310062_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quai

e- - �'w_ It
O'Division of Water Resources
Facility Number - , C 1_1 O Division of Soil and Water Conservation
p Other Agency
Type of Visit: ��Ro
omn�pliance Inspection Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: t-Y'utine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: �f{ /� Arrival Time: Departure Time: /► County: Region
Farm Name: 1f ���p�t.I J `AI
Owner Name: �Y_4Gr�`� ' y��`-n� ✓�
�T
Owner Email:
Phone:
Mailing Address: "'!M
Physical Address: JUL 2 0
wat
Facility Contact: 'Ds �� 4-a.vIl le-4^ Title: l�}q erQUality _
ilmiRi;t Seectio nal
Onsite Representative: �•-� Integrator: %�1 penal p i-
Certified Operator: ��� a �c rj c� Certification Number: 73 t
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish
Wean to Feeder Op _5-2m
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
Non -La er
ury rouirry
Layers
Non -Layers
Pullets
Turkey
Turkey Poults
Other
Design Current
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [9-IQa ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No 21NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ED 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 BIN ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ff No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3
21412015 Continued

Facility Number: 21 - -2 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[ca.Nv— ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z,
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[[]. -<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
❑ 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
Eff<o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[Tlgo
❑ 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 D-Nt_ ❑ NA ❑ NE
maintenance or improvement?
Waste_ Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes EEr&o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes ❑l o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift, f [:]Application Outside of Approved Area
12. Crop Type(s): so r
13. Soil Type(s): i`d+r---yr 1,-
14. Do the receiving crops differ from those designated in the CAWMP?
15 Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
❑ Yes [3-'No ❑ NA ❑ NE
❑ Yes []allo ❑ NA ❑ NE
es ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[al�o
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
Q No
❑ NA
❑ NE
Required Records &_Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑Yes
❑'No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
EJ-No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes,
❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑-1�o
❑ NA
❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E(No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

lFacilil4y Number: - Z Date of Inspection:
24'Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [G]N—o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [:J o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes F- '`-o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Q 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:
033. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ❑•No ❑ NA ❑ NE
❑ Yes [ 'No ❑ NA ❑ NE
❑ Yes UNo ❑ NA ❑ NE
❑ Yes [goo ❑ NA ❑ NE
es TrNo
❑ Yes C! No
❑ Yes CB-I�o
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refef, to qusrst,o #): $Explain anyYES answers4nd/o"r and adds nal recon>imendations or. any,otheracomirtien
Use' Arawings�of f c�1MWFto better explain situa3tions (use additional pales as necessary).""
C-t L nA C. _9'� - ? ,t -�_--1 �q
3 7- t tJc-, Ce Jry b­t q
� 7
C4 1(0
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3of3
q 2_%
- cO r—w (
Phone-10—GS33
Date: ' F7
21412015

i %J Division of Water Quality w t/ .,
F3
-acility Number O Division of Soil and Water Conserfation',
0 Other Agency,
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:© Arrival Time: Departure Time: f� County:t `p/ y Region:
Farm Name: 1 ! 1 C �l![ �� j �� 111 _ Owner Email: ,
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: J U in Lo. r.. L e
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
E Qther
Phone No:
Integrator•
Operator Certification Number:
Back-up Certification Number:
Latitude: I[= = Longitude: [� o = L
Design . .Current - Design -urrenf��
Wet Poultry Capacity Poputation Cattle' ',Capacity"; Popuiahan
❑ La er
❑ Non -Layer
Dry Poultry
Pullets
Other
Poults
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?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Numbef of Structures �-�
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
f
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes -0 No ❑ NA ❑ NE
❑ Yes
tj No
❑ NA
❑ NE
❑ Yes
E No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[TNo
❑ Yes
6No
❑ NA
❑ NE
❑ Yes
f:rNo
❑ NA
❑ NE
12128104 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4<Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
G No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
0 No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: '
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ('I
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.)
Y
T
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
P No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[� No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E�rNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
Ej No
DNA
❑ 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
�],No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
JD No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
D'No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�' o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
P No
❑ NA .
❑ NE
the appropriate box.
TT
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes UNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: 3 - _ _ jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes SZNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 5/No
the appropriate box(es) below. 7
❑ 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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
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 P No
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
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 Pr No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
0 NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
No
❑ NA
❑ NE
33: Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 0 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).:.
Gt/� hJ
/613,1,5 I s�
r �
j`l eed We�� [C✓1 0 / SoC'
' PP t o �-C/S fez-tr -,� f - d'�Gcc�[
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: _ /Cf' Date:
Page 3 of 3 214,12015

rvision of Water Resources4 ,,� ? t ,- ; r.
Facility Number � ^® � O Drvrsion of Soil and�Water Conservation � ��- s s, -�,.
Type of Visit: 4EMmpliance 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: Arrival Time: 3, Departure Time: County { Region: (jlvl�
Farm Name: N �� l + -� ,r y,.. Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: tom, —
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator: or
Certification Number:
Certification Number:
Latitude: Longitude:
.tea �� DQS1gn CUiC�eElt " = F l w DesimnGurrenti d - a+ rtW,, y uliCSrgI1 Cgr[ent ;
Swine . Capac�tyh Pop Wet Poultryy; Capacity Pop W,Cattle,*Capacity -Po
,.
La er Da' Cow
Non La erw% Da' Calf
'� �" Da Heifer
' k ub. a%r zas S.k - Y V gig
Design Current Cow
F• �';,=D ;,Pool Ca aciP•o Non -Doi
q La ers Beef Stocker
Non -La ers Beef Feeder
Pullets x Beef Brood Cow
Turkeys
O#ber Turk
e Poults� '
"u
Other Other
3
ems.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 13'No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes • j No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes EfNo ❑ 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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ZrNo ❑ NA ❑ NE
[:]Yes KNo ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
Page 1 of 3 2/4/2014 Continued

Facility Number: -G Date of Inspection:
Waste Collection & Treatment
4. Is -storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 'GTNo ❑ 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: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
41 7-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes L2'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 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? El Yes ❑rNo ❑ 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 ;2'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes /ice No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes oNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E�fNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes J2�No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reuuired Records & Documents
❑ Yes 2 No ❑ NA ❑ NE
❑ Yes 12'7o ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes .12-No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes rlo
❑ NA
❑ NE
the appropriate box.
''"
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes �No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes ff No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes a"No
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes a No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes .rNo ❑ 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 FZTNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �TNo ❑ NA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes r�o ❑ 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
�To
❑ 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
�o
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
1;2rNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
" �1, No
�C
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El"N Yes
o
%
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
o
❑ NA ❑ NE
Comments (refer to question #): Explain; -any YES,answers_and/or any'ad'drtional-recomniendations oar any other comments
Use drawings of facility better explain situation-s°(use additional a es'as.n. wecessao)
Gv /%,; `
Reviewer/Inspector Name: _ {`i�I rt VC'r'r'_)(Q "Z
Reviewer/Inspector Signature: �C
Page 3 of 3
Phone:
Date:3
21412014

ivision of Water Quality _
Facility Number L 1 , - ® O Division of Sall and Water Conservation
O Other Agency -
type of Visit: P Tompliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
teason for Visit: 6Routine O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: =-F` M County: Region:
Region:
Farm Name:_ I'fwlv_/`t/jr� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: -TA Certification Number: 17 �b
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry. Capacity Pop.
Wean to Finish Layer
Wean to Feeder ]Non -Layer
Feeder to Ftmsh
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Discharees and Stream Impacts
Other
Poults
Design Current
Design Current
Cattle Capacity Pop..
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation? ❑ Yes XNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass -the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes Elo
❑ Yes �No
❑ Yes T1;31Ko
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes jf 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
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
Structure 5 Structure 6
❑ Yes rl 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 environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes �TNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes PNo
❑ 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 VrNo
❑ 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 EfNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 9No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ,yj No ❑ NA ❑ NE
❑ Yes V1 No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes V] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ONo ❑ NA ❑ NE
the appropriate box.
❑WUP El Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tra sfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes VNo
o
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes
❑ NA ONE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3
21412011 Continued

F icili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes XNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes O'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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
[:]Yes VfNo
❑ Yes �`o
[—]Yes ZNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[-]Yes WfNo ❑ NA ❑ NE
❑ Yes Z No ❑ NA ❑ NE
❑ Yes P?fNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes �TNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 9'No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes FNo ❑ 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 fuse additional nacres as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature;
Page 3 of 3
Phone: 9501_3;1�n
Date: 4—Po"`�"7`
21412011

r
Division of Water Quality
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit:C.,o/mpliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (2 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: LJ Departure Time: ;5 County:
Farm Name: rt4&6 Owner Email:
A .A
Owner Name:
Mailing Addres
Physical Address:
Facility Contact:
Title:
Phone:
Region:
Onsite Representative: YW14 1-my— Integrator:
Certified Operator: '•a Certification Number:y7 316 }
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
L
ayer
Non-L
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 DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [dNo ❑ 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 ZNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes E�No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

