310015_INSPECTIONS_20171231

NQHTH CAHULINA
Department of Environmental Qual

'{ 5 16 --T-uNE:T[ zo
L&1vivision of Water Resources'
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of visit: c�ompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Q Reason for Visit: Koutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: . Arrival Time: I jCXo'o Departure Time: c27 County:
Farm Name:tu t,, q - ` Owner Email:
Owner Name: f t%oyl S-4E4 JA&cmr ►M Phone:
if
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: i
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Title:
Latitude:
Region:W ;
Phone:
Integrator: g� c ee
Certification Number: i 1 E s a
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
` Carp �q °'�I INon-Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
1p0
k4f v
Farrow to Feeder
Farrow to Finish
Gilts
Boars
t
Other
Other
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El 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)?
Longitude:
Design Current
Cattle Capacity Pop.
DairyCow
Dairy Calf
Dairy Heifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes L� o ❑ NA ❑ NE
❑Yes
❑No
[ A
❑NE
❑ Yes
❑ No
[ 011A
0 NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No �NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [�t No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ZNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 1 2/4/2015 Continued

Facili ,Number. jDate of Inspection:
Waste Collection & Treatment —
4. Is sto>'age capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [g.4 ❑�NA
❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No !❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 3 — S 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes P<o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes O<o ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental rest, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ff No ❑ NA ❑ NE
00
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes E:10'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
l0. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes 2 No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes El"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):
10
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
do
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
dNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
dNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
dNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E!fNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
�o
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:],Yes 6 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes 6No ❑ NA ❑ NE
Page 2 of 3 214120I5 Continued

Facilit ,:Nmmber: I I - I SS JDate of inspection: sc ­
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �o ❑ NA ❑ NE
91
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes To ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes G O ❑ 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?
0 Yes YNo ❑ NA ❑ NE
❑ Yes Ca"No ❑ NA ❑ NE
[:]Yes El"No ❑ NA ❑ NE
❑ Yes ZoNo ❑ NA ❑ NE
❑ Yes 5ErRo
❑ Yes [a'No
❑ Yes [�fNo
❑ 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).
.tc( `tto- —61g�5(
Reviewer/Inspector Name:
Reviewer/inspector Signatm
Page 3 of 3
Phone: 0_ i
Date:' � Oc a
21412015

0 Division of Water Resources
,,,Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: Com anee Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: gRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: f 1 Arrival Time: Departure Time: ! p O County: Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: /I Title: /f 1 Phone:
Onsite Representative: n F�� �s v 9 1 I —S Integrator:
Certified Operator: Certification Number: �S % 3�
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
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er I I d
Non -La er
Pullets
Other
Poults
Design Current
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[:]Yes
Ef-No
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

4 ff-or
Faeflity Number: 3 jDate of Inspection: 1 i
/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
0 Yes No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: y r �. 3-4
1-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Y 7 4 S y 331
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes EyNo
❑ 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 P<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 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ 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 to ❑ 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
No
❑ NA
❑ NE
❑ Yes
P
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes ,E:fNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
[DNA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes EXNo
❑ 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 ❑ Sfudge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes [�
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Faci I ity Number: - f Date of II ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [3--No ❑- NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No [DNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No [/ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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 [3-No ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ Yes qNo
❑ Yes 6o
❑ Yes f
❑ YesYes
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature: Date: f / q
Page 3 of 3 21412015

it I,
IaIV U Division of Water Resources
9Eacility Number � ( L _` �J O Division of Soil and Water Conservation
O Other Agency
Type of Visit: om ce Inspection Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: r `1 (t Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: jj Title:
Onsite Representative: tT �• �. ��� 00 �` ! �T• S
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Integrator:
Certification Number: I �- k
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
��I INon-Layer
VU-dn to Finish
an to Feeder
Feeder to Finish
-00
Farrow to Wean
o oo
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Pullets
Poults
Design Current
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?
Longitude:
Design Current
Cattle Capacity Pop.
DairyCow
DairyCalf
DairyHeifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes No ❑ NA 0 NE
❑ Yes [:]No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
[—]Yes
[-]No
❑ NA-
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
rffNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ YesFTNo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

F'acili N ber: 3 1 - Date of Ins action: t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Struc e 6
Identifier: f- Z � -3 Y` 3
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?
-3 k _ 31
[-]Yes No ❑ NA ❑ NE
❑ Yes UfNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environments threat, notify DWR
7. Do any of the structures need maintenance or improvement? C] Yes o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? `
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes d /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
dNo ❑ NA
[] NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
E No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
ONo ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
ElYes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage &Permit readily available?
❑Yes
V5"N; - NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
M 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 Cli oo - NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑`No u NA ❑ NE
Page 2 of 3 21412015 Continued

o If
Facility Vu` ber: 'y - j Date of Inspection: l
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [2No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ YesF3"Co ❑ 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 Rio ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
C]"NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
ONo
❑ NA
❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
!!!(((```""���"""
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[] Yes
i
OP] No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
J
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
VN
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ NA
❑ NE
Reviewer/Inspector Signature: Date: VI!6bl
Page 3 of 3 21412014

w
ivision of Water Resources
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: om ' ce 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 0 Denied Access
Date of Visit: :Z)�r Arrival Time: T O Departure Time: � County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title:
OnsiteRepresentative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
to Feeder
We
Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone: -
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Non-L
Pullets
Other
Poults
Design Current
Dischar es and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes D_N ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA [] NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
❑ Yes ]"No ❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facility Ny"er: - Date of Inspection: 114Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [frNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 36 �� 3 7_ 37 ; 'f �(sr
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [�No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ErNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ]'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes []No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Q o
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2No
❑ NA NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[:]Yes
❑ No
❑ NA �NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA �TE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
0 NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
dNo
❑ 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
Ef NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Surve
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
0 NA
aNE
Page 2 of 3 21412015 Continued

Faciji %ithber: - Date of inspection: IlZ I t
24. Did the facility fail to as required by
/ S`
Yes
No
NA NE
calibrate waste application equipment the permit?
❑
❑
❑ L"J
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
�s
❑ No
[DNA 0 NE
the appropriate box(es) below.
❑ Fai a to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
on -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ No
❑ A NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
[I NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
�o
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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
C: 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
0 No
[] NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
d�No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
E11140
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[D No
❑ NA ❑ NE
Comments (refer to question ft Explain any YES. answers and/or'.any additionalrecommendations or any other comments.., - -
''n
-
Use drawings of fadlity_to better°exptai situations (use additional pales as necessary):-.
T`
3- S 3- Y 5 1,
[ n f n-ovrtn� 5 jN%C >o^�
-- �5 1-4
.� r+C W t G t ca JAI 2
4 nsr.
Nac-� as 6Kr'!F �r.J�f I
G T j 7� s A
u 6.— s-�Qr�c s f� C'
-e vr�y Z JOL s, tom,,.-��..��,. 1-s
[l'q'�S .S f� �r�on S l �z 3 ►�`'� ,
y�
QI?� S�/1 6� �' haw �f jP/'"� �/jI iv�►r4ri sc.. Ctf l+Ih/rtis �F-751M�V
Reviewed]nspector Name: ✓ e �� Phone: j r o
Reviewer/Inspector Signature: _ _ _ Date:
Page 3 of 3 21412015

Division of Water Resources
-Facil:ty Number 3 I - 0 Division of Soil and Water Conservation
0 Other Agency V,
Type of visit: o=outine
ce Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: .Arrival Time: l g 7 Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: r � Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer qI jNon-Layer
fan to Finish
can to Feeder
eeder to Finish
5
Farrow to Wean
ns)
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
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 DWR)
L
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
DairyCow
DairyCalf
DairyHeifer
D Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
�] Yes No ❑ NA ❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ Yes
[] No ❑ NA
❑ NE
❑ Yes
NA
❑ NE
Yes
rNo�❑ NA
❑ NE
Page I of 3 21412015 Continued

)3acili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ET -No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1
Identifier: y—i -
Spillway?:
Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
_f--'A 13 Y`Z q-3 _ �� 3-S7
Designed Freeboard (in):
Observed Freeboard (in): �� 5 LC �_ `U6
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?
f5- Y�
❑ Yes E]"No ❑ NA 0 NE
❑ Yes L._ 1 o ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [] No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the pen -nit? ❑ Yes FJINo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [J"No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance 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?
❑ es
0 No
0 NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Yy-es
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Q 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
L�J No
ET
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ YesF31N__o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rainfall Inspectior;N�c[:]
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [] Yes NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA 0 NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection:
24:1-Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yeses
No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
2 Yes
❑ No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
1 Dion -compliant sludge levels in any lagoon (-A
I ( aols—
-) -
POA-10A.16
List structure(s) and date of first survey indicating non-compliance: 0l3 — e',A
i+)
-
3
26. Did the facility fail provide documentation of an actively certified operator in charge?
a
❑ Yes
E <o
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
Q3-IqA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA ❑ NE
❑ Yes L_I 0 ❑ NA ❑ NE
❑ Yes []o ❑ NA ❑ NE
❑ Yes FKo ❑ NA ❑ NE
[:]Yes o ❑ NA
❑ Yes &N� ❑ NA
❑ Yes No ❑ NA
❑ NE
❑ NE
❑ NE
Comments (refer to question #): Eiplain any.YES answers. and/or any additional recom nendatidikssor.a©y-other comments: "
Use drawings of facility abetter explain.situations {use additional,pages, aspecessary). a, " ", _
f-ef e,—r-4-e i;., sefcf�i
1 y _ ( , t-- -�c � " o,j'o I i ,.'fAr ps
3-4
� n n !�` (L. �i� r r�v-L1 J L
( ct S 44 e �' S(� r�.'r"-EGA t C i
`ye �f
or.r., 4r+ I` ca �L �, �`� C �• 5 1�2 t—A c 5n •, h,. l D
lU- 17 e rf^-a r.R ,
V C-P 4,S (flp r/T 5 .-0 C(
'-- " i i,1 �,, 7 & 3 5-V
Reviewer/]nspector Name: 4 t,- I C {, 'e q
Reviewer/Inspector Signature: K
Phone:
to 7 96
Date:
Page 3 of 3 21412015

