310063_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quai

&YAs I I SVL-
ivision of Water Resources
Facility Number ®- (� j 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: GKIko-utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: t{ (tz Arrival Time: Departure Time: County: (I4t Region:
Farm Name: � emu- ._L s t Ccf><t!' f;t- yk1' Owner Email:
Owner Name: 1bVK6 It zX Phone:
0'
Mailing Address:
I I�
Physical Address: JV
Facility Contact: �o s wtt i—u �t'{y" Title: Ph �e TL Q
ip/r0ato�' R
Onsite Representative: [ i Integrator: D °n R S.Qfi2 Ral
��
Certified Operator: vt'1 Q-f tc Certification Number: Z L/L(,? Ce
Back-up Operator: Certification Number:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish 5 3 Z.Q 3 oro
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Discharges and Stream Impacts
Latitude:
Design Current
Wet Poultry Capacity Pop.
La er
Non -Layer
Design Current
Dry Poultry Canacitv Pnn_
La ers
Non -Layers
Pullets
Turke s
Turkey Poults
Other
Longitude:
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
❑'1Vo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
D-N-A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[a<A
❑ 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
E],NA'
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[ -No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[3 110
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili 1 Number: [ - Date of Inspection: "
i
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Q-Nu--❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No � ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z- %
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes EZP6
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes [ [ No
❑ NA
0 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
0 NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes [3'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 BNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [—]Yes allo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): b'(,'�
13. Soil Type(s): 4ta
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Ea -No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes Ec �o ❑ 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?
Required Records & Documents
❑ Yes [4-No ❑ NA ❑ NE
❑ Yes L2 No ❑ NA ❑ NE
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
Q'1`Io
❑ 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
[aJNo
❑ 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
[�No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [3"'No ❑ NA ❑ NE
Page 2 of 3 214,12015 Continued

Facil' , Number: jDate of Inspection: Tul
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes I3 G ❑ 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 L3 "'o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E-Pdii ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes E3 5o ❑ NA ❑ NE
❑ Yes E:I'Wo ❑ NA ❑ NE
❑ Yes [ "qo ❑ NA ❑ NE
❑ Yes Eq-1 o ❑ NA ❑ NE
❑ Yes Ea o
[-]Yes E No
❑ Yes Ef'No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
CommeQ#s (rel[c •,"to question #) Explain any Yj S answers and/or any additional recommendations or anfother ornments. E! IE"
Use drawings of facility_to better explain situations (use additional pages.as necessary).
C�� q10-130? _6ffss1
Reviewer/inspectorName: Phon(qry -�(3 y
Reviewer/Inspector Signature:` (t,ltiYa Date: r
Page 3 of 3 2/4/2 15

—e'Division of Water Quality
Facility Number 3 1 O Division of Soil and Water Conservation
0 Other Agency
Type of Visit jQ-tompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit --0 Routine O Complaint O Fallow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 1d___L_z6 Arrival Time: De arture Time: County:
� e G� �
Farm Name: L � S V 4 -7 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
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
El Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
Other ..�
❑ Other
Title:
Phone:
Ph/one No:
Integrator: �Il�
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: = o [= I [= Longitude: = o = L = 1{
Design - Current DesigCurrent
Wet Poultry Capacity Population. Cattle "Capacity Population p
A
❑ Layer
❑ Non -Layer
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?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures Yep
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes J:allo
❑ NA
❑ NE
❑ Yes M-f4o
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes-Z No
❑ Yes 'J�No
❑ NA
❑ NE
❑ Yes E No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: -3 - 6,_�3 Date of Inspection:
Waste Collection & Treatment
4. Is stVage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
,❑ No
❑ NA
❑ NE
c a. If yes, is waste level into the structural freeboard?
❑ Yes
0 No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier: /J
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
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
Q 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
E]'No
❑ NA
❑ NE
8. Do any of the structures lackadequate markers as required by the permit?
❑ Yes
[2-No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[,_2�o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[3"No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
FeNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of 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
Q No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[2-No
❑ NA
❑ NE
acres determination?
'
17. Does the facility lack adequate acreage for land application?
❑ Yes
ENo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�No
TT
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Z No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Q 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 _[2'No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes © No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of Inspection: —6-1
k�
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA ❑ NE
25! Is the facility out of compliance with permit conditions related to sludge? if yes, check
❑ Yes
[No
[]NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
[�lo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑'No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ,EfNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes �N ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes o ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility, to,better.explain situations (use:additional pages as necessary).;
❑ Yes La -No ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes JZ'No ❑ NA ❑ NE
❑ Yes ffNo ❑ NA ❑ NE
i 3
s
V__c C olraJr /'Le-4i -7L-
Reviewer/Inspector Name: 2y b, � �'-�/ Phone: qL 0 �z ! 6
Reviewer/Inspector Signature: v Date: ���
Page 3 of 3 21412015