J
Facility Number: - Date of Inspection:
J'
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ef"No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
ONo
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: Lpp�y�
Spillway?:
Designed Freeboard (in): jq._
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
['Tio
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[:]Yes
[ o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[7TNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E f No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
rNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ZNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
Zr 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
[2 f No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[�J'No
❑ NA
❑ NE
acres determination?
17. Does the facility. lack adequate acreage for land application?
❑ Yes
[l No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[fNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
RTNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E�TNo
❑ 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 [2TNo ❑ 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 [TNo ❑ 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

f
40 - r
Facility Number: jj -16 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ENo ❑ 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 2fNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ZNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes jNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, 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 Er No ❑ NA ❑ NE
❑ Yes K No ❑ NA ❑ NE
❑ Yes e No ❑ NA ❑ NE
❑ Yes KI—No
❑ Yes 21 No
[—]Yes PTNo
❑NA ❑NE
❑NA ❑NE
❑ 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).
7
I .. V • .� �
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:zai
Date:
21412011

�` ;z Division of Water Quality
Facility Number Division ofSoil and Water Conservation
©- ® 0 Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 1Q Departure Time: County:
Farm Name: {mac icaq-U / L-(_ /,�(�(1/l Owner Email:
Owner Name: C G L IVL �h 1 C c-,A/ Phone:
Mailing Address:
Physical Address:
Facility Contact:
/V C(ODIA/ nc
Title:
Onsite Representative: 1r—Q�LA �(/! [ R - Integrator:
Phone:
Certified Operator: Certification Number:
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
Other
Certification Number:
Latitude:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Capacity Pon.'
Layers
Non -Layers
Pullets
Turkeys
M
Turkey Poults
Other
i
Longitude:
Region:
Design Current'`
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes o ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA [] NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 9No ❑ NA ❑ NE
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
zaaN
1
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes] No ❑ NA ❑ NE
0 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): F—o(L-eS
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
No
1P
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
6 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
JF] No
❑ NA
❑ NE
Refired Records & Documents 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 QDesign Q Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
El Waste Application 0 Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis ❑ V 4te Trans ers [] Weather Code
0 Rainfall ❑ Stocking ❑ Clop Yield CD120 Minute Inspections 0 Monthly and V Rainfal Inspections Q 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? ❑ Yesq�No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facila Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes ❑ No
❑ NA
XNE
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?
j Yes No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
P❑� Yes No
PkNA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office 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 gNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA
❑ NE
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).'
(91l.INC--El crop OF aC�lk CA(-lf3(Z14 /0�
— w1 t� C C� P ► o N CXT SST d F r,vfP�c; a�vs r 4ww�1
3I�l�a 1. ] `�
11 GD Ca of gCUD 6 IC qfi6_ wic-C cta C<<
(o �!goQbl NI s is Mr�KC S,AC C/C flc; I
IS . c c_D oT piAF6p o1V A N A6 ao/vv,t1 17
P S
G U1�Lu 7Ei1 I �� (� -- u C 6L . �- I -TT CC- Kr�hl FIE
+� d�`i 1
16Lb SZ t4 A 5 AA(- � ERu� ADA Qat.i1� N r S sa M & ,47 Q.P/
(;66LAAL 0j4 /s 5pp-SE /,41 pCACES
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: qlQ'-6
Date: 5) _— f P
21412011

T — Division of Water Quality
Fac ty Number 3 j - U Division of Soil and Water Conservation `
Other Agency -
Type of visit: Compliance Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: f o Departure Time: ® County: LIIV
Farm Name: AI C JCO(L SA tl i C_ F_i4 (LAA Owner Email:
Owner Name: H l C Phone: !� - �e5 L� I
Mailing Address: J 01 LI L G AN R-J �.lf //�L[ l9 �! JV /VC VE1 S 9
Physical Address:
Facility Contact:
Title:
Onsite Representative: ��}(.�( �(y1 j r J4
Certified Operator: q_E_C C'(f_ ! N 16 P6 A
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
Latitude:
Phone:
Integrator:
e�
Ckrfi ii cation Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
00 1 Non -Layer
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)?
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?
Longitude:
Region:
R 31CQ
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes No
❑ Yes ❑ No
[:]Yes [:]No
[]Yes []No
❑ Yes No
❑ Yes �No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: '3 1 jDateof Inspection:
Waste C%Ilection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �A No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: L 9C ON
Spillway?: _
Designed Freeboard (in):
Observed Freeboard (in): ZS 3Z_
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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
❑ NA
❑ NE
TT�No
❑ 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):P 1✓ q` l Y�
13. Soil Type(s): F0a, (-,5 iOlj
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
TT❑D
❑ 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
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 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 XNo
❑ NA
❑ NE
the appropriate box.
QWUP ❑Checklists ❑ Design Q Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes VNo
0 Waste Application 0 Weekly Freeboard Q Waste Analysis 0 Soil Analysis ❑ Waste Transfers
0 Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections 0 Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes &No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 1�kNo
❑NA ❑NE
❑ Weather Code
Q Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 3 1 - jDate of Inspection: to 19 j hI
24. Did tote facility fail to calibrate waste application equipment as required by the permit? ❑ Yes o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes JANo ❑ 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: A
26. Did the facility fail provide documentation of an actively certified operator in charge? ElYes No XNA
❑)NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑No ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No ❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No ❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
000
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?
❑Yes
I ❑ NA
❑ NE
34. Does the facility require afollow-up visit by the same agency?
❑Yes
I ❑ 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).
�►F�(.D � A N F�CD SornE W �-E� �,tF ; GIoL
�+- Q ��c� Df-}
Lod -
1GL_41)c' 6 --�u
GZf i �5 Utz llp-51)LL-NCEN�i o1ve f-- - f�1
Q
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 395010
Date: (pig ! `�
2/4/2011

Facility Number [ a
Division of Water Quality q
0 Division of Soil and Water Conservation
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Asoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: UA/ Region:
Farm Name: AL GICU9-k VA iI LC E C; AA Owner Email:
OwnerName: Z L6G i r ) n O"t - ! 91_Ci �)y Phone:
Mailing Address: IC NL/ tS4(n N Qd Cq//v*xt,ap/ Luc /D g 5 }
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: cerwe M • I G PE N
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ o ❑ d =is Longitude: = ° ❑ 6 = «
Design Current Design E
Swine,' W Capacity. Population, Wet Poultry ,'Capacity';
❑ Wean to Finish
191 Wean to Feeder 106
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other
r
IIJ Non -Layer I
Dry Poultry
in
❑ 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?
..�
tittle
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
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 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[]Yes
1KNo
❑ NA
❑ NE
❑ Yes
Po
❑ 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 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes III❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: L4C QL:))q
Spillway?:
Designed Freeboard (in): 9.
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) \
9. Does any part of the waste management system other than the waste structures require ❑ Yes )�No ❑ NA ❑ NE
maintenance or improvement?
Waste Aoolieation
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below
❑ Yes KNo
❑ Yes 4 0
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
El NA ❑NE
❑ NA ❑ NE
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) SG QsQ_cp�
13.
Soil type(s) F0q-es'-C iw
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
ANo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
*o
❑ NA
❑ NE
Comments (refer to question.#): Explain any YES, answers and/or any;ree6mmendations'or;any otller compnents '_ _
Use drawings of facility to better explain .situations: (use additional pages.as. necessary) f h
w A.
/0
//&//o l• 9
1I185/o� I.3
Reviewer/Ins ector Name } 03
P 4�1& ..{1 / � Phone: ��6 " 7G 3
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

[Facility Number: 31 — 6 �2 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes ❑ No
❑ NA XNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ yes XNo
El NA
❑NE
the appropriate box. 0 WUP 0 Checklists 0 Design 0 Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes XNo
❑ NA
❑ NE
0 Waste Application ❑ Weekly Freeboard 0 Waste Analysis 0 Soil Analysis ❑ /ste Transfers ❑-nual Certification
El Rainfall ❑ Stocking ❑ Crop Yield G1 120 Minute Inspections 0 Monthly and 1" Rain Inspections Q
Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes VNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes �?fNo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes j, No
El NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes klo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes XNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes ❑ No
�NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did -the facility pose an odor or air quality concern?
❑ Yes No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes 2�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 56No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑Yes -No
❑ NA
❑ NE
Additional�Comments.andlor. D�a►vin�s.. �«,yt .„� �„* ',�"+�a.� � ,�'`�=�,`"'-a� �:: ':��.> ,a.�_"r:`"�' �""s'.. .' F
CAC:t 2�-r �av but 90► t
E Cs. c�� G� -gj_9M1 r Pu +�� cQaflS
Page 3 of 3 12128104

