it
Waste Transfers
Rain Breaker
PLAT
1 -in Inspections ✓
Date Nitrogen (N)
Ws Z. Z .(
Pull/Field Soil Crop Pan Window
CY a Y
OV l�
ftxy
'30 ,, —
t o o
010
t 4 y ()P -e
-- YY)G-L s
r 37
l� Z

Type of Visit iJ"Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: � tQ10 Arrival Time:F_77," Departure Time: County:
Farm Name: _e1 r�Z+ �Arrr15 _circ . Owner Email:
Owner Name: GyQL/ fid` /GGt�mSr+G Phone:
Mailing Address:
Physical Address:
Facility Contact: �rzt] %!2.r �r4 Title:
Onsite Representative: -S/zs Y
Certified Operator:
Back-up Operator:
Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Region: LZ
Phone No:
Integrator: 1.;12
Operator Certification Number:
Back-up Certification Number:
Latitude: 00 =I
El 1
1 Longitude: [__1 ° F_T = u
Design Current Design Current
Capacity Population Wet Poultry C.1pacity Population
❑ Layer
I' ❑ Non -La et
Other .
❑ Other --
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑
Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation'?
Discharge originated at: El Structure ❑ Application Field El Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity. Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cowl I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
I? No
❑ NA
❑ NE
❑ Yes
[RNo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
No
❑ Yes
No
❑ NA
❑ NE
Cl Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection L/
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ER No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Z1 Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
[,Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections R Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes MNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
C@ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
®No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
E] No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
91 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
KI No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[0 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
[R No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[}R No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
❑ Yes
0 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�jNo
❑ NA
❑ NE
AdditionalfComi<nents and/orgDrTawings-
.__
1
12/28/04

Facility [dumber: — Date of inspection ��ro
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 l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
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 [4 No ❑ NA ❑ NE
❑ Yes q No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ® No ❑ NA ❑ NE
El Yes ®No [:1 NA El 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 �KNo [:INA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?❑yes rvr12g El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes JZNo ❑ NA ❑ NE
maintenance/improvement?
1 I . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ERNo ❑ 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 El Evidence of Wind Drifl ❑ Application Outside of Area /
12. Crop type(s) C,,n &)./,./1%-�risz�c�/�
13. Soil type(s) ,d[I9ZLf- --J!
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 4 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes LM No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[:] Yes
JRNo
❑ NA
EINE
17. Does the facility lack adequate acreage for land application? ❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
C,No
❑ NA
❑ NE
Reviewer/Inspector Name �,�,v L ��`i.-.-� Phone:
Reviewer/Inspector Signature: Date:/ �3% O 6
12/28/04 Continued

[}.."Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 9 0" Longitude �I � K
Design Current
Swine ra.tiAft, Pnnvd*6nn
❑ Wean to Feeder
❑ FpTerto Finish
Oif arrow to IVean q400 25161
❑ Farrow to Feeder
Farrow to Finish
Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
1,, 1 1 JE1 Dairy I
❑ Non -Laver I I I[] Non -Dain
❑ Other
Total Design Capacity 2YDV
Total SSLW
Number of Lagoons i A j 10 Subsurface Drains Prese_nt� U Lagoon Area ILI s rav €field Area
Holding Ponds / Solid Traps � ❑leo Liquid Waste Management System - � -
Discharges S Stream Impacts
1. Is anv discharge observed from any part of the operation? ❑ Yes 99'90
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach R ater of the State? (If yes, notif} DWQ) ❑ yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does dischar&ge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑Yes so ,1- 0
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? El Yes GPFc
Waste Collection & Treatment ,,_,�
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway [I Yes CI �o
Stmctur; I Structure�I Structure 3 Structure 4 Structure 5 Structure 6
Identifier: !
Freeboard (inches):
05/03/01 Continued
Dace of Vicit:
3 %� d Time: - 3b
Facilit}- Number
B
L
Not Operational 0 Below Threshold
Permitted M Certified
0 Conditionally Certified
© Registered
Date Last Operated o Above Threshold:
Farm Name:
,%fink Faf'" e-
County: "" N
Owner Name:
Phone No:
Mailing Address,. _ g?9
"Iter Ad.
!
/n -t. 0l;t►r �
NL 198369
Facility Contact:
WA dr -C
Title:
Phone 1o:
Onsite Representative:
S W. f er. It.,
AcwwJ
Integrator: 1 � M
Certified Operator:. _
��i5 U1hIlGK
Operator Certification Number:
Location of Farm:
[}.."Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 9 0" Longitude �I � K
Design Current
Swine ra.tiAft, Pnnvd*6nn
❑ Wean to Feeder
❑ FpTerto Finish
Oif arrow to IVean q400 25161
❑ Farrow to Feeder
Farrow to Finish
Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
1,, 1 1 JE1 Dairy I
❑ Non -Laver I I I[] Non -Dain
❑ Other
Total Design Capacity 2YDV
Total SSLW
Number of Lagoons i A j 10 Subsurface Drains Prese_nt� U Lagoon Area ILI s rav €field Area
Holding Ponds / Solid Traps � ❑leo Liquid Waste Management System - � -
Discharges S Stream Impacts
1. Is anv discharge observed from any part of the operation? ❑ Yes 99'90
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach R ater of the State? (If yes, notif} DWQ) ❑ yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does dischar&ge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑Yes so ,1- 0
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? El Yes GPFc
Waste Collection & Treatment ,,_,�
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway [I Yes CI �o
Stmctur; I Structure�I Structure 3 Structure 4 Structure 5 Structure 6
Identifier: !
Freeboard (inches):
05/03/01 Continued

Facility Number: g —
Date of Inspection Y
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
I i . Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type /5(-^ 4A if. St -4 tr bruit.
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15_ Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
&quired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.) '
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & oil samp a reports) r
20. Is facility not in compliance with any applicable setback criteria in effect at the time of estgn.
21- Did the facility fail to have a actively certified operator in charge?
22 Fail to notify re ional DW f mer n w t 'r d b G 1 P 4t'7
❑ Yes QN/0'
❑ Yes LKNo
❑ Yes
ElYes 3<0
❑ Yes Lr3'tvo
❑ Yes E iso
❑ Yes Lf'No
Ell_`� Yes No
El Yes [3.N6'
E3 Yes
El Yes ,[�ti�
El Yes
El Yes
❑ Yes L!No
❑ Yes
040
❑ Yes
[I Yes
,.©�
E3-N—o
El Yes
0<o
g Q o e ge cy st a tons as re'I. e y ­­ertnt . ^ ' T—
(ie/ discharge, freeboard problems, over application) ElYes E94 o�
23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? ❑ Yes ,[9i o�
24. Does facility require a follow-up visit by same agency? El Yes Blq
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.

Facility Number: —.3 IDate of Inspection / o
Odor issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
24. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (Le, broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes � I�Io
(`
❑ Yes <
❑ Yes Dqvv-�
❑ Yes Oxd
❑ Yes �Q''vow�
❑ Yes ,E�o
❑ Yes l—�}'No
1ddna nntmeutsgan orrawings•
... .. _
i
05103101