Ivision of�Water Resources
aCility Number s Divrsion of Soit,andWater Conservahon�.
�a O;c 2U - �
r. aWO#her Agency
type of Visit: -Compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
teason for Visit: 3a-routine O Complaint O Follow-up O Referral p Emergency O Other O Denied Access
Date of Visit: 3 f Arrival Time: .IX Departure Time: County: �v\ Region:
FarmName: �a��j—�. Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: � ",nk eC— Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Certification Number:
Longitude:
affiffil-I
�*eq�y�wine; ��Ca aciPo W.etPoul Ca acr Psi Cattle" Ca aci Po .
P ty P
Wean to Finish La er DairyCow
Wean to Feeder Non -La er Da' Calf
Feeder to Finish _} Dairy Heifer
Farrow to Wean "^ �' 'Design Current Cow
Farrow to Feeder �D Pool �. ' Ca aci pi±. Non -Dairy
Farrow to Finish JLayers Beef Stocker
Gilts Non -La ers Beef Feeder
$oars IPUIlets Beef Brood Cow
Turke s .
Turke Points -
�- s
t` Other Other I
- Pr
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: _
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes J] No ❑ NA ❑ NE
[]Yes IffNo
❑ Yes j2fNo
❑ Yes ,fNo
❑ Yes P No
❑ Yes �ffNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412014 Continued

Eacili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ZNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 0 No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PNo ❑ 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 0 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ,� No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? YJ
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes &o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes El No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes J�j 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?
Required Records Required Records &Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes &
❑ Yes 6 No
❑ Yes No
❑ Yes No
[:]Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Q No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [� No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E� No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued
❑ NA
❑ NE
❑NA
❑NE
❑NA
ONE
❑ NA
❑ NE

Facility Number: - Date of Inspection:
24"Didthe facility fail to calibrate waste application equipment as required by the permit? [—]Yes �No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ff 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 E!�No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [] Yes dNo ❑ 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.
❑ Yes jEfNo ❑ NA ❑ NE
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
�No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
T
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
ZNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
KNo
❑ 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_ nestiou # • Explain,an YES answers,and/or, an additional recommendations-or�an 'other'coin" �'nts.
� q )•Y y 3' me
Use. drawings of facility. to better explain: situations (use:additional pages as -necessary): :
lsyo z
6/e-3/1y
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: g10�q b 132�
Date: a lS
4l201

Division of Water Quality
Facility Number - 0 Division of Soil 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: Departure Time:
County:
Region:
Farm Name:
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: ) ff Title:
Onsite Representative: —rhD m t_,c �� Tn
Certified Operator:
Phone:
Phone:
Integrator:
Certification Number: Qq* } o
Back-up Operator: Certification Number:
Location of Farm: Latitude:
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
Design. Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current -
Non-L,
Pullets
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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:
Design =;Current,-... °<
Cattle Capacity_," Pop. m
Cow
—Dairy
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[3 Yes Z] No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
fiallo
❑ NA
❑ NE
❑ Yes
ff No
❑ NA
❑ NE
❑ Yes
eNo
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Facility Number: j- Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 32
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ❑`No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes ;2'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 )ET'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes )?I 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 PNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes CR'No
❑ NA
❑ NE
maintenance or improvement?
!`
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes 2TNo
❑ 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 jallo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 7 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?
to
17. Does the facility lack adequate acreage for land application?
❑ Yes V�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes �no
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes 2TNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes Vj 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 ;ZNo ❑ 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 Ff No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P!fNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of Inspection: -j
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ONo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E!fNo ❑ 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 )Z�No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus toss assessments (PLAT) certification? [—]Yes FfNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to property dispose of dead animals with 24 hours and/or document ❑ YesTo ❑ NA ❑ NE
and report mortality rates that were higher than normal? TT
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 tite 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 VrNo [] NA ❑ NE
❑ Yes 4No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes o
❑ Yes WNo
[] Yes 0 No
❑ NA ❑ NE
[3 NA ❑NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of facilitv to better explain situations (use additional naues as necessarv).
Reviewer/Inspector Name: �^ Phone
f\
Reviewer/Inspector Signature: vA Date
NJ
Page 3 of 3
21412011