Division of Water Quality ,
4
Faeillty Namber , 3 j (9� ,O Division of Soil and Water Conservation , ° `
O Q ther.;Agency
Type of Visit XCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time.
Q0� Departure Time: County: l A( Region:
Farm Name: "i cti<oeyi 1A )L_c 1PAQ_rn Owner Email:
Owner Name: E �� 1�E Phone: 1 i�p'�o�/���
Mailing Address: i C� y Li t M Ate! 1(�3 Col&_? u pow., /C 42 �[ 1
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o ` " Longitude:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
I
❑ Beef Brood Cod
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 1 of 3
❑ Yes XNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

i
40 Facirty Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: Laclocw
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No No
ElNA
[I NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
ElNA
❑ 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 0,,No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes *o ❑ NA ❑ NE
maintenance/improvement?
1 l .
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[(No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12.
Crop type(s) S (& (Z (
13.
Soil type(s)
S 10/v
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
9 No
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
A 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
ANo
❑ NA ❑ NE
J%-J. k !
Q/1-+10g D, 3
�--
�?'11�L
Reviewer/Inspector Name j H00AA10P 1r S .. • ,. . . P - I , j Phone: 410- iM!P_ f5�j f
Reviewer/Inspector Signature: Date: ! ¢ ID(4/04
Page 2 of 3 12128104 Continued

r
f
1
Facility Number: "j — Date of Inspection
1
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes V No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1XNo ❑ NA ❑ NE
the appropirate box. 0 WUP ❑ Checklists El Design 0 Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �XNo ❑ NA ❑ NE
I] Waste Application ❑ Weekly Freeboard 0 Waste Analysis 0 Soil Analysis ❑ 1 aste Transfers ❑ Xnual Certification
0 Rainfall 0 Stocking ❑ /rop Yield 0 120 Minute Inspections 0 Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install andmaintaina rain gauge? ❑ Yes 4 No ❑ NA ❑ NE
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
� No
❑ NA
El NE
❑ Yes
R No
❑ NA
❑ NE
El Yes
� No
❑ NA
❑ NE
❑ Yes
1ANo
❑ NA
❑ NE
❑ Yes
❑ No
IONA
❑ NE
❑ Yes
[%No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
4No
❑ NA
❑ NE
❑ Yes
%,No
❑ NA
❑ NE
Additional Comments and/or Drawingsc
-, 7 co?�� OF 'oq 41C eP�Z 4-PA-7 w1 VAGC S -CKD VD IMS 1 CHIC HCrf1k Z
w�CZ-�- oN C TT�n/�C C3�i TG Gz �3E(zM.LoA C_
LD Lk-4 �c-�5 � �S �fnOSr�
IVFIC.. , � `�
I
Page 3 of 3 12128104

Q� Division of Water Quality
Facility Number (p Division of Soil and Water Conservation /
- --- 0 Other Agency v
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 10 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: �U Departure Time: County: �%� Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title
Onsite Representative: C)t4NN ��N l CLZ—
Certified Operator: �� l C_ ! � 1 6 ew
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 v
Phone No:
Integrator:
Operator Certification Number: { —i J 1 L9
Back-up Certification Number:
Latitude: = o =' 0 Longitude: = ° =' = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
20001 1 ElNon-Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharses & 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 Co
Number of Structures: El
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes ANo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104 Continued

.l
Facility Number: Date of Inspection
Waste Collection &'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes , No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:FYioTtl
Spillway?:
Designed Freeboard (in): �.
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ,XNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes XNo ❑ 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 SRrVo ❑ 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 JXNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes 19�No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or l0 lbs ❑ 'total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
gNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
1PNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
N No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
VNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
19,No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
r.v F tk A ��� o F �2u��
Reviewer/Inspector Name — - -_ N S Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

i
Facility Number: 3 —(9 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes NNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[XNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
NNo
❑ NA
9kNE
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
NNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
M No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Pq No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[)�No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
kNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
( ,
1 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
,Z No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[KNo
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

0 Division of Water Quality
[Facility Number 0 Division of Soil and Water Conservation
0 Other Agency 4e
IType of Visit 9Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit JO Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit; i 0 Arrival Time: : Departure Time: A0 County:
Farm Name: �ctr Z[6 Owner Email:
Owner Name: Z�/G —.--1'. )6v _Zd Phone.
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative.
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Integrator:
l
lJ
>. DRegion:
Operator Certification Number:1�
Back-up Certification Number:
Latitude: = o =1 = Longitude: 0 o 0' =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La et
❑ Wean to Finish
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Puults
❑ 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 Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef 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?
❑ Yes 0No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
;KNo
❑ NA
❑ NE
❑ Yes)�fNo
❑ NA
❑ NE
12128104 Continued

f . . �.
Facility Number: 3/ —& Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Z'No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: k1_
Spillway?: A/O
[-I NA ❑NE
❑ NA ❑ NE
Structure 6
Designed Freeboard (in):_ -
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ANo El NA El 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?
❑ Yes No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ NA
❑ NE
maintenance or improvement?
/PlNo
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 JO 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 ❑ vidence of Wind Drifl' El Application Appplication Outside of Area
12. Crop type(s) /-l1/n
13. Soil type(s) ����-gyp a
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 9No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes A No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes 9No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ YesNo El NA El NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
r�
Reviewer/Inspector Name ,c� Tic
. Phone: / o
Reviewer/Inspector Signature:
Date: Z/ 0
12128104 . Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IVNo ❑ NA ❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes �No
❑ NA
❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes ZffNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes 'Al No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
/
❑ Yes ❑ No
NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ElNA
ElNE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
No
ElYes?�o
❑ 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 PNA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWW? ❑ Yes Q,No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes �No ❑ NA ❑ NE
r
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ YesNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ONO
❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative? ❑ YesZO No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes VNo ❑ NA ❑ NE
Additional Comments and/or Drawings:
AL
g 6zl-z
/44- /VO 7- 7-
f 147
12128104

�D1V151on of Water Quality
Facility Number 1p�. 0 Division of Soil and Water Conservation
- - 0 Other Agency
Type of Visit 9j�C,lompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
�v f
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access I
Date of Visit: Arrival Time: ;/ parture Time: fJ aunty:
Farm Name: ���� 7LL Owner Email:
Owner Name:G' yf Y��I11 Phone-
Owner
Address:
Physical Address:
Facility Contact: Title: Phone No.
Onsite Representative: /` 4Integrator: 'i� - �'17•
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Region: 0, 4?_0
Latitude: = o= 4 Longitude: = 0 0 d
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish I i
Wean to Feeder Q
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other_
❑ La er
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: MJ
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 ), No ❑ NA ❑ NE
❑ Yes
X10
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
ElNA
ElNE
❑ YesNo ❑ NA ElNE
12128104 Continued

Facility Number: — 2 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes A No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?: )09
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes )Z No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ZNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No El NA El 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
El Excessive Ponding ❑ Hydraulic Overload El Frozen Ground El 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 Dri ❑ Application Outside of Area
l2. Crop type(s) �f�/n LlQ q—�t�ff t�� �t/fyPr 1
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ZfNo ❑ 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 JdNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes EfNo ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
?JLo�s� 0/_Rena ,o+ "DI-14 ro iv411-o5
r� A%Ft_O.acfz
1-4,(
Reviewer/Inspector Name ( Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12/28/04 Continued

Facility Number: Date of Inspection /
Rewired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design [I Maps El Other
❑ Yes No El NA ❑ NE
❑ Yes /No ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below.
10 Yes
El No
El NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis El Soil Analysis ❑ Waste` Transfers ❑ Annual Certification
❑ Rainfall �Stocking "El 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
X No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
ONA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
X,No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
Rf NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
�YNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? .
❑ Yes
/No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[� No
❑ NA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
/
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
/P"No
�dNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
likF.D Jv 60-C
Page 3 of 3 12128104

i
r
Division of. Water Quaht?
Ta iftt Ntimber j� (pZ O Division of Soil C and Water onservation T s
y ;Other. Agency
Type of Visit Qf Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 16Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: i Q Departure Time: ounty: Region: C64 •017
Farm Name: Owner Email:
Owner Name: �WF/'z —1 2 � r—e _�(� �. Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
4 9 g 0
Phone No:
Onsite Representative: �/�/�/
I Integrator: ,�,I�f,@2.
6722
/��
Certified Operator:
Back-up Operator:
Location of farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = { =di Longitude: = o ❑ A ❑ 1L
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
's(p(,Y>� p, Q� ❑ Non -La et
Other
❑ Other I-- -
Dry Poultry
Non-U
Pullets
Poults
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
❑ Daia Cow
❑ Dairy Calf
❑ DajEy Heifej
EfDry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef 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 J] No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
J4 No
❑ NA
❑ NE
❑ Yes
ANo
❑ NA
❑ NE
12128104 Continued

