310810_INSPECTIONS_20171231

NORTH CAHOL#NA
Department of Environmental Qual

G
Type of Visit: Qf Com ce Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: L n A Q c r t
Certified Operator:
Back-up Operator:
Location of Farm:
Title: Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Cu �reut
ensign
Current
Design
Curent
Swine
1
C pacify
Pop.
Wet Poultry
Capacity
Pop.
Cattle
Capacity
Pop.
IHFI9tt
■714�.1INA
IIihAlt
F!lCNiU
an to Finish
La er
Dai Cow
can to Feeder
2-- o
Coop
Non -La er
Dai Calf
Feeder to Finish
DairyHeifer
Farrow to Wean
Design
Current.
D Cow
Farrow to Fecder
D . Poult
Ca a f
Pop.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
WOtherN
TurkeyPoults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
ZrNo ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No ❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No [] NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ ❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
.Y 1-1Yes
`
El ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
u No ❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

IFacility Number: - 9_j Date of Inspection: f Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): l_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 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 u fVoC
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ 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 ADMication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes P40
D 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 from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes❑
FNN
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes❑
NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes VN,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 o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
[] NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below Yes ❑ No ❑ NA ONE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ N
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Q No ❑ NA NE
Page 2 of 3 21412015 Continued

Facili .Number: - 0 Date of Inspection: J r Z. /
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? e 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 No NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
'30. Did the facility fail to notify the Regional Office ofemergency situations as required by the
❑ Yes
No ❑ NA
permit? (i.e., discharge, freeboard problems, over -application)
VE
31. Do subsurface tile drains existat the facility? Ifyes, check the appropriate box below.
❑ Yes
❑ NA
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
<oO
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
NA
❑ NE
n
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
j�CYf
❑ NA
ONE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No ❑ NA
❑ NE
r''ri.ia.�nnia/rein>M..hn5ni�oafinn':fEl%G'rnlain.-o �tv'VI�'Q'..ancwaid�o'nNln i�:an`v:o`i r�if�nn`ol:�oenmmar►da4anne"n'�'nnVn�6ar nnmmnnM-""i.' i. 3�..r Ci
C C�Si Pn u
Reviewer/Inspector Name: �` SVVt Phone:
ReviewerllnspectorSignature: Date: �� L (7
Page 3 of 3 21412015

Type of Visit: U Co iance Inspection Q Operation Review Q Structure Evaluation p Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access II
Date of Visit: r ( Arrival Time: Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: % i� ��` r {
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
f
1111
LD)esj nyLeurgent
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle
Capacity Pop.
an to Finish
La er
Dairy Cow
can to Feeder
.Z (1U
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
Current
22 Cow
Farrow to Feeder
D , P,oultr
Ca aci
P■o P.
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
T key Poults
Other
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
❑ No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility N mber: - Date of Inspection: Z /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: _� Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes 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 ErNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ Ko- ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [ o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ES�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [:]No 0 NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ErNo ❑ 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 E
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes El"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 11'15-0
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes :f No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 6No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 214120I5 Continued

Facility Number: -iir 7 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes ❑`l�lo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes aN6 ❑ 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 to !❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? []Yes []No ❑'NAS❑ 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 GAWMP?
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 [2r'rl4o ❑ NA ❑ NE
❑ Yes D1ro_ ❑ NA ❑ NE
❑ Yes J`1Vo [] NA ❑ NE
0 Yes M—No ❑ NA ❑ NE
❑ Yes �No
❑ Yes Q No
❑ Yes E No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
.......,........ ter.,., .............. ,� � ....,..,,. - -
Reviewer/Inspector Signature: ��—y—�--r Date:
Page 3 of 3 21412015

0
Type of Visit: 0 YRoutine
pliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: o I Arrive Time: Departure Time:® County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: Llrt� AZ
Certified Operator:
Title:
Back-up Operator:
Location of Farm: Latitude:
Phone:
Integrator:
Certification Number: r)SZ
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
La er
Design
C*apacity
C►urrent
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder S
t< oa
Non -La er
DairyCalf
Feeder to Finish
D , l;oultrr
Layers
Design
C•a acit
C•urrcnt
P,a ,
DairyHeifer
D Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other I IOther
Turkeys
Turke Poults
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes EYNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
[] NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
r?D o
❑ NA
❑ NE
❑ Yes
o
❑ NA
❑ NE
Page I of 3
21412015 Continued

Facili Number: - 1 Date of Inspection: 1115
Waste Collection & Treatment ���
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes L%J l�o ❑ NA ❑ NE
a. If yes, is waste level into the structural Freeboard? ❑ Yes ❑ No ❑ NA [D NE
n Structure I (DItructure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 4 Z43 2 4 Y
Spillway?:
Designed Freeboard (in): { 'S R
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ONo ❑ 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 [2 "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 0 N ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Q'�10 ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes dNo ❑ 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 from those designated in the CAWMP? ❑ Yes D o ❑ 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 fNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [�o ❑ NA ❑ NE
❑ Yes ❑'Vo ❑ 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
�o
[] NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? I f yes, check the appropriate box below.�r�YcsffN
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
�rather Code
❑ Rainfall ❑Stocking ❑ Crop Yield �20 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[n_Nio
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E:fNo
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facility Number: ''� - �i Date of Inspection: ti
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ETN"o
i
25. the facility out of compliance with permit conditions related to sludge? If yes, check © Yes ❑ No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ NA ❑ NE
❑ NA ❑ NE
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
iA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA ❑ NE
❑ Yes [rNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ]No ❑ NA ❑ NE
❑ Yes g No ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
Reviewer/Inspector Signature: Date: 1 L v J
Page 3 of 3 21412015

Type of Visit: aCo liance inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: utine Q Complaint Q Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: Arrival Time: a Q Departure Time: ® County: X )
Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Phone:
Integrator:
Certification Number:n1
Certification Number:
Longitude:
Design Current
Design
Current
Design C*urrent
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle C►apRU Pap.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder 2.0b I
INon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design
C►►urrent
Dry Cow
Farrow to Feeder
Dr, P,ouitr,
Ca acf
P,o .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (1f 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 0NNo ❑ NA [] NE
[:]Yes [:]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes 6/p o ❑ NA ❑ NE
Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: Date of Inspection: I:W
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
n
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
dNo ❑ 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 environment threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 1 ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes rNo ❑ 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 [�/No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Q No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Y
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
rNoo
❑ NA
❑ NE
acres determination?
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
❑ o
❑ NA
0 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
2/es
Yes
❑ No
❑ NA
❑ NE
the appropriate b
WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Othe :
V
es record keeping need improvement? If yes, check the appropriate box below. yes ❑No ❑ NA ❑ NE
aste Application ❑ ekly Freeboard ❑ Waste Analysis Soil Analysis D Waste Transfers D Weather Code
❑ Rainfall ❑ Stocking 0 Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑Yes [�o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes Vo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Faclli ' Number: 31 Ds ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit. Ves
No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check es
❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
dNon-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance: L-A ( .` 4 2,
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes
o❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ YesgNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes
P<0 ❑ NA ❑ NE
and report mortality rates that were higher than normal?
No
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes
2 ❑ 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
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 Flo ❑ NA ❑ NE
❑ Yes [fNo ❑ NA ❑ NE
❑ Yes
[l"No
❑ Yes
'
❑ Yes
VNo
❑NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawinns of facility to better explain situations fuse additional naves as necessarv}.
-Lb), Ew WWe . N EED �-b aL�O+JG- w4= o W 004
WAS-TC APP LTo%7 -s-)-. zc c. a a_D s rn�s s .►J�, rg_atM. 4 I-S T 4lzo k3 .
�J . w CL�. �duoLJ .w.zrT W
CR4p J1ZE(_D NI•�S ST 1,.1 �, � C �RlS w64Ck CADSE o( �'-o�v
LACra Z �5s 0.813 FAIZo 4M D
EC-�S S1.,,PG_e ?.A .PoNc ,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
�. Phone:Mlb
Date: 1
214 OI J

Type of Visit: Q Co lance Inspection U Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Timc:� County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Phone:
Phone:
Onsite Representative: Integrator: �]
Certified Operator: Certification Number: J 9q.2S-7
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
Design Current
Swine Capacity Pop. Wet PoultnJ
Wean to Finish Layer
Design Current
Capacity Pop.
I I
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder 11 INon-Layer
I
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder D.rr P,oultr,
Design Current
C*_a aei P,o
Dry Cow
Non-Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Qther
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[:]Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[:]Yes [:]No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes ❑
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes Y zo
❑ 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 21412011 Continued

A
Faeili Number: -glig Date of inspection: Y,
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 25"No [] NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: CA 665 V ! k0J Z—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 11;1,(
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [3"No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [2/No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [:]Yes ZNo ❑ 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 ENo ❑ 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 from those designated in the CAWMP?
es
0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Vyes
❑ 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
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑EZes
�No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ No
❑ NA
[] NE
the appropriate 06.
WUP ❑Checklists ❑Design [] Maps [] Lease Agreements ❑Other•
21. Does record keeping need improvement? If yes, check the appropriate box below. [Yes [] No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking F2/Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:]Yes rNo
� ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

J
t
Facility Number: - Date of Inspection: !v 1-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C�? ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L o ❑ 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 N
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes V
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes blNo
❑ 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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ Yes ]�No
❑ Yes Ej"No
[:]Yes
N
[] Yes5zo
❑ NA ❑ NE
❑ NA ❑ NE
[DNA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to question ##): Explain any YES answers and/or any, additional recommendations or.any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
�;) 0i ZZ ri-a 0 Of 6C2v-+U041 ;2d'0(L—SAPC, WC-c C�n��ILaL,1�f f� D
;j) dfOAre tAd? �J-16.a r(L- 6MMU0A J- Cf4p rftct✓ofk
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
r4t�(�i�, Phone: (j 13�
r 6
Date: lb
V41101I