c
Division of Water Quality
Facility Number - ® O Division of Soil and Water Conservation
O Other Agency
type of Visit: GrCompliance Inspection 0 Operation Review p Structure Evaluation O Technical Assistance
teason for Visit: (Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: IT 1 Arrival Time: Departure Time: County:
Farm Name: gf,4, :T� Reyy_� Owner Email:
Owner Name:
Mailing Address: Y.D.
Physical Address:
Facility Contact: Title:
Onsite Representative: &JAiP�1
Certified Operator: .—Tow,
Phone:
i K— oi k
Phone:
Integrator:
Region:
Certification Number: ;L44 o b
Baca{ -up Operator: Certification Number:
Location of Farm:
Swine
dean to Finish
dean to Feeder
eeder to Finish
arrow to Wean
arrow to Feeder
arrow to Finish
lilts
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -Layer
Design Current
Dry Poultry CaDacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dai Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes �No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[20IN—o
❑ NA
C] NE
❑ Yes
�'No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

jFaciUty Number: - - Date of inspection: nil) I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
JZr No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
ZNo
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): Kil s KIN�
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Ej 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
ff No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
allo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
0 Yes
O No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[](No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[a No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[fNo
❑ 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-No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [Z 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?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes ff No ❑ NA ❑ NE
❑ Yes 2' No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[?1No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
VTNo
❑ 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
E No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
C'No
0 NA
❑ NE
Page 2 of 3 21412011 Continued

Facili Number: 4& 1- Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes [�fNo ❑ NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes Zf No ' (] NA NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey Ej 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 [ I'No NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Yes
E20'No
NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[TNo
❑ 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
f
[!5 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
[7f 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.
0 Yes
[?f No
[DNA
NE
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
[]ErNo
[] NA
NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Yes
[6 No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[%'No
❑ NA
❑ NE
Comments (refer to question ##): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facilitv to better e%Dlain situations (use additional ua2es as necessarv).
Na�x W-04, %'9.0d -
Latoolhs Y -%
Reviewer/Inspector Name: Jln
ReviewerlInspector Signature:
Page 3 of 3
Phone:
Date: 5/ ^f 113
21412011

Division of Water Quality
FaiMit]PNember 3 - ® 0 Division of Son and Water Conservation
0 Other Agency
type of Visit: Rcompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Aoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 3 Departure Time: County:
FarmName: 1SC��}�Vi� �M Owner Email:
l
Owner Name: Noah'-. n
�/� 16 C?C— "'y Phone:
1JC
Mailing Address: P Q. xY p' 1(p �C—LA. LAUtLLE / V C Qk<;D I.�.�
Physical Address:
Facility Contact:
Title: Phone:
Onsite Representative: F AW- 11—AN1 6? , I (r(I G96N
Certified Operator: ACMAS
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
Latitude:
Integrator:
Cert� do Number:
Certification Number:
Longitude:
Design Current Design -. Current
Capacity Pop. Wet Poultry Capacity Pop. Cattle "
La er
Non -Layer
Design - Current
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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?
Region:
Y's (0
Design., Current,
Capicity' ' Pop
Dairy Cow
Dairy Calf
Dairy Heifer
D Cow
Nan-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes JkNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes to
o
❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: -75 jDate of Inspection:
Waste -Collection & Treatment �[
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ry.(, 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: i r�
Spillway?:
Designed Freeboard (in):�
Observed Freeboard (in): : LIP-
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
0 No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify 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
RjNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding 0 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): Z>e 1?- 6�� �C1 E(LCP�
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
9No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
O� No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
KNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Oo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ W UP ❑Checklists ❑ Design [] Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes NE ❑ NA ❑ NE
Q Waste Application 0 Weekly Freeboard Q Waste Analysis Q Soil Analysis ❑Waste Trans ers Q Weather Code
Q Rainfall ❑Stocking Q Crop Yield ❑ 120 Minute Inspections E] Monthly and 1" Rainfall Inspections ❑ Sludge Shy
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: 1 - 3 Date of Inspection: S /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes KNo ❑ 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)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes 0 No ❑ 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 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).-,..
crc>pia� ► 1 1 0611 5 tcuD�( StQu� - N�ic— w1L+- ���u�Id5of
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: -436
Date: 5�����
2/4l20II