Facility Number: 51— Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [I Yes ❑ No ❑ NA ❑ NE
S�t/ructure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: �ss
Spillway?: Ala
Designed Freeboard (in): /q.5
Observed Freeboard (in): 36
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No
ElNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) /
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ZNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No
ElNA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes VNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No
❑ NA ❑ NE
JO
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes INo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Froien Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 4607i
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
VfNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement? A 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
XNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
0 No
❑ NA
❑ NE
I�) 10�3/ LTG fi T Aacz-r SffOwr /o ,3 Gr'nt£ lam, /yf�-l�i4i�0i fLy'G
Al '1 ,os o
Reviewer/InspectorName;�q�; Phone: ��— • Z�T
Reviewer/Inspector Signature: Date: OS
12128104 Continued

i 11
Facility Number: 7 — Z Date of Inspection !d
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ 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 ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ZYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ZStocking A 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
PfNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P�No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[�rNo
❑ NA
❑ NE
26,
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
ONA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ZNo
Cl NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
[-INA
❑ 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
INo
El 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
PNo
❑ 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
�} No
/'O
El NA
El NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional'Cd ' ents and/or.Drawin s
Awwzo
V.-K" S/ 5
AUigle = firlljr4 7,4i4w No7,',o 11,4-
4 a,o2 0 5 /t*A r X0 �Q'o,gsee L,
12128104

r
:. w _: vistan Qi Water Onahty
lType of Visit iZrCompliancelnspecdon O Operation Review O Lagoon Evaluation I
Reason for Visit ,�Routlne O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: to / G Time: y
Facility Number
0 Not Operational Q Below Threshold
AwermittedA3 Certtifieed 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: _.
Farm Name: ...1�J �.:7til.�t ` � 11..... -.'n .................. ............ _ ........ County: , L,t'Y� ............. _ . ...� _.......
OwnerName:........................................................................................................................... Phone No:............... _.. .... _._ ........_.__..� ._.. .
Mailing Address :.......................................
Facility Contact: ...... __ Title: Phone No:
............
Onsite Representative:. Q[, CA � �. .. Integrator:
Certified Operator:
Location of Farm:
Operator Certification Number:.......... _.._...... .-----
06wine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 " Longitude • 4 66
a
Destgo `" Current Desigan Current , & llgn Cureitt
Sw_ ine Ca act
x
Pi
ePo�ulahon _ Panitiy _-Ca' 'ei Po ulatton .e.7Cattle -.__. Ca" Po illation
can to Feeder
5-00
❑ Layer ; ❑ Dairy
El Feeder to Finish
❑Nan -Layer u ❑ Non -Dairy
El Farrow to Wean
Farrow to Feeder
. ❑ Other. a ,
_ _ e
Farrow to Finish
i0 �SI�wG'1pSClt; "
Gilts
' r
El Boars
Total SSLW:� e
Dischanes & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes �io
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. if discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes eNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 0"No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes )21'No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............,.._ .... ............. ......... ............................. ..... ............................... .....................
Freeboard (inches):
12112103 Continued

Facility Number: — Date of Inspection 1 4
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes LRrNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes EINo
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancetimprovement? ❑ Yes ,rNo
8. Does any part of the waste management system other than waste structures require maintenancerimprovement? ❑ Yes ONo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ; No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 014o
I I- Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes E'No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type fz&12NU/y0L fA
13. Do the receiving crops differ with those design—ave the Certified A ' Waste Management Plan (CAWMP)? ❑ Yes 2 No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ofio
b) Does the facility need a wettable acre determination? ❑ Yes 0No
c) This'facility is pended for a wettable acre determination? ❑ Yes ZrNo
15. Does the receiving crop need improvement? ❑ Yes VWo
16. Is there a lack of adequate waste application equipment? ❑ Yes eNo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes �No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 2"No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes Eno
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ClNo
Air Quality representative immediately.
>C(inoments (refer to question #) Explain any, Fses aid%rany reramm_endatoas or anyoher cooe
mote
UFieldopFinalse wings offeiLtytbpf
sagN`
-^'+
- r..a- = Ts _ ...- - - ... v
f is .a-a-�- -""'� �• w-..: »,w--aw»»».
eose
" �0(7C/
farm ��s ire ood �h� ccn
Ll
Reviewer/Inspector Namer
Reviewer/Inspector Signature: Date: Q
I2112103 Continued

J
Faoility Number: Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes .KNo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.) ❑ Yes ❑'No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑oNo
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
24
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
call o
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
(iel discharge, freeboard problems, over application)
❑
(�To
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
O*No
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ 4o
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
P-So
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
; ' o
3I_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
12112103

... er iviston of Water Quality
O'Divisiowof Soil and Water Conservation
O'Other Agency
Type of Visit O Compliance Inspection O Operation Review Qfagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: Time,16 -C7
Z
Nat O erational OBelowThreshold
U Permitted O Ceertified O ConditionallyyCertified ©Registered Date Last Operated or Above Threshold:
Farm Name: 1. f ��V,_y Ri (( Fa ra...,_ County: [hl �»��1�
f � Owner Name: P4! e 1 t 4 ne., Phone No:
Mailing Address:
Facility Contact: Title: Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 Du Longitude a 6
Design Current
L`SWean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑Dai
❑ Non -La er I I ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Subsurface Drains Present 11" Lagoon Area
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a_ If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c- If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Feehoard (inches):
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued

�3
Facility Number: 2 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or mananed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ 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 ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ 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 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? (iel 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 notifi regional DWQ of emergency situations as required by General Permit?
(W 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
© No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
a Y� da
Goatmebts (re%r fo goestson �). 'Eplain%any ers an sn o mm n ti as
, :, =
Use drawings of facdtty to better ezplsia sitnahotts. (use addtttanal pages as neary) 0Field Copy ❑ Final Notes ='
r
4t Od/'1 -51? eo77 e /(O -�
Reviewer/Inspector Name e -r ==
- —
Reviewer/Inspector Signature: Date:
05103101 4y f Condnued

Division of Watei uab `�
Q ty;
0 Division of Soil and Water Conservation
a ;
Other„Agency.. y
Type of Visit P Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for VisitP Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number
Date of Visit: Time:
Not Operational QBelow Threshold
Permitted E3 C 7
rtified [3 Conditionally Certified 0 Registered Date Last Operat or Above Threshold:
Farm Name: �r t /11 County: WI':7tj
Owner Name: —F r� l! ZF� G rOF� Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: 7�
Location of Farm:
Phone No:
�RFEn��.r.�-ti ��D�►�PD
Operator Certification Number:
J�5wine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 0` 0" Longitude 0' ` 0�
Design Current
Wean to Feeder (o470
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Design Current Design Current
Poultry CapacitV Population Cattle Ca acity Population
❑ Layer FE
Dai❑ Non -La er Non-Dai
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ S rav Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Im acts
1. Is any discharge observed from any part of the operation? ❑ Yes '0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes A No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment/XNo
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): 3 Z'
05103101 Continued

Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
I I - Is there evidence of over application? , , q Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Croptype _,jD6P1y)u1)A t l-tigV 1 J�A/a /rK�-zeal 1d-VtZSfJ
13. Do the receiving crops differ with those designated in the Certified Animal Waste Manatement Plan (CA
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?
Rewired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
B. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes 10 No
❑ Yes FfNo
❑ Yes No
❑ Yes No
❑ Yes �No
❑ Yes "No
❑ Yes XNo
❑ Yes 5NO
❑ Yes / No
❑ Yes No
ElYes N
o
El Yes
❑ Yes XNo
❑ Yes YNo
❑ Yes N No
❑ Yes ANo
❑ Yes XNo
❑ Yes '�INo
❑ Yes O No
❑ Yes jzfNo
❑ Yes �fNo
❑ Yes XNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments;("refer to_questton.#� E pliiW,any YES answers;and/or any reconrmendabans of<any outer comments F , , i
Use drawings of factlrty to better e :Al
plain situation"sf:(ns`"eR`addrhonal.pages as:neCessary) t' Field Copy ❑ Final
�t Notes
J . .. •,� 4 .
15 pNfz�►1c/F �o 1�U4.Pk �NS�,q��2S/�JG ��,enl clU,¢�T
4,e.6+5
48
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number. `j — 2 Date of Inspection
dor 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?
��F � �r1�i9� �i�/11 � �✓ �vo �� �z >z� .tJ
❑ Yes U(No
❑ Yes . No
❑ Yes No
❑ Yes XNO
❑ Yes ,�_Q[ No
❑ Yes No
El Yes /❑ No
05103101