(Type of Visit: U CC pliance Inspection O Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral 0 Emergency O Other Q Denied Access
Date of Visit: ►t l S { Arrival Time: Departure Time: 20 County: OUPLE J Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: Wilms &4u4E _ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Certification Number: 1 q 41.5 rj
Longitude:
Design Current _rJDesign Current
Swine Capacity Pop. Wet Poultry Capacity Pap.
Finish Layer
Design
Cattle Capacity
DairyCow
C+urrent
Pop.
Feeder 5 7.6a rja6p
Non -La er
Dai Calf
Finish
Dai Heifer
rpGilts.
Wean Design Current
D Cow
o Feeder Dry P,oultr, Ca �ci P,o
Finish La ers
Non-Dairyo
Beef Stocker
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Qthcr
Other
Turkeys
Turkey Poults
Other
Discharees and Stream Impacts
. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: _
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2, is there evidence of a past discharge from any part of the operation'?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes 2�No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
[]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[]Yes
�?`No
[DNA
❑ NE
❑ Yes
o
❑ NA
❑ NE
Page I of 3 21412011 Continued

Waste Application
Facilit Number: -� Date of Inspection: ktilsilt
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
y
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: L AC-mfl✓1 ! Q�?/
Ef/No ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? EYes �No[j ❑ 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 environment threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ffNo ❑ 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?
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. 12 Yes [:]No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
MP N ❑ 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): tws OATS k5we QE,Q..y► UD'A ISGo
13. Soil Type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
El Yes
YNo
❑ 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
o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Z/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 EfNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis D Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �o ❑ 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 21412011 Continued

Fac#Iit Number: -sib Date of Inspection: i 15 l
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ZNO ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check []Yes dNo ❑ 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 Ef 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?
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, aver -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes dNo
❑ Yes No
❑ Yes []/No
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
J No
VNo
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any..YE S Answers a'nd/or any addihonalarecommendatigns or anylotlier commentsli�A a i
Use drawings of facilityao better explain s##uationsl'(use:addittonal{pagesaas necessary)'
10.) rJEE 0 ro GET WUP "%ALrµ N E Gy owNt tL SZtJATIJ".. C-LAuFrcA f Mo,J oN 149A i C"e5
dagx To BE DorX.
AF-re(L- JW Fk_Cr f�.a1 APPLXCATX&N gc
rnpfLc CAMrvt. 6F UPeVc F"Yyje�
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
JaW u FA9LMC k._
Phone: Old ! 16 —73'9
Date: I I t ,� t
21412011

(Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit XRoutine ()Complaint C)Follow up O Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: 1 �Departure Time: � County: � �- IV Region:
Farm Name: �'y d / Ywz(S 7Q Owner Email:
Owner Name: �� fit C S CNN 1 H A N y! L L. Phone: 3 dr 5`t - 9
Mailing Address: `� � 't 1%yCc--c _ �04� __at cQ4RV05
Physical Address:
Facility Contact:
Title:
Onsite Representative: 1F �T►2i - C'S S 1a-L
Certified Operator: _ =1CWAQ'D C' J(mvs'o'v
Back-up Operator:
Location of Farm:
Phone No:
Integrator: Operator Certification Number: 19 q n �` s�_
Back-up Certification Number:
Latitude: = o = d =, Longitude: = ° ❑ 1 = "
Design Current
Design Current
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
Wean to Feeder
❑Non -Layer
El Dairy Calf
Feeder to Finish
❑Dai Heifer
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
El Turkeys
Other
❑ Turkey Poults
❑ Other
❑Other
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 ANo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
❑No
❑NA
❑NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
C�No
❑ NA
❑ NE
❑ Yes
gNo
❑ NA
❑ NE
12128104 Continued

Facility Number: -31 — 8 )Q
Date of Inspection /� 5
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: QQ
Designed Freeboard (in):
Observed Freeboard (in):
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 XNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes �kNo ❑ NA ❑ NE
❑ Yes XNo ❑ 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 1AVo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ElNA ❑ 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 ANo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alteratives that need ❑ Yes )6 No ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
P No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of
Area
12.
Crop type(s) 'I (Z- CA0%U_')t1EAT S f dA 7 SCt4C
13.
Soil type(s) _�o 04 PAr
_
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
XNo ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
[:],Yes
No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Comments (refer to question #):, Explain any.YES,answers and/or.any-recommendations or any other,comments ;
Use drawings of facility to better explain situations. (use' additional pages as necessary):
-To L4'?D T( OIG Dr✓S,6NAT-)0,V - Ama 64evq,cL
•
0)j3o1/� l i /.v L6TE-b wo-r (Rtcg0Qk7b C. _oGiJNSONI
11151l0 492 1•4 'rA. NeF4 -10 unD4g7r? Cgcp L'�164�
r Pfl�,� fuSSE4�-r�1L�UE� �CCo4i`p5 1 N MRR-�N �010
TO S EAq- id
Reviewer/Inspector Name S . ` , � ,i: r,i
Phone:
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection � D
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
YLNo
❑ NA
El NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
El Yes
� No
❑ NA
❑ NE
the appropriate box. 0 WUP El Checklists ❑ Design EJ Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
Yes
❑ No
❑ NA
❑ NE
Waste Application XWeekly Freeboard Y Waste Analysis Soil Analysis ❑ Waste Transfers ❑ Ayl'nuai Certification
Rainfall ❑ Stocking X Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections ❑
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
tNo
ElNA
ElNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
Ayes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
❑ NA
❑ NE
27.
Dad the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
❑ Yes
❑ No
)kNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�No
❑ NA
[:I NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
4 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
^ONo
❑ NA
❑ NE
Additional.Comments and/or Drawings:
��. l�.SIJ�Q NAB [- (_ISTt;1� 0S gj�(GMuDI? Coe" Sa�43EAx►3
CA- oA15/rSc'E6�)
C.00r-5 LlT-r Ir u- fw I ECDS P"W7�6b 1N ?E0ZL M, tt_Ls j
45T►u IIV oUZ> awNIER-S N+RMr
wuP H6GDS To (,r L&pVP � To RE`Lt�cT GitoPS /NF1�CDS gFNEw
C-J-,3N rSH1
N� Sale_ ANAL-�S1S �� 9 — Nl>FE� ��1C� s�M�x� ► SAP
5E-,gb 9.�SULTS 70 0C&A-At00 R4W65-D''-'Q
�!O-�So-�Cw�-1 - R.ESuL-�S/SIF
of,
18� GAftNAl 4L D; - G�cr CI N 3o DABS
wi�nlLn�GroN,/VC �8Mo5
THL--(1-E 1 S A w,4s,,C-_ AA/.4L )S FRzofA 11/4fc_l TO L/ jS1Ja - NI~GD TO Qeol>kco
T 14ME Q ECs LDS
- WR57G fl C-1CR71dJt1 ZECA¢D5 ARF�No7 GaMP4Ei= FQof^ a0001- N-Eb70?R4 NA CC
FfLFE.(30ARD 0?- ?.AINPAuGLGGoRDS 1"roCZ. �A�t o���Q NE�A'TaQRo �
NO
o• N O C AUB4�►� 51 �/ c C o2OC;+ - GA;-' WTG A 5 �4P -� s �Tct� io %WQ �..al ry 30 D4
Page 3 of 3 12128104

Type of Visit 'Q Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit , b Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Region:
Farm Name: _ "�1 V ` Q Owner Email: e� r�
(Yl —� FTN QNFfILL Phone: � 1 r&9Jy
OwnerName:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone No:
Onsite Representative: Qww/y `ln l ;I L- Integrator:
Certified Operator: , ES r�JVN9r7 oQj/�.(WoL �Q Operator Certification Number: ��o
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 0 = = Longitude: = ° = d =
Design Current Design Current Design Current
Swine
on
Capacity Population Wet Poultry C►opacity PopulatiCattle Capacity Population
El Wean to Finish
❑ Layer
El Dairy Cow
Wean to Feeder
❑ Non -Layer
❑ DairyCalf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
El Layers
El Beef Stocker
❑ Gilts
❑Non -La ers
El Beef Feeder
❑ Boars
El Pullets
El Beef Brood Cow
❑ Turkeys
Other
❑ Other
Ej urkey Poults
10 Other
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 )A No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑NA
❑NE
El Yes
[I No
❑ Yes
x No
❑ NA
❑ NE
❑ Yes
ANo
❑ NA
❑ NE
12128104 Continued

Facility Number: — 9101 Date of Inspection Q�7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
Yes
❑ No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA ❑ NE
Structure l Struc, e 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: OC
Spillway?:
Designed Freeboard (in): ,
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
El Yes
No
ElNA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
*o
❑ NA ❑ NE
maintenance/improvement?
I. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
'�kNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 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)
U. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
? ❑ yes
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
11ANo
❑ NA ❑ NE
VyA
gg
>'a,W A ,Sy: 'j a, *� ;.�»::, 7;.. � `€� �� � aj. a.,'e:� �� ,A �.� ..;: :P �a -"� .t 0��i:::��'�i' _ o-l� �s�.�•y'� q�. r ' - 1."
Comments {refer to question #). 'Explain any YE5 answers and/or any recommendations or ai�yYothercomrnentsi
Use dr.'iw:n s°of,facilit1. to'better ex'lainµsifuatlon�s,.(use`;additrnpal,pa esasi nee'ssary)if 'd i x a `
a ga t y, p R� g } c '�. w {_,
Ar7f-Q- 9,A1N 7HI5MDe�vin+6; # )50 -S&Vz� /w q 710+
e�,S moNDWj � Jtil10
ASAP
a 1 . No (31e.�ESICNA-rc� j Qlm� -fir
5 l�lo` 141 Co I Lq t t:;�-r cQ-01P 1�.I r-1-6
'oq 3oS 9SA? / E'a�T c.AU t3QgTI0N 1+ SC—N�
Reviewer/Inspector Name -.'`
iPhone: 14011
Reviewer/Inspector Signature: Umvamdonn Date: 931109
12128104 Continued