Type of Visit: (J Co�pliance Inspection V Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: URoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Q_ • UP U�0 Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 06y 6r ATKU S
Certified Operator:
Title:
Phone:
Integrator: q �7
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Dischar es and Stream Impact
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)?
Longitude:
❑ Yes ]1No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [-]Yes rN❑NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑Yeso ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facili Number, rj - S Date of Inspection: d,&
Waste Collection & Treatment 1 I
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
Struc 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 3-LI T` 1 a -2_ /Kf 1� 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): TC46- — — �-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes &No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ZNo ❑ 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 environm71�
threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Noo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes O N ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 /NNo ❑ 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
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
V7)
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
YNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
ZN
❑ NA
❑ NE
18. Is there a Iack of properly operating waste application equipment?
❑ Yes
ETNo
❑ NA
❑ NE
Required Records & Documents
<No
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
rj
❑ 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
ETNo
❑ 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 inspectioWN�o
Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
o
❑ 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? ❑ Yes t 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.
NF❑ ilure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
on-compliant sludge levels in any lagoon
List structure(s) and date of fast survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? [:]Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes Co"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?
S , Sri�IsE i��R G& bM 3 32
Reviewer/Inspector Name:
Lk
[—]Yes C2No ❑ NA ❑ NE
[:]Yes (/N9 ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes Er4o ❑ NA
❑ Yes ❑ NA
❑ Yesr?No ❑ NA
❑ NE
❑ NE
❑ NE
i -?3yd
Reviewer/Inspector Signature: Date:
Page 3 of 3

Division of Water Quality
Facility Number ©- O Division of Soil and Water Conservation
Q Other Agency.
Type of Visit: 0 Compliance Inspection 0 Op ation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: p Routine O Complaint Follow-up O Referral 0 Emergency O Other 0 Denied Access
Date of Visit: l t Arrival Time: ® Departure Time: County: ( Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: j4 UNT6
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
r7f6lher
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current
Wet Poultry Capacity Pop.
La er I I :::�]
Non -Layer
Design Current
Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [ /No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ o ❑ NA ❑ NE
El Yes Zo ❑ NA ❑ NE
[:]Yes VNo ❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Farili umber: IDate of Inspection: 1, 11 11:3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: {A { CVX)1 L 26mz_
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): SO 50 -So
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 ❑ NA ❑ NE
[:]Yes [/ No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmen l threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
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
dYes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[2"'No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
�No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
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?
❑ Yes
JZ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ �KNo❑
NA
❑ NE
acres determination?
T
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
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
El Yes
WNo
❑ NA
❑ NE
thA a ro riate box
pp P
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ? ❑ Yes ❑ No ❑ NA dNE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes dNo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fatili Number: - I`� Date of Inspection t� 3
2.4. 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 D.NA (2 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:
G>id the facility fail to provide documentation of an actively certified operator in cha e?
FFYes dNo ❑ NA P6e
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification.,
[—]Yes [�No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes E� 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 No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes �o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
YNo
[—]Yes ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
EdYes ❑ 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).
-TAC ► EL-4 --1-W!D XVs. 0UAt--?r-8-MS.T f,,rL E�tLG Y
p�*�^"�'L wAStE. S�15T�r+n 1B� ��Ja� ,E�Eri`G� s'o�vT�anlS, y�1ti'f u�i
117 i.zM°^� �oF DCA A ljn - 13uFT- 1JAL664CT' -OF KZ 5s
5) ,>_r5c,vjSED SEcooDiaRv cokr.NiN {AztE� ' ARCAS Doti 3_.oD�GESTocL ii uKS��
-Hrc 5_-vE t-t'r or la- MAL FVA)Cftr6P.. ANC SE cTsLrJ • 1 pArkSrap
tU dPee - sEcT�od -YL 8 0( eC-R AN-7-Y T �azdG go-�� Do1JE w.ilA
.tiTEAR OF OKOA-rs�, SVBKT-T fia �vsS-r.V,J C�t�R)
21) S �cT�� • .tip' 3 , SA 4 S ANNuA[. aac z T t PEW LAoAr�-YZEQ uLs
�
ESE 1t. ~� 3 EAKS . �a (L_ A 1JI N1 AV 1AM TC 0 f r--k r1 1{
X00 r
ra r
w ,
34) v0MIS ArtE 6QEIL.ATZ4IJAL A►sOfW V_TSX7 'r0 aE SCNEoULED-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �-3
Date: A /11
214MIr

0 Division of Water Quality
Facility Nufmber ,:❑ © Division of Soil and Water Conservationry
Other Agency
b
Type of Visit: ompliance Inspection 0 Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: Routine 0 Complaint Q Follow-up O Referral O Emergency Q Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name:
Owner Name:
--- Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
Title:
Onsite Representative: ] p jC, Axk�u•(S
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
W15
66o
Farrow to Wean
t q00
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Q.Other ..
Other
Latitude:
Phone:
Integrator:
Certification Number: 9T 5 122�
Certification Number:
Design Current
Wet Poultry Capacity Pop.
La er I I �:�]
Non -Layer
Design Current
Dry Poultry Capacity Pot).
Layers
—.Non-Layers
Pullets
Turkeys
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity''.', Peo
Dairy Cow
Dairy Calf
Dairy Heifer
Cow
_Dry
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes E2 /No ❑ NA ❑ NE
[:]Yes [—]No
❑ Yes [:]No
❑ NA ❑ NE
❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes VN9, ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facai Number: - Date of Inspection: Ct
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ZNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Struc l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: pN1�3-+1 (:A 3_ hiaG -I *%A6� J-1- MA6- . q::q /1�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): :2-2 �J 3 Z5. Are there any immediate tto the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ZNo ❑ 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
2f o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
WNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
dNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
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
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
FN
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
O/No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ YesE?<o
❑ 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
Qeo
❑ 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
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
No
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facilio Number: 31 - IS Date of Inspection: $ 3
24..Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
Vjo ❑ NA ❑ NE
No ❑ NA ❑ NE
❑ 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 ErNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [3'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
2(No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
❑ Yes
❑ Yes
No ❑ NA ❑ NE
❑ NA ❑ NE
o ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone 111 q rp 13 9
Date: �1 3 3
21412011

Wean to Finish
Wean to Feeder
L10
6
Feeder to Finish
9 to
y M0
Farrow to Wean
qLLuo
CS
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
CYDivision of Water Quality
Fac Num-ber ©- 5 0 Division of Soil and Water Conservation
V.-
0 Other Agency .
Type of Visit: TRoutine
pliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 7. Arrival Time:�Departure Time: © County: �7�(jjf Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: __�oUG AT (L~J tiJS -
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Integrator: G
Certification Number: q a 5 '73
Certification Number:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity " Pop. ' Cattle
Layer
Non -La er
Design "Current
Pullets
Turkey Poults
Other
E
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?
Design Current"
Capacity Pop -
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Da
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes E] No ❑ NA ❑ NE
[]Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
[] NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ YesgNo ❑ NA ❑ NE
v
Page
Page 1 of 3 21412011 Continued

Facilis u&ber: - 5 Date of Ins ection: II Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
•
[]Yes
[dNo ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 3 5ao 0h&3 - M U 044-.1 AIM, q -Z_
11�AG 143
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): cl N 5Z I S
5 g
46
5. Are there any immediate threats to the integrity of any of the structures observed?
0 Yes
dNo ❑ 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
ENo ❑ 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
�1�To ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
TT
9. Does any part of the waste management system other than the waste structures require
❑ Yes
dNo ❑ -NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes dNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes D/No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [] Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Q No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [�No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes y No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes [E]No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes D No ❑ NA ❑ NE
Renuired Records & Documents
14. 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 54/o ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes C:rNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ENo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

lFacilityNumber: 3t Date of Inspection:
24. Did thtfacilityZail to calibrate waste application equipment as required by the permit? ❑ Yes EJONo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes YNo
o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ 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 E No ❑ NA ❑ NE
❑ Yes E fNo
❑ Yes [:fNo
❑ Yes EJ'No
❑ Yes []�`&o
[:]Yes 2No
El Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer,to question # ): Explain any YES answers and/or anyadditional.recommendations:or,an-other,comments F -
Use dr'arWings of.facilityto better explain situations (use.additional.pages as necessary).­_­........`.
Reviewer/Inspector Name: V 014J i A
Reviewer/Inspector Signature:
Page 3 of 3
Phonk. If IDY lR 6 -- I3tI
Date: 1 t 2i
214,1201

1` if U Division of Water Quality
acility Number 0 - 1S O Division of Soil and Water Conservation
'{
O Other Agency
Type of Visit: Q5 Conppbance Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: -y $ Arrival Time: Departure Time: � 5 County: 4UQ Wj Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: L75 AT14LO
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone:
Integrator:
Certification Number: q 8 573 k
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
I INon-Layer
Wean to Finish
Wean to Feeder
Op
400
Other
Other
Poults
Design Current
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)?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [—]Yes ED No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters El Yes blv(
❑NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [—]Yes ED No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters El Yes blv(
❑NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued
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 ED No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters El Yes blv(
❑NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

FacieityNumber: Date of Ins ection: 12q S1 q
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
Struc e l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 3-q r<{ — - Z L[ -3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 t{ q 3 G
�{ g
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ffNo ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
No
6. Are there structures on -site which are not properly addressed and/or managed through a
(—]Yes
Q ❑ 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 environ:;No
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ 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
VN ❑ NA
❑ NE
maintenance or improvement?
Waste Application
0. 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 tbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ YesFNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
17, Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
[-]Yes
Zo ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
dill o ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No ❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes bi" "' ❑ 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 InspectioYl�
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:]Yes ❑ NA [] NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facih Number: - Date of Inspection: 7— 11
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [''�, No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [_]Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes E6 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes C3"'No ❑ NA ❑ NE
Other Issues
2$. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes VNo ❑ NA ❑ NE
❑ Yes O/No ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ Yes M/No ❑ NA ❑ NE
❑ Yes 0/NNo
❑ Yes o
❑ Yes �No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Comments (refer to question #):.:Explain any YES answers and/or any, additional recommendations or.any other comments i
�4�rw
Use drawings of facility to better explain situations (use additional pales as necessary): = , _'
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: / fd �6 /3�a
Date:
21412011

