310811_INSPECTIONS_20171231

NORTH CAROLINA
r._�
Department of Environmental Qual

Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit QVoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:
Farm Name: _
Owner Name:,,_
Mailing Address:
Physical Address:
Arrival Time: Departure Time: County: Regfon6u�
Facility Contact: rrff Title:
Onsite Representative., RlcG.�,
Owner Email:
Phone:
Phone No:
Integrator: 'r
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = e =1 0 is Longitude: = o = ` =
Design Current
Design
Current
Design Current
Swine
Capacity Popun
V1'et Poultry Capacity
Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ -Dairy Cow
'Wean to Feeder
on -Layer I
Dairy Calf
Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ L a ers
❑ Beef Stocker
❑ Gilts
❑ No ers
El Beef Feeder
❑ Boars
❑ Pulletsets
El Beef Brood Cow
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes j'No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes-15No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes "Qo
ElNA
❑ 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 0No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes �[ ^No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes /No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Z No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ,E!jNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes Q.No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
TT
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes 7No
❑ 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 a No
T
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes [;-N! 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 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 E2,�q'o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil 4,
❑ 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
L�rNo
0 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
E]No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
ONo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�^ o
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes 1:]Mo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes; check ❑ Yes r7rNo ❑ NA ❑ NE
the appropriate box. .4
❑WUP ❑Checklists .. ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes j::ff No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes gNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 2No ❑ NA ❑ NE
. Page 2 of 3 21412014 Continued

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Cl Yes J' No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ff No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes P No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ,I No
Other Issues
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes MNo
❑ 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 J�No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes �no
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes allo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes .6 No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes [3'lNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes �No
❑ NA
❑ NE
Comnieq'6 (refer, to gaestidiiV),. Explain any;YES answers�and/or; any aiidittonal€recommendations or,any otherlcomments
. ��;, :.; xt. �.,8 £%?, i -raY,s�T.i �$ i�'�s �'s�'7`e +t�
Use drawings of facility to better ear Jlain sitaatiohs,(use additaonal ages�as necessary,). !;,, �<;
a
f
F�z r
r. /�-%/ y i �o
Rev iewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: q'l 0 73a3
Date: VzVuT
2/4/2014

(Type of Visit: Q�Cbmpliance Inspection V Operation Review U Structure Evaluation O Technical Assistance I
Reason for Visit: 01outine O Complaint O Follow-up Q Referral O Emergency O Other O Denied Access
. j -
Date of Visit: Arrival Time: Departure Time: County: Region_
Farm Name: Z- Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Integrator:/
Certification Number:
Certification Number:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish La er
Cattle
DairyCow
Design
Capacity
Current
Pop.
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
DairyHeifer
Farrow to Wean
Design Current
D Cow
Farrow to Feeder
Dr, PU7UIt . Ca aci P.o P.
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Wither
Other
3 urke s
Turkey Poults
Other
i i
0
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes �no ❑ NA ❑ NE
[—]Yes
No
❑ NA
❑ NE
[:]Yes
No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes
0 No
❑ NA
❑ NE
❑ Yes
Ej No
❑ NA
❑ NE
❑ Yes
E� No
❑ NA
❑ NE
Page I of 3 21412014 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes J2 No ❑ NA ❑ NE
S_ a. If yes, is waste level into the structural freeboard? ❑ Yes [ZNo ❑ NA ❑ NE
7—
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 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 2fNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes j �No ❑ NA ❑ NE
maintenance or improvement? TT
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 ,E� No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes M No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ErNo ❑ 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 eNo ❑ NA ❑ NE
❑ Yes eNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes J" No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes allo ❑ 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. ❑ Yeso
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste ransfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E!rNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �o
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continuer!

Facili Number: - Date of inspection: L
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0No ❑ NA ❑ NE
25. Is thc;�cility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes C�f_No ❑ NA ❑ NE
%the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes EfNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [fNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3 I. 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/[nspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes Z No ❑ NA ❑ NE
❑ Yes E5No ❑ NA ❑ NE
❑ Yes [allo ❑ NA ❑ NE
[]Yes ff No ❑ NA ❑ NE
❑ Yes [Z'No
❑ Yes No
❑ Yes 9No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature: 1� Date: /;pt-
Page 3 of 3 /4 014

Type of Visit: 9rcompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Q'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: *± / V Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: Azb� Ao.,.Jos "x
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Region:
Integrator:
Certification Number: 1
Certification Number:
Longitude:
Design
Swlne Capacity
Wean to Finish
Current
Pop.
Design Current Design Current
Wet Poultry C*apacity Pop. Cattle Capacity Pop.
La er Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Dairy Heifer
Design Current Dry Cow
Non -Dairy
Farrow to Finish
Layers
I 113eef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
TurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes Z No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
�' No
❑ NA
❑ NE
❑ Yes
ONo
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facili Number: -1117 jDate of Inspection: r/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes A No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E!j No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes JZ 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 Z'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes P"irNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes )3—No
❑ NA
❑ NE
maintenance or improvement?
Waste_ Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes iT No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes VJ'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 �io ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes P No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes JZ7No ❑ 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
ZNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�
21 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
`F-' No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
VTNo
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facili Number: -1 jDatc of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes E'No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 2`No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ,EfNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface 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 ONo ❑ NA ❑ NE
❑ Yes PTNo
❑ Yes Z No
[] NA ❑ NE
❑ NA ❑ NE
❑ Yes VrNo ❑ NA ❑ NE
0 Yes ;EFNo
❑ Yes EZrNo
❑ Yes rl—
❑NA ❑NE
❑ NA [] NE
❑ NA ❑ NE
Comments (refer to, question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: -Zw :" n 0az
Reviewer/Inspector Signature: !�AA� e6tvknJ"`y _
Page 3 of 3
Phone:
Date:
21412011