i
Facility Number: , — ' d Date of Inspection Q�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. 0 WUP 0 Checklists [] Design [] Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes 4No ❑ NA ❑ NE
❑ Yes _0,No ❑ NA ❑ NE
❑ Yes )� No ❑ NA ❑ NE
El Waste Application [11 Weekly Freeboard El Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ ,9riinual Certification
0 Rainfall ❑ Stocking ❑ Crop Yield [l 120 Minute Inspections ❑ Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ic/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes]
No
r
❑ NA
❑ NE
❑ Yes
, No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
XNE
0 Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
A NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
No
ElNA
❑ NE
ElYes
No
❑ NA
❑ NE
Add tf"It na C mments anFi. Drawings:
pU"i o� -r FIAT w I Al mow A- ~r Q �� (.pGoou INSQ CTlOX/
--ram !N 1110L Z0/Alf ACC 1''c c GRre
np � �" C.oCt,C� � 1 ' � � SuQu !G c�
6 r Doi r- 5L - t�4
p,T►rr � ENS � C= 1 � 10 '�' S�N� TO �
!`Im+INfJ�} l�All�fFoS � (}IAµJAI G S
OTv�I o��
'j () 35 d
(�J►1✓fnINCxTo^/ j Al C_
pay l Et25 1�!14rn }S SoaAl
pub O S C � �41N C, TU ��•- !N iw 4 -0J5
AS Lou.
LA�r b oN r1 ��p �u - To )�vGcern7" r uqA7��Cz-�
-TV C.Un1�T W-4 (l��L� <7�nlu�.R�, Eh]/ JY` � Cll� 1-wv �41�rS.JVVVr r� r7! 7C_7 n/T6�01T'4-r•L 1^ F=
W u ! c�r� S TC 7H�5 7�M l; a� ��,4i2- - wi�s< niEE1� AAt 19MQVQ/KCxj i

Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ,Routine O Complaint O Follow up Q Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:+
Farm Name: _ j:j,
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: W&&-4z --�6 4&_C'1E,i9q
Certified Operator:
Back-up Operator:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = e 0 I = Longitude: ❑ o = ` = "
NDesign Current
Current
Design Current
Capacity Popu� lation
I
Wet Poultry Capacity Popuilat on
C►attle
Capacity Population
FMWenish
❑ La er
❑ Dai Cow
-
eeder
IDesign
❑Non -La er
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dr>y Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Turkey Pouets
❑ Other
❑ Other
Number of Structures:
Discbarges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
�No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
El Yes
,--,,�
No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
;J<o
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
.� 1''0
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
❑ I
❑ NA
❑ NE
other than from a discharge?
/
Page I of 3
12128104
Continued

1+acility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JU'T'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes E;'No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
[2090
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
PNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
PNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
C2rNo
❑ 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
�io
❑ NA ❑ NE
maintenance or improvement?
Waste- Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
Z No
❑ NA ❑ NE
maintenance/improvement?
1. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
;No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes PoNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
J�-,1Qo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
P�Go
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
FeMo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Zo
❑ NA
❑ NE
Reviewer/inspector Name'
..f a" Phone: +
I 2t
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/0 Continued

Facility Number: — Date of Inspection
Required Records & Documents ,��,//'
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes „ 12 o '❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes FeNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design
g ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ;;rNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis 85-11
Analysis ❑ Waste Transfers El Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
;31Vo
❑ NA
❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
VNo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
PYes
❑ No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
P-No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
P-No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
PVo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
C"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
J;FNo
❑ 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
V No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ZNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[7/No
❑ NA
❑ NE
car 1112i/4�e
y
c2la�/ i/a
J
Page 3 of 3 12,128104

P1
Type of Visit QrCo pliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: g I Arrival Time: Departure Time: County:04104,_TdRegion:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: QLiX_I_ _.I ra YAJOf - _
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ❑ o Longitude: ❑ ° ❑ L = "
Design
Current
Design Current
Po
,,Design
CO
urrent
Swine.
Cajtacity
Population
Wet l y C paclty P0puu ation
Cattle
Pop�ulartion
❑ Wean to Finish
❑ La er
❑ Dai Cow
•C0apacity
Wean to Feeder
2/oo
I U00❑Non-La
ei I
Dairy Calf
❑ Feeder to Finish
❑ Dai Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
E]Non-Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
El Pullets
❑ Beef Brood Cow
❑ Turke s
Other
❑ Turkey Poults
❑ Other 1 1110
Other
Number of Structures:
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
E/No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑�No
El NA
El NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
❑ NA
[I NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
VN
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

L Facility Number: —f 6 Date of Inspection 1 S 3
aste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: �A400AI CA&oM "L
Spillway?: '
Designed Freeboard (in):
Observed Freeboard (in): 36 3 `�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
G]"No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA
- ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
dyes
❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
"No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
�
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
El Yes
,,//
IQNo
❑ 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) Gi L I AOCA L 6) .SC,O C W S O Al-y
13. Soil type(s) J N Pa
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ICJ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes CJ I.No ❑ NA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'(] Yes 1(QNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes VNo
�El NA ❑ NE
18. Is there a lack of properly operating waste application equipment? El Yes ❑ NA ❑ NE
?�) OSk(-- t✓A U4S N E CP
Reviewer/Inspector Name ! , .
Reviewer/Inspector Signature: Date: I &az os
12128104 Continued

Facility, Number. — Date of Inspection i 4I1 d /V I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP adily available? If yes, check
the appropirate box. .L;n
❑ WUP ❑Chkli ecsts Design ❑M❑Oth aps er
2 L Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional'.Comments and/or Drawings:
❑ Yes ❑ No ❑ NA ❑ NE
Yes ❑ No ❑ NA ❑ NE
❑ Yes O No ❑ NA ❑ NE
❑ Yes E No ❑ NA ❑ NE
❑ Yes ❑ No 2�* qA ❑ NE
El Yes El No 1-' NA ❑ NE
❑ Yes B No ,❑l NA El NE
❑ Yes ❑ No L1NA ❑ NE
❑ Yes
Dl o
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
BIN o
❑ NA
❑ NE
❑ Yes
B o
❑ NA
❑ NE
❑ Yes
NA
rix-00--po
❑ NE
❑ Yes
NA
❑ NE
12128104

(Type of Visit 0 Compliance Inspection O Operation Review Q Lagoon Evaluation I
Reason for Visit PrRoutine Q Complaint O Follow up O Emergency Notification Q Other
Facility Number Date of visit: %O U Time:
0 Permitted r] Certified ©/fCoonditionally Certified [3 Registered
Farm Name: .l,d .Ix
�.� .».. .
OwnerName: __. ».......»........».............»................ .. _..»»... »..... » ..... ..
MailingAddress:.._ . _... _.._....... _ ..........»..... . _ ............_..... ..
❑ Denied Access
Not Operational O Below Threshold
Date, Last Operated or Above ,Threshold : ................ _._»..
County:......' ^' .7--�.
'Phone No: ».».» ................ ............. ................
_.....
Facility Contact: » _---------------------------------- Title:.._ .............. _W_» » Phone No: ....... ._ _........»._ ....
Onsite Representative: .... ».......».....»....» .»..»».».».. Integrator: �r �` �'... ..........._.... ..._........,
Certified Operator:._ ----------------------------------------------- _ ....._.�»»» »».__ Operator Certification Number: ....... », ,,,,».............._.
Location of Farm:
i
❑ Swine ❑ Poultry ❑ Cattle 0 Horse Latitude 0' 04 0" Longitude • & 44
Discharges & Stream ImRacts
1. Is any discharge observed from any part of the operation? ❑ Yes 12No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes J21No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ,:jXD
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes 9-No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: __._. L._.. »...._... ..» .».._ .» .._ _ ..__ .. _» __. _ _.... ».. .. .. ___ .._ _ _.. .._..... »... ..........
Freeboard (inches):
12112103 Continued

Facility Number:. Date of Inspection % ; 07
5. Are there- any inunediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenanc&rimprovement?
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?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
❑ Yes ,014o
❑ Yes _L;-No
❑ Yes . [3Vo
❑ Yes E;Wo
❑ Yes ,:No
❑ Yes A2'No
❑ Yes J:;•No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 4a No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15, Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes .0"No
❑ Yes P�No
❑ Yes ;2 !go
❑ Yes ,M-Ko
❑ Yes _E-.-Nb
❑ Yes JD.Ne
❑ Field Copy ❑ Final Notes
ReviewerilluspectorName z p ,rj. .S I,
Reviewer/Inspector Signature: Date: p

Facility Number: Date of Inspection
ReQuired Records & Document~
2 f . FaiI to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes 'Ea90
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes 12fito
23. Does record keeping need improvement? If yes, check the appropriate box below.
es ❑ No
❑ Waste Application Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes olio
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes Oto
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes qNo
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ,e'No
28. Does facility require a follow-up visit by same agency?
❑ Yes ,ENo
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes j Rillo
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes IP3'110
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes ❑ No
34. Did the facility fall to calibrate waste application equipment?
❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit. You will, receive no further correspondence about this visit.
KeDn -_4eeldbard rec or s . 5 r
eel rl -Free back f cl re'
�t S hevt Y� �-�,J
' _rJ�c:�- I�a'kc;e o
permi.y was %G e l
Vidke�G'q will
ease PuknP 6OuJy*_1
Cerro A-5,
12112103

Type of Visit /11 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Vlslt O Routine O Complaint O Follow up 0 Emergency Notification 00ther ❑ Denied Access
d:
Facility Number ate or visit
Permitted [3 Certified 0 Conditionally Certified 0 Registered
10
Farm Name:
D �
Owner Name:
Mailing Address:
Facility Contact: Title:
Onsite Representative: 1 m
Certified Operator:
Location of Farm:
Time:
Date Last Operated Above Threshold: _
County: 1./ G;�—_,4/
Phone No:
Phone No:
Integrator:
r
Operator Certification Number:
A Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 01 0" Longitude a I u"
Design Current Design Current, Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Po ulation
Wean to Feeder OO ElLayer ❑ Dai
Feeder to Finish 1E] Non -Layer I JE1 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW v
Number of Lagoons ©; ❑ Subsurface Drains Present 110 Lagoon Area ❑ Spray Field Area
Eioldin Ponds,l Solid T ra s .....D;.,❑No Liquid Waste Management System
_....
Discharges 8& Stream Im�t
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of 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?
WasteCollection j& Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
.Identifier: 4 ; ?/
Freeboard (inches): ZS 2y
OSIO3101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �z No
Structure 6
Continued