Division of Water Quality
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
rype of visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Ntoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 110� Departure Time: County: L!/V Region:
Farm Name: J SC_AM L� 1Pi� (Z AA Owner Email:
Owner Name: �j- �(}� 5 i HI G(2EA1 Phone: ,,- 16 —3o9'�?y
Mailing Address: �. G . 'VOxx j1 LA(_ Q,)LCC- ,%U C
Physical Address:
Facility Contact:
Title:
Onsite Representative: SMITH
Certified Operator: I i f (o M Q 1 ,41 c OF—)
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
Latitude:
Phone:
Integrator::
CeLflicati n Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Canacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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:
09y1-r3�
Design Current ,� I
Cattle Capacity _Pop."_'
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes �No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [ ] No
❑ NA ❑ NE
❑ 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 OC�o
o ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Condnued

Facili Number: 3 t - 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: I v--A r,
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
H S _ Iq.S
L4S' 3�
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 0 No
❑ Yes I 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 XNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0, No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �61
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
eeoff Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �7F�'-� �` � 5 �� 1 ) eq'M> --
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
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP QChecklists QDesign 0 Maps ❑ Lease Agreements ❑other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
Waste Application Q Weekly Freeboard ElWaste Analysis [�] Soil Analysis ❑ Waste T�No
ers [] Weather Code
0 Rainfall ❑ Stocking Crop Yield Q 120 Minute Inspections Q Monthly and I" Rainfall Inspections [] Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes o ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: '31 - to Date of Inspection: J
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
El Yes �k
[] NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes �kNo
TTTT
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
0
❑ 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
0
❑ 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 V+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 j No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 7'�lNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes o ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use. drawings of facility to better explain situations (use additional pages as necessary).
`rT l GLA-f 10 1S G19 0/0 - M?-. Ti1lquv Ac-�ADc) OAS LAND uNf_b Lc
6Lo
vfzl� a131r� 1.3 ►.0
gia/o 6.99 WD111
1S
So l � GZCQo�-T p�` F��
(J` OA-1 e IQ�R-�. H .N lJ
1
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
. Cow F.-S I 'Al
Phone: 9/6 '1% 3 3M
Date: �IOf 1 f
21412011

Division of Water Quality,
Facifity Nutnber 3 l9� Division of Soil 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 ❑ Denied Access
Date of Visit: Arrival Time: Q fit^ Departure Time: County: U !u Region:
Farm Name: �&,ACA-4 ) S LA)VV__'� 1 AtiZ M Owner Email:
Owner Name: �NonnF�S •�� 1tELA-AU
CA/ Phone:
Mailing Address: V *•�-�X ��ILCr,/YC er)gS)S-6 -D(D
Physical Address:
Facility Contact: Title:!
On site Representative cm 1441GP1Wb0gLNL
Certified Operator: )4,C>MAS ol<N
Phone No:
Integrator:
gor C�
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
QyL/"3(0
Latitude: [= o [= 6 [= is Longitude: Q o =
Design,Current
� � _m .Caace Current
Wet Poultry C-aPacg Po Mahon ' CattleSwine Capacity Mahon
P, _ tY,.Populatton,
Other
❑ Other
❑ Layer ❑ Dai Cow
_Ej
❑ Non -Layer I❑ Dairy Calf
- ❑ Dairy Heifer
.Dry Poultry ❑ D Cow
❑ 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
LJ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number,', Structures:,
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?
N:yt
❑ Yes ANo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
[I No
❑NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
tg No
❑ NA
❑ NE
12128104 Continued

Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: T I i T
Spillway?:
Designed Freeboard (in): i9 , rrS
Observed Freeboard (in): 3 3 1
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes I0 No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes j No ❑ NA ❑ NE
❑ Yes KNo ❑ 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 stucture's lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes VNo ❑ 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) � E e(L (14�
13.
Soil type(s) FOCZ E_S 1 GI✓
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑Yestz
No
❑ NA
El NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
:&Z o
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments
Ilse drawings of facility to better,; explain situations. (use additional pages as necessary):K ,
LAFOCWS CCWNF C-jC_ N PF A CI TTcE N-GC r MaMe
do'sN t_RG00AIS - Au 4 Poi. �n N �1r,FE¢o lei c�E� S
Reviewer/inspector Name
MAN.e D G fl/N�m ` ' Phone:
Reviewer/Inspector Signature: Date: y1P 3116
0
Page 2 of 3 12128104 Continued