�Divi'sionra FiW. ater Quality
METEHRUN.umber ©- �5) • Division of Soil and Water Conservation
Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: $ r Arrival Time: ICE Departure Time: j f County: Region:
Farm Name: 1` AGOG[ 7 2(-A/Y 0 &R'3C--(UA #oQ Owner Email:
Owner Name: 91CIC-Lk 01 L410I 1 SOS % )e Phone:
Mailing Address: IQ S . Caws ri't-� Cc-cc��0..�cc►4NS�tL«�r3 L19
Physical Address:
Facility Contact:
Title:
Onsite Representative: �CNS7)C� T --
Certified Operator: LON &SS 7 ! G
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Inteeggratlor:
Certification Number:
Certification Number:
Longitude:
9LIP 9,
Swine
Finish
Design Current
Capacity Pop.
Design Current
Wet Poultry C►apacity Pop.
Layer
Cattle
DairyCow
Design Current
Capacity Pop.
Feeder
(p
Non -La er
DairyCalf
o Finish
o Wean
o Feeder
DesignD
Dr P,oultrCa aei Po
DairyHeifer
Cow
Non -Dairy
o Finish
FFd
La ers
Beef Stocker
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Other
I
Turke s
Turkey Poults
10ther
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes 4 No ❑ NA ❑ NE
[:]Yes [:]No
[:]Yes ❑ No
[:]Yes D No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: -S I I I Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: _
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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? r
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): CS `l JE.& l iL „ ---
13. Soil Type(s): L.ad
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes 19No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
9No
❑ 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 No ❑ NA [] NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ] No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Trans ers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections ❑ Sludge Survey
22, Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA E] 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

Facility Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [ Yes []No
the appropriate box(es) below. T�
'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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑NA ❑NE
❑ NA ❑ NE
❑ Yes
JA-No
❑ NA
❑ NE
❑ Yes
❑ No
[k NA
❑ NE
❑ Yes No
❑ Yes �] No
❑ Yes No
❑ Yes No
❑ Yes 0 No
❑ Yes No
❑ Yes �] No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA [3 NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments:
Use drawings of facility to better explain situations (use additional pages as necessary).,
r Poi ��„��P�'3
c
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9/ 6 - 6 � _o 4
Date: V45 f
21412011

Division of Water Qnaality
�IacihSoil and Water Conservation
0 Other Agency �./
Type of visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 66,Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: © Departure Time: County:
Farm Name: QA��ji T &-RAID &Q.<�C—eSAA # C Owner Email:
Owner Name: j CICyl PC AA1 bO5 71 C. Phone:
Mailing Address: � �� S • CC,tW7-4Lv` G-L- 9, )9 �CIV,4N301 LLE ,/\JC OF9_
Physical Address:
Facility Contact:
Onsite Representative:
Title:
Integrator:
Phone:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Region:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design Current
Capacity Pop.
Design
Cattle Capacity
Dairy Cow
Current
Pop.
Wean to Feeder 14cCO
INon-Layer
I I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr> Poult ,
Layers
Design Current
Ca acit P,o ,
I
Dry Cow
Non-Dai
113eef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I
113eef Brood Cow
Other
Other
Turkeys
Turkey Puuets
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
No
jNo
❑ 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

Faciii Number: - Date of Inspection: S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
gNo
❑ 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:
Opt
Spillway?:
Designed Freeboard (in): ) Q• S
Observed Freeboard (in): '?
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
D<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
XNo
0 NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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 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 _9�No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift ElApplication
Outside of Approved Area
p /
12. Crop Type(s): C `� 1. 4
_
13. Soil Type(s): L ecw
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?
❑ Yes o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Y c s No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
O Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists Q Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes -] No
0 Waste Application 0 Weekly Freeboard Q Waste Analysis E] Soil Analysis ❑ W Ste Transfers
Q Rainfall ❑ Stocking Q Crop Yield 0120 Minute Inspections 0 Monthly and I" Rainfall IInspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑NA [3 NE
E] Weather Code
Q Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facility Number: 113ate of Inspection: S 3 //
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
'j NA
❑ NE
❑ Yes [ No
❑ Yes No
❑ Yes No
❑ Yes I
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes _E;lNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes XNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes &No ❑ 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).,
C 4t✓Igi[A T ro1Li DLtC-nr\j 1 c- c4q._bz4 FV-T L'V
-3_ �E� /rv�PEc?ron.l ro(� �1-ail
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: C] /6 I ca 430
Date: '5Z3,/
21412011

Division of Water Quality
Facility NumbeC ` $� •Division of Soil and Water Conservation
0 Other Agency
Type of Visit XCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit A Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: �(7 Arrival Time: 1 ff f Departure Time: � County: L�� Region:
Farm Name: `_A�,/ T�}J SCA� cI / Y JAas oz2 A � oC Owner Email:
Owner Name: V_ICjL'_4 Pow 1`oSTI c � Phone: 10- 9 '��
Mailing Address:Lq S Cexc-
A14IR CLL& �� 1C,vAHs01LLEl, Il-7 �-
Physical Address:
Facility Contact:
Title:
Phone No:
Onsite Representative: Integrator:
Certified Operator: C L� �S; W Operator Cerrttilication Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o = Longitude: ❑ o =' = "
Design Current
Design C►urrent
Design Current
Swine C►►opacity .Population
Wet Poultry C•apaeity Population
Cattle Capacity Population
❑ Wean to Finish7 1
10 Layer
❑ DaJEX Cow
Wean to Feeder
JEJ Non -La er
I I
❑ Dairy Calf
El Feeder to Finish
El Dai Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non-Dai
❑ Farrow to Finish
El Layers
❑ Beef Stocker
❑Gilts
❑Non -La Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
❑ 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 9No ❑ NA ❑ NE
El Yes
❑No
❑NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
LY No
❑ NA
❑ NE
12128104
Continued

Facility Nujkber: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
nnStructure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier; '` 7:-- a
❑ NA ❑ NE
❑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? ❑ 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
❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of
Area
12, Crop type(s) 5 C, &_�L C 1-4
13. Soil type(s) _ C ep) _1
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA ❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA ❑ NE
Comments;(refer io question.#) ;Explain. any YES answers and/or any recomirien'dahons or any other comments ,
Use.drawingsof facilityto'lietter;ezplain,siivations. (useadd�tionalpagc's`as nec'essary).
i3
AL
y +5�
Reviewer/Inspector Name ��� �.: � � ,. �w� �„g,. ,��,,,,, �, �, � Phone: ��Q �-�1(4 �3 �
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

Facility N ber: J — j'j Date of Inspection
Required
Records & Documents
o
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
No
[:1 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. 0 WUP El Checklists 0 Design El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
X No
❑ NA
❑ NE
0 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis 0 Soil Analysis ❑ yste Transfers ❑ AMhua] Certification
0 Rainfall 0 Stocking ❑ Crop Yield 0 120 Minute Inspections 0 Monthly and 1"
Rain Inspections 0
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
, KNA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
e�'No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[I�'No
[I NA
El 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
ONo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Cl Yes
` No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JdNo
❑ NA
❑ NE
Amments!a and/di/oDrawm sg;.x s +L W.r�
additional=Coi
�1 /8/Q
Page 3 of 3 12128104