Type of Visit (3Compliance Inspection Q Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: t Arrival Time: ll OU Departure Time: County: A-202CLIJ Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
Title: Phone No:
Onsite Representative: „ DJ(-'- PT41 _O<' Integrator:
Certified Operator: I Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Latitude: = o = 4 [= u Longitude: = ° = 6 = If
"dad
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Laver
❑
Wean to Finish
Wean to Feeder
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
ElPullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharzes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ElApplication Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
El Dairy Calf
El Dairy Heifer
El Dry Cow
ElNon-Dairy
ElBeef Stocker
ElBeef Feeder
ElBeef Brood Co
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?
Page I of 3
❑ Yes dNo ❑ NA ❑ NE
❑ Yes
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?
Page I of 3
❑ Yes dNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El NA
El NE
❑ Yes
[,:1, No
El Yes
o
[I NA
El NE
El Yes
Zo
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection ll 1Y
Waste Collection & Treatment
4. 1s storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ONo Cl NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Struct e 3 Structure 4 Structure 5 Structure 6
Identifier: cnr►, Cr 3 4 —1 `{—Z 3
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
dNo
❑ 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 tt at, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
❑ No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
['No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes
_,(
E/J No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
dNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of 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 land application site need improvement?
❑ Yes
dNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
o
El NA
El NE
17. Does the facility lack adequate acreage for land application?
El Yes
WN o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PNo
❑ NA
❑ NE
Reviewer/Inspector Name {;._� , _ �o-lt,LlAE(,L _ Phone: ]V 6
Reviewer/Inspector Signature: Date:
Pau& 2 of 4 12128104 Continued

Facility Number: — 2 S Date of Inspection 4
Required_ Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No El NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 6l�lo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design [I Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below_
❑ Yes
EYNo
❑ 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
d No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
[XINo
❑ 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
I/�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
� o
❑ 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? ❑Yeso ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
U 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
ENo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
El/ Yes
�10
❑ 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
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
LldNo
❑ NA
❑ NE
Additional Comments and/or .Drawings:.:
Page 3 of 3 12128104

Facility Number j
V Division of Water Quality
Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit C mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ul 1 �107 _ _J Arrival Time: (y0 Departure Time: County: 01RCL — Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: _ ® OQLr PaIC"W_ Integrator:
Phone No:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Latitude: [= o a ' = is Longitude: = ° ❑' = Ii
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
U b 6 6 p ❑ Non -Layer
❑ Wean to Finish
OR Wean to Feeder
Feeder to Finish
l q�� S-261
2S-0-bi
farrow to Wean
o
❑ Farrow to Feeder
ElFarrow to Finish
El Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
ElNon-Layers
ElPullets
ElTurkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ElStructure ElApplication Field [IOther
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
El Dairy Cow
El Dairy Calf
El Dairy Heifei
El Dry Cow
ElNon-Dairy
ElBeef Stocker
ElBeef Feeder
ElBeef Brood Cowl
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 E I No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes VN o ElNA ❑ NE
❑ Yes DeNo ❑ NA ❑ NE
12128104 Continued

�.R
Facility Number: Date of Inspection v
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3
Identifier: 6 3 — Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): q6L
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes IQ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
3-S
❑ Yes E No ❑ NA ❑ NE
❑ Yes 21No ❑ 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? [2 es ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes To
❑ Yes _[3 No
❑ NA ❑ NE
❑NA El NE
❑ Yes E No ❑ NA
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA
❑ 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)
❑ NE
❑ NE
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
allo
❑ 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes d1i. ❑ NA ❑ NE
❑ Yes LrNo ❑ 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):
�7.) 5Aw A5 31-kq A60r PAS- WNUS.
L
er/Inspector Name r Phone:er/Inspector Signature: Date: 6Z I.LL02--
1212ftlad PC"Ji sl1nd

r
Facility Number: — Date of Inspection
R_enuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropiate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
D4te Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Yes ZN(o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
es ❑ No ❑ NA NE
❑ Waste Transfers ❑ Annual Certification
❑ Rainfall Stocking 40 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
dNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[PKNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
C3No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[�&
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Y s
[ o
ElNA
ElNE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
' Yes
❑ No
❑ NA
❑ NE
Other lssues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ NA El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
7No
❑ 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
UK)
❑ 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
E 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
40
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA ❑ NE
Additional Comments and/or Drawings:
12128104

0 Division of Water Quality
Facility Number j 0 Division of Soil and Water Conservation
- - 0 Other Agency L0000�
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: , � 0 Arrival Time: 8 �`30 Departure Time: IJr,//fi0 County:
Farm Name: _I I 1 Al-*iJ1� .Q/�� L�TZD� `T ��T�S r 7 Owner Email:
Owner Name: , 9-4 69g r? Phone: —
Mailing Address:
Physical Address:
Region: i K40
Facility Contact: �} Title: /Phone No:
Onsite Representative: �i1-/�% ��.E �!�©46r, f-- 2 IJs integrator // / 41i��iS�S�- ���lcliJ
Certified Operator: _Dour, Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: = e 0 g = Longitude: = ° = 6 = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
O 4 ❑ Non -Layer
❑
Wean to Finish
Wean to Feeder
Feeder to Finish
5
Farrow to Wean
El
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
El
-Boars
Other
❑ Other - -- --- -
Dry Poultry
ElLayers
ElNon-Layers
El Pullets
ElTurkeys
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
El Dairy Cow
El Dairy Calf
El Dairy Heifer
El Dry Cow
ElNon-Dairy
El Beef Stocker
i
El Beef Feeder
El Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ID
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
❑ Yes ❑ No ❑ NA ❑ NE
El Yes ❑No ❑NA [I NE
El Yes El No El NA El NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
Page 1 of 3 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 ANo ❑ 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: 50,Q) J354 5355 _� Z -3 4—*
Spillway?: /Ve /V� NO No i/o No Np
Designed Freeboard (in): fqs !9',; 9_.5 lg.s
Observed Freeboard (in): 2
- - d
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 property 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
7JNo
❑ 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 101bs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [:]Evidence of Wind Driftq ❑ Application Outside of Area
12. Crop types) &&
/ 1
% /� f/tlnl <f}
13. Soil type(s) Al Jror1, , / i!6! i :�i f fJ Z LL se01
r1L05�d2©
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
VNo
❑ 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
VNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Z.¢c
Loc,00,j ANo Wow 4ut56sti
Reviewer/Inspector Name I Phone: - Z�
Reviewer/Inspector Signature: Date: ?.6 lob
Page 2 of 3 12128104 Continued

Facility Number: —/ Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �No El NA El NE
the appropriate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes VrNo ❑ NA ElNE
ElWaste Application ElWeekly Freeboard ElWaste Analysis ElSoil 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 40 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
96No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
9 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
;dNE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[]Yes
R!(No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
gNo
❑ 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
ElNE
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
ElNA
ElNE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ZNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
'4 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
j7 ©/did_ (G�00i5 to'z- el ✓4q"gi '!�-z Jf- C'V'(
,4f 5z ,& &Iq A k
Z ) G(J_;�u
/ V Dr1
Hi
Page 3 of 3 12128104

0 Division of Water .Quality
Facility'Number 7 Q Division of Soil and Water Conservation
Q' Other Agency
Type of Visit P 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 Departure Time: Accesss,
Date of Visit: 8 Arrival Time: �� r0 County: Region: Re on: Gy'0
�d �
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: ,04 &_zw
a YO
Certified Operator: _auGL1rs dxii:g 5.
Back-up Operator:
Location of Farm:
Swine
Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 6 Longitude: = ° = i
Design Current Design . Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
❑ Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
DO
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ 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 Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: FTI
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 jo No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
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
ONo ❑ 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: so__ot
535�F S3 SS
-2 3-
Spillway?: /'J.O
No
/Vo
Designed Freeboard (in): /0,9"
/NCO
�q � [ q,., % l.Jr
����
AS- &JO
Observed Freeboard (in): 2 `- "
113 _ 2& _ c� �%
22 . 30
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ZNO ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ;Z 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? 0Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes ONo
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
C
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 Vj No
❑ NA
❑ NE
maintenance/improvement?
IL Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes 1KNo
❑ 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
t2. Crop type(s) 2 . � s G �� s� �>
eE
13. Soil type(s) _Al_�_49 7. f V g q /C . /`f�Orit'ifU ZLG� _ ��h�U/I/Ti4
[l'OGD�BAQO
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes 0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 'EfNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determinations❑ Yes ,ONo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes RfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 16 No
❑ NA
❑ NE
2//OJ` SOZG 7�5% /�f{�7�e� SffJGc%%,O �.v —r©� f5� -1
CRG
Reviewer/Inspector Name
Phone:
Reviewer/Inspector Signature:
Date: /
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes )ZNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design
g El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ZNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes X No
❑ Yes VNo
❑ Yes A No
❑ Yes XNo
❑ Yes A No
❑ Yes ❑ No
El NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
El NA El NE
❑NA El NE
❑ NA ZNE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
ONo
❑ NA
❑ NE
❑ Yes
;ZNo
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
❑ Yes ,❑ No ❑ NA ❑ NE
—cA P0,9s V--J WZ� W`104 ­�­✓ e
o 72 v0,4 S iFGZ
�JA7Cr-F f�(� /J � G- v e4'7&cvc�'
i9n1!
n5was NeqL­r
cry r-
O/Z e__
12128104