f i Facility Number: 3 —rya Date of Inspection
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 No
[INA
ElNE
the appropriate box. ElWUp ❑ Checklists 0 Design 0 Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes ANo
ElNA
❑ NE
ElWaste Application 0 Weekly Freeboard ElWaste Analysis ElSoil Analysis El Vaste Transfers❑nual Certification
0 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 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?
IX Yes ❑ No
❑ NA
❑ NE
25, Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes XNo
❑ 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 FNo
❑ 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 ONo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes J<No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes ,KNo
❑ NA
❑ NE
un e..,- •r e,Kv, ,-..
Additional Comments and/or'Drawings
n;AL
v� I UQT Pu7 IN 11Y OQW (9 - Xb C A u BtLPTr c2VI 11V - L 45T Y-lo v- r -
WAS No-1 IE 1�:, o N I AIVC710A1 1 H4T H Q� w�� �uf3Q�`, t` �N 2cjoq - iva
CA a 6QA ; 1 d,v / �! �c�9 - KC- E � I C--"CAC% ► C �� v CsT �S AP , (� t �5 6-FAX
Corn PL 9- i C a L I R,Q 4 i I. C k/ -o .
A-rT//: ArKAivDA &f%A/rvr S
S`i 'T
Page 3 of 3 12128104

Fac>tty-Nutnber:
k
i9
Division of Water Quality
0 Division of Soiland Water Conservation
O Other Agency
Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: iIIV Region:
Farm Name —� _ !S m Owner Email:
Owner Name: TAP S_ i6. ] 16 oq--*N Phone:
Mailing Address: �`,k « �UJL4►LLe . �+' G �O S1 O rd� a� �u
Physical Address:
Facility Contact: Title:
Onsite Representative u&IJ5 &W1C-C DM )H1 ti"
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
Other
❑ Other
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = n = Longitude: = ° = A
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Co
Number of Structures: EJ
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
kfNo
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: � j ] — (93
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: LQLQ Y(-
Spillway?: Q
Designed freeboard (in): ! 9.5
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 10 No
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes 0 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 \ � No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El� 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 4No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes XNo [INA ElNE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop / Window Evidence of Wind Drift ❑ Application Outside of Area
,1
12. Crop type(s) 6 z, F_ (Z- ( W
13.
Soil type(s) _ �--O e2 . % Oy
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
4 No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
ANo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] yes
ONo
❑ NA
❑ NE
IT
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
dents (refer to question #): Explain any:YES answers and/or -any recommendations.orI r co any otheinnnenks
rawmn is of facility"fo better' -explain situations., (use addi#ionalpa es:as, necessary):.
'yi CA(ZDYJOT Ou T c�� 1 S CHIC_ A e7l6C--
V1 UM— W J LI` �� CAC-t t�CZ � ��7�/ - N �C (Ln c�A /T JN4 Fa`L A
TO cc RV .EC T F C_aw KA C 76-�Z-
Reviewer/Inspector Name F' mLo Phone:
Reviewer/Inspector Signature: Date: LVI
Page 2 of 3 I2128104 Continued

Fae9lity Number: `j j — (p Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes X 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 appropirate box.
0 WUP 0 Checklists 0 Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. [I Yes XNo ❑ NA ❑ NE
0 Waste Application ❑ Weekly Freeboard -0 Waste Analysis El Soil Analysis ❑/aste Transfers ❑ Aual Certification
0 Rainfall ElStocking ❑ Crop Yield 0 120 Minute Inspections El Monthly and 1" Rain Inspections E]Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
4 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fait 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
hA
^No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
N No
[INA
❑ NE
Other issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes VNo ❑ 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 ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ANo ❑ NA ❑ NE
Page 3 of 3 12128104