Type of Visit g Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit X Routine 0 Complaint 0 Follow up . 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: %%k_:B_ Arrival Time: Departure Time: County: Region:
Farm Name: �ZA iT i�jCAN� NLI�CSEi2��oL Owner Email:
OwnerName: �N7f"C Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: -Tcw integrator: n
Certified Operator: Operator Certification Number: �4110L
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: [= o ❑ l = Longitude: = ° = ` = "
Design
Swine Capa�citV,
Current
Population
Design Current
Wet Poultry C►apaclty Fopulation
Design Current
Cattle Capacity Population
❑ Wean to Finish
La er
PO
❑Dai Cow
Wean to Feeder O0
Non -Layer
airy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
El D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
.0 Beef Feeder
❑ Boars
❑ Pullets
❑Beef Brood Co
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
KNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
XNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
AN o
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

Facility Nuinber: — g Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: c/
Spillway?:
Designed Freeboard (in): IC1.5
Observed Freeboard (in): 34
❑ Yes X No
❑ Yes ❑ No
Structure 5
❑NA ❑NE
❑NA ❑NE
Structure 6
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.)
/ 1
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
ANo
❑ 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)
to
f
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 FINE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 1bs ❑ 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) 7a ( 0$ } 1rj E_�L Ltf J
13. Soil type(s) C_e0N
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
O 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
o
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/ar any recommendations or any other eomments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
w.4.
aq
FI N ► 5N f" � � caN OI r—� w Act - 5 ace i �� 6z7
Sty-11og
�`� C al 5owc-, VGCn 12, 4710Al
Reviewer/inspector Name -s �'>, ";,}' z _}"
I +.. (}NG: C'7 /,/4C S x Phone: 9/0
Reviewer/Inspector Signature: Date: S 4110
Page 2 of 3 12128104 Continued

Facility Number: — Q i Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes X No ❑ NA [INE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ElYes XNo ❑ NA ❑ NE
the appropirate box. 0 WUP 0 Checklists [] Design [l Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X No ❑ NA ❑ NE
❑ Waste Application 0 Weekly freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ baste Transfers ❑ AAual Certification
0 Rainfall S Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes •l;fo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes 7% No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes V No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ❑ No
XNA
❑ 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 ANo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative`?
❑ Yes ANo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes olo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

44 Division of Water Quality
Facility. Number, Q Division of'Soil and Water Conservation
- — -
Q Other Agency
Type of Visit (ACompuance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency 0 Qther ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: C� County: u N Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: ((��!Title:
Onsite Representative: '1_>I
Certified Operator:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = ` ❑ ° Longitude: = °
Swine
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
(pt ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑❑ TEl urke s
Turke Poults
Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes N No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
ZZ No
❑ NA
❑ NE
12128104 Continued

Facility Number:' j
Date of Inspection �!
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
0 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: L"bOA(
Spillway?:
Designed Freeboard (in): �(•
Observed Freeboard (in): ok-1 fi
scZ'oac ";WVCDa�
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 ❑ Yes
JX No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box. below. ❑ Yes
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 Drifl ❑ 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
No
❑ NA ❑ NE
15. Does the receiving crop and/or iand 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
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):
_Lfl6 & 3 JUG C�14ELOC" 6rD 4
�
LL
�, pr C_r-r7r~E 01 r&
AieE1-
F�01"- c�ousEg
Q
Reviewer/Inspector Dame AMANOk NdF- Phone:
Reviewer/Inspector Signature: Date:
12128104 Continued

. . . ,.
Facility Number: — Date of Inspection
R_eauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes h No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Ycs KNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? [:]Yes ZNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes qNo ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
RNo
[]NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit`?
❑ Yes
M No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
5d No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
ZNA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
wl� No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Wo
❑ 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
ElNA
❑ 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
4 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
O No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JZ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Nee t> I o m arL '5LR E T a 6 E-r H o rF a F t& L1'�, w A[ ccA
R,ALE I/V$ 2CKavC-J'�s
FAa
S� IN�pC-_C71CW
Pri
12128104

'Division of Water Quality
k-
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit compliance 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: Arrival Time: Departure Time: County: Region
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone
No:
Onsite Representative: integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: = O = I = u Longitude: = ° = 4 = `{
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
DischarEes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design . ,. Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifej
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA
❑ NE
❑ Yes ❑ No ❑ NA
❑ NE
❑ Yes No ❑ NA
❑ NE
❑ Yes No ❑ NA
[I NE
,(�
❑ Yes �f ❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
(Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,lA No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes VNo ❑ 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 ENo ❑ 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 strictures need maintenance or improvement? ❑YesNo ❑ NA [I 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 ADDlieation
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [No [INA El 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 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 dNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ElYes [�/No ❑ NA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes 0"No ❑ NA ❑ NE
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 m No ❑ NA ❑ NE
IComments (refer to question ft Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
lRevLiewer/Inspector
r/Inspector Name Phone: Q �%
Signature: Date: 1�
12/28 4 Continued

0Faciiity Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 6No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �(J No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? El Yes 1VNo ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ElYes O No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes �No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
V, �r 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?
Comments and/or Drawings:
❑ Yes o
❑ NA
❑ NE
El Yes2��No
❑ NA
❑ NE
❑ Yes (Ea No
❑ NA
❑ NE
❑ Yes
❑ NA
[I NE
,D�70
❑ Yes .- No
❑ NA
❑ NE
❑ Yes -BNo ❑ NA ❑ NE
Y
I - - lzeal
ff '6rf44 �7a6� cp6d_ ie66V CI&
d- a r�r�r
12/28104

%J Division of Water Quality
Facility Numbeir � f 0 Division of Soil and Water Conservation
_ J _
Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: D U Departure Time: County: Region:
Farm Name: .�- .-C&Z& 6�_'P ner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
LJ
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
P one No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: o =' = Longitude: 0 ° = ` = «
Design :Current Design` ' Current
swine La actt Yo ulatton
p, . y" p..
❑ Wean to Finish
Wean to Feeder In CC22
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Wet:Poultry. Capacity Population
❑ Layer
❑ Non -La er
Dry Poultry.
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
El Turkey Poueis
❑ Other
Design Current
Cattle, Capacity Population'
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: '
Discharges & 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 discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes ElNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[]NA
❑ NE
❑ Yes
;3No
[:]Yes
WNo
❑ NA
❑ NE
❑ Yes
Z No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ;21-No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ['No ❑ NA ❑ NE
Struct e 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 [IIQo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6, Are there structures on -site which are not properly addressed and/or managed ❑ Yes [:INo ❑ 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 ZNo ❑ 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 12No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZfNo ❑ NA ❑ NE
maintenance/improvement?
l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes W(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) j V 11,1, jpr'j`,
13. Soil type(s) [Xe v v
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
ElNA
ElNE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes,.,ONo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes W No
❑ NA
❑ NE
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 o
❑ 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).:
Ue s c�./.� P� t acN+�. �clyr\ �-s ,r �e c vr. s.
Cl tei `
Reviewer/Inspector Name s✓ ) i k.,
Reviewer/Inspector Signature: _141
Phone:
Date:
rA
N
rage z of 3 1-1iaaiu4 uonnnuea