N
Type of Visit oCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ORoutine O Complaint O Follow up O Emergency Notification O Other I ❑ Denied Access
Facility Number 31 Z Date of Visit:
0 Permitted 13 rC'ertified 0 C
onditi
onally Certified [3 Registered
Farm Name: �! t...:!.'.�'.fear!`!.........................
OwnerName:........ 'PQt...................................................................
FacilityContact: .............................................................................. Title:.........................
Mailing Address:
Ol Time; 9.5
Not Operational O Below Threshold
Date Last Operated or Above Threshold: .........................
County: / r�
�o............................................ �.
PhoneNo: ................................................ . .................... . ........ . _..
Phone No:
Onsite Representative:. �� 44 ► e � i pL"' Integrator:'rl!Y.
/ .�` }..��n��CI-!:.d .....................
J•-.. ................U......-...............................................
Certified Operator: ........................................................................................ Operator Certification Number:..........................................
Location of Farm:
❑ SwIne ❑ Poultry ❑ Cattle ❑ Horse Latitude ram• �` " Longitude • 4 64
Design, Current
f'anacity Pnoulation.
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Gilts
❑ Boars
Design . Current Design: '. Corte
Poultry 'Capacity Population-, Cattle Ca ac � w ulai
❑ Layer I❑Dairy
❑ Non -Layer 1 1[3 Non -Dairy
❑ Other
Total Design Capacity
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: ❑ 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/rnin?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ........... .J.................... .................................... ........ .................... I......
Freeboard (inches): 39
5100
❑ Yes fNo
❑ Yes ZNo
❑ Yes fa'No
n l4
❑ Yes ONO
❑ Yes [�f No
❑ Yes _13=No
❑ Yes _Q44o
Structure 6
Continued on back

Facility Number: 3 / — 2 Date of Inspection ,
i 5: Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type & f v`1 tad q lyc1 t, Grq " h
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?
Re uired Records & Documents
17, Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21, Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
1Q YioipkWijs .or, deficiencies were poled ditt`ing this;visiti You wiij teeerye ij6 furl tgr ;
correspondence about this visit.
:to`tietter exobain situations (iise additionalua�es'as necessar'v) �-:'.
❑ Yes, !fNo
❑ YesEl—No
❑ Yes _Jallo
_ErYes ❑ No
❑ Yes ffNo
❑ Yes EfNo
❑ Yes �No
❑ Yes ONO
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
_01(es ❑ No
❑ Yes ,EfNo
❑ Yes EfNo
❑ Yes _' to
❑ Yes ONO
❑ Yes ZNo
❑ Yes 'WNo
❑ Yes ONO
❑ Yes [2No
❑ Yes J2'No
❑ Yes j'No
A.
IS• Somme a,-eas o- _ be,-"tudc, .gelds Fw4 s; ;/, c4n1 work c6re4o el:,.��'.+af�
na�ber�lvdrt v��e f�6h �naf � � es �i�S�, bel'.iudel
the re toms A/e rlaq¢/7 keff , .
Reviewer/Inspector Name
Reviewer/Inspector Signature: e m4t& Date: 713/�a/ 5100

Facility Number: 3/ — Z Date of Inspection 3'
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor 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 _[a -No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes-,dNo
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 -dNo
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 J 'No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ZNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
tro -omments andfor rawings:--
5/00

Division of Water Quality
Division of Soil and Water Conservation
0 Other Agency
Type of Visit Tcompliance Inspection O Operation Review Q Lagoon Evaluation
Beason for Visit A Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
FFacility Number
Date or visit: ®'rime: © Printed (on. 7/21/2000
7-
.,. .1 0 Not Operational 0 Below Threshold
Permitted l] Certified [3 Cond1it{i1onally Certified 0 Registered Date Last Operated or Above Threshold
Farm Name: ��c ... ..VAl\.... A 0,— y .............. �....... I---..... County........ IN....................................................
Owner Name: ...:.:..................... . . . . Phone No:
------------ ------------------------"-------------------------------------- --"
FacilityContact: ....................Title:..............................:................................. Phone No: ...................................................
MailingAddress:......................................... ........................ ............ I ......................... .......
Onsite Representative: __.. Integrator:... ,; (J i+ - d
r..... .. ....
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude '°° Longitude �• �� ���
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
Wean to Feeder (,00 ❑ Layer I ❑ Dairy
❑ Feeder to Finish JE1 Non -Layer I I JEI Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts Ej
❑ soars Total SSLW
Number of Lagoons JE1 Subsurface Drains Present D Lag -on Area 10 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? ❑ Yes N(No
Discharge originated at: [-]Lao, ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If dischar!-,e is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes ❑ No
c. II' discharge is observed. what is the estimated floxv in gal/min`'
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. is there evidence of past discharge from any part of the operation? ❑Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes qNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes P5No
Structure I Structure 2 Structure 3 Structure -I Structure 5 Structure b
Identifier: .................................... .................................... ................................... .....................................
Freehoard (inches): a-
5/00 Continued on back

Facility P:�mber. —�'� Date of Inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes XNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes tXNo
(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 CKNo
S. Does any part of the waste management system other than waste'structures require maintenance/improvement? MYes ❑ No
9. Do any stuctures lack. adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes MNo
Waste Al2elication
10. Are there any buffers that need maintenance/improvement? ❑ Yes JZNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes JoNo
12. Crop type S
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 91 No
❑ Yes J4 No
❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
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?
Oe/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
....yioiafigzis.. deficiencies were noted d>rring �his:visit; 'You will receive Rio further
�orresb6iident' e: a a ' this' visiti :
❑ Yes ❑ No
MYes ❑ No
❑ Yes XNo
,ryes b<No
j(Yes ❑ No
❑ Yes 5'No
❑ Yes ONO
❑ Yes KNo
Comments (refer to question#): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
❑ Yes ONO
❑ Yes L2-j'iV0
❑ Yes 4 No
❑ Yes ONO
Voa,_� hie 4-e t-{�PFj eel 4- A.S- s►�.11�-������ LZ ►-���t��� mil_,.
:e `--. �-w ,.-�c� ��~ ►tee-�d.r� � � tt�
•te�-
Reviewer/Inspector Name CIP _77S 3_ �GQ 'Xr-0-ac-
Reviewer/Inspector Signature: �_—' Date: 6 4 9 -co 5100

'Facility Number: -- 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 Ador below ❑ Yes �INO
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes bNo
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? ElYes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) _ ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑'Yes J�No
Additional Comments7and/orDrawings:
`
-�-e�� -�—�► '1� �c�� �- cam.,, �,r.�j�� Q �-3 �2e�s
AU L��3
S R Vy cl,� �r— 5e 054 �Q
a �— 41
^^
I
1
5100

:: 1 D�s3stan of Water 1 u
of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other
❑ Denied Access
Date of Visir. 10-1$ 2000 Time. 930 Printed on: 10202000
Facility Number 31 G2
0 Not Operational O Below Threshold
Permitted MCerfified E3Conditionally Certified E3Rebistered Date Last Operated or Above Threshold:
Farm Name: ] ckaxl. Tell i am ................... _.......... ......... ................. _........... ....... County: Auiiiia.................................... 3?4M ...._.
Owner Name: &.a ie----------•--•--------•--•- jujap ,te_._----•--_- _._------------- Phone No: MzZ.$4222- -- - -- - -- - -- - -- -- -- -- --
Facilih7 Contact- - - -- -- -- - - - -- - -- -- - -- -- -- -- -- -- Title:. -- -- - -- - -- -- -- -- -- - -- -- - Phone No: - - - -- -- -- -- - -- - --
Mailing Address: 1044 LN man.Rd.............................................................. ....... .......... .... 01JU41 lodix.-NC....----.......................•..._.............. 28521 ..............
Onsite Representative: Qumct.................................................................... Integrator: DQ=o9Ayar.......................................
Certified Operator. rt,Ae Operator Certification Number: 1231E
Location of Farm:
South of Beulaville. On East side of SR 1801 approx. 1.2 miles North of Hwy 111 and Lyman.
T
DischarLyes & Stream Impacts
1. Is any discharge observed from any part of the operation? Yes ® No
Discharge originated at: ❑ Lagoon © Spray Field [l Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes El No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) -3 Yes 0 No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes [l No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [K No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? (l Spillway D Yes M No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......... ...._.............................. . . . . .. ...._..- ..._.._.._.._
Freeboard(inches): -- -- -- --42-- -- - -- - -- -- -- -- - -- - - - -- -- -- -- -- -- -- - - - -- -- -- - -- -- - -- -- -- -- -- -- -- - -.._ .. -- - -- -- -