Type of Visit 0 ZRoutine
pliance Inspection O Operation Review O Lagoon Evaluation
Reason €or Visit Q Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Facility NuTPer ( date of Visit: G Ot Tune:
NNot erational O Below Threshold
© ermitted Certified E3 Conditionally Certified 0 Registered Date.Last Operated or Above
}Threshold•
Farm Name: County:
Owner Name: _ _ . .. _ _ „ _ _ Phone No: . .
Mailing Address:
Facility Contact: .. ___ _ 1 --Title: Phone No:
Onsite Representative: „A, � bJfi Integrator. M
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ` " Longitude • <
to Feeder
z-I�to
Finish
g
to Wean
r
y4AO
to Feeder
Farrow to Finish
El Gilts
El Boars
Non -Layer Non-DairyL
Other _
Total Design
- sslm g
Discharges - StreamImpa
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?
❑ Yes
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �ZQ
❑ Yes
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 7No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) Less than adequate? [I Spillway ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
inrA .5 y._ ..3
Identifier: G' 3 3 �' 4 � ...............__.... 4 � ......_..... _.._ ... �-.. ......._ 4 ..............�..._...
Freeboard (inches): 2Z Z.rr1 2�1 23 2.y
12112103 Condnued

Facility Number: 3j— Date of inspection
5. Are, there any mediate 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 ❑ Yes Yo
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? 2/yes do
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 7No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelmtprovement? ❑ Yes eNo
11. Is there evidence of over application? if yes, check the appropriate box below. ❑ Yes
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type S3[� my pa C14) nw
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
I9. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Aix Quality representative immediately_
Drvm 4 -(A ").a s0 e La rcS
❑ Yes. Q No
❑ Yes Zo
❑ Yes 2
❑ Yes 7No
Yes 7No
❑ Yes
❑ Yes No
❑ Yes No
❑ Yes EKo
❑ Yes No
❑ Field Copy ❑ Final Notes
s.) Loh1T_I.0uk Wef-V C-JNrROL 'rW t3E R-114004!1, CZ&l p .
c. o u C a- o'r I a-r kk wA UPS, is 0"(4- y
-ro ar- os-r-M ,l�Ebs -� r3� Oot-A- As As Posssgl,G
Reviewer/Inspector Name
ReviewerAnspector Signature:
Date: q
12112103 Continued

Facility Number: -- 1 S Date of Inspection
%equired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(id discharge, freeboard problems, over application)
27. Did ReviewerlInspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes E� /No
❑ Yes [,3/No
❑ Yes dNo
❑ Yes' 6No
❑ Yes ' 'No
❑ Yes Q No
❑ Yes [],?t'o
❑ Yes Leo
❑ Yes D4o
04�es' ❑ No
[--]Yes t3Tio
❑ Yes [)WO
❑ Yes ❑ ,
34. Did the facility fail to calibrate waste application equipment? ❑ Yes [JD6
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes"'
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

ANIMAL FACILITY ANNUAL CERTIFICATION FORM .
Certificate of Coverage or Permit Number dc.A M1 013 County h _ Year 200 3
I
Facility Name (as shown on Certificate of Coverage or Permit) m v--Aiv tile-1. 1 - 4 ec.�ia 3
- n
Operator in Charge for this Facility RlFr�C Certification # J $6.3�
Land ap_W4cation of animal waste as allowed by the above permit occurred during the past calendar year
t/ YES NO. If NO, skip Part I and Part II and proceed to the certification. Also, if animal waste
was generated but not land applied, please attach an explanation on how the animal waste was handled.
Part I : Facility information:
1. Total number of application Fields Pulls ❑ (please check the appropriate box) in the Certified Animal
Waste Management Plan (CAWMP):
6,2s-
Total Useable Acres approved in the CAWMP
2. Total. number of Fields 0 o�ulls ❑ (please check the appropriate box) on which land application
occurred during the year: Total Acres on which waste was applied (0 75
3. Total pounds of Plant Available Nitrogen (PAN) applied during the year for all application sites:
103� oozy,"
_
4. Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied annually by the CAWMP and
the permit: / 3, /S eZ -
5_ Estimated amount of total manure, litter and process wastewater sold or given to other persons and taken
off site during the year .9 _ tons ❑ or gallons ❑ (please check the appropriate box)
6. Annual average number of animals by type at this facility during the previous year:
FAerov1- we.orn -- l-1. ,XZl wean - Fe -der _12 FeeSer - F6 n,'ati
7. Largest and smallest number of animals by type at this facility at any one time during the previous year:
Largest Fwrrovw h = yy36 wewn-- Feuer ; .313 Feeke r�-F;n, h 114s61
Smallest 3, `� I^._ f� w 3y, 381
(These numbers are for informational purposes only since the only permit limit on the number of animals
at the facility is the annual average numbers)
8. Facility's Integrator if applicable: m the pinu J- c�.t wo L L R 1= G FE1 E D
Part II:_ Facility Status:
MAR 0 1. 2004
,-OALITY SECTION
IF THE ANSWER TO ANY STATEMENT BELOW IS "NO", PLEASE PROVIDE-A::W ire Eni.
DESCRIPTION AS TO WHY THE FACILITY WAS NOT COMPLIANT, THE DATES OF ANY NON
COMPLIANCE, AND EXPLAIN CORRECTIVE ACTION TAKEN OR PROPOSED TO BE TAKEN TO
BRING THIS FACILITY BACK INTO COMPLIANCE.
1. Only animal waste generated at this facility was applied to the permitted sites during P es ❑ No
the past calendar year.
AFACF 3-14-03

2. The facility was operated in such a way that there was no direct runoff of waste from
� y
R Yes ❑ No
the facility (including the houses, lagoons/storage ponds and the application sites) during
the past calendar year.
• 3'. There was no discharge of waste to surface water from this facility during the past
19'Yes ❑ No
calendar year.: ,
4. There was no freeboard violation in 4ny lagoon or storage ponds at this facility during
❑ Yes P o
the past calendar year.
5. There was no PAN application to any fields or crops at this facility greater than the
2` es ❑ No
levels specified in this facility's CAWMP during the past calendar year.
6. All land application equipment was calibrated at least once during the past calendar year. ❑ Yes "o
7. Sludge accumulation in all lagoons did not exceed the volume for which the lagoon ElR Yes No
was designed or reduce the lagoon's minimum treatment volume to less than the volume
for which the lagoon was designed.
8. A copy of the Annual Sludge Survey Form for this facility is attached to this Certification. ❑ Yes & No
9. Annual soils analysis were performed on each field receiving animal waste during the C"Yes ❑ No
past calendar year.
10. Soil pH was maintained as specified in the permit during the past calendar Year? 2111yes ❑ No
11. All required monitoring and reporting was performed in accordance with the facility's 211yes ❑ No
permit during the past calendar year.
12. All operations and maintenance requirements in the permit were complied with during C�Yes ❑ No
the past calendar year or, in the case of a deviation, prior authorization was received
from the Division of Water Quality.
13. Crops as specified in the CAWMP were maintained during the past calendar year on all Yes ❑ No
sites receiving animal waste and the crops grown were removed in accordance with
the facility's permit. �/
14. All `borer requirements 4as specified on the permit and the CAWMP for this facility were � Yes ❑ No
maintained during each application of animal waste during the past calendar year.
1-certify under penalty of law that this document and all attachments"were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of
my knowledge and belief, true, accur4te, and complete. yarn aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
A a
Signat�fre of Werafor in Ch
(if different from Permittee)
u l �,►.� r;�c 13 �I1o.,a� �
Date
s?—d 3 ^dam
Date
AFACF 3-14-03 2

Explanation of Non - Compliance Issues
NPDES Permit #NCA231015
2003
2/24/04
To Whom 1t May Concern:
* Part 2 number 4: During the summer months we received chronic rainfall which caused
us to have freeboard levels of less than 19". The information surrounding this non-
compliance has already been forwarded to the Division of Water Quality earlier in the
year.
* Part 2 number 6: Due to the fact that the permit year started at the end of April we will
have our equipment calibrated by April of this year.
* Part 2 number 7: Due to the fact that the permit year started at the end of April we will
have our sludge survey completed by April of this year.
*Part 2 number 8: We will complete this form when the sludge survey is complete.
We believe these explanations meet the requirements of the division and our
permit. If there is any further questions or if any of the above need to be discussed please
do not hesitate to call. We look forward to any feedback you may have.
You may reach me at 910-289-7298 ext.202 if you have any questions.
Sincerely,
Q�
AJ Linton
Environmental Specialist
DM Farms of Rose Hill LLC.

J e
O�of
r
Michael F. Easley
Governor
William G. Ross Jr., Secretary
Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
June 6, 2003
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
DM Farms of Rose Hill LLC
PO Box 1087
Rose Hill NC 28458
SUBJECT: Request for Information
Inadequate Freeboard
Mag III, DM Section 4 Sites 14, Section 3 Sites 4-5
#31-15
Duplin County
Dear Sir or Madam:
On May 27, 2003, a representative of your farm informed the Division of Water Quality
(DWQ) that there was high freeboard in your lagoon(s). DWQ needs more information to
determine the site -specific factors that resulted in the high freeboard at your farm.
Please provide the Wilmington Regional Office with the reasons for the high freeboard
and your plan to prevent future freeboard violation(s). This explanation and plan must include
but is not limited to the following:
• Current freeboard level(s)
• Freeboard records for the past 12 months
• Spraying records for the past 12 months
• Rainfall records for the past 12 months for your farm (if available)
• A copy of your waste utilization plan (WUP) If your crops did not comply with your
WUP, provide details of the crops you did have for the past 12 months.
MEW
Customer Service: Mailing Address: Telephone [phone] Location:
1-877-623-6748 1617 Mail Service Center Fax [phone] N. Salisbury St.
Raleigh, North Carolina 27699-1617 State Courier #52-01-01 Raleigh, NC 27699-1617
An Equal Opportunity/Affirmative Action Employer
50% recycled / 10% past -consumer paper
ht1p:/1h2o.enr. state. nc. us