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Ko ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes JZNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ;'No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ZNo
El NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes PP No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes �5 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes VNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes 'P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes JZNo
❑ 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 IeNo
❑ 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 ZNo
❑ NA
❑ NE
General Permit? (ic/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes f('No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes RNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
3,3q T `eve/Il
� ��4w� PamPamAij
Page 3 of 3 12128104

Type of Visit compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visitoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: ��` Q. Arrival Time: Departure Time: County / Region:
Farm Name: ��1C1� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other
Phone:
hone No:
Integrator:
Operator Certification Number -
Back -up Certification Number:
Latitude: = c ❑ i Longitude: ❑ ° = 6 ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
� ❑ Layer
{ ❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockee
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
J
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the'waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes .2 No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes „RNo
❑ NA
❑ NE
❑ Yes Frio
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment �►
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes O 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: l
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes .allo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed El Yes ENo ❑ 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 0-No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes O-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 ,rNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes !T No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes ETNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs ❑ 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) �f � G , 1 x rcf=L 2
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
[]Yes 20No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ,ETNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination:
❑ Yes O No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes ,rNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ;'No
❑ NA
❑ NE
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: 6
12128104 Continued

Facility Number: Date of Inspection b
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes L—dNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check ❑ Yes,--f'—rNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ,Crop Yield ;B120 Minute Inspections �Ivlonthly and I" Rain Inspections 2<eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes *zrNo ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ZNA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit'?
❑ Yes ❑ No
;/ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes ❑ No
911NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes ,'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ❑ No
❑ NA
XNE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes,ZNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes g No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes �No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes �No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problerns, over application)
32.
Did Reviewer/inspector fait/ to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency`?
/0
Cl Yes /No
❑ NA
❑ NE
Additional Comments and/or Drawings:
�� ease (ecord
Y11 �104 a ti d�4 M I nG�-Lc� .S
n I �-LQA CL It Y2n n I �,.� Pec-h.oki
I
C� ar c-dock-ijk4p C4
Vex- 0 `of 'S
6 LeA fe-a
�a-i­ cx- r1
12128104

(Type of Visit fo Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit Routine O Complaint Q Follow up O Emergency Notification O Other © Denied Access
F7aciility Number 8+ Date of Visit: la % d Time:
O Not Operational O Below Threshold
0 Permitted ❑ Ce ed © Conddiit�io/nally Ce /'�� Q Registered Date Last Operated or Apove Threshold:
Farm Name: �. ..-1.»�_ 'I.�t�r[',fFP�... .............. County:...( .../��L.. .....»..» . __� ._
OwnerName: .... ».».................................. ..... ....... __...._._...._»...__ ... . _ ....._.. Phone No:V—4 .»
?Mailing Address:.... »......_.»._....... ......._... .. » .. .»... »........_ . _. .. . ___ _____._ . _»7�� 3 .....
Facility Contact: __._._— _ _» Title:... ___ _ ».» ».__%Phone No: __.__..__..._»..__ ....
Onsite Representative:.RE
_ _ _....__ . _._........ Integrator: _.._._ ............._.....»».».»......
CertifiedOperator :.............._...» ».»»»................ ... _._..... _....._.........__........._ Operator Certification Number: ....... _..._,,..............
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ` " Longitude • ° "
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation? [:]Yes ,2To
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 _.O'►No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes []vc
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 3-No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier: .....»..........__
Freeboard (inches):
12112103 Continued

Facility Number:3 — Date of Inspection d 4
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑Yes 2'lvo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes eNo
closure plan?
{if any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DW(2)
7. Do any of the structures need maintenance/improvement? ❑ Yes ZNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes dNo
9. Do any stuctur+es lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ,0 No
elevation markings?
Waste Aanlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes E3140
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes j'No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type /iri lAo"%s t5 C� ll?f/1?e , A_
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes I-7No
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 O No
16. Is there a lack of adequate waste application equipment? ❑ Yes fNo
Odor Issues �/
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes � No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes PNo
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Air Quality representative immediately.
" harm �-
G.ord S
eLd�S �n c�o0c(' SY
(Iea4 o
Please be- sufe-
o
❑ Field Copy ❑ Final Notes
A
4--o jo aC 1c ou � �'`� ct t� 51 S
a+ a 5 SeV\- -� o
dJ Qm
be r PLAMP i r�5 e u ev1,43
C hec k W [ �h S a- U-) +o
C.o v-er- -3e I- P-O r ) 4 .
ReviewerAWspector Name
Reviewer/Inspector Signature:
5
�+ new
Date: /-,/- /Jif
I7/77/na

Facility Number: -_� Date of Inspection O !j
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ❑14o
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 ;'No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E?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
,H No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
eNo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
�allo
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
E!rNo
28. Does facility require a follow-up visit by same agency?
❑ Yes
ONo
29. Were any additional problems noted which cause noncompliance of the Certified AWN??
❑ Yes
3No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
J�No
3I. 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 fail 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 I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Facility Number Date of Visit: I Time: M
rO Not Operational 0 Below Threshold
Permitted M Certified Q Conditionally Certified [3Registered pate Last Operated or Above Threshold:
Farm Name: �i!`f �s/fi/�� rf�ic� County:
Owner Name: �� `G Phone No:
Mailing Address:
Facility Contact:
Title:
Onsite Representative: �e L' e _
Certified Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 6 " Longitude C�• 6 66
Wean to Feeder
Feeder to Finish
1LJ Layer
[]Non-L
Farrow to Wean
❑Other
i .. .
Farrow to Feeder
Farrow to Finish
Boars
Subsurface Drains Present U
No Liquid Waste Management
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:
Freeboard (inches): 72'&0
05103101
Field Area
❑ Yes UN No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ Yes 9 No
Structure 6
Continuer!