Facility Number: — 8 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
& Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes El No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8, Does any pan of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Aimlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
1'?. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Reauired
Records & Documents
17.
Nail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)Z
Yes
❑ No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notif; regional DWQ of emergency situations as required by General Permit?
(ie. discharge. freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
;?No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
[:]No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
'1C,1...1:, why.. �.-�, - . - w� e"H '-C +1 •6i�a � ti.'^1P`� ,"r 4Y.�rt?.tc!$"R'd' I S. .7 a4 r.�Nr„^e•-+ ,''.�L � , t�F�Y" i 4"
Comments; r'eferto ' nes>a6ii :' E" Zain any., YES snswer§�audlora recommendations or a ether comments,o � r l
Usc drawings of fact�tty to better erplam situations. (use additsonal'pages as necessary) K r,Y ra
s z ❑ Field Copy ❑ Final Notes
,d :f a Y .
2t+'.b8.-:.i.••w-'1f•:
.0 s A.e,
NFL
�o� a;��, ��z .e ��,c 2r, Vs
—1--4-9 nlf, x4lfi�'
G � [91�� 3.5a Zook
Reviewer/Inspector Name . °' 4ua;rh�:.b
Reviewer/Inspector Signature: Date:
05103101 Continued

Date of Visit: % Time:
Facility Number rO Not O erational 0 Below Threshold
,® Permitted (Certified [ llConditionally Certified 0 Registered ' Date Last Operated or Above Threshold:
Farm Name: County:
Owner Name:
Mailing Address:
Phone No:
Facility Contact: Title: Phone No:
Onsite Representative: �ta x__ V..r a r l��; integrator:
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ 5wlne ❑ Poultry ❑ Cattle ❑ Horse Latitude ' Of 0" Longitude 0' 0° 0"
Design:
Cu rr ent
Design - Current
Design Current
Swtne
Ca act
Population
l'aultr,.y Ca aci Po ulation Gat i-e
Ca aci P,o ulation
to Feeder
3ZOO
Layer
❑ Dairy
❑ Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
IWean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
- Total Design Capacity
❑ Gilts
FQ Boars
TOtal SSLW
Number of Lagoons
❑ Subsurface Drains Present ❑ Lagoon Area
1E3 Spray Field Area
ons / a ement System
Holding PdSnlid Traps ❑ ste No Li uid WaMan
Discharges &Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ)
2. Is there evidence of 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?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: _ - 2
Freeboard (inches): �� 2
05103101
❑ Yes 21No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes allo
❑ Yes 19 No
❑ Yes 91 No
Structure 6
Continued

Facillty Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes 9_jNo
❑ Yes P No
❑ Yes [A No
❑ Yes L No
❑ Yes n No
Waste Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes m No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ®No
12. Crop hype %/l�tr �l . f"F2
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes RNo
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
e) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15.
Does the receiving crop need improvement?
Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
F4LNo
R guired
Records & Dogllmgnts
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
U,No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[ ZNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
SNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
CgNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
(9No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application) ❑ Yes D& No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes R No
24. Does facility require a follow-up visit by same agency? ❑ Yes CK No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 0 No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comirfients referto''uestio � ° { n # Ex ]ainan YES answers and/or any recotnmendatlons,or°any other commentsa`;
q } p y
��.,,� s � .
Use drawings of facility to better explain situations (use additional pagesinslnecessary) ❑Field Copy ❑Final Notes
Ze �e l�l��.� a," C��� f�� �► a �.�
�r�h �[ d/ G�✓��J. �1� ;s ;n ���y s ,V4_P - ..5y.1Wr -74P/l a/o
,ti"r� �e�alS e., Af&- ztad/1
Reviewer/Inspector Name 1,
Reviewer/Inspector Signature: Date:
05103101 l Continued

f+acility'Number:2 — Date of Inspection 7 /�1 Printed on: 7/21/2000
'Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes KNo-
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 9No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
fq No
roads, building structure, and/or public property)
24:
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
M,No
30,
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
® No
tt�ona omments an or rawrngs:
4l �Cil/Y1
7/ -/ : Z�Pc4-GSe 47� 7360 yhe 414 d s�s��Lt y4e yesk /fs
✓c' 7114v 4- Z-4 LyQf/ Ll�l� �C fi � (/k G�� ��G�'F / f�— ��riG lA r
J
5100

..Division of Water Quali
Q Dwrs►oii of Soii and Water C,onservatian tr `x
J
f
ype ofVisit Compliance Inspection O Operation Review O Lagoon Evaluation
eason for Visit t(Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number giG Date of Visit: —r%—Q} Time: E- Printed on: 7/21/2000
Not Operational O Below Threshold
Permitted © Certified [3 Conditionally Certified © Registered Date Last Operated or Above Threshold: .........................
FarmName: ..... T.......- !l .......... i^►.`,1.4u..................................................... County ........p ...................................................
OwnerName: ................................................... ...........................
Phone No
FacilityContact: ................................ ...............................................Fitle:................................................................ Phone No:...................................................
MailingAddress:..................................................................................................................... ....................
Onsite Representative: V,i!lA ... ... G.. 1 -c.!............................................... Integrator; ......................�
Certified Operator:................................................................................... .................... Operator Certification Number:
Location'of Farm:
0 Swine ❑ poultry ❑ Cattle ❑ Horse Latitude • 4 66 Longitude • 4 6t
Design Current
I ;Current
Design Current 131 i "99
cPo elaton
PoutCatteCa
. , Po tilation
Wean to Feeder a
❑Layer ❑Dairy
�41jG
:> Feeder to Finish
❑Non -Layer ❑Non -Dairy
Farrow to Wean
Farrow to Feeder
❑ Other
Farrow to Finish
Total Design Capacity
Gilts
g Boars
Total 'ssLw'
PNum�er of Lagooas ,
v �r"'ti
❑ Subsurface Drains Present
❑ Lar-on Area Spray Field Area
❑ No Liquid Waste Management System
f-6:. r�
yyHplding Ponds/ Solid Traps
Discharges & Stream Impact4
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed• what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of 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?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:............................................................................................................................................................................
/
Freeboard (inches):
5100
❑ Yes ANo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
14No
❑ Yes
x No
❑ Yes XNo
Structure b
Continued on back

'jF
acility, Number:31 -- �fU Bate of 111spection
Printed on; 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 'jNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes M No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require 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?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
r
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?
Requited Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19, Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24, Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0' No •*i0latiols;o� ¢efciencies ol` re po'fpq. 0(wing Ns' visit; • Y00 will •teeeive oq fu>rt�cr;
. - . , cor'resaorideni & abvtit this visit. .:: ::::::::::::::::: .
r�_��__a !__t ' a_ �_= �i1. � t 1... VY.+C...................Jl.........::...........-...-.....Y...a.....................al...................
P t 57
❑ Yes ONO
❑ Yes J)Po
❑ Yes &No
❑ Yes [�No
❑ Yes JXNo
❑ Yes J�(_No
❑ Yes X No
❑ Yes ❑ No
❑ Yes ❑ No
f Yes ❑ No
❑ Yes allo
❑ Yes XNo
❑ Yes 1K No
Z,Yes ❑ No
❑ Yes *0
❑ Yes ONO
❑ Yes fi(No
❑ Yes XNo
❑ Yes 15�4o
❑ Yes jRrNo
a�='l;, �w r2 ia'"ty3,
Reviewer/Inspector Name "'`1
Reviewer/Inspector Signature: Date: _Q 5/00

Ii'aciliV Number: — C) Date of lnspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of property within 24 hours?
28. Is there any evidence of wind drift during land application? Ox, residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. 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? (i.e. 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 !lush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ('� No
❑ Yes No
❑ Yes No
❑ Yes e� No
❑ Yes No
❑ Yes No
Additional Comments an or. rawmgs:
R
Ye s 41::, 4e,
�� cam+--►-�-e_� C1rG� ��'�.��� , �L�t_t,r;�
Lk lx--J�
6
<«��`�

11
Facility Number Date of Inspection
I Time of Inspection 24 hr. (hh:mm)
[3 Permitted M Certified [3 Conditionally Certified E3 Registered Date Last Operated: ..........................
FarmName: h.40.MArfi9rY-AI..&#Z ................................................................................. . County:
OwnerName: Allen ........................................ Raymor ....................................................... Phone No:
Facility Contact:
Title:
Phone No:
MrXIMM
MailingAddress: 5M.M.PrIld ......................................................................................... Wallace.NC ............................................................ 284.66 .............
Onsite Representative: ........................................................................................................... , Integrator: MujThy..F.wWly..F.u= .....................................
Certified Operator: Allen ....................................... Rayx=,Jr ...................................... Operator Certification Number: 229.8.6 .............................
Location of Farm:
.................................................................. .......................................................................................................................................................................................................
40 . ...................... ..........
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .......................................... ........................................................................... . . . . . . . .
Latitude F347OF44_11FTF'�_ Longitude [_ 7779 F-57-11
IN
o
�JDOWW,,," C
........ .. .. ..... .....
T, � i I u '
t
2:
, ­.n. R., ry_:'-':� , � I..
H
Wean to Feeder
5200
10 Layer
0 Dairy
C]
Feeder to Finish
I[] Non -Dairy
E]
Farrow to Wean
. .......
.. ...... . ..
Farrow to Feeder
..
. ...... .. ... .....
F1
Farrow to Finish
.. ....
1V
5,200
Gilts..........
..... . ..... .
.......
......... .. .. ..
... ... .. .. ........
.......... ... USSMN,
156,000
e r LagoonArea Spray Field Ar:ea],��:
2 1EISubsurface Drains Present 1111
. . ... ... . ...
A JEI No Li�uid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? E] Yes [] No
Discharge originated at: OLagoon OSprayField nOther
a. If discharge is observed, was the conveyance man-made? E] Yes E] No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) E] Yes E] No
c. If discharge is observed, what is the estimated floW�in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) Yes C] No
2. Is there evidence of past discharge from any part of the operation? E] Yes E] No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Yes E] No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? 0S pillway 0 Yes E] No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................................... ................................... .................................... ................................... ................................... ...................................
Freeboard(inches): ................ 13 ................ ................ Is ............... ................................... .................................... .................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, 0 Yes 0 No
seepage, etc.)
3/23/99 Continued on back