Inadequate Freeboard
Page 2
4 A summary of actions taken to lower the freeboard such as using additional irrigation
equipment, using third -party spray fields, buying additional land, removing animals from
the farm, delaying restocking, pumping and hauling waste to another site (please state the
location of the other site), etc.
• A description of water conservation measures in use at the farm and the date(s) installed
• If the freeboard level(s) are still in violation, provide an updated Plan of Action as to how
the farm will return to compliance.
• Provide a detailed description of the actions you have taken or will be taking to reduce
the possibility of freeboard violations at your farm in the future.
DWQ will look at each case on its merits. Your efforts to notify DWQ of the problem,
the efforts you made to resolve the problem and the actions taken to prevent future problems will
work to your benefit. However, please be advised that civil penalties may be assessed if
warranted.
This information must be received by the Wilmington Regional Office at the following
address no later than 10 days after receipt of this letter.
Division of Water Quality
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
We know that gathering this information will take additional effort. If you have
circumstances that will make meeting the 10-day deadline very difficult for you, please contact
your regional DWQ office. If appropriate, you may get a short extension of time. If you have
any questions regarding this letter, please do not hesitate to contact our Wilmington Regional
Office Staff at [phone].
Sincerely,
Zian'WtV. Klimek, P.E.
recor
cc: Wilmington Regional Office
Non -Discharge Compliance/Enforcement Unit
Central Files

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number
Date of Visit: � L Time:
rC �'
Not Operational 0 Below Threshold
Permitted ® Certified D Conditionally Certified 0 Registered pate Last Operated or Above Threshold:
Farm Name: County: AZOAIA
Owner Name:
Mailing Address:
Phone No:
Facility Contact: Title: //Phone No:
Onsite Representative: 1_X bhia n _ Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 06 " Longitude 0a Of �K
Design Current
awrrre Uapacity Population
® Wean to Feeder Yee
® Feeder to Finish
® Farrow to Wean
❑ Farrow to Feeder
ri Farrow to Finish
Gilts
Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer I ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons 1 7 1 1LJ Subsurface Drains Present IILJ Lagoon Area ILJ Spray Field Area I
Holding Ponds 1 Solid Traps ❑ No Li uid Waste Management System
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?
❑ Yes [12 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes CR No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
JR No
Waste Collg_ctioon & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Spillway
❑ Yes
91 No
Structure I Structure 2 Structure 3
Structure 4 Structure 5
Structure 6
Identifier: 3 -4 3-57
— f 5`—Z
9--�4
Freeboard (inches): 7
7 V-3
G
15,f
05103101
Continued

Facility Number: N — /5_ Date of Inspection G Z
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 A
iDnlication
❑ Yes ®No
❑ Yes ® No
❑ Yes RINo
Yes ❑ No
❑ Yes ® No
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
t0 No
It.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
®No
12.
Crop type ,A"&14 /*4A4 #44
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
19 No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
t@ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
V.No
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(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
9[No
2l.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
51No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes (A 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
rVi
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes Iai No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
�Commen �(refer._to,�question #).� Eaplaur+anv��YES answers andlor anyrecommendations or anyotler comments. _-.; � - .�
d., _
[Jse drawings of fac�lrty to better explain sitoatrons�(useea`�d�drtto�niil=pages as necessary). ` �� �sb.
�
nal Notes -
..._ r; ❑ Fteld CaUY ❑ Ft�
/ -
#g A1 �1)/d^nf�DC �Ohe SAVO,+ •n 1✓ft 7�u��it 4 G✓e4 A� A flu v e IW7't �trit
W6,-ILrtnj ah -kj /1QleJ y- Azwl6[ Ae 4e• :A TL r zoaL,
.Ale: - Zbn4 40 6eej ��a�l�`� %z o// -1,'eas _S w Aj /1' e4l- "At s�.l sr,•r�/Q resu/rs.
lgeOe 740 0044- Gil e_57%JkTJ,r Cede/y/7ssO�t4a;jeon s v-- 4X*.X
tii es, 6/ a /Zvm 6B�iA.of s/ -rir TYPl��s �"�! `�S m0�►'�f
/
Reviewer/Inspector Name^
Reviewer/Inspector Signature: Date: % Z
05103101 v Continued

Facility Number:
Date of Inspection (s Z
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes [3No
❑ Yes ® No
❑ Yes allo
❑ Yes allo
❑ Yes No
❑ Yes ® No
❑ Yes ® No
05103101

r
Type of visit Z Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit eRoutine O Complaint. O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: t} 01 Time: : 3 0
1 5'
Q Not Operational Q Below Threshold
0 Permitted © Certified 0 Conditionally Certified 13 Registered , `!Date Last Operated or Above Threshold: ..................
Farm Name: ......w! ..7` .{. Str�r.�.:J<.....�5....... ..:SeC ,�i ....f_T... County:.. ................................................ d.....................
OwnerName:.......... ....L..rr .:........................................................................ Phone No: ................................................ ........................ _....... __:.
FacilityContact: ................................................................... ........... Title:...................................................... Phone No:
Mailing Address: ............... . ..........................................
Onsite Represent ative:..... AJ..Le.jo.'r'..............................................I.................. Integrator: .�.............................. ...... ............ ..._
Certified Operator: .................................................... ...... _..................................................... Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Norse Latitude * 4 66 Longitude • 4 66
Design
Caoacifv
Ax ❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
-` ❑ Gilts
= r° ❑ Boars
Design . Current _ ._ ;Design' Current:
:•=
- lt'oultryCattle - Ca ` aci Po ulatioa -- Capacitj.,PiOulalfon.
❑ Layer ❑ Dairy
❑ Non -Layer - ❑ Non -Dairy
❑ Other
TOW Design -Capacity.
Totals9i -
Number of Lagoons ❑Subsurface Drains Present ©Lagoon Area ❑ Spray Field Area 17
_. . _.
Holdu gtPonds / Solid Traps.. ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes JdNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ONO
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes J'No
c. If discharge is observed. what is the estimated flow in gal/min? 1 C'
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes XNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes VN0
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? []Yes oNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes VNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Struct re 6
- u
Identifier: .... .qA-a.... .... - .'S!.............. `�..�i:.sz ._453 s
..............................................................� �............................................
Freeboard (inches): 5 ? 1 g 3Z
5/00 Continued on back

Facility Number: 31 115 Date of Inspection g p
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ONO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ONO
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes 19No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ONO
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes RfNo
Waste Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes )2(No
IL Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes J2(No
12. Crop type �e '� U d°1 SIG f A f"(A iri't t3A 11Z a,T .�0 6 q y i s
13. Do the receiving crops differ with those designatedin the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ,0No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ONO
b) Does the facility need a wettable acre determination? ❑ Yes VNo
c) This facility is pended for a wettable acre determination? ❑ Yes PfNo
15. Does the receiving crop need improvement? ❑ Yes ;3'No
16. Is there a lack of adequate waste application equipment? ❑ Yes ONO
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ,dNo
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 CdNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes RrNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ONO
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes �ZNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes PNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes .ONO
24. Does facility require a follow-up visit by same agency? ❑ Yes JZ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes
.10No
Yi ii9As :e dgficienc..s ► P �lH?ng ib � IG You wi�i wteoci t!4 �>l tw .
correspondence: abotit this visit: -
er pquestioiu #) 4E5cphun"any" ES answers and/or auy.
A4, s3ss 14.900rh Lias 42 i�G�cS 'rcG�aa�{•
!l-. All ti7AekAP%f" l0 Gg4ioyts -cis we-oc�btc acres V"10 haven®�
ye-4 been iIt54C,UCA m -mnke Sur r 4-J puir 3g ;s Cn-,',c
iv,v -& je4wcera puIt 146 A 4 q1,B on nlaf. 1
-ri'e JA Gc 1;4 y APIA mcofd s Are '#7aaV y �ke�f. � nS vYe A 9"'4 S�-trtl Ar
1d
ReviewerMspector Name
Reviewer/Inspector Signature: Date: I O J 5100

Facility Number: ' -- S 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 ZYes ❑ 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 ff No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes �No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes XNo
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 PNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes �No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes /❑ No
JAdditional-Comrnents;andforDrawings:
.&t
5/00

Plan Amendment to Include S&WCC Chronic Rainfall Practices and Standards through March 31, 2000
1 If this facility can comply with its existing permit and CAWMP it must do so.
2 Temporary Addition of New Sprayfields {') (Check appropiate boxes.)
_--- 0 A. acres of cropland List crop type used: - -
0 B. acres of hardwood woodland @ 100 lbs PAN / acre added.
0 C. acres of pine woodland added @ 60 lbs PAN / acre added.
3 Summer Perennial Grass (Check appropriate box.)
0 A Application window extended for 100.30 acres of perennial grass until first killing frost
B. An additional 50 lbs of PAN applied to acres of perennial grass prior to killing frost
4 PAN application Increased for Small Grains & Winter Grasses to be harvested. (Check appropriate box.)
[�] .A. PAN application increased up to 200 lbs per acre for 552.90 acres of small grains or winter grasses to be harvested.
B. PAN application increased up to 150 lbs per acre for acres of overseeded summer perennial included in 3.13.
5 Waste Analysis (Check appropriate box.)
0 A Prior to December 1st, 1999 the calculation of PAN will be based on a 35% reduction of the last analysis taken
prior to the first 25 year 24 hour storm event (Current waste analysis must be used after Dec. 1st)
0 B. Use current waste analysis to determine PAN. .
6 Required - Maximum Nitrogen Utilization Measures for Small Grains and Winter Grasses.
A. Use of higher seeding rates,
B. Timely harvest of forage to increase yield. -and
C. Irrigation during periods of warmer weather.
7 Required - Irrigation Management Techniques to Reduce Runoff and Ponding Potential.
A Making frequent, light irrigation applications, and
B. Not irrigation immediately before predicted rainfall.
8 The owner / manager is required to manage the movement of animals to and from the facility to minimize environmental
impacts, ensure compliance with the facility's permit and amended CAWMP, and avoid discharge to surface waters.
9 Authorization to use the additional practices included in the amendment expires if a facility discharges to surface waters.
Any discharge is a violation and may result in an enforcement action.
10 The owner ! operator is required to keep records of all waste applications.
11 This revision must include a map or sketch of new land application areas.
Facility Number 31-15 Mag III;DM4,1-4;DM3,4-5
Facility Name
_DM Farms Kraig Westerbee
FaciliV,Owner / Man r dame (PRINT) Techni LSft
PF
Q
Fa Owner/ Manager Signature echnical pecialist Signature
Date 11 /30/99 ` Date k 11 /30/99
This document must be filed at the SWCD office and be attac4d to the facilities CAWMP
and be available for inspection at the facility
(') New temporary sprayfields must meet applicable buffer and setback requirements. Waste must not be applied to wetlands.