UV
FaciUty Number. 31-6_ Date of Inspection 1U-18-2UUU Printed on
5. Are there anv 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 swctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application? ❑ Excessive Ponding []PAN ❑ Hydraulic Overload
12. Crop type Coastal Bermuda (Hay) Small Grain Overseed
(_0111112l(Ct i;I, n(l'.'r
10/20/2000
❑ Yes
Z' No
❑ Yes
i13 No
❑ Yes
X. No
Yes
❑ No
❑ Yes
9 No
❑ Yes
®No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes I& No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes [:] No
15. Does the receiving crop need improvement?
16. is there a lack of adequate waste application equipment?
Re uired 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? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/'inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
No violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
9 Yes ❑ No
❑ Yes X- No
(:]Yes [R No
N Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes 91 No
❑ Yes 0 No
❑ Yes ® No
❑ Yes N No
❑ Yes ® No
8: Moderate leaks at 2 fans on both houses need to be repaired & sealed ASAP. Smaller foundation leaks should be
repaired as well. Corner of House f#1 (backside) near lagoon has major crack that needs to be filled & repaired for
stabilization & leak stoppage.
15. Field with waterway could use some improvement. Soil test indicates need for over 1.5 tons/ac of lime. Lime needs to
be applied for amounts over 1 ton/ac. Grower should try to concentrate applications to best bermuda field early in year &
mow other field every 2-3 weeks to minimize competition. Also, fields may benefit from only overseeding i field each year &
alternate years if lagoon in good shape'by mid -October. Suggest 1 soil sample for each field not just 1 for entire farm (Rule
of Thumb — 1 sample for each field/10 acres). Cont. --->
Reviewer/inspectorHame Dean Huttkele 395 39{iQ X-22b ....:.

f I XV I[, 1, cl, t u�t PULtR It Of'-Ila LUI C. Ualc: 7. IIU
FBCtuty Number: 31-62 Date of Inspection 10-18-2000 Printed on: 10/20/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes 09 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 9 No
28. Is there any evidence of wind drift during land application? (i_e. residue on neighboring vegetation, asphalt, ❑ Yes 9. No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? - ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) - ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 09 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Q Yes 0 No
B. Need copy of lagoon design in records.
I, records in good shape —just need to add the lagoon design.
No copy left on -site — copy to be trailed to grower within next week.

Division of Soil and VYati Conservation Operation Renew - f
Di -'on of Soil andWateKCo ervatEnn Comphance ectaoa f z
®Division of Water Qualtty Cam Lance` Ins`' ecdon'
J3 Other Agencyr Operatiofl Review . ` _� '`'
0 Routine O Com faint ® Follow-u of DW ins ection OFolluw-up of DSWC review Q Other
Facility Number 31 Z Date of Inspection 2 2 00
Time of Inspection SO 24 hr. (hh:mm)
© Permitted ❑ Certified Q Conditionally Certified Q Registered JEJ Not O erational Date Last Operated:
Farm Name . G IC a ri.....�.?..!.1'._..Fa.I'+a1................... County: L"o I.!. ......................................
Owner Name: „..................... T� .7��n ............. Phone 7Vo:
Facility Contact:..---•...................................................................._..Title:.....................-----.. Phone No:
MailingAddress: .................................................................... . ..... .
Onsite Representative: •„•,,, v� le Tjl ; q e h Integrator: �,,.ao ar'''`l _......................
....- .............. J--..................... b ........0 w ......�.
Certified Operator: ................................................ 1. .. .................... . .......................... ............ Operator Certification Number :.....................................
Location of Farm:
Latitude Longitude
Design Current
Swine Caoacitv Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts.
❑ Boars
Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer 10 Non -Dairy
❑ Other
_ ._ _ - = - _ • _ =- _ Total Design Capacity
- - Total SSLW
'.'Number of Lagoons ❑ Subsurface Drains Present Ho Lagoon Area ID Spray Field Area
. Holding Ponds / Solid Traps = ❑ No Liquid Waste Management System
Discharees & 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 DNVQ)
c. if discharge is observed. what is the estimated flow in gal/min?
d. Discs discharge bypass a lagoon system'? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure ? Structure 3 Structure 4
Identifier: !
Freeboard(inches): .......... 1...................... ........................... ._...................... .......... ............... _._....
❑ Yes ❑ No
❑ Yes ❑ No
[]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 10 No
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion,
seepage, etc.)
3/23199
❑ Yes ❑ No
Continued on back

FUZ"AY �N fiber: Date of Inspection 121 Z q Oe
6. !rAre there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7, Do any of the structures need maintenancelimprovement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ 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
I8.
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
(0 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
�' pia-*Whtigtis'ei def ciencie5 wtgre noted ilunng �his.vpsj t, • Y:oj.} wiil-receive do fui•tlter
corrt:s oricXence a�atit this visit: ...... .
Comments (refer.to ,quesfroti #) Explain any YES answers and/or any recommendations or any other comments Use drawings of facility to better explain situabons�'1" a addxhoa pages i. necessary)• � _ --
1r,sPGc (row co�duG{cnf q s �ollecv - �� �o 4 k e- r"c.cehi 'DLei Q insfeC4, o ns
1-0 �a:r •�-�ar2 ,+1s,'Shf intro recent oftsc►1��geof wasfeg4 44e6ac;4 .
Reviewer/Inspector Name .5-4-0 ►tiGW eii il- =�'t q �`kcS '
Reviewer/Inspector Signature: Zi Date: '% QQ
3/23/99

Facility Number Date of Inspection
Time of Inspection F/4 10 24 hr. (hh:mm)
0 Permitted © Certified [] Conditionally Certified 0 Registered 0 Not O erational Date Last Operated:
FarmName: ..................... + G o.r...... N'.1 /... Va r._.................................... County: ...............................................
OwnerName: ...... Q.19...+.e.................... .�h..'. e......... Phone IVo:......................................._.............................................
Facility Contact:..............................................................................Title: ............ Phone No:
MailingAddress: ................................................ .......................................................................................................................................................... ......................�..
Onsite Representative: .. -
,.RC ,c Th, e� iC�c�or�, 'Ici•���Inte6ratar• ............ �� ivooOr, ��,�'"'-s
Certified Operator:
Location of Farm:
Operator Certification Number:
Latitude 0 6 •1 Longitude • 1 44
Design Current
Swine"' Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Design 'Current :.._ ; - _ Design Current
Poultry ' = Y';; Capacity Po ulation Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer I I I[] Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
!Number of Lagoons _ ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
. a
Holdi4 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. Ir 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?
,V:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[:]Yes ❑ No
1Z Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 0 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): .......��.................. .................... -........ .............
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion. Cl Yes ❑ No
seepage. etc.)
3/23/99 Continued on back

Facili v Number: 3 � — 0_ Date of inspection
�6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7, Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
28 zoo
❑ Yes
❑ No
❑ Yes
[:]No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
[:]No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? []Yes []No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0' No yiolatioris'oi• &ficiei3cies wLere noted- di[Wing this•Visit'. - Y;oir will-teceiye Rio: fufther
correspondence.abvut.thL'S visit
[]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
Comments (refer to'quest<on #) Explain any YES answers andlo� any recommendations or any other comments - -
„ ,,;
Use drawings of facility to better explain situations. (u`se additional pages as necessary): w
�n s��G{`o� c,ondvG}eot as a-o'ollow-v�
i¢.6�.�= -peo0% .2/26/2o00.
2- WGS4-edsf,
g4kcfesi ;,Ie{4"- ` W-,v �P, 4c s��w�f�ejd ad�Gc'nt -}o pull 3-4
4,-,,C' o(vel- vq Ae z/i5� Oo 51veg7 evenq v,C S;X ovl 41-,e
re�rrec,ncM fu11 ►'j7�.T11 �loc� a(�Scrvcd Fh;s nod �'n�iGq��cl F4�s to me
f a,,ded t-,c,s4e Was o6,­,veA oL4 -the. 4^d a-F 41,e w�► e.,rwo�,%. Two 61oG Ls
{ - -e, G o,, s4 o (,+ad, 4 o � C o � 1 a � h {..�o. � E� . of .i e ✓ �r i t.✓ � S-t� Lt a d d r' re�a r
fo c/e4le, Y+a(lwoodS afea got jaczV4 -�a SP"i A. 7 A v;sesd T4 /0en
Reviewer/Inspector Name Sao V1 e t-rl q l.1 _;_ � �� S
Reviewer/Inspector Signature: , !y l,r ✓ Date: '7 O O
3123199

Facility Number: 3f— (a Z Date of Inspection 2 2 Qp
00dor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes. ❑ No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes ❑ No
31. Do the animals feed storage bins fail to have appropriate cover?
❑ Yes ❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments an or_ rawings
1 3
2.�Gan+� 'to YIO� S�ray e��•�e��-lL� Over• h�-.f i,�1���✓'tv4'9
at''td(
e�'t�v�C
�
a �oad 54,q I nF
rerur,re,vtce o-E ={%,-e
vec?e�l�c�;oh ►'+-t - e 1,v44e.^1,.,f4�
J e r✓tG;ete►'I+. L)o,-fier iva'►;
�
�tev"eni
set�eeS
and � i,+,Ires were
�a
3/`' 3/99