t Facility Number: 31-810 Date of Inspection
6. 'are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require 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?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN.,
12. Crop type
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?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
r 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
211E 7/2000
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
. •l�o vio)lat... ar:d'eircierici. ...re:rioted:durin .t�iis•v.. .... ....iv,e n .f.....:
..........................................................
❑ Yes []No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[] Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
tremely wet fields. Recommended to Mr. Raynor that he should first transfer some liquid from 13" to the 18". Maintain lagoons
about 16" until capable to Spray. Mr. Raynor can make a pull on the Coastal field between the two lagoons (only field not saturated)
help in maintaining freeboard levels below 12".
Raynor plans to plant corn in field behind hog houses around March 22 (out of any freeze danger). Once a definite date is set for
ting corn, DWQ will need records showing when corn was planted and first spray made on field. Field currently holds no crop.
Reviewer/Inspector Name
Reviewer/Inspector Sin Date: 3 //G /��i

Facility Number Date of Visit �� Printed on: 4/3/2000
1 r0_ Not Operational 0 K17owlThEreiMold
[3 Permitted 0 Certified [3 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .........................
FarmName: I-.40.NA1r1uerxAI.A&jM2 ................................................................................. County: D.UprM ............................................... WJR0 .........
OwnerName: Ajjgja ........................................ R4y.iior ....................................................... Phone No: .......................................................................................
Facility Contact:
Title:
Phone No:
MalUngAddress: 532.jUVcr.Rd ......................................................................................... wallacc.Kc ........................................................... 2.8466 .............
Onsite Representative: ........................................................................................................... Integrator: Murfilty.Yanift-Farm .....................................
Certified Operator: Ali= ....................................... Rayx=,Jx ..................................... Operator Certification Number: 229%6 .............................
Location of Farm:
OSwine E]Pouftry []Cattle []HorLatitude F_3_4_j*F_4_4_j1F_1_2__j- Longitude F-7-77* F-5-7-16 F-0-471,
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? Yes [] No
Discharge originated at: El Lagoon [I Spray Field 0 Other
a. If discharge is observed, was the conveyance man-made? Yes E] No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) Yes No
c. If discharge is observed, what is the estimated Ilow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) E] Yes No
2. Is there evidence of past discharge from any part of the operation? 0 Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............ front. ............ ............. b=k ............ .................................... ................................... ................................... ...................................
Freeboard(inches): ............... 21 ................ ................ L6 ............... ................................... .................................... .................................... ....................................

Facility Number: 31--810 _ , Date of Inspection 3/2812000 printed on: 4/3/2000
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need. maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste AWlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15, Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, frceboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/hWector fail to discuss review/inspection with on -sits representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
No yioiatious: tir:difieiericies•i�vere:tioied:du'riiig itiis visit:: Y'•ou �vtal:receive no hift i&:
..........................................................
' .ert';fA.A iU' HA'deA'sa'hrtdt •thih.ilicit, .
check. I did receive Mr. Raynor's permission to visit farm site.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes © No
r:
arSSS� :
......�ri'�s�`?� <::�e;>�<
Reviewer/Inspector Name :i��e�ar:�k+Jtc':`1�i :I�t�:'��

Facility Number 31 8 0 Date of Inspection 3 13 DO
Time of Inspection J Z SQ 24 hr. (hh:rn
© Permitted ❑ Certified 13 Conditionally Certified 13 Registered 10 Not Operational] Date Last Operated:
Farm Name. 40 N v ese,r.' County: D tin .....................
........... ...................... .......#...........:�.........�..............................................................
OwnerName:............ �.�. �.�!.....-•................ 'a.�G.h�' .................. Phone No:.......................................................................................
FacilityContact: ........................•-.----...............---.--.....--•-----------....... Title:............................................................... Phone No:.....................................---...........
Mailing Address:
Onsite Representative:.......�.....�e. ......�.`....°.r............................................. Integrator:... .r � ......................................................
CertifiedOperator: ....................................... ............ ............................................... ­­.­.... Operator Certification Number:..........................................
Location of Farm:
J
Latitude 4 •4 Longitude • =` «
Design Current
Swine— Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
._ ;Design "Current = Design Current
_Poultry Capacity }..,;,Cap Po ulahon :Cattle Capacity Population
❑ Layer I I 1 10 Dairy
❑ Non -Layer I I ❑Non -Dairy
❑ Other
T Total Design Capacity
Total SSLW
Number of Lagoons g Y
M :::. ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
....::: Holding Ponds / Solid Traps ":' '`; ❑ No Liquid Waste Management System
Discharges & Stream Impacts
Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
T
❑ Yes ❑ No
[]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[]Yes [:]No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a dischar-e? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes '®'No
Structure I Structure 2 Structure 3 Structure a Structure 5 Structure fi
Identitier: N I M 2
Freeboard(inches): .........21.4..............................1.1........................................................I........................... ............. .....................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes []No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 31 -- )o Date of Inspection
3 13 00
6,• Are th6e structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? [—]Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soiI sample reports) ❑ Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ® No
24. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
Rio YiglaiFgtis'or deficienciie� ware 1nofed• 00-• itng 4his'visat: • Yoer ivili•;eceiye ijo futtitetr -
corresporicience: abOU thi's visit.
Comments (refer to 'questsou #); in -Explaany YES an"swers'and/or any recommendations'or any other comments
Use drawings of facility to better xvlain situationst"(use additional. pages as necessary);
:,, r s .
�vi5�[C�iav� oor.o(vG}�d 613 Gt Fa�low-fi� C��' Yecdn �LJC ir�f1o©Giio✓15,
No4e ' 1 ,-- fZa•j�o� said 4tiAk co,,, wM 6c p(.1"+cd ox-. 3115loo.
No-I-c` tjtiee-)� crdr 4k_44 was locetkad 1',1 :r;eld bekwee+,, N urrge�7'. and.
j'✓1r. R v1a S komc . 6aS bera11. 01: sccd irl . r )ZGi hur I'1aS in�'or
hate-FI-vGi l.Jc,s4 otp0 t,Gakia S t,��re p%q,,O(a �o lJ i Wkeq4^ieGc+;sc',^
01ee(vC4;oY,s I'll 0,1fat��61¢ �1�1U q p1iC�kren .s►-oc-uld 6e wtotoje
1�1ex� GrO� W �'1�G1, alGGvc,LY44 !~^o>' !� W�is�� OtPf r1Ga-i 1.V-\S xia_.(e to �r1eW Q,
Reviewer/Inspector Name s o ►'leW`t, f �I I j
Reviewer/Inspector Signature: Date: �0 O p
3123199

,. Division of Water Quality
Q Division of Soil and Water Conservation '!
0 Other Agency
Type of Visit WCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Ig Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date. of Visit: 2 00 1 Time: /0 •inted (tit. 7/21/2000
Facility Number 3
Q Not Operational Q Below Threshold
Af Permitted © Certified 0 Conditionally Certified. © Registered Date Last Operated or Above Threshold: .....................
Farm Name:............................................................— µ0 Av -Se rje,5 1.4 � County: U,Q. 1........................................................
................................................... fl ..
Owner Name: RI ki. l...' a h
1 hone No:................................................................
.......................
FacilityContact: ..............................................................................Title:............................
:failing Address: ...................................................... ..............................................................
Onsite Representative: .....
IrJ..1Le.!'1.,or...................................
CertifiedOperator : ................................................... .............................................................
Location of Farm:
Phone No :..................
Intel;rator:... .!1.� .`�...1' '^.�^!. ..........I ...................
Operator Certification Number: .........................................
❑ Swine ❑ Poultry []Cattle ❑ Horse Latitude �' �� ��� Longitude �• ��
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
Wean to Feeder 00 S'20 ❑ Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present J113 l.ag"nn Area 10 Spray Field Area
Holding Ponds 1 Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impac
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ)
c. ll'discharle is ohscrvcd. what is the estimated flow in gal/mitt?
Lt. Does discharge bypass a lagoon system? (Ifyes, notify DWQ)
2., Is there evidence of 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?
Waste Collection & 'Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway
Struelturc I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ...............1[.............................. Z.......................................,.......,................................................I............................
Freeboard (inches):
5100
❑ Yes ONO
❑ Yes No
❑ Yes No
h /A
❑ Yes 5'No
❑ Yes ;9 No
❑ Yes ,3 No
❑ Yes UNo
Structure 6
Continued on back