OF Wki�cp
C r
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Kerr T. Stevens, Director
Division of Water Quality
May 3, 2001
Mr. AJ Linton
DM Farms of Rose Hill
P.O. Box 1076
Rose Hill, NC 28458
Subject: Wetted Acres Status & Notification
DM Farms
31-15 & 31-16
Dear AJ:
You were sent a letter on February 5, 2001 requesting that you provide me with the necessary
information to complete the evaluation of your facilities with respect to a Wettable Acres Determination.
The result of this evaluation and the required action to be taken by you is indicated below.
X Based upon the new information your facility is exempt at this time from undergoing a
Wettable Acres Determination. No further action is necessary at this time.
Information that was provided was not sufficient to exempt the facility from a Wettable
Acres Determination. The Division of Water Quality will notify you at a later date by
certified mail detailing the requirements of a Wettable Acres Determination.
If you have any questions regarding this letter, please do not hesitate to contact me at the
Wilmington Regional Office at [phone] ext. 226.
Sincerely,
Ll"_avlz�7�
Dean Hunkele
Environmental Specialist
cc: DWQ Non -Discharge Compliance/Enforcement Unit
Wilmington Files 31-15
Wilmington Files 31-16
S:IWQSIANIMALSIDUPLIN12001131-15 & 31-16 DM Farms WAD Status.wpd
Wilmington Regional Office
127 Cardinal Drive Extension Phone: [phone]
Wilmington, NC 284053845 Fax: [phone]

State of North Carolina
Department of Environment
and Natural Resources Ii�FC'`FT�T�
FEB 13 2001
Michael F. Easley, Governor 1-my:
William G. Ross Jr., Secretary12
Kerr T. Stevens, Director
CERTIFIED MAIL
RETURN RECEIPT RE VESTED
DM Farms of Rose Hill, LLC
CDENR
NORTH CAROLINA DEPARTMENT OF
ENviRONMENT AND NATURAL RESOURCES
February 5, 2001
Mag 1H, DM Section 4 Sites 1-4, Section 3 Sites 4-5
PO Box 1076
Rose Hill NC 28458
Subject: Notification for Wettable Acre Determination
Animal Waste Management System
Mag III, DM Section 4 Sites 1-4, Section 3 Sites 4-5
Facility Number 31-15
Duplin County
Dear DM Farms of Rose Hill, LLC:
A letter dated January 15, 1999 was sent to advise you about concerns associated with Certified Animal
Waste Management Plans and the method by which the irrigated acres within the plans we're calculated. Only
the acres that are wetted can be credited in the waste management plan as receiving waste application. Any
acreage within the plan that can not be reached by waste application equipment can not be used as part of your
plan.
An evaluation by Dean Hunkele on 11/10/99 was made to review the actual number of acres at your
facility that receive animal waste during land application. The evaluation of your facility has yielded one of
the following two results as indicated by the box marked with an "V.
Category 1:
The evaluation of your facility could not be completed due to a lack of information. Please
contact your Technical Specialist to assist in providing Dean Hunkele the necessary
information to potentially exempt your facility from undergoing a complete wettable acre
determination. Please submit this information to Dean Hunkele, at 127 Cardinal Drive
Extension, Wilmington, NC 28405-3845, within in 90 days of the receipt of this letter. If you
have any questions please contact Dean Hunkele at [phone]. If within 90 days you
are unable to provide Dean Hunkele with the information you are automatically
required to complete a Wettable Acre Determination as described by Category 2
below, within 180 days of receipt of this letter.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10%o post -consumer paper

Notification for Wettable Acre Determination
Animal Waste Management System
Page 2
Category 2:
❑ Your facility has been identified by the Department of Environment and Natural Resources
as a facility that may have overestimated the number of acres actually receiving animal
waste. Therefore, some or all of your fields may be exceeding the allowable loading rates
set in your Certified Animal Waste Management Plan.
In order to resolve this issue, please contact a designated Technical Specialist to have him
or her conduct a Wettable Acre Determination for your facility. The Technical Specialist must
be one that has been approved by the Soil and Water Conservation Commission to conduct
Wettable Acre Determinations. Many Technical Specialist with the N.C. Cooperative Extension
Service, the Soil and Water Conservation Districts, the Natural Resources Conservation
Service, and the Division of Soil and Water Conservation have received this special
designation. You may also contact a private Technical Specialist who has received this
designation, or a Professional Engineer.
All needed modifications to your Animal Waste Management System must be made and
the Wettable Acres Determination Certification must be returned to DWQ within the next
180 days. If the needed modifications are not made and if the form is not returned within the
required time, DWQ will be forced to take appropriate enforcement actions to bring this facility
into compliance. These actions may include civil penalty assessments, permit revocation,
and/or injunctive relief.
Once a Wettable Acre Determination has been completed, a copy of the attached Wettable
Acre Determination Certification must be submitted to the address listed on the form. Please
note that both the owner and the Technical Specialist must sign the certification. A copy of all
the Wettable Acre Determination documentation that applies to your Waste Utilization Plan
must be kept at your facility. DWQ and the Division of Soil & Water Conservation Staff will
review all documentation during their annual visit of your facility. An additional copy must by
kept on file at the local Soil & Water Conservation District Office. Please note that if you install
or modify your irrigation system, a designated Irrigation Specialist or a Professional Engineer
must also sign the Wettable Acre Determination Certification.
Please be advised that nothing in this Ietter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Sonya Avant of our
Central Office staff at [phone] ext. 571.
Sincerely,
Kerr T. Stevens
CC'. Wilmington Regional Office
Duplin County Soil and Water Conservation District
Facility File
Murphy Family Farms

ADivision of Water Quality
O Division of.SoiLand Water, Conservation
O Other Agency
Type of Visit ACompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit xRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Fate ur Visit: ®Time: 3 00 Printed on: 7/21/2000
Q Not O erational O Below Threshold
Permitted 0 Certified 13 Conditionally Certified ©Registered Date Last Operated or Above Threshold
Farm Name: .]J.4*........ ,. ...�. 1.:.f... t—. .. «! .. �� .... count�':...lJ ��� .....................................................
t..:...............
�( t
OwnerName: .....�.11`.�...� �............................................................................. Phone No:......................................................................................
Facility Contact: .............................................................................. Title:........................................ ... Phone No:
..................... ........
Mailing Address: ...................................N
......................................................................... .
................................................................................... ..........................
]��(Onsite Representative: Lj•+-� _... ..... Integrator:.....r.'.
........
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
�1
T
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �j ��° Longitude �• �� 0«
Design Current
Swine C'anacity Ponulation
Wean to Feeder
q6O
Feeder to Finish
�s
arrow to Wean
4p
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons 17 ❑ Subsurface Drains Present ❑ Lagnnn Area ❑ Spray Fietd Area
Holding Ponds I Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impact~
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. II discharge is observed. what is the estimated flow in gal/inin'?
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 W No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Ef No
❑ Yes XNo
4. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Spillway
❑ Yes
I'No
Structure I Suructure 2 Structure 3
Identifier: -
3...��._...._............(�....................
Structure 4
—
Structure 5 Structure 6
a 3
Kr..................
..3....................3)1-K............_..
Freeboard (inches): vI 'I 3 �Q
I i
...I..a............... .....
{ qr?
f"o
5100
Continued on back

- s
Fariiiity N Mher: 3` �� Date of Inspection Printed on: 7/2112000
5- Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ANo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes VNo
(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 XNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes WTo
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 XNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes XNo
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16- 1s 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 Reviewerfinspector fail to discuss review/inspection with on -site representative'?
24- Does facility require a follow-up visit by same agency'?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0 INO MblaWtis'ot-- deficiencies •were pgfecl- du-ritig �bis:visit'. Y:oi} will-teceiye d6 fu _ ther
co, riesnon nce. a�ota this :visit::::::::::::::::::: :::::
❑ Yes XNo
❑ Yes f�3No
❑ Yes ❑ No
❑ Yes ❑ No
MYes ❑ No.
❑ Yes D�'No
❑ Yes XNo
❑ Yes
XNo
❑ Yes
9No
❑ Yes
ONo
XYes
❑ No
Comments (refer to question #): Explain any YES answers and/or any recommendations or any.other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
9)
k� V1k VQ-Lj ahQ_�T
(jz_v3e� W X-1, <A�� L"ZQ
❑ Yes WNo
❑ Yes MNo
❑ Yes gNo
❑ Yes gNo
Reviewer/inspector Name
Reviiewertinspector Signature:
Date:
5100

FW+ Iity umber: �j 1 — �� Date of .Inspection ) Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge ;lt/or hglow Oyes ❑ No
Iiquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
kN 0
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
9 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
�INo
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
CINo
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
1�fNo
Additional —Comments: and/orDrawings: _
k'
�3 � .. � t-�.� �-1 `��� 1� tS `�Q s �i G �\���-.�� � �T . � t--�-p`-Z�l ►-C'-�cti
vim cuss G� .��`H,c�S TESL C��e
ST o`er-
�v�����
0
5100