DiVW.6n'of Soil and Water.Coniservation Operation - Division --Compliance, uspectio of Soil and ConservationInspection
ARce'Inspection ofWaier Quality i�oiu'lia s p Divi'ion
0 Other -Agency' -Operation -,Review"
�
QRoutinc OComplaijit_OFollow-tipof])WQins cction 0Follow-upofDSWCreview 00ther
Facility Number Date ol'Inspection
r Time of Inspection 24 hr. (hh:m
E3 Permitted Certified E3 Conditionally Certified E3 Registered JE3 Not O erational Date Last Operated: ..........................
Farm Name: Countv: ..... .4t .................. ........ ........... ......
.... I �.r ri .. .......... ........ ........ .................. * ...
Oivuer Name: ................... 4-n ........................................... Phone No: . IqIO\
.......... 741 ...........................................
FacilityContact . .............................................................................. Title: ................................................................ Phone No: ............... ...................................
MailingAddress: .......... 0.44 ........... . . ..... Xd ..................................................... ......... 6.0zxVVVf 1,6 .... ............................ ..........
Onsite Representative:............
...... 11c, 41- ............................................... Integrator: ....... Nv� ...........................................................
Certified Operator:. ............... . Operator Certification Number:.... f.731(7 ......................
Location of Farm:
........................ job ..... CAA-_.Vj2......C........I." .................................... .....................................................
Latitude Longitude
Design Current
t-apacity
Wean to Feeder 6L 6n
E] Feeder to Finish
E] Far -row to Wean
[] Farrow to Feeder
C] Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
JE] Layer I I Dairy
J EI Non -Layer El Non -Dairy
I[] Other
Total Design Capacity Do
Total SSLW
Number of Lagoons I FE—ISubsurface Drains Present _❑ Lagoon Area JE1 Spray Field Area
Holding Ponds / Solid Traps FE—jNo Li(luid Waste Management System . . I
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: [:] Lagoon [:1 Spray Field El Other
a. If discharge is observed, was the conveyance man-made?
b. II' discharge is observed, did it reach: E] Surface Waters [] Waters of the State
c. If discharge is observed. what is the estimated flow in oat/min"?
d. Does discharge bypass a lagoon system?
2- Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & 'rreatinent
4- Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard(inches): ........... 7-.i........ I ........ .................................... ....... .. .............. I—' .......... .............................
El Yes 0 No
El Yes r No
El Yes P9 No
[I Yes' No
D Yes No
El Yes IF] No
El Yes 1;M , No
If
Structure 6
1/6/99 Continued on back

Fac$itp Ptumber: 3 — 62— Date of Inspection 2/L _
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, �`❑ yes �] No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? Yes ❑ No
S. 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 top of dike, maximum and minimum
liquid level elevation markings?
❑ Yes • ® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
64 No
1 1. Is there evidence of over application? ❑ Ponding ❑ Nitrogen
❑Yes
No
12. Crop t e ] ........... .......................................................................................................
P type �3�.�4m.tll.....................Stre��....t YA*......_.........................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. Does the facility lack wettable acreage for land application'? (footprint)
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
® No
16. Is there a lack of adequate waste application equipment?
❑ Yes
[A 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.)
[P Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
jA 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 certified operator in responsible charge?
❑ Yes
No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ 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
0 N.o:violations;or. defciendes :were noted: during Ois.visit:... u will:re>rei . e nQ iuriiiei- :::: :
eorrespo�ideitce; about; this ..visit.:.: • . • : • : • . • : • : • : • : • ..:.::.::::::::::::::.:: :
Comments (refer to question#): Explain any YES answers arid/or any. recommendations or any other. comments - ,
Use drawiti s offacility to better ex laimsituations. use additional pages.as n-eciissa _
1. I�o„•c. wt,i~� or o,.kr 1�]i14wtrl� e{' �a�oor.. Si1iw��t]
tvpp. gStbf� �QSi�ti- SLwLi� 6 i;r- 4,►-ft, YtCVA.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
1 /6/99

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
10 Routine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other 1
Date of Inspection I x ()-I LE .
Facility Number
Time of Inspection EK= 24 hr. (hh:mm)
© Registered OrCertified 0 Applied for Permit [3 Permitted JE3 Not Operational Date Last Operated:
FarmName:..... ...1. `.\...1-�............................................... County:.................................................'.......................
w y �\ e........Phone No: CCU �- l0 ..' C �
Owner Name:....... k1\` ................... `� ... L �.
Facility Contact: ...................... ....................................................... Title:..................... . Phone No:
Mailing Address:..1... ....`........Y! .................. t 1 - ?11--t �........��aA............................. ....... ..... ..........................
Onsite Representative:..O�!.I.—. . � ,p.Q.�A........................ I......... Integrator:..! ��..�`3''�........................................
Certified Operator,.................................................................................................. ... Operator Certification Number;.
Location of Farm:
..... j y.. ........... 4 ........................�...............................................................................
.
Latitude 0 4 " Longitude • 4 66
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes ONo
❑ Yes M No
❑ Yes No
❑ Yes No
❑ Yes DINo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes j[No
❑ Yes K3 No
7/25/97

i
+ Facility Number: —
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
C�No
Structures (Lagoons.Holding Ponds Flush Pits etc:
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
0 No
Structure 1 Structure 2 Structure 3 Structure 4
/
Structure 5 Structure 6
Identifier:
Freeboard(ft):.........3.!5� ....................................................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
M o
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
9No
12.
Do any of the structures need maintenancelimprovement?
( Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?.
❑ Yes
❑ No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
MNo
(If in excess of , or runoff entering waters of the State, notify. DWQ)
15.
Crop type ......... f.. s�......................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
'1�1 No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the receiving crop need improvement?
Yes
❑ No
19.
Is there a lack.of available waste application equipment?
❑ Yes
%No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
ONo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
JK No
22.
Does record keeping need improvement?
Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
5No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
1 No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
No
No.violations;or. ddidencie's.were.i;oted,during this.visit.- Yo"U4411 i6cei i�eiko:furttier"
eorres066dence about this:visit:- .
%\go— ill tie
�� ! / � � \ �\ `� ,�\ ���� �•e�A 1 r ���� \, �`""C. �� f � I l aim �V`j J � ��1
,�c)LN4 Ao
f Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:

Y y4
❑ DSWC Animal Feedlot Operation Review��3
F a] DWQ Animal Feedlot Operation Site Inspection_
a
® Routine O Comnlaint O Follow-uo of Dt' O inspection O I allow-uo of DSWC review O Other
Date of Inspection ID 1-+ 7
Facility Number Z
Time of Inspection �24 hr. (hh:mm)
g i� pp © Not Operational Date Last Operated: © Registered Certified ©A lied for Permit (� Permitted
Farm i.,.. Frtr- .................... County: V1t+�.................... ..............................
Name:
4
OwnerName:p.......!, 0ee......... .......................................................................... Phone No:..i!g. A..zu-..q.in.............................................
Facility Contact:
1c.tf
Mailing Address:. J9.q!i.... �-juhGa►y..{...PA .......................
OnsiteRepresentative: .... -C.......1h!.�t�th................
Certified Operator ,....,,..�...�
Location of Farm.
Title: L)4Wro.i ....................................... Phone
CW
...........................................V.k-J(...........................................ZB S.. t.......
........................... p Integrator:....... 04................_.........................---...---........
.......................................... Operator Certification Number ..........................................
y.... l...nar.l1+..:.... ........ i,{'r►r1a ` xra..�:.... r. ors.... Al i....�ac�.�4lr�.. A+......y�a�.....4a�rxa...l.�.F.f........
...arm- ........ ..:...A...rn+.lC.._._..ar....... cosk..... S.tAG.....Cr;. �t�.........................................................................................................
Latitude ` i " Longitude ' 4 "
Design Current Design; Current Design Current"
Swine Capacity Population Poultry Capacity Population Cattle Capacity. Population
Wean to Feeder sj, ❑ Layer JE3 Dairy
❑ Feeder to Finish IQ Non Layer I I I IE1 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
El Boars Total SSLW
Number of Lagoons / Holding Ponds ❑ Subsurface Drains Present JIO Lagoon Area 10 Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes No
Dischar-e originated ar. ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. Ifdischarge is observed. did it reach Surface Water? (If yes. notify DWQ)
c. If dischar«z is observed, what is the estimated floe.• in -al/min?
d. Does discharge bypass a lagoon ,vstein? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback Criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7125/97
❑ Yes 0 No
❑ Yes
P No
❑ Yes
No
❑ Yes
No
❑ Yes
ERNo
❑ Yes
-RNo
❑ Yes
El No
❑ Yes
UNo
Continued on back