Facility Number: Y j — ]Q I)ate of Inspection 9 22 0 Printed on: 7/21/2000
5' Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, ate.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require 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 maintenancelimprovement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes , 5No
❑ Yes ONO
[:]Yes ONO
❑ Yes fSNo
❑ Yes ;0 No
❑ Yes CjrNo
❑ Yes No
12. Crop type �6 bBcol Ce,r'MIJ a Grcize
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes X[No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
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?
Required Records _& Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
I S. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge'?
22. Fail to notify regional DWQ of emergency situations as required by General Permit'?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
24. Does facility require a follow-up visit by same agency'?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0: Ko•vi h'ti0iis:or• &hcie.ncies were po#etal dii-fing Ois'visit.' - Y:oit will -receive iri fut�fte
'CO rresnorideiice: aboist
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 9 No
❑ Yes IN No
Yes ❑ No
❑ Yes 19 No
,KYes ❑ No
❑ Yes 2�No
❑ Yes IR No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
❑ Yes Of No
❑ Yes 0 No
❑ Yes No
❑ Yes No.
I?. 06 et;-, Ce,-4;.r;ea+c- cPCeyera94-A6ene✓w1 P¢ryn.'4 Amgl keep wv;44
reaorA r.
14. Se rye Getj,CUja ;,prts ev, =►�)2^ Z�S are ;,ieorn_re�, Need 4v
cletirl rnrl�� wh,,,_j� ees 1 re be, s-
y � a � A y 1
NOTE : gC/'r,vG�pJ e►s �e.+� s�prared nrt ernd r,�e-ds 46 �e� C L/ k b-11dolf•
NaTE: trot ev- 44ec�n;cell spee���,"s� ►)zeA to s,3"-�Ag4e plgh_
NoTr, *' L)eveo s'.j+ arofthX liokse -1 � N yr sery 2-
' T
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: q1,z Z /00 5100

Facklity Number: Date of Inspection 7Z D Printed on: 7/21/2000
Od(ir lss6es
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below 9Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes eNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ;�No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes �fNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes R No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes $No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ONo
Additional Comments an orDrawings:
Al oT'C- * 1'1'j r - �I y' � r s�orRy s a1GrQ SS W �q�
is S�oW �1 o rz rho cif
�,.e-fled /'fir. �q nar .ra ►
s -th: s
6s &een de4e, ry1;Ae4
40 �ve
fo kio4 be q, we-rr �dt. P)J�,
O
l�'�t nvy'
p7ecdt
Sv 6r f i� dO�un�e�-i a3 iDh mar r
_4, have [a wG added
n a W r, s#e PIavI . Thy ar
f'M baw e� h V ALL UN 3 F; cld e.
5/00

Facility Number 3 f r O Date of Inspection ;Z2Q oO
Time of Inspection 1 I °l 24 hr. (hh:mm)
Permitted 0 Certified ❑ Conditionally Certified ❑ Registered E] Not O crafional Date Last Operated:
Farm Name: �— 40 N v� ser 1 -� Z County: . U fL.n.........................................................
1�c►�a i.ar
Owner Name: �..........`�....................I.,....... Phone �fo:.......................................................................................
FacilityContact:..............................................................................Title:................................................................ Phone No:
MailingAddress: ....................................................................................................................................................,.y............p..............r.—.-.................... .........:................
OnsiteRepresentative: ........................................................................................ Integrator:..:..`..��.r h. ...r �� r. L f ..................... I........
CertifiedOperator:.................................................... ............................................................. Operator Certification dumber:..........................................
Location of Farm:
............................. .................. ..................................
Latitude ' 4 •4 Longitude ' ' "
Design Current Design - Current Design Current
Swine Capacity Population Poultryachy Population' Cattle Capacity Population
❑ Wean to Feeder ❑Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean _
❑ Farrow to Feeder Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts.
❑ Boars Total SSLW
­ :'Number of Lagoons ID Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
HoldingPonds / Solid Traps
p '�� •������10 No Liquid Waste Management System .. .
Discharges & Stream Impacts y
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: []Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was die conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes ❑ No
I
c. If discharge is observed. what is die estimated flow in gal/min'?
d. Dees discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment y
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway Yes ❑ No
Structure I Structure 3 Structure 3 Structure 4 Structure a Structure 6
Tdcnui icr:
2 2,5 f7
Freeboard(inches): ...................................................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [:]No
seepage. etc.)
3123/99 Continued on back

Facility Limber: Date a1' Inspection
6 Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7, Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application -
I0. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14, a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
Ib. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ❑ No
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ❑ No
24. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
14 viglai�Qtis'oT aeliriendie9 *• re )iotied• Ootiog � bis'vasit: • :Y;oir w ij.teetiiye do fu tii�r '
corres• oridence: about: this visit..
Comments (refer to'giieshoa ): ExpIam any YES answers andlor any recommendations orany other comments
Use i3rawtngs of facility to better esplam sttt ahons _(use adcLhona..pages as necessary): " �Et
1►ls�,���ra� covxd L G,04r -�o de w,-,�� c co �l;�,n�< spa �vs a�' A.
Sed ft1/• Ray ,or +ha-b -T kbe
wotd PeG� n0� �c,r►+1.
Laga0ki l ;u�vrG� le✓ef' in T `qO 2 few[,/Ecl-
}orow.'oI /akcc i►t A res vtjx,'�Ve, _�i�eLy An etrtAer
l 1 ,/ I
N.n+e Wck_r+c 4oi;co,�Io�s �avc fer-e-vt tj 6-a-ki made, 5o✓,%e etrecS of
F;o(c! a.-e -Vey t, s-q+u,,q �ed e,t--,cl tic,v.e PonAed wo►34e• - C,-ojo.r ►"t vS4
! w
Reviewer/Inspector Name
Reviewer/Inspector Signature: _ Date:
3/23/99

Facility Number 1 Q Date of Inspection 1 ) /2 7-060
Time of Inspection I ! ,�S 124 hr. (hh:mm)
[j Permitted 0 Certified [] Conditionally Certified [3 Registered rNot Operational Date Last Operated:
Farm Name:................,v...,SeY'........./.Z............................................. County:...P?,49w... /;"1
.....................—............I......
OwnerName........... ......................... `. hD►"........................................... Phone No:..........................................................................,............
Facility Contact:.............................................................................. Title:..............
Mailing Address: ...................................................
Onsite Representative: AlAn l�Ct �/►1 0 ..
........................................................................................
CertifiedOperator: ................................................... .........................................
Location of Farm:
................. ....... I................ Phone No:.......................,............
........... ..................................................................................... ..........................
Integrator:., u w r``?. �. °�.� .......
........... Operator Certification Number: ... ......................................
A
.. .................................................... ............... ................. ...................................................... .
Latitude ' 6 14 Longitude ' ° 46
Swine °�°
Current Design Current Design Current
Population. ': Poultry: .'' Capacity Iopulation 'Cattle Capacity Population:'
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
f� u�tber o Lagoons
❑ Spray Field Area ,
❑ Subsurface Drains Present
❑ Lagoon Area
g /.Solid Traps
Hofdin ponds
❑ No Liquid Waste Management System
°.
,.
Dischar;ees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
❑ Yes
El No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/ruin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: 4 413
q r.................
Freeboard(inches): .......... . .................................... ................................... ...................................
...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
3/23/99
Continued on
back

Facility Number: '31 —Bid Date of Inspection 1 JZ 2/DQ
6. Am the re.structures on -site which are not properly addressed and/or managed through.a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Anolication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11,
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12,
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reouired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24,
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
0" Rio yiolattons :or. de#idencies •were n6ted" dii"ring 4bis:visit; • Yoir :will-r:eceiye Rio: Further
ctirres oricience. about this :visit. • . • .. • • • • .. .
Comments (refer to.question #): Explain any YES answers and/or any recommendations or any other comments.
use additional pages as necessary): Use drawings of facility to better explain situations.,.,(•:: ., p g ry :
Sa A,r e X4 FA GE
Reviovertlnspector Name �-r0►1�'W n?� �s}-��; J
Reviewer/InspectorSignature: e�� �/j„� Date: %3 2d00
3/2 3/99

Facility Number: Date of laspection 1 !Z ivoo
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below []Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
❑ No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan bladc(s), inoperable shutters, ctc.)
❑ Yes
❑ No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Wditional Cominenu And/or Drawmgs:
Wlr. IT4)yncr' �rq.S 1.1)�tCQ"- P)14`1-'rof 'Ok7 4boLt4 8. 1) RC e+c
S. A9--O
18r' ID�S SltDGtl� be 1pl�N-fed diGGdf�l�'LGj Tp Lr��+e Pr°"
j Y1 order 40 41 l)t OL►1 ,Tr r n ► Vx J A T4 )J u4r ; e-MlU 44 1 e , Me9A Y PI AP I-
Sa f �-� +11c Lvhe� 4t �s Gurrcrt-�'1 I'?-I'Cd wqS l
r � � (ene � i� �e-� aecA�� cal�5 cc,`otJis-i
m/rI- �4e4 AtO14 _ ) tt ee k oo , lie
f01- ardvl lie D>1 �1st►7�ln� t.,1�r+'ti }cr Gra�S.
1U07E% NaatS qre CUrre►ti-�ly
lUaTC% fir. ,rAYs ��Q� ruta�s� rccE�? �va5-r?e 'PI*l0 t.raSdon�
)�t rCCOrdl is �4�Cd 1�`�%• Neeot
1 1^ecen4 I'v s-�e plrh ;n reearWs.
n r" &A � T 1-, a 1
G W� SQ /�c�a1 ►an eXG¢�f �ar q swt�;�l berM vdr, :C,GU,
)G I
�� 1� PZ�an s�taws f%el� q� iS LtlPret?7�b1 flan ed j',,l WAcg4
gS q-�t?SGVB �:ei�, qs Skilled, {o�;�e q GeF7 -0-Pr )110`4 rccel
W�s-}e 1 An and( le Ae L jaS- a yl a n .
3/23/99