Dry ion_of"So>l and rWater,Eons+ rvaon- Operation Review
ry O Drvtsion of Soil and Water Conservation :Comp)ance Itnspecfon
�I) v* lion of Water QuaJtty= Compuauce Inspecuoi � - Y
Ot13er:Agency OperahAn_Reveew
Q Routine Q Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review , Other
Facility Number Date of Inspection
Time of Inspection j_ 24 hr. (hh:mm)
© Permitted © Certified [3 Conditionally Certified 13 Registered [3 Not O erational Date Last Operated
j.
Farm Name..l.t.� r�...r. !.'R� ...... County: .............. ...�..'..............................................
Owner Name Phone No�..6
...........................................................°'J
Facility Contact: .............. .Title `q Phone No.
MailingAddress: ..................................................................................................................... .......................................................... ..........................
Onsite Representative: 7-1 ....).� If; ...fz � ..... . ................ Integrator: ..... I.&
..... ....................................................
Certified Operator:,••,•,,,,,,,,,,•,•- ............................................................• Operator Certification Number:
Location of Farm:
r
......................................................................... ...................... ........ ......... ....................................................
Latitude �'�� �•� Longitude
'Swine
Design: .'Current
Canacity. Ponulation
n to Feeder
lFeeder
❑to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design - Current' Design Current
Poultry Capacity Population Cattle: ..Capacr :Population
❑ Layer ❑Dairy
❑ Non -Layer I I JE1 Non -Dairy
❑ Other
Total Desigi Capacity-
- Total ssi w=_
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
- Holding Ponds Solid -Traps "' ❑ No Liquid Waste Management System
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 ycs, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
,(Yes
❑ No
❑ Yes
❑ No
❑ Yes ❑ No
Structure 6
Identifier:
Freeboard (inches): ..--•.•--.•,••.-
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued on back

FacilityTNtunber: — 7 Date of Inspection
6. Are thererucure structures on -site which are not properly addressed and/or managed through a waste management or
clpsu replan?
❑Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12. Crop type
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
. ; Rio yi. . . . r. . .... ri... "re noted during #;his;v..! ... .. re. Dive Rio further .
�corresp&ide i & ab' ' f this visit. .. ' ' . ... .
Comments {refer to_'gnestion #}: Explain any YE5 answers and/ar?any-recommendattons o�:any other comments:
Use drawings of facility to better.explain situations. (use:addthonal pages as,necessary)
LjL�y 2d 1.. Cc� ,ti A'
r Gt_ 40� Ck s1 � . C rtit , t-,U T
44
Reviewer/Inspector Name - -
Reviewer/Inspector Signature: Date:

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
December 30, 1999
DM Farms
DM Farms - Mag III, Section 4 Sites 1-4, Section 3 Sites 4-5
692 Bonham Rd
Magnolia NC 28453
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 31-15
Duplin County
Dear DM Farms:
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. IRRI, 1RR2, DRY1, DRY2, DRY3, SLUR1, SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincerely,
Kerr T. Stevens, Director
Division of Water Oualitv
cc: Wilmington Regional Office
Duplin County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

_ 13 Division of Soil andMater Conservation_ -'Operation Review
sion of Soil and Wafer Conservation -Compliance Iuslieetion -
Dtvision of Water , - � Quality -Compliance Inspection .
Cj"O#her Agency,. Operation Review.-
#gkRoutine Q Complaint Q Follow-up of DWQ inspection Q Follow-up f DSWC review 0 Other
Facility Number - Date of Inspection C;
Time of Inspection ® 24 hr. (hh.mm)
Permitted 0 Certified [3 Conditionally Certified [a Registered JE3 Not O erational Date Last Operated:
Farm Name: r..J.G�..[....:....1..�...43.....:. County:...........'`..��'.................................
Owner Name: `` ......................................... ..................................................................... Phone No:q��'''.^r�.°.�
Facility Contact::N- .................... ........................Title:............... .................................. Phone No:
N-lailing Address: ..................................................................................................................................................................................... ..........................
Onsite Representative:.V.`.-C�� Integrator:.......i,!\.........
�................�............................
Certified Operator:....... !....................................................... Operator Certification Number:.... �(y-76 ............
Location of Farm:
Latitude �' �" Longitude 0 • �'=
Design.- Current
Swine Canacity> Population
Wean to Feeder
lfco
Weeder to Finish
Marrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current r Design Current
Poultry Capacity Population Cattle :=Capacity, Population
❑ Layer I 1 ❑ Dairy .
❑ Non -Layer I ❑ Non -Dairy
❑ Other
Total Design Capacify
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid -Traps.' ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ElLagoon ElSpray Field ❑ Outer
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?
❑ Yes O(No
❑ Yes ❑ No
❑ Yes ❑ No
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 j9 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes CKNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway Yes ❑ No
Structure I Structure 2 Structure 3 u Structure 4 Structure 5 Structure 6
Identifier: "``] u— ��} 'l�43 [ 3 1_0 3f—gIq 3—S
Freeboard(inches): ............... ................................................................ o...................��...................�"................................... `....{.........................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] Yes (Vo
seepage, etc.)
3/23199 Continued on back

IFacility Number: 31 — t5 Date of Inspection
0
6. Are there structures on -site which arc not properly addressed andlor managed through a waste managoineni or
closure plan?
❑ Yes
ONO
(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
ONO
8. Does any part of the waste management system other than waste structures require main tenance/improvement''
❑ Yes
RNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
(YNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
b'No
11. Is there evidence of over application? ❑ Excessive PondinL, ❑ PAN
❑ Yes
N No
12_ Crop type S try
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
y
Cl Yes
b�'No
14. a) Does the facility lack adequate acreage for land application:?
❑ Yes
j R 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
XNo
16. Is there a lack of adequate waste application equipment'?
❑ Yes
M No
Required Records & Documerits
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?
D�No
(ie/ WUP, checklists, design, maps. e!c.)
ElYes
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
IM 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?
❑ Yes
CKNo
(ie/ discharge, freeboard problems, over applica(ion)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
[KNo
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
j No
.. o •V16jati&is'ok- deficiencies -ryTre h6ted during thls.vlslt. - You wifl-r. a dVe d6 further
• corres onde' ' e. about_ this .visit: • . - . - . .. ..... ... ............ .. .
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):
S r- 3s e.l.4a5, c `i� c ► f� ti� ��
QVlcSt G 61
TIL_A� "I I -le"
Reviewer/Inspector Name
ReviewerfInspector Signature:
0 3?r3 706 hd,
Date: ( I_ in— Qt
3/23199

i
Facilit !Number: t� 1 Date of lus ection
Y a� — 1� A
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ( yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27, Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes J 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 A No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ,4No
32. Do the flush tanks lack a submerged lilt pipe or a permanent/temporary cover'? ❑ Yes j7*No
Additional Comments and/orDrawings:
R) 1,A
��k1__W\`vzd _� Gl—\ %:7�_ ��,A t2�
Z' " q3mq,�__�
s s�-,�t�l �� �'" �� 1�� �� +-te r G� ,�4 �P
_-,U 1, L Q71
CIA� n �kAV
3/23/99

Rak.,=S
Revised April 20, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number 3 - S Operation is flagged for a wettable
Farm Name: -I acre determination due to failure of
On -Site Representative:' Part H eligibility item(s) F1 F2 F3 F4
Inspector/Reviewer's Name: �`1���
Date of site visit: � �_ W-99
Date of most recent WUP: ..7 'a q9
Annual farm PAN deficit: ���b G t pounds
Operation not required to secure WA.
determination at this time based on
exemption E1 E2 E3 E4
✓ Operation pended for wettable acre
determination based on 8 P2 P3
Irrigation System(s) - circle #hard -hose traveler, 2. center_pivot system; 3, linear -move system;
4. stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system w/portable pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system w/portable pipe
PART 1. WA Determination Exemptions (Eligibility failure, Part 11, overrides Part I exemption
E1 Adequate irrigation design, including map'depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D�D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ill. (NOTE:75 % exemption cannot be
applied to farms that flail the eligibility checklist in Part 11. Complete eligibility
checklist, Part 11 - F1 F2 F3, before completing computational table in Part 111).
PART 11. 75% Rule.Eligibility Checklist and.Documentation of WA Determination
Requirements. WA Determination. requiredbecause operation fails -one of the eligibility
requirements listed -below:
F1 Lack ofacre age _whichTesultedin=overapplicationmfvvastewater(PAN) on:spray_
fields) accord ingrtofarm'Blast -two years -of irngation--ecords:-:
F2 Unclear,-lllegiblel:or lack of information/map.
F3 Obviousfield-limitations-(numerous_ditches ;failure #o=deductrequired_:
buffer/setbackmcreage;-or25%.oflotal:acreageddentifieddri�CAWMP iricludes _
small;-irregularly-shaped.fields;.�fields-less than -5acres-for travelers-or_less than
2 acres for.-stabonary-sprinklers).
F4 WA determination required because CAWMP credits fie[d(s)'s acreage -in excess
of 75% of the respective field's total acreage as noted in table in Part Ili.

Revised April 20, 1999
Facility Number
Part III. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT FIELD TYPE OF TOTAL CAWMP FIELD COMMENTS3
NUMBER NUMBEW-2 IRRIGATION ACRES ACRES %
SYSTEM
f
f
I
I ! �
� I
FIELD NUMBER' - nydrant, putt, zone, or:point numbers maybe used in place of field numbers depending on L:AINMP
and type of irrigation -system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption; -otherwise operation will be subject to WA determination.
MELD NUMBER - must be clearly delineated on map.
COMMENTS' - back-up fields with CAWMP acreage _exceeding-75% of its total:acres -and having Teceived less than 50%
of its annual PAN as -documented in the farm'sprevious.two .years' (1997 8.:1998) of irrigation Tecords; cannot serve -as -the
sole basis for requiring a WA Determination: -Back-up fields -must be -noted inthe-comment.section-znd mustbe accessible
by irrigation system.
Part IV. Pending WA Determinations -
�i P1 Plan Jacks. following -information: V\el-4kX Ir���-lec5G��14��-�.Q��`��.`5C^t'�
P2 Plan -revision -may_satisfy75% rule based on adequate overall PAN deficit 'and by
adjusting -all field -acreage -to -below 75% use rate
P3 Other (ielin process of installing new irrigation system):