I
[Facility Number
Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit acompliance Inspection O Operation Review Q Structure Evaluation 0 Technical Assistance
Reason far Visit M Routine o complaint O Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 0ltl Arrival Time: o Departure Time: County: '164P L" /V Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: �+ p Title:
Onsite Representative: ` kV_,n s br4R.w� 1 C_ awt 1 N 1,qF Fd
Certified Operator: �I Orrl S 1141 G (7f 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
Other
❑ Other
Phone:
Phone No:
Integrator• /)L/
Operator Certification Number: O< <
Back-up Certification Number:
Latitude: = o = 1 =61 Longitude: 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
�1 10 Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Imams
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility dumber: '3 1 — ID I Date of Inspection S Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ANo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: �.F�-�,cyc)?j
Spillway?:
Designed Freeboard (in): - 19.5
Observed Freeboard (in): 9 Ly
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes )o 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 4 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes V1 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 JQ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes JRNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
X) No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Ej 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
KNo
❑ 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):
CIF t.� 1C L 4":� 14 e(A; wl 9-EC_0Vj") S
Reviewer/Inspector Name QnagrmoA j Phone: 916-74'i(-'� 3c24
ReviewerAnspector Signature: Date: 3 6
12128104 Continued

Facility Number: — 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 D(No ❑ NA ❑ NE
the appropirate box. ❑ VAR ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes inq No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
W,No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
IgNo
❑ 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
,nj 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
i No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
12128104

W Division of Water Quality
Facility Number 3 O Division of Soil and Water Conservation
O 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: /2 Departure Time: I 421,549--i-county:
Farm Name: f f�C'ri�1--S41/U Owner Email:
Owner Name: % �/�:`l_. �!F/✓ Phone: _
Mailing Address:
Physical Address:
Facility Contact:
Title:
t1LEif. _F Phone No:
Onsite Representative: f440b 6 --la4 uRTrS Integrator:
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:
Region
Latitude: = o ❑ 6 ❑ « Longitude: ❑ o = , = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non-Layer�
Other
❑ Other - _ .. _
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
❑ 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?
Page I of 3
❑ Yes /fNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El NA
[I NE
El Yes
El No
❑ Yes XNo
0 o ElNA ❑ NE
El Yes ❑ NA ❑ NE
12128104 Continued

a- . i
Facility Number: — 3 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. if yes, is waste level into the structural freeboard?
Strugture 1
Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
A)O
Designed Freeboard (in):
Observed Freeboard (in): 3
Z
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes )YNo
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes gNo ❑ NA ❑ NE
❑ Yes ONo ❑ 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? 9fYes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes gNo
❑ Yes VNo
El NA El NE
❑NA ❑NE
❑ Yes.111No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA El NE
❑ Excessive Ponding ❑ Hydraulic Overload El Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? Yes ❑ 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 E�No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes OrNo ❑ 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):
T_�7�/ZJ���. �J��'I /���bS20n! (/F �J1� f� .� C�/I�GC OL'CG!/•liQ�iJC �T
Reviewer/Inspector Name &A26 A2, ( Phone: q1b —�
Reviewer/Inspector Signature:ZZ,2�L/� Date: .3
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
❑ Yes 21No ❑ NA ❑ NE
❑ Yes ' ' No ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes )2�No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes A, No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? El Yes VNo ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes j2fNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes [21No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes XNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes I[J 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 ElNA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application) /�d'
32, Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ElYesNo ElNA ElNE33. Does facility require a follow-up visit by same agency? ElYes lNo ❑ NA ❑ NE
Additional Comments and/or Drawings:
l5iQ�r,�p,g�s<iJT
%� .��3Gv✓ ��LG � �„10 �X ��%9� l�
Page 3 of 3 12128104

1 i
Facility Number 3 6 3
(Division of Water Quality
O Division of Soil and Water Conservation
Q Other Agency
Type of Visit (7Routine
pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 4 t 6io Arrival Time: 7.06 Departure Time: County: i) {1ptLh Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: 1goMw JAQf6,4j Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 0 ' ❑ Longitude: = ° = ' = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
_❑ Non -Layer _
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ 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?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Daia Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: M
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes dNo ❑ NA ❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
No ❑ NA
❑ NE
❑ Yes
El Yes
,❑,
El NA
❑ NE
❑ Yes
7No ❑ NA
❑ NE
I2/2"4 Continued

Faciliq Number: 3176271 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ZNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: L A&O-Aj f LA 6--d -I-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 13'L 7�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes dNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes dNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental) threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes Li No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes L3No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes dNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ENo ❑ NA ❑ NE
maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 24 ❑ 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) 6 e4LtAW 14 L } S G a
13. Soil type(s) AA GC 03"-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes PNo ❑ 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 ff No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes 2r o ElNA ❑ NE
❑ Yes CJ 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):
t 5-,) a wN EIS 4� P Ra c.� SS RE SP l�-z S C,�.275� (3L- M�►�pA w t A, A l.sa i'VL p d
J71t,t. _rrj
Reviewer/inspector Name f Phone: 4'i0
Reviewer/inspector Signature: Date: t-/ !L o6
Page 2 of 3 12128104 Continued