01
Facility Number Date of Inspection
Time of Inspection 24 hr. (hb:mm)
[3 Permitted M Certified C3 Conditionally Certified E3 Registered Date Last Operated: ..........................
FarmName: 1-.4Q..NAirfi%:jrjv.A1.A#z ...................... I ... I ...................................................... County: Dmplk ............................................... WIRG .........
OwnerName: AJUCA ........................................ Raynor ........................................................ , Phone No:
Facility Contact:
Title:
Phone No:
MailingAddress: 539..Riy.erRd ......................................................................................... Wauacc.Nc ........................................................... 184.66 .............
OnsiteRepresentative: ........................................................................................................... Integrator: MuMby.Futilly-Fanns .....................................
Certified Operator: Allen .......................... ; ............ Raynar,1j: ..................................... Operator Certification Number: 22,9.8.6 .............................
Location of Farm:
----11 E---�46
Latitude r-----1 F 127"
1 J-4 OF 44 Longitude 57 04
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
E] Yes
E] No
Discharge originated at" [3 Lagoon [I Spray Field [I Other
a. If discharge is observed, was the conveyance marimmade?
0 Yes
E] No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
El Yes
[:] No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
E] Yes
E] No
2. Is there evidence of past discharge from any part of the operation?
0 Yes
No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
0 Yes
No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ri Spillway
D Yes
El No
Structure I Structure 2 Structure 3 � . Structure 4 Structure 5
Structure 6
Identifier: ................................... ................................... .................................... .... ............................... ................................... ...................................
Freeboard(inches): ................ 13 ................ ................ I& ............... ................................... . ........ * .......
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
El Yes
0 No
seepage, etc.)
3/23/99
Continued on back

t
Facility Number: 31--810 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require 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?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN.
12. Crop type
2/1712000
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[] Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes Q No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
s,
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
4 •No•i'oiaiioris: ar:&frciericies• ivetre:rioieii:during ttiis visit:: -'•ou -�vUri!idVe :no hirttier
..........................................................
.6ri rrrcA fin ii Ati Ph 'a hAai t 'th it. V-mitt . . . . . . . . . . .
❑ Yes ❑ No
❑ Yes ❑ No
[:]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes []No
❑ Yes ❑ No
tremely wet fields. Recommended to Mr. Raynor that he should first transfer some liquid from 13" to the 18". Maintain lagoons
about 16" until capable to spray. Mr. Raynor can make a pull on the Coastal field between the two lagoons (only field not saturated)
help in maintaining freeboard levels below 12".
Raynor plans to plant corn in field behind hog houses around March 22 (out of any freeze danger). Once a definite date is set for
ting corn, DWQ will need records showing when corn was planted and first'spray made on field. Field currently holds no crop.
Reviewer/Inspector
Name
ReviewerlInspector Signature: Date:

tine p compiamt p r'ottow-up of tuwt2 tr
Facility Number
p Permitted E Certified p Conditionally Certified p Registered
Farm Name: ]- lkAuxs ry.A1417.
-up or uavv%_ review vrner
Date of Inspection
Time of Inspection ®24 hr. (hh:mm)
in Not Opera Iona Date Last Operated:
County: Duplin WIRO
Owner Name: AUen........................................ Raynox ....................................................... Phone No:
FacilityContact: ...............................................................................Title: .... Phone No: ...............................................................................................................
Mailing Address: 539.Rixer.Rd......................................................................................... W.allacRL.NC..................................... .,..................... 2846b..............
Onsite Representative: Kexxn..W.xAujx............................................................................ Integrator: Marphy...Fami1y..Farms......................................
CertifiedOperator:................................................................................................................ Operator Certification Number:...................... ...................
Location of Farm:
Latitude =a 4 ©66 Longitude ©• ©` ®g
Des ur:ren
Swine Cap Icty Population
i
® can to Feeder
Poultry
pLayer
esign -urren .
Capacity Population Cattle
[3 airy
esign' •urren
Capacity' Population
13ce er to inis
p on- ayer
p on- airy
p arrow to can
p Other
Total Design Capacity 5,200
Total SSLW 156,060
[3 arrow to Feeder
arrow to Flints
Farrow
0[3
p Boars
Number ofSgoons.
olid i s
�,_id P
p u sur ace rams resen 13 agoon rea 13 pray ie
o y ui as a ana emen s em
r 0 q g y
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? p Yes p No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made? 13 Yes p No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) Yes p No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) p Yes p No
2. Is there evidence of past discharge from any part of the operation? p Yes p No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? 13 Yes p No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? 13 Spillway 13 Yes 13 No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. .................................................. 2...........................
Freeboard(inches): .............. .15...............................19..........................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, 13 Yes p No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 31 _810 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
13 Yes
p No
(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?
p Yes
p No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
p Yes
p No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
p Yes
p No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
p No
11. Is there evidence of over application? p Excessive Ponding p PAN
p Yes
p No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
p Yes
p No
14. a) Does the facility lack adequate acreage for land application?
p Yes
p No
b) Does the facility need a wettable acre determination?
p Yes
13 No
c) This facility is pended for a wettable acre determination?
p Yes
p No
15. Does the receiving crop need improvement?
p Yes
p No
16. Is there a lack of adequate waste application equipment?
p Yes
p No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
p Yes
p No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
p Yes
p No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
p Yes
p No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
p No
21.
Did the facility fail to have a actively certified operator in charge?
p Yes
p No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
p Yes
p No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
p No
24.
Does facility require a follow-up visit by same agency?
p Yes
p No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? p Yes t3 No

Printea
on 311112000
Facility Number: 31_810 Date of Inspection
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
13 Yes
p No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
p Yes
p No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
p Yes
p No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
p Yes
p No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
13 Yes
p No
31.
Do the animals feed storage bins fail to have appropriate cover?
p Yes
p No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
p Yes
p No

1)atcof'Inspection
Time of Inspection ®24 hr. (hh:mm)
p Permitted a Certified p Conditionally Certified p Registered p of perafioua Date Last Operated:
Fttrni Name: I-9f)~.lYureery..#.1..&.#2................................................................................. County: DuPlin WIRO
OwnerName: Allen. ....................................... R,aynar.................................... .................... Phone No:.............................................,.........................................
Ftrcility Contact:•...•.••••..••...•••.•••.......................................... .Title: .. Phone No:
MailingAddress: 539.Rixer..Rd......................................................................................... W.allace.A.0 ............................................................ 28.466 ..............
Otisite Rcpresentative: Kexin..W..cstolt............................................................................ Integr•ator:Mtirriby..Fa:naily.:Far,tits......................... .............
Certified Operator:........................................................................................................I....... Operator Certification Niitnber:
Location of Farm:
Latitude ®r ®4 ©« Longitude ©• ©6 ®4�
Design Current
Swine Capacity,, Population
®Wean -to Feeder
5200
p Feeder to Finish
p Farrow to can
❑ Parrow to ee er
❑ Farrow to Finis
p Gilts
❑ Boars
Design Uurrent.: esign Current
Poultry Capacity Population- Cattle - Capacity Population'
p Layer
❑ Non -Layer
❑ Other
Total Design Capacity` 5,200
Total, SSLW 156,000
Facility Number
Number of Lagoons ` ❑Subsurface rains Presentp agoon rca p pray ie rea ',:
�'
olding Pnnds l Sand Traps "� F. ❑ o iqui as a Management System
Discharges & Stream Inipac
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b, If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. if discharge is observed, what is the estimated tlow in g ilh-nin?
d, hoes discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 11 Structure 5 Structure 6
Ideli I i I icr: ................................................ .............................. ..... .................................... .................................... ....................................
Freeboard(inches):...............15............................ -19............... .................................... ................................... ......................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued un hack
Number of Lagoons ` ❑Subsurface rains Presentp agoon rca p pray ie rea ',:
�'
olding Pnnds l Sand Traps "� F. ❑ o iqui as a Management System
Discharges & Stream Inipac
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b, If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. if discharge is observed, what is the estimated tlow in g ilh-nin?
d, hoes discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 11 Structure 5 Structure 6
Ideli I i I icr: ................................................ .............................. ..... .................................... .................................... ....................................
Freeboard(inches):...............15............................ -19............... .................................... ................................... ......................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued un hack

p . ,
Facility Humber: 31-81U Date of Inspectiou
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes p No
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
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?
11. Is there evidence of over application? p Excessive Ponding p PAN
12. Crop type
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?
Rec aired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
p Yes p No
p Yes p No
p Yes p No
p Yes ❑ No
p Yes p No
p Yes ❑ No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes 13 No
p Yes p No
p Yes p No
p Yes p No
13 Yes p No
p Yes p No
p Yes p No
p Yes p No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? p Yes p No

[] Division of Soil and Water Conservation ❑ Other Agency
[ Dtvtston of Water Quality',
WOR',4..�au,
Routine O Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number ;3 Date of Inspection
Time of Inspection 24 hr. (hh:mm)
©Registered R Certifled © Applied for Permit O Permitted JCJ Not Operational Date Last Operated:
Farm Name:........ nT'.`. �....... .+GCS.{( ... ........ ..r.... .... Z..................... I ..........
. County: ..... f �!eOin....................................... .......................
Owner Name:......./.1.1................................. 1k10.r..............................................I. Phone No:..... .i jCt�..2 5".. ,t.�...... :!�}.` :�Nx ..................
FacilityContact:..............................................................................Title:................................................................ Phone No:...................................................
Mailing Address:
.......,.cicY:........................................................................ ......11.i...................................... L.i!L�..........
Onsite Representative:... k�). -t........R9.1!f1tAf........ S.c.............................................. Integrator:........ m.l ?l
Certified Operator;........................................................................ ........................... Operator Certification Number:.......
Location of Farm:
..r..m.....t ....A.r.......r�ur 4-.... {......e........ i�...1........t...;y.�s ...la .. ..... �n�ic��...�u�ar......-.40............................................................
..... .. ..... ... .... .......
Latitude =0 ° 46 Longitude ©` l ` ®"
;Design
; Design Current �� Design Current
,Current
R : wme !;, Capacity Poultry , capacity Population ' CaitkRl apacity Population
,Population
®Wean to Feeder
S `ELayer '� ❑Dairy
❑ Feeder to Finish
':Layer I ❑ Non -Dairy
❑ Farrow to Wean
`� ❑ � Farrow to Feeder
- Other
❑Farrow to Finish
El
Total Design Capacity
El Gilts
❑Boars
..�
$ `Total SSLW `;" IT(, 17CD
x
�'
t:
Number of Lagoons 1 Holding Ponds ©Z10 Subsurface Drains Present ❑Lagoon Area I0Spray Feld AreLV.
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: []Lagoon Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaUrnin?
d. hoes discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes
® No
® Yes
❑ No
® Yes
❑ No
R3 Yes
❑ No
❑ Yes
ED No
❑ Yes
® No
❑ Yes
[ No
�i Yes
❑ No
❑ Yes
(BNo
❑ Yes
[ANo
Continued on back