■
_ ° , , . �.� - -�. , . �, �. • : •-.. R ,r.,,� , $ �: '� � � � ram°
[]Division of Soil and Water Conservation ❑ Uther Agency`
a
Division of Water Quality
j!tRoutine O Com laint O Follows-u of DW ins ection O FoHow-ue of DSWC review O Other
Date of Inspection z
Facility Number 3 1
Time of Inspection 24 hr. (hh:mm)
0 Registered Certified © Applied for Permit ;j Permitted 10 Not Operational I Date Last Operated: .
Farm Name: ...... Ng.I.5 County:.......�#l! ........................................
.. A)....5�Owner Name:.......... .M ...p�+zm ....................... .................. Phone No: �`)1t5�.. `�. �.'IJ ?lx ..........
FacilityContact: ................. .D! V.ce ........1 .Y4i Yes..................... Title:................................................................ Phone No:...................................................
Mailing Address:.... 2-....on4v...... U............................................................... . i1Q��s �.. L-...... ........... ...aqs-i.....
Onsite Representative: .................5G4........?61('4.1................................................... Integrator:........ MvY..........................
Certified Operatort.................................................................................. ... Operator Certification Number:...................
Location of Farm:
Latitude • 6 " Longitude • ' "
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes PO 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 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? NIA
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ) ❑ Yes 1A No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes tA No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes M No
5. Does any part of the waste management system (other than lagoons/holding ponds) require N 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

I l It
Facility Number: � — � S .
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes 19 No
Structures (Lagoons jlolding,Po dim s, Flush Pits. etc.1
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes (A No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ma�$................S.�G:....` `............Sec. -Z ScG_ ' ..... ..........:5�.•.A— �%... ........ 4..:3 ....... .
Freeboard(ft):.............. 1_1.............. ............... Z.:..! ?-7- - ......... Z G Z•�
10. Is seepage observed from any of the structures? ❑ Yes [9No
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 maximum Iiquid level markers? ❑ Yes t9 No
Waste ADDlication
14. Is there physical evidence of over application? ❑ Yes E`,No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
�W
15. Crop type .............. bLX.1'nd.o........................ --swe'!l.......yGUn..................17t!.1... ...................�YIaT A.............. �91111.7� &.................
16. Do the receiving crops differ with those designated in the Animal Waste'Management Plan (AWMP)? fig Yes ❑ No
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 reviewrnspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities On1F
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
[3' No.violations"or. deficieitcies.were.notid-during this:visit.- You.-,viH ieceiveno-ftirttier':
0&0004debce about -this: visit.
❑ Yes [A No
10 Yes ❑ No
❑ Yes No
�] Yes ❑ No
❑ Yes No
Yes ❑ No
❑ Yes V3 No
❑ Yes 5 No
❑ Yes 1p No
5 NoM46 ow%k bee�,x4 (a aon 3-'{ �ti rv?6tr_A 1- valva . V&\vp- Vv,s be ev% v'tr1VVj- Nry •
A� v�AcJ fir}"p- +r 61aLK ate to a r ev wo-s� f M •...
dtsc��r�, + gra� o�vta- t{� t` orc Ltc ir. r,�er Zi 92 skzu) b�. r MA
tl ir� j+bin"_1t P10,<- �r srJatii artt� if\ Se(-. 3A .
1<,7c ti,� 1
li'rrZ• eroslon r�rce.s ovarcr c�tK� wall 4 IoLyem 3-4shnj) be `l�.Cc� a4 d resee�}er�. C-l" r
ors i nrtXC a lu W&Ai 0� kl"-%- -9 5koh,A b,_ NtJ LJ -' A4,- LI" + ttsp�eoitc . a �, O."C_% 0"
d;� WCJ1 A"'i of Goons &A , 3-s1 M�� j 14-1. Con�;nVL ffeq-orb !�L10 '-O r'v'rrje"
6o,ec o._P.S ar,, t"00i%s 14`31 q-4. -tv-,- W��1� o� iac�Oo�.S 3�`�� y-T� y-3� 'Z S�­0�7/25/97
rj
Reviewer/Inspector Name
Reviewer/Inspector Signature: , I-// Date:

acility Number: 3.�_. Date of Inspectis►n:
Z2. 9
Additional C6fium6nts and/or Drawings"
be "wv-�• +n%P%4J CAVULSS PDX6 in 1moor, be n*,OCkj 4
1�. -pulls is(.ITg)) O) qZr 941 °�S a -PC 5e,ia in sntllt� � b,)k LJu1 cc,ll5 for be,rrhu O,
r8. Cei-t� r%ut emits io � rn�vovr.- 1�i c, y %ammc- � - hcrmuda� Smsse s.
��. Comc.` p%l�l 5�juid ,ae' 1 O- 1(a i r., S�ml rc cork " e, W kfick
�►, SP l rcc&k j 28otl0sr� ;,, w�P ��' rr•,ll,�� i5 b be ctrowr• .h �c�1ls gb, ;�;
e �,,,Q tv► 4-�v- Wut? S�ccv,� eau s tgvn rno. va Au5 •
4/30/97

DSWC Animal Feedlot Operation
Review
w m� DWQ Animal Feedlot Operation
Site Inspection
x
..
-
®Routine O Complaint O Follow -tip of DW ) inspection
O Follow-up of DS'4' C review O Other
Facility `lumber 3 l
Date cif Inspection
Time of Inspection i : I 24 hr. (hh:mm)
Total Time tin fraction of hours
Farm Status: Registered ❑ Applied for Permit
(cx:1?S for I hr l_5 min)) Spent on Review
Certified Permitted
or Inspection (,includes travel and processing)
[] Not O erational Date Last
3Operated: ............................................................................................
Farm Name:.. ..... .a..r.:! r.5.........s .� 1..........5..±.. - 1 „ �....... County: I)." �. ts.►.................................. .i.. .-
....... ....................
Owner Nanrc:.... ..Ll.y. .. ..ul!�.s.�. fsF...r....... 5_ . Phone No:
..................... .............�... .... -
t 9 I o ��•� � ��L4 �`�
Facility Contact: .. .. .u..C.R.r.... `!..R .►^ 5.......................`1'itir:....... ......................................................... Phone No: �1.1.0�....x,.`. ......S1--`-{.{?t irtn,�
Mailing address .....`.. ...... ... .. ..,...................................� ue.- �.rA.,C ........................ ,I J ..7r:�.���.�....
Onsite Re resentat.ive% r u.Ly...... t.n ..r... Integrator: �.�^-�.......................................................
Certified Operator: .................................................. .............................................................. Operator Certification Number:....! Yiv
.......................
Location of Farm:
tDr,...-.1 k.r,..... n8.f.....,s.t.v -......fl.......,�.R..1..i..1......,.....�.�.�.r..a-x.i.r�^1..a...........ir►�,.l.t„ ..Yka..r...t.�......p....i ^..-....
j..�.......vrt�....r .....,J�i.r,.a.� ................................................. �..e. .......�,......rea.►tl,....... .K...l.l. �............................................................................. t
Latitude E •* 4 l�Z6 Longitude ©' ®4 ®41
Type of Operation "Design Current y Design Current
swine.Capacity Population Poultry Capacity,Population
❑ Wean to Feeder
Feeder to Finish
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Other
Number of Lagoons /Holding Ponds Subsurface Drains Present
Design C>rrreht
Cattle , 'Capacity Population.
❑ Dairy
.11 Non-Dairvl 1 11.
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes Z 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 man-made' ❑ Yes ® No
b. If discharge is observed, (lid it reach Surface Water'? (If yes, notify DWQ) ❑ Yes Q No
c. if discharge is observed, what is the estimated flow in gal'nun? ,Ck
d. Does discharge bypass a lagoon system? (If ves, notify DWQ) El Yes ®No
3. is there evidence of past discharge from any part of the operation? ❑ Yes [9 No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes 0 No
5. Does any part of the waste management system (other than lagoons holding ponds) require MYes ❑ No
4/30/97 maintenance/improvement?
Continued on back

Fa' ility Number:
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
allo
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
19No
Structures (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
O L%jo
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
.......... Zn...... I .............. ............ Zr.................. .............. ,?..� ................... ................ 2.................. ......................................
................................
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?
10 Yes
❑ No
12. Do any of the structures need maintenance/improvement?
21 Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
O No
'Waste Application
14. Is there physical evidence of over application'?
❑ Yes
1Z No
(if in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type Y. ^^rL? L� �. ...........................1� a. !. tx................................ a..0..r<`.c. . ............... ............ ... r1..........................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?ELYes
IN No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
�No
18. Does the receiving crop need improvement?
E.Yes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
0 No
20. Does facility require a follow-up visit by same agency?
® Yes
❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
®,No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
10 Yes
❑ No
24. Does record keeping need improvement?
R[Yes
- ❑ No
Cox�arients (refer to questtan�#) ':Explain any�YES ansvvers`�ancUor aay recvmm�dattotis ©r arty ofher�cflmments': '�
Use dia�ings oft facilityltabe�tterFe�cpl{a�tn,�tu- a_tt+ � �Ituse add:taonal pages as i<es'sary)� � -v, r
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W r Fi t ` �S z• v-S u! �.c-y. @ :
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Reviewer/Inspector Nameaw
t1r t a
Repiewer/Inspector Signature: Date: g J 14 1 'a
;;4,..
1
cc: Division of Water Quality, Water Qualily Section, Facility Assessment Unit 4/30/97

Facjlity_Nmber: 4A._... Date of Inspection: g 1 14 A -1
• f
P►dditiosial.Cominents..and/or Drawings:
j..,. _ _ .:�.:...: _ `. `- _ A
•f9� t u--b [ e - ,� L l �1 .R-{F 111 t��N` i F"l '�C� p t r` 1 1iL % i 0." S � � 1�•�- p � C,
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O U ��';t�q
Ti"'o 11
5 ti• a v l c �2 o- f; �� e� w�� S n CO. c-O T II to r%-� j> W Q a , c t c—
IN 4 ` tiw "' 4ua
2. L4�1 r ra-�RM� �'� j 0 J S U -i i Y� +^�-al.
V Y� i i -[J v. LPG✓ t a� . O✓r'L v'-E— Cp Y"V-'•--a- b rt 0L) 1 v r' q 0. f 0
A w e rice c �i c; w E 1 I 1} e d i t �o r
�'% /
4/30/97

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