Fadiity Number: — Date of Inspection �/ 1
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑p ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes LlNo ❑ 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
❑ Yes �N ❑ NA ❑ NE
❑ Yes a ❑ NA ❑ NE
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes dNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes � o El NA El NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? El Yes 20 ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes N ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes LJ N ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes 2 No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
2 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
QX0
❑ 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
L✓J 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
zll;�
[INA
[INE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
7N
El NA
El NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
L7 No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

Facility Number
I
J
r
Division of Water Quafity
Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit Co fiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: �l OS Arrival Time: 1 f i�J Departure Time: County: Q1 )P)_ Region:
Farm blame:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: o M 1 1A -r& !2 C
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
Other
❑ Other
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 0 d Longitude: ❑ ° = 4 ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer I
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ 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
EJ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures: =I
b. Did the discharge reach waters of the State? (If yes, notify D WQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El NA
El NE
❑ Yes
No
El Yes
�❑
IQ�No
❑ NA
❑ NE
El Yes
❑ NA
❑ NE
12128104 Continued

Facility Number: 31 — Date of Inspection dui a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: C•AGOof� i cAraol) >'
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): %
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
El yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes WNo ❑ NA ❑ NE
❑ Yes [2No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmentalthr at, notify DWQ
7. Do any of the structures need maintenance or improvement? ElYes E No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes VNo
I [I NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes ❑ NA ❑ NE
maintenance or improvement?
Waste ApDlication
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
I_/J No El NA El NE
maintenance/improvement?
/No
IL
Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes
❑ 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) GEa mt�DA N) S �d
13.
Soil type(s) n-)cr , V5
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
E(No ❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? E Yes
El No ❑ NA ElNE
lN
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑ Yes
L/I No ❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
El NA El NE
18.
Is there a lack of properly operating waste application equipment? El Yes
yo❑ NA ❑ NE
.lrt,) U9 b QTEX Ca_O. P
Reviewer/Inspector Name O z � = Phone?t�lCS 776 ' 70165
Reviewer/Inspector Signature: Date: O�
I2/28/04 Continued

Facility Number: 31 — 7J Date of Inspection a a
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. LJ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Week y Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking Zrop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Rr/m ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 7N❑ NA ❑ NE
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 ❑ NE
El Yes 1 INo El NA El NE
❑ Yes 6 El ❑ NE
ElYes ❑ NA ❑ NE
ElYes [;No ❑ NA ❑ NE
❑ Yes E;mo ❑ NA ❑ NE
No
❑ Yes
O
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
��o_❑ NA
❑ NE
❑ Yes
yo
❑ NA
ElNE
ElYes
❑ NA
❑ NE
"ditioual ,Cotnments and/or Drawings
�" • ' �
12128104

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine Q Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit: p Time:
L41Q Not erationai Q Below Threshold
Permitted 0 Certified © Conditionally Certified [] Registered Date Last Operated or Above Threshold: ...�..—
Farm Name: County: -
Owner Name: ------ L !7`Q1?�.._ . ,C�L��� . ___..... _.. 'Phone No:
:ViaiMing Address:
Facility Contact: I'� . _„, Phone No: Ck�
Onsite Representative- DinA_-_2 _ Integrator.- _ .. ------
Certified Operator: , , , _ ..... _ . _ , , Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude
Longitude �• �' �"
`Cnrret a _ , Correct
Design Desga
= i?ega r : Current
$wiDe l —tia ` � p '9_= �.Po�
CaMi
Wean to Feeder. Layer
- Dairy
eeder to Finish 32 f Non -Layer
Non -Dairy
Farrow to Wean
Farrow to Fender
Farrow to Finish x' TOW DestgII
�P t9
Gilts _
._._
Boars -, 'Total SSLW
t.=.
Flo -
Discharges - Strram 1wacts
1. Is any discharge observed from any part of the operation?
❑ Yes ?rNo
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 12rNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Oro
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes_jffl4o
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .. _ . _ ... ..._ _ ... .. .. _ .
Freeboard (inches):
12112103 Continued