Facility Number: — GZ
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,Iiolding Ponds, Flush Pits,_etc.1
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2
Identifier:
Freeboard (ft): ....... Z-q..
10. Is seepage observed from any of the structures?
Structure 3 Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes ® No
❑ Yes ® No
Structure 5 Structure 6
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste A�pliration
l4. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crap type .... ..barv.w jv .............................---.............1Y1VI ................st1l.Ply %......................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement'?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No- .viol ations or deficiencies. were' n6ted during this'visit..You:will receive no' further
. c6rrespondence about this:visit.-
„ _.
❑ Yes Callo
❑ Yes 91 No
XYes ❑ No
❑ Yes W No
❑ Yes K No
❑ Yes [I No
❑ Yes {g No
WYes ❑ No
❑ Yes [9No
❑ Yes 91 No
❑ Yes No
{Yes ❑ No
❑ Yes ® No
❑ Yes 10 No
❑ Yes bg No
1I_ _.&M crXtCL oVX laye, wafts si,&Q be vv%Wd. 5 6ros.1m, cots w, ot1tu- "« skevld Le- AJLJ wlk—
t�ltry � w,tStet)fJ,
I,Z. �1 YtiCcx�S Sh�sl(1 iaaf 1�Pftd w°Tl�-GafYt� �t�� •W�lri�bti 1'1u�t�% Ufl�tc� �l
r� wns� sor�.l,tL �.►�al�kc sl�a.;� �oe +�. ���,,••
7/25/97
Reviewer/Inspector Name — -
Reviewer/Inspector Signature: f 1 Date:

Facility Number: 3( - ( Z
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date: g " Zo—.Q (,
Time:.
General Information:
Farm Name: tv,, r /�IQW'l County:
Owner Name: .< < En) phone No:�Y-'15 21
On Site Representative:_ j�,�,'� ice, Integrator:
Mailing
�fr� - FA,W KQWW
Operation Description: (based on design characteristics)
Type of Swine No. of AnintaLs Type of Poultry No. of Animals Type of Cattle No. of Animals
❑ Sow ❑ Layer ❑ Dairy
P[Nursery ri G 00 ❑ Non -Layer ❑ Beef
❑ Feeder
OtherType of Livestock Number of Animals:
Number of Lagoons:_ (include in the Drawings and Observations the freeboard of each lagoon)
Facility I ection:
Lagoon
_
Is Iagoon(s) freeboard less than 1 foot + 25 year 24 hour storm storage?:
Yes
Nam
Is seepage observed from the lagoon?:
Yes ❑
No Of
Is erosion observed?:
Yesq
No ❑
Is any discharge observed?
Yes ❑
No9f'
Q Man-made 0 Nor Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Yes ❑
NoW
Does the cover crop need improvement?:
Yes ❑
NoZ
( list the crops which need improvement)
Crop type: %6CcSk aL Acreage: /0
Setback Criteria
Is a dwelling located within 200 feet of waste application?
Yes ❑
Nob
Is a well located within 100 feet of waste application?
Yes ❑
No l
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Yes ❑
No C;
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream?
Yes ❑
No
AOI -- January 17,1996

Maintenance
Does the facility maintenance need improvement? Yes (Y No G
Is there evidence of past discharge from any part of the operation? Yeses No ❑
Does record keeping need improvement? Yes ❑ NoO
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes ❑ No (a
Explain any Yes answers: 1J
u
Sismature:
cc: Facility Assessment Unit
Drawin s or Observations:
Date: (9 Z 4 ° 7-1-
Use Attachments if Needed
AOT — January 17,1996

Site Requires Immediate Attention:
' Faciliry No. �1� R3
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE:_ 7-1 , 19911::7
Time:
Farm Name; Owner: i 41I_ I I g157e .IE Wl C��C/il
Mailing Address: y �/ l✓ C r✓rGillA,aT �� Z kSzl
County:
Inter=ator: ^yN/��l_ _ Phone: Sal Z ` ZIy`/
On Site Representative: Phone: A! fj G/9 Z-9
Physical Address/Location:. it M i /1515 /(1.. .gm( 14W t,_I
-_6A-e".taC d ler
Type of Operation: Swine X Poultry Cattle
Design Capacity: Number of Animals on Site:
DF-M Certification Number. ACE DEM Certification Number: ACNEW
Latitude: I trLongitude: " Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour store event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard: 2-Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or(O Was any erosion observed? o or 14,
Is adequate land available for spray? Yes or N Is th over crop adequate? Yes o o Crib
rn J
Crops) being utilized: r �S ; C�"�
Does the facility meet SCS minimum setback criteria? 200 Feet from DweliingsX.for No
100 Feet from Wells? Veor No
Is the animal waste stockpiled within 100 Fect of USGS Blue Line S tre :m? Yes ore9
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes oc
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or (9 If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes or' an�,re,1 d applied,
spray irrigated on specific a-cre ge with cover cro ?Yes o/ No
Additional Comments: A' 14"a� e_ o/i/ .P, /.
r
eel /1 —,.47 cl C1•F'Yd
S f/� a yi•L vt 9 Ty e,4 rG
7-
inspector ame
11
cc: Facility Assessment Unit
41
Use Attacliments if Ne,:ded.

•
f
Site Requires Immediate Attenti n:
Facility No. r 4 3
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: ® , 1995
Time: /�JJ
Farm Name/Owner:
Mailing Address:
County: 1.1
Integrator �� ��Gk� l7 Phone:
On Site Representative:Q" Phone:
Physical Address/Location: e C�
war
Type of Operation: Swine Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude:tiLongitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes r`No Actual Freeboard: Ft� Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No
It Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria?_ 200 Feet from D
100 Feet from Wells?(Yes,6r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flashing system, or other
similar man-made devices? Yes r N If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific
Additional Comments:
with cover crop)? Yes or No
cc: Facility Assessment Unit Use .attachments if Needed_

•
�
1
a Site Requires Immediate Attention: %S
Facility No. �Z
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATION STIE VISITATION RECORD
DATE: JO /g .1995
Time: �/_�
Farm Name/Owner:
Mailing Address:
County:
Integrator.
L
� � s
On Site Representative:
Physical Address/Location:
Type of Operation: Swine Poultry Cattle
Design Capacity:
Phone: rS 7 �
Phone: �7 9
Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: ttElevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes r No Actual Free board t$`�Ft. Inches
Was any seepage observed from the lagoon s)? Yes No as any erosion observed? Yes No
Is adequate land available fo spray? Yes or No Is the cover crop adequate? Yes or No
Crop(s) being utilized:�����
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? e or No
100 Feet from Wells? es r No
Is the animal waste stockpiled within, 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes ON If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specifi eage with cover crop)? Yes or No j� ,jj
Additional Comments: ��1� {4'�i n D
- P 2 *211" e,0�1 --- /n/S 1 +fir Cy r e,i/e, P
_j + 74-i CAP W Nh-� f)ORA-z,) WO Qnl p&fyT b P
Inspector Name
cc: Facilitv Assessment Unit Use Attachments if Needed.

4 CA
Site Requires immediate Attention: W`-"
Facility No. 3 1— 6 2—
DIVISION OF ENVIRONMENTAL MANAGEME-NT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 1 b ' 3 , 1995
Time:
;`
Farm Name/Owner: [v_a r
Mailing Address:
County: V _Pi_ 1
Integrator: L U W _ _. _ _ Phone:
On Site Representative: Phone:
Physical Address/Location:
Type of Operation: Swine Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification 'Number: ACNEW
Latitude: - Longitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste L aJmon have sufficient freeboard of 1 Foot — 25 year 24 hour storm event
. (approximately 1 Foot T 7 inches)6e r No Actual Freeboard: __Z> Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility mcct S (7 -Iainimum setback criteria?_ 'QUO Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made disch, flushing system, or other
similar man-made devices? .Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No A
Additional Comments: (LIP-5IL
�►� �-_ .✓ S
W G_ S Sell ekm ri t. C.� _ _ 0 C 'a ndLil {IL D
C.: V cIA-14-
✓
� v, c1 n s
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
• ANIMAL FEEDLOT OPERATION SITE VISITATION RECORD
DATE: , 1995
Time: Z0
Farm Name/Owner:
Mailing Address:
County: V
Integrator. (_ U/i
On Site Representative:
Physical Addres
Type of Operation:
Design Capacity: %{Q00 dUE-&
DEM Certification Number: ACE
Latitude: 3 `� .. a r2' 3/ „
Number of Animals on Site:
DEM Certification Number: ACNEW
Longitude: *7 7 * _" Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 ho:W7 event
(approximately 1 Foot + 7 inches) Yes Vo Actual Freeboard-* ,� _ Ft. nches
Was any seepage observed from the lagoon(s)? Yes o No as any erosion observed? Yes ot./
Is adequate land available foy,spray? Yes r No Is the cover crop adequate? Ye r No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings Yejr No
100 Feet from Wells?/ Yeshr No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific
Additional Comments: /1
ti
0' 1 a_)1ez_1Al2j:f
Inspector Name
cc: Facility Assessment Unit
with cover crop)? Yes or No
6
Use Attachments if Needed.