Facility Number: 31 — 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?
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 /,�1�✓/Yf a, Az ( M*/ f !;?4d-L_ 67Ai 1
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 or other 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?
❑ Yes CQNo
❑ Yes FE!'I-No
❑ Yes JRNo
❑ Yes P..No
❑ Yes Cg No
❑ Yes �E[No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
® No
,DqNo
❑ No
❑ No
® No
MNo
❑ Yes %No
❑ Yes P] No
❑ Yes XjNo
❑ Yes KLNo
❑ Yes E-No
❑ Yes ®,No
❑ Yes �No
❑ Yes ,S-No
❑ Yes E-No
® No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments, (refer to questlibq #) Explain any YES answers;ani3/off any recommendations oT any o tber comments „
Use,drawings of facility to better explain situations:;(use,addltionahp
" m ages as necessary), ❑Field Copy ❑ Final Notes
/V1ft r `�Cr�b✓ LYI Z��%%r' Zlvorr !✓,CS Ca�.o dcJAr/tG %!tQ',d/}h -�✓ysr�/S iry
AL
fib -� �i'HG� G�ftt� r%� /1PaC�sr j�b �C �iL�itv�t -�'�Le Gci10r� 6�irte� ��s�
71/A Ae—
Reviewer/Inspector Name;"
Reviewer/Inspector Signature: Date:
O5103101 Continued

Facility Number: 3 — ! Date of Inspection
Odor hsues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes OZNo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �SNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ANo
roads, building structure, and/or public properly)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes r.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 AD-9No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes XNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes �Uo
Additional Comments and/or Drii<wings:
05103101

Type of Visit t8 Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit (§ Routine O Complaint O Follow up O Emergency Notification O Other 1 ❑ Denied Access
Date of Visit: 2 OI Time:
Facility Number 10 Not Operational 0 Below Threshold
® Permitted ® Certified [3 CoondittionallyCertified 13 Registered Date Last Operated or Above Threshold: ...............
FarmName: ....... �rca f.....TS.A.a.....: z............................................................. County:......... A4n ................................ .......................
OwnerName: .......... Alj, l... A6 .............................................................................. Phone No:........................................................................................
FacilityContact: ............................................................................... Title:................................................................ Phone No:...................................................
MailingAddress:........................................................................................................................................................................................................... ..........................
Onsite Representative: ........(.IW..A(C............................................................................... Integrator:.... 4?C�+?�a�1.... �!'T��1�I.... A!7.?5.................
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude • 1 bd Longitude ' 9 . 61
1
Design.,Curren,
:Swine Cgnocity Ponulalion
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Numbeir of Lagoons
i
Holding Ponds/ Solid -Traps;:
Design Current. Design Current,
Poultry _Ca aei ` , Po ulation• Cattle Ca aci :;Po ulatioU.,
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Desio Capa0ty
`Total SSLW1
❑ Subsurface Drains Present [] Lagoon Area 10 Spray Field Area
❑ No Liquid Waste Management System
Discharges & 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 ❑ No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DW Q) [j Yes ❑ No
c. If discharge is observed'. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ;3 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?
Structure 1 Structure 2 Structure 3
Identifier:..........30....................................................................................
❑ Spillway ❑ Yes 0 No
Structure 4 Structure 5 Structure 6
Freeboard (inches):
5/00
Continued on back

Facility Number: Date of Inspection I�
5. 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 K) No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes S1 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 ❑ Hydraulic Overload
❑ 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
KNo
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
J• No
15. Does the receiving crop need improvement?
A Yes
M No
16. Is there a lack of adequate waste application equipment?
❑ Yes
M No
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
IM 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
[BNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
2) No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
M 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
4 Yi4i s :ox d0f cjeji0{& *gre P4t.� drift tbjs'vjsjt; • Y;ou M, III �ee�iye too' #'u t�tgr :
• corres orideirce: a�atit: this visit` • • • • - • • - • • - • •
� r• r t.....
Comments (refer to gueStion #) 'F.xplaiII any YES answers and/are any reeommendadons orPany other co
Use drawing§ of facility to'tietter explafn situadons; (useiddi6nA pages as necessaryj;
4imt 6+ / S 6,n & Haul- be 41? l,o
��� Gwn� �a y >,��n� z4,�1� � K �D'z �ela� he,� u?odr'L.. � � ��1� 4
•
Reviewer/Inspector Name
�_•7� �U c1L-.� r .% r rr' .� �, . �'.r. ,,, �,.�a n .�.�i� ,. "ri-". .r'i�� . i';�i
Reviewer/Inspector Signature: �J,�j�, g Date: lL /t /Q 1 5/00

Facility Number: 31' — j j 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 ❑ Yes 2g 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 PS No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes CSNo
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 C@ 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? 0 Yes ® No
0�4difional Comments an or ra ngs: 1 - A ' !:=z r + rE+.
Aki
5100

Type of Visit_ O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 7-6-200d Tune: 1600
Facility Number 31 811
O Not Operational 0 Below Threshold
❑l Permitted U Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: ... ........ ..
Farm Name: RAbhi1.Jfi arid.Nn raclryA2......................................................................... County: Rupan .................................... WJRQ......
Owner Name: E,i, kX---•--•--•--•--•--•--•--•--._$Qstic........................................... Phone No: 91R:29G. kQO.4_a429Q.-2212.OW--------•--•---
Facility Contact: - -- -- -- -- -- -- ---- -- -- ------ - - - -- -- Title: - -- -- -- -- -- -- -- .....- - -- -- -- - Phone No: -- -- -- -... -- -- -- -- -- -- -- --
Mailing Address: .19,1.Suuth.Counitr:.Club.Dl:rive.....................................................K=Aa&ViUe.N.0 ................................................... 28.149 ..............
Onsite Representative: Qaxncr.4&cpxdsj.................................................... Integrator: NILaCpil�.�a> y.� t�.............................
CertifiedOperator: •- -- -- -- -- -- -- -- •- -... -- -- _ -- ..._ .. -- -- -- -- -- -- -- -- -- -- -- Operator Certification Number:_.......___..
.. _. __ ._ ..
Location of Farm:
'forth of Greenevers. On South side of SR 1954 approx. 0.8 mfle West of Hwy 50. First site on farm path. s
t
• •_-•-••••••� . ..... ® Swine [I Poultry [I Cattle [I Horse Latitude 34 51 , 42 iu Longitude 77 • 53 16 r 35 I��
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
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes [@ No
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: ..... _.. _.. _.. _.. _.. _...... ........._............................... _.. _.. _.. _.. ......................... _ ... _.. _.
Freeboard (inches): .....- --24 - - - --- ------ -- -- -- -- - -- -- - - - -- -- -- -- -- -- -- -- -- - - -- -- -- -- -- - - -- -- -- -- -- -- -- --