Facility ~umber: 31 --,%10
8. Are there lagoons or storage ponds on Site which need to be properly closed'?
❑ Yes
[B No
Structures (La goods 11oldin = Ponds FIush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate:'
[,Yes
❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Struc•utre 5
Structure 6Identifier:
t. Tit. .......................... .....
............. ...............
Freeboard tftJ:.............1:............... .................... .......... ..,...................................... .... I ...............................
...........................
10. Is seepage observed from any of the structures'?
0 Yes
® No
11. Is erosion, or any +ether threats to the integrity of any of the structures observed'?
❑ Yes
(9 No
12. Do any of the structures need maintenance/improvement?
Yes
[:]No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
® No
Waste AnpIication
14. Is there physical evidence of over application'?
Yes
❑ No
(If in excess of WMP, or runoff entering waters of the State. notify DWQ)
15. Crop type............................................................................................................................................................................................................................................
16, Do the receiving crops differ with those designated in the Animal Waste Management Plan (A1 MI")? ❑ Yes ❑ No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes ❑ No
18. Does the receiving crop need improvement?
19, Is there a lack of available waste application equipment?
20, Does facility require a follow-up visit by same agency?
21. Did Reviewerllnspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certi ied or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24, Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ No.violations or deficiencies were'note'd during this:visit. No'"ill receive no further
correspondence about this.visit'.- . .
® Yes ❑ No
❑ Yes ® No
® Yes ❑ No
❑ Yeti ZI No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Cotrimeats (refei•'`to question #):. Exolain'iny YES answers and/or any recommendations or any other comments u .
Tg
Use drawings of facility to better:explain situations. (use additional psiges as necessary
,.
/14. C)?w(.Aoc Ho% ever a (rta CwjMaj we.S�e a,-\ Sara t) iio ss mu ` 1) �K e_Kecss;ve to.<...C"'. `
WKtx�� dtitiey5;o,• �w ad jUe k i {�b, . V
eN s.� rtrsc• C� 4 d?✓<v �or�.i a a��C4- u�s�r{� �v.r? aaw►,s t^tt�•-]
t.,C) �um P WASk e,..t' dti e rlero G,retx5 Ci ' ��
4.L ,e" Atla • Wea C f� Sp».p1�s LIOUV
C'W A� lae fc1l h^e rt.�o�f low cti.rcas. l 1
i- 'ON # If �.ai %/XSU'�fiil e x�Cnv� . 1-4r, (.¢tn{
Z , ?ar-*z nxea
0K o�-"�r �(t of �a ao:� # Z � ►'e—st!erie
m khs.A;4ttt� crop SPmY Pt*, rCp5 OWLII� \04 %re1wj. 7/25/97
Reviewer/Inspector Name
RV_i r ttn
Reviewer/Inspector Signature: Date: �'f Q jQrp

[3Division of Soil and Water Conservation [3 Other Agency
® Division of Water Quality
10 Routine O Complaint 'G ollow-up of MVQ inspection O Follow-up of DSWC review Q Other
Date of Inspection I
Facility Number '
Time of Inspection % 'fip 24 hr. (hh:mm)
Registered R Certified © Applied for Permit © Permitted 113 Not Operational Date Last Operated:
Farm Name:......... r.'.ii 5... ........�V.::L�.; ..... .1.,.`'# ............................................ County:......�7ti!��li:ti...............................................................
OwnerName: .......... ��.�:-:.............................i r!�T..................................................... Phone No:... .... 04a.......................
FacilityContact: ............................................................................... Title:................................................................ Phone No:...................................................
MailingAddress:...3 C1.... ''.....!ti>..................................................................... ...... &DAGt........ }L.................................... .. iG .......
. grator:_„ . '
Onsite RepreScntattve:....�L. �............�ipa�.Y%c�........................................................... Integrator:_. ��.�1e�................................................................
Certified Operator................................................................................................................ Operator Certification Number:........................-----............
Location of Farm:
S.LC ......1 ....kK,....l�f.. .......Si .G.....CL�...... ....i.. !� .I.... just....ku iCR�. �l crS.....::W!?Y..... .". a ............. I.....................................................
.. .... .... .. .. ... ........ .... 7
Latitude Longitude = •
,Destgn Current Design Current < Design Current
Swane
Capacity:" Popnlati6n '� :Poultry Capacity Population Caitle ;, , Capacity. aPopiilaiia
Wean to Feeder
'gyp
❑ Feeder to Finish
❑ Farrow to Wean
I ❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer ❑ Dairy
❑ Non -Layer JE1 Non -Dairy
❑ Other,, r
F+f Towl'.
Design Capacity„ c-
:Total SSLW IsCr �co
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gaVmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes ❑ No
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes ❑ No
Continued on back

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed'?
❑ Yes
❑ No
Structures (La goon~ 11oldhi Ponds Flush Pits etc:
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure
6
Identi r'ier: ...............................
Freeboard(ft):..............................................................................................
10. 1s seepage observed from any of the structures'?
I] Yes
El No
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
❑ Yes
❑ No
12. Do any of the structures need maim(�nance/inihrovement'?
❑ Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
❑ No
Waste Application
14. Is there physical evidence of over application'?
❑ Yes
❑ No
(If in excess of WMP, or runoff entering waters or the Stag. notify DWQ)
t
15. Crop type .....!zY.1+rt.U;�A...................:Avv.g-........................... ... ...... ....... wi.,ta,t........... .............................
.... I .........
,................
16, Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
❑ No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
❑ No
18, Does the receiving crop need improvement?
❑ Yes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
❑ No
20. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'.'
Cl Yes
Cl No
22. Does record keeping need improvement?
[0 Yes
❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Permit'
❑ Yes
❑ No
0 No.violations or deficiencies Were note'd-during this.visit..You.will receive no further
.- correspoiidence a4oiit this.visif.: .
I Cotrttments (refer to question #) Explatrrany YES ansm,ers and/or fnvgrecommendations or an
drother commentsµ °a
Use awings of facility tobetter explanisttuahuns (use additional ti es as necessary) ;'s r
{Y I I y
7M. U-y avu;, )5i-s 5k.J6 �- JpJR, Gt:*1 Af l Cry 4fYt� �qr 1�-� 5�WJ6 , ctl si k" `ril'xti
* �(LTUv'1 5 i�b 1 f
C Lvxw rc+ Wcl, WOCKgU� It
. 6tgv5;eO 7'1 d iY_V je -JuvO be- blc,,k ! L�'f' s�+'Sh. M1+ o
a4(-cjjfl� sf.o��� be ��oc4Lca ,�,,ti.� �.1..,.. �S� �""•� �� i►.� (u.�ti��,.s, �—
it)�r• rurr- �S �" J� i an. 04 ' Vmp M'� W'.)` {,o C' le-5a w
7/2 5/97
Reviewer/Inspector Name
Reviewer/inspector Signature: n T Date: .3/14�i8`

Routine O Cam laint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number 3
Farm Status: ❑ Registered ❑ Applied for Permit
® Certified ❑ Permitted
Date of Inspection
Time of Inspection D.0 24 hr. (hh:mm)
Total Time (in fraction of hours
(ex:1.25 for 1 hr 15 min)) Spent on Review 0
or Inspection (includes travel and processing)
❑ Not Operational Date Last Operated : ...... ................ ......... .......... ........ ......... ............. ......`................................. .................. ..................
Farm Name:........Z:.tiU....nA...LVuGse!�(........*J.... *..#:L........................................ County: ....... Di4l.k%......................................... .......................
LandOwner Name:...» ...�xti.i@ ......-..., .... t1t............................................... Phone No:...4g1O).2 �/. Q�g...... .................................
Facility Conctact:....... AIL ............&!1nar............................. Title: .......... C?.1 ARr..................... Phone No: ..1k1���8�:.�'`��....................
Mailing Address: N.,=
............................._......._................................ G�......���i1. s...?.PL................_.................._....._Z.Nt'...� ......
OnsiteRepresentative:..... [�k �......... ............................................................. I Integrator:.....................................................................
Certified Operator: .................................................. ............. ............................................... Operator Certification Number ...... .).1.U.. ...............
Location of Farm:
. t xr7Q..l s ...... �L........ ,...:... �x!,t '..... .......�ara.... ......l f�, ......�a 1.1-Lb m... NJ ....QA. 1:.... 4
.4p.v� c�.tub.... C.r .......�. ...s� ..... ... �t&...19.4.1.....�.�r:M....i�...� .x x..... ,...mt.lxs.......Q,a....�lie►r 1 ..51 Q...�.�.�. .............
Latitude • 4 " Longitude ' 4 66
Type of Operation and Design Capacity
Getl_eral '
1. Are there any buffers that need maintenance/improvement? ❑ Yes V9 No
2. Is any discharge observed from any part of the operation? ❑ Yes [A No
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes [,No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes No
4/30/97 maintenance/improvement?
Continued an back

Facility Number: 6( — B p
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes KA No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
8. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes J�rNo
Structures (Lagoons and/or Holding fonds)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes No
Freeboard (ft); Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
............Z ......1-...................I..........3..........................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes I;a No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes XNo
12. Do any of the structures need maintenancehmprovement? NFYes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notiC'v D"'Q)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes R�No
Waste Application .
14. Is there physical evidence of over application? ❑ Yes J&No
(1f in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .................�AKN JC..........................�...................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes 9 No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
IN No
18.
Does the receiving crop need improvement?
RYes
❑ No
t9.
Is there a lack of available waste application equipment?
❑ Yes
RNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
52rNo
For Certified Facilities Only
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
WYes
❑ No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
([No
24.
Does record keeping need improvement?
❑ Yes
® No
E Reviewer/Inspector Name
Reviewer/lnspector Signah
cc: Division of Water Quality, Water Quality Section, Facility Assessineut Unit 4/30/97