Facilit$* Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (iTe/ trees, severe erosion, ❑ Yes - P'No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
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 maintenancerunprovement? ❑ Yes ONo
S. Does any part of the waste management system other than waste smicnues require maintenance!unprovement? ❑ Yes P'No.
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ,6No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancermprovement? ❑ Yes ;(No
i 1. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes )eNo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground Copper and/or Zinc
12. Crop type 64V ) l/`
13. Do the receiving crops differ with those ignated in the Certified Animal Waste Management P CAWMP)? ❑ Yes ONo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ;IrNo
b) Does the facility need a wettable ache determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? OYes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ONo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes XNo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed. of properly within 24 hours? ❑ Yes 0No
19. Is there any evidence of wind drift during land application? (i.e, residue on neighboring vegetation, asphalt, ❑ Yes XNo
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ yes No
Air Quality representative immediately.
Use drawer4 ft-0- toil aa#rwms. (" l!I-W 'as;-
4 ' KK ❑ i+;eld Copy ❑Final Notes
/'9��o
rW17)
4/�0
I-Iz-5 A�77-
ReviewerAWspector Name a
Reviewer/Lmgm ctor Signahrre:
Date:
12112IU3 cowed

Facility Number: Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/lnspector fail to discuss reviewimspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ Yes ONo
❑ Yes )Z No
❑ Yes gNo
❑ Yes ONO
❑ Yes ONO
❑ Yes ❑ No
[:]Yes PrNo
❑ Yes ENo
❑ Yes )2,No
XYes ❑ No
❑ Yes ONo
❑ Yes PrNo
❑ Yes `No
❑ Yes No
❑ Yes j11No
❑ 120 Minute Inspections ❑ Annual Certification Form
© No violations or deficiencies were noted during this visit. You wrfl receive no further correspondence about this visit.
!f-TAQg56 lD
s
CAW�itio �6C�crzo
12112103

Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 10 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit Jo Routine O Complaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facilitv Number Date of Visit:
Permitted O Certified ©Conditionally Certified D Registered
Farm Name:
Owner Name:
Mailing Address -
Time:
Date Last OperateAlpZZ/111
Above Threshold: _
County �
Phone No:
Facility Contact: Title: hone No:
17 / Onsite Representative: S 01,0 ` ri"grator:
Certified Operator: Operator Certification Number:
Location of Farm:
Swine []Poultry ❑ Cattle ❑ Horse Latitude + [[ Longitude ' �' 0 GG
Design Current
awtne Capacity Population
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds 1 Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I JE1 Dai
❑ Non -Layer I 1 10 Non -Dairy
❑ Other
Total Design Capacity
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?
Total SSLW
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?
Area Spray Field Area �, I
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): G.'2
05103101
❑ Yes )ZNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
[:]No
❑ Yes
No
ElYes
YNo
[:]Yes
/No
Structure 6
Continued

Facility Number: 31 — Date of Inspection ' J
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 maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Annlication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? , ❑ Excessive Pond ng ❑ PAT$- ❑ Hydraulic Overload
� • � - ;iT�� �/ . / r/�»L��/lir7_J1iJ'I�"�al[%lldLl►T��!
13. Do the receiving crops differ witfl those8esignated in the Certified Animal Waste Management
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?
(CAWMP)?
16. Is there a lack of adequate waste application equipment?
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel 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 /NO
❑ Yes ko
❑ Yes a
❑ Yes TNO
El Yes FNo
❑ Yes &o
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes �No
❑ Yes �No
❑ Yes No
❑ Yes No
❑ Yes 7(No
❑ Yes �No
❑ Yes fNo
o
El Yes
❑ Yeso
❑ Yes V
No
ElYes � No
❑ Yes o
❑ Yes XN0
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
"MOW 011, 318 a
Comments (refer to-questran:#)Explain any YES ans�rersanr)!or-any recomtnendahons or any o her comments r=
_ ° �
Use drawings of facility to better explain situations(use additional pages as: necessary)Field Copy ❑ Final Notes
Try lkT,Fem �04r---29N �PinP�.�r, s
'
r
Reviewer/Inspector Name s
Reviewer/Inspector Signature: Date:
05103101
Continued
f

Facility Number: 5 1 —&51 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?
Additional._ omments andlor'Drawm s: ,;
12
Zel-
06 5407144
--I--� Gf/�i�� /�rJ /��� ,ems✓ /!J ---
� 7Y � C4- Or✓
�reI�SS�s r",e0a► ��2��ir�y� ��,¢-�/�Z�.dS�
❑ Yes ❑ No
❑ Yes No
❑