.)iuu
F'aUdy Nllm%er: 31-811 Date of Inspection 7-6-2000
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 maintenancetimprovement?
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 butlers that need maintenance/improvement?
l 1. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Coastal Bermuda (Hay) Small Grain Overseed
c,onunuea on back
❑ Yes
® No
❑ Yes
H No
❑ Yes
® No
❑ Yes
No
{� Yes
® No
❑ Yes
H No
❑ Yes
19 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 0 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, 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?
No violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
® Yes © No
❑ Yes 19 No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
© Yes ® No
® Yes [:]No
❑ Yes ® No
® Yes Ci No
❑ Yes ® No
❑ Yes ® No
15. Work on improving bermuda on pull behind hog house. +
18. Obtain new aerial photo of farm from district or Murphy.
19. Suggest taking new soil samples since lime is highly elevated since last report. Apply this fall according to analysis
results. No pumping as of 6-29-2000. Start pumping ASAP here to lower level & help bermuda crop.
1. No OIC designated for facility in database. Grower is re -certified after failing to pay annual fee. Forgot to leave OIC
designation form on -site. Will send via mail (Added after inspection).
23. Owner on -site for record review previous week — rained out from doing physical inspection. Notified grower of intent to
perform rest of visit if he wished to attend which he did not show up.
T
Reviewer/Inspector Name
^ - -- -_.. _.1.-- -- - -a . _. r i - -- - ---

G.
02 Routine O Complaint O Follow-up of DWQ inspection 0 Follow-up of DSWC review O Other
Facility Number
` Date of Inspection
Time of Inspection = 24 hr. (hh:mm)
Permitted Certified 0 Conditionally Certified [3 Registered Not O erationa Date Lllast Operated:
'� County: .................. \1
Farm Name: 1^�
OwnerName:........................................................................................................................... Phone No:.......................................................................................
Facility Contact: ........................................
Title:
Phone No:
Mailing Address:. ...........................................
Onsite Representative:—.... .......................................
Integrator:.,................"......................................
Certified Operator: ..................................:.............................................................................
Operator Certification Number:..........................................
Location of Farm:
J.-
Latitude ' A " Longitude ' ' "
Design..
$wine ° , Ceg'
Po
Poult
elation ry
''t''i�1$D
Cattaae
ouoCesicgn 'Po ulatiot n
1AWean to Feeder t5
❑Layer
�[� ❑Dairy
❑ Feeder to Finish
❑Non -Layer
',� ❑ Non -Dairy
❑ Farrow to Wean
1FN
❑Other,��t
i., r
Farrow to Finish
Toltal�Design° Capactty`�
❑ Gilts
; :
':
i ❑ Boars
! T SSL ow W
-
! . ❑Subsurface
i
Drains Present
❑Lagoon Area
❑Spray Field Area ,
° H'Aung Ponds'I Sottd Traps r;
;; ` ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation? ❑ Yes gNo
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 ycs, notify DWQ) ❑ Yes ❑ No
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (11' yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation?. ❑ Yes too
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes CE(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: }}'
Freeboard (inches): .............—.L. .................
..... .......... .............................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes gNo
seepage, etc.)
3/23/99 Continued on back

Facility Number: 3 — (j Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? Cl Yes 9110
(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 WNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes WNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes [�(No
Waste Apelication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
N�&o
11.
Is there evidenc of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
j No
12.
Crop type I"
13.
Do the receiving crops with those designated in the Certified Animal Waste Management Plan (CAWMP)? .
- [] Yes
WNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
NrNo
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?
Oyes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
RNo
Renuired Records & Document%
17,
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
Io
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
9No
19.
Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
allo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
9No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
WVo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
1p:'k(No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
MYes
❑ 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
CRNo
o viola tot s'on dgficie.ncie5 -Wgre n¢te�1 during •this' Vislt; y0il wiil•teowly 06 fufft
corir s• ondei & about: this :visit;
sE E. c °:� s ;; r E
U4s'eEdrawrngs of facil�tyEo'better,explain situations (use,adcLdonal pages as necessary) ,
Ljc_�kl < �
��{'l soy
r-`'--p ins
Reviewer/lnspector Name C1 s
ReviewerAnspector Signature: Date:

Facility Number: 9 k-- K t ( 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
❑ Yes
dNo
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
�kNo
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
11
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
O�No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
b�No
Additionaomments an orDrawings:
AL
V
��✓"�L�v � �L- p

[] Division of Soil and. Water Connuseirvation .Operation Review + t'
a , - ""4
L
3 Division of Soil and Water Conservation Comphancetlnspection
xj
I r Y
�Dlvislon of Water Quality-0011lplEanCB )(nspeC$on� is k {` +, 3>f r tI + •`
3<r = ,Other Agency - Operation Review
Routine OComplaint O Follow-u of DWQ inspection O Follow-u of DSWC review O Other
Facility Number Oate of Inspection
Time of Inspection 24 hr. (hh:mm)
© PermittedCertified © Conditionally Certified [3 Registered Not Operational Date Last Operated:
�l 2 .........................
- county:.......... .2..4-- ........Fa
rm Name: C ..r .Q.3..t.T.....� S..f. `k. ..I�..... .�(„2. ..Srt.G`7i-TA ............ ...........................
Owner Name: ,.i .lG-`i'................. .n..Q.5TLC..................................... Phone No:.. .. ..c.....2 .Q.�..... .1..�.. .......
Facility Contact: T )F-Y........Q S T..Ir ..... Title:...... . . t�,�................. Phone No:... .-...........
Mailing Address: 2_a.Q ...... .Q. .TH........ ....... L� ! ..1....'l�c.,....... 2. t .lc5"'
Onsite Representative: �as.1. ................................... [ntegrator:.. 16, ..Y?,.....................................
Certified Operator:.... }� C- ,-` ........... .... ,5, `�,�, ..... ........ Operator Certification Number:... -
Location of Farm:
► �........ Z.AA...... ....ra........ Q..r.,....... ....s..o........... .......tt:.... ...
.....T.U.r�. in......* . = x-.... 10.1,.1...... .,......t=' r , ......t s.... -I� a .�.�... .. ...
Latitude L-3 I I'J° I k4 Z f" Longitude �� • �3�J�F — t
r' 1 Design Current i� �' it -Design Current � 1 „ Design Curri
hula Po
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Poultry,,-„ Capacity;:- Population Cattle
❑ Layer JE1 Dairy
❑ Non -Layer I I❑Non-Dairy
❑ Other
'tj, r
Total Design Capacity
s ..
f, oL
T t
1 aFJSLW
Number of Lagoons ❑Subsurface Drains Present ❑Lagoon Area
Holding Ponds'/ Solid Traps � ; P F ❑ No Liquid Waste Management System
r... .f .
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. II'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)
I Spray Field Area
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): .........'41,3. rr............................................. .................................... ........... I....................... ... ... I ... I..........
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes KNo
❑ Yes KNo
❑ Yes R90
❑ Yes fZNo
❑ Yes V�No
❑ Yes �' o
❑ Yes Vo
Structure 6
.....................................
❑ Yes Xo
3/23/99
Continued on back

Facility Number: Date of Inspection E= E
�6, Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan`? ❑ Yes 19No
(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 , ,0
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 9No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes XNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes INo
12. Crop type i < _t-Z1tn., (' i--)A / l)Q5'_ C T t- n C-i 7 LT-H OAT-
s
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
9No
14, a) Does the facility lack adequate acreage for land application?
❑ Yes
Wo
b) Does the facility need a wettable acre determination?
❑ Yes
P<No
c) This facility is pended Cora wettable acre determination?
❑ Yes
D3�No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
KNo
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
, \ o
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
XNo
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
5�No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
KNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONO
yiola�iQtis or agfc�enc�e v► re ngte� iiirririg phis visit= ... w.. reeeiye
Mq
C rres ondeRce. about. this 'VWt: ' '
Comiiients' (refer to;questi6n #) iiExplain any YES answers and/orr'any=recommendatt6ns o`r:any'o er,comments +a
Use,drawiags of -facility toatiettereXplatn sttuattons (use pages as%°necessary){ter
Paddttianal
r nr Iff rf r E _ , �E •.,. �r,, f'�� €� �� ' !r ;`' E`EN 1„e.,
Reviewer/Inspector Name
Reviewer/Inspector Signature: t-A C AA A , n /-I Date: (. a 1-Q G
3123/99

Facility Number: — Date of laspection !� cq
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes *0
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? [:)Yes VNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes t<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 KNo
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 K10
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 5�10
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ,�Ycs
Additomrrients an or rawtn s ��
g
[
�3� ST l C_ S � A k'l--'�N L � r�C�3 Q
t n 0 D r
L3 CD S T t L W t I�� r
A, b c� L L-A--
C_ L-j A t) b I-)-
3/23/99

Division of Soil and Water Conservation 0Other Agency
11,1[3
° r ® Division of Water Quality
10 Routine O Cam hint O Follow-up of DIVQ inspection 0 Follow-up of DSWC review O Other
Date of Inspection 1� 2
Facility Number Time of Inspection � 24 hr. (hh:mm)
Registered 01 Certified ©+Appplied for Permit 0 Permitted 113 Not Operational I
rDate Last Operated:
Farm Name: ............! tC?� ......l S!(lh�.........�Zr ... ..... County:.... Dfl�(.'A........... .............................. ........I.........
OwnerName: . It-x ........................................................................ Phone No: ..... �FIQ...'. 3. .........................................
Facility Contact:...................................................... ............ . Title:................ .. Phone No:
Mailing Address: .......... .21Y.S18 .......
.....M.t71................... �......................................................... i�.Y► �. 1... A....:...............................
Onsite Representative: ... *.av_v, .......... 05 i�,,.�........................................................ Integrator: ....... 1V1 .
Certified Operator................................................................................................................ Operator Certification Number............ 3 ......
Location of Farm:
... fax 1.... �:5... jai .....��pr.-.Sau... .... sh .e.... Dt .......5&..h9�.. 1..L?��.1n!.. ..... . m...,....1. .................. .........................................
Latitude =• =` 66 Longitude • 6 = Gi
Design yE,_ >Current Design :Current,Current
Swme Cspacity, Population,. Poultry Capacity 'Population Cattle Capacity Population,
❑ Wean to
o Feeder ❑ Layer ❑Dairy
❑ Feeder to Finish JE1 Non -Layer I
JEINon-Dairy
Farrow to Wean
[I Farrow to Feeder 10 Other
i ❑ Farrow to Finish •Tote Design Capacity
FO ❑ Gilts
g " 9 n r ` Uu
❑Boars Total SSL` W v
N
Number ©tLa oonsYAioldui Ponds .. ❑ Subsurface Drains Present 110 Lagoon Area ID Spray Field Area ;
k ❑ No Liquid Waste Management System`
k
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes 00 No
2. 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 than -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 gaUrnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes M 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 [2 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ® No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
7/25/97
Continued on back

Facility Number: 3(— $li
8. Are there lagoons or storage ponds on site which need to be properly closed'?
❑ Yes
® No
Structures JI-woons,tioldina Ponds, Flush Pits, etc.)
9. is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
00 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure
6
Identifier:
Freeboard(ft):..................................................................................................................................................................................
10. Is seepage observed from any of the structures'?
❑ Yes
® 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 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 inaximum 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 of the State, notify DWQ)
15, Crop type ............. �tvmvj.&........................................................ . ...............................
16, Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
N 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
M No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ED No
22. Does record keeping need improvement?
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 noted -during this visit. Vou.will recei've-l]o farther
correspondence about this'.visit.
Comments (refer to question #) `Explain any ' S answers an or any r'ecn�mendattons of any other commtents.�
Use`drawinf s Of fuClllty tO Ilettei` ex sltuati6m- ( 4 addlti —:1 pa is dS neClssaiy� 2° a
t $ &-rmudo, he m 4- _,4ftr, .
orrt .+ t � � tic r✓s �, l , ✓jt be trg d Who- ��� �f'_ `�+- SO>� t�tt S' Wa s�-
Si s Shotl�c� be : �S -tot�i SNa d ��e. ►t trc�c��t�(J a�,� S� � hii�++i k'`
��e� �� s '� �rz;11. 11I`i�ft} u-. was v 'I{IirJ 40 e. cV"eP.
7/25/97
Reviewer/Inspector Name {
Reviewer/Inspector Signature: 6A..X— , Date:

13 Division of Soil and Water Conservation - Operation Review
0 Division of Soil and Water Conservation - Compliance Inspection
® Division of Water Quality - Compliance Inspection
© Other Agency - Operation Review
0 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection 1129198
Faci�yNmber 31 Sli Time of Inspection 15.10 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status:.CgrAlfwd............................................................................. (ex:1.25 for I hr 15 min)) Spent on Review
or Inspection (includes travel and processing)
Farm Name: ]Eiul�l�it�slrup�l.�Iux arx.# 2.......................................................................... County: D.up[k............................................... ..I1.i.G.........
OwnerName: JUAI l:...................................... Bo tic............................................
Mailing Address: �902..S�1Y..Sl1........................................................................
OnsiteRepresentative:]k�r.,.astAs:.�iit,i.'..��Xixt;��..................................
Certified Operator: ft................................ 00fic.................................
Location of Farm:
PhoneNo:.......................................................................................
rµla�rilly..NYC....................................................... 285IN ..............
Integrator: MalrAb�X. ��tpa1lX.�11C�p&......................................
.. Operator Certification Number:.1.h7.3.4.............................
il
tn..tIte.Icft..................................................................................................................................................................................................................................................
Latitude 34 • 51 ' 42 it Longitude F 77 • 53 ' 35
Not Operational Date Last Operated: ...............................................................................
of Operation and Design Capacity
Farrow to Finish
❑ Other
Non -
General
1. Are there any buffers that need rnaintenaiiee/improvement'? ❑ Yes E] No
2. Is any discharge observed from any part of the operation? 0 Yes [j No
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 E] 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 0 No
. maintenance/improvement?

6. Is facility not in compliance with any applicable setback criteria'?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/]/97)?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons and/or Holdine Ponds)
9. is structural freeboard less than adequate?
Freeboard (ft): Lagoon l Lagoon 2 Lagoon 3
10. is seepage observed from any of die structures?
l l . Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(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 adquate markers to identify start and stop pumping levels?
Waste Application
14. is there physical evidence of over application'?
(If in excess of WMP, or runoff entering waters of the State, notify D WQ)
15. Crop type...................................................................... .......... ....................................................................
16. Do the active crops differ with those designated in die Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For Certified Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan.in any way?
22. Does record keeping need improvement'?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes ❑ No
❑ Yes ❑ No
Yes ❑ No
❑ Yes
❑ No
Lagoon 4
❑ 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
reddish colored water was observed draining from farm into roadside ditch at SR1958. No evidence of a discharge could be found at
;ility. The lagoon level looked fine, and there was no evidence ghat die operator had pumped recently on his spray fields. The color of
ainage coming from a wooded area downstream was also reddish in color.
Name•:'iv?i(����i"er'�=s'€r''s<`�"`€<€���?_€>:>==':«<'<�:>:«:��ry<'`��<>�•'?s<�<<'�:>€<?<�?��<<s'�<':<:<€`:::;:a"':'�'':.<'<><>'<
Reviewer/Inspector
ReviewerlInspector Signature: ��' �"� �,�,,,�,� `,�� Date: Z, / C� / d p

Ig!Routine O Com laint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facil#ty Number Date of Inspection
.
Time of Inspection : 24 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:.1.25 for i hr 15 min)) Spent on Review C� .
pCertified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:......_..............................................................n..........
{.......................................... ........................
FarmName: ........ ?'?%!±...... 1.11AJ...... ..».................................................... County:......:t ?I.tiln....................................... ............ ...... ...
Land Owner Name:......&Ilr
............................................................... Phone No:..C.1.�OJ.. 1�..........................................
Facility Conctact:....................._Ea5.hr................. Title: ..... .W.?' jW.hAC ....................... Phone No: ...................
MailingAddress:..... zaal .......1 .....N.(r... ... ............... .............. I ......4�e F-IN^..................... .................. .1.ml$........
OnsiteRepresentative:.... `91L.........1,?5.,6r........................................................ Integrator: ....... hlN................................................. ..........
Certified Operator:........ .t�Y....... ................. 0. 'h..,,................................., Operator Certification Number: ..... % ..............
Location of Farm:
..xwy .......... m...... zz.gb..... v...h... ...... . ..... 5
... z....... ►�.il.�s.. sf :.......K.kg5-A,.. ��+��...tis..�.......?:.�.. �iLt4w...... on...... ........................................................ a
Latitude Longitude �• �� ®��
Type of Operation and Design Capacity
.,�� -; - �� � � � � , ,� •mot �^,�� :�, �;
Design Current Design Current F s Design Curreist
Swine" Pnult Cattle °�
Po elation. r3',.: Ce aci .: Po ulaEion Ca aci 1?0` ulatIon
Wean to Feeder❑ Layer
❑Dai
' Feeder to Finish ❑Non La er ❑Non Dai
Farrow to Wean
Farrow to Feeder ' s Total DesegnCapacity�; 00 `
Farrow to Finish
��. � � � Total: SSUW 000 £
w
u 0 Other E Ti a t :� s 3 o�,sr ,
v
E1711r.Ek
umber of Y.agoons / Iloldmg Ponds ❑ Subsurface Drains Present
❑
f Lagoon Area t� ❑ Spray Fie Area ld�... y
General
1. Are there any buffers that need maintenancelimprovement?
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 gal/min?
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?
. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes ®No
❑ Yes V No
❑ Yes Z No
❑ Yes CA No
❑ Yes 'd No
❑ Yes C& No
❑ Yes r,No
❑ Yes P No
Continued on back

Facjtlity Number: ..2►1....... `....$ �l..
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?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures ([lagoon. and/or Holding Ponds}
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure 1 Structure 2 Structure 3 Structure 4
13........... ........... _............... ............................ ...........................
10. Is seepage observed from any of the structures?
11. 1s erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(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?
Waste -Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ................. X)c 1M1�G[t►.................................. ..................;04... Ap.. I Wh
❑ Yes 00,No
❑ Yes 09 No
❑ Yes NJ No
❑ Yes N No
Structure 5 Structure 6
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
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 Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certifled Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes 14No
❑ Yes & No
N Yes ❑ No
❑ Yes Ig No
❑ Yes a No
❑ Yes 15?1 No
❑ Yes )a No
AYes ❑ No
❑ Yes IS No
❑ Yes ONO
❑ Yes K No
❑ Yes 1;9 No
❑ Yes C&No
Yes ❑ No
Comments (refer ta'questtou #) xolainyany YES answeis and/or any recommendations or any othercomments--:
Use drawings -of facility to better explain situations? (use add�tronal pages as necessary)
S6r)I� 60 � f(U) w uaj ;rtseoe� S(, s s( ou(c 6c, mecQ c .
it. (0&5A'F'1 uz� s6ufd 6V rcsPr;yger�.
2-4. S y-ecnYd-s 56t)10 be- i�ty and 44 IP
cc: Division of water Vuality, Water Vitality Section, tacittly Assessment Unit 4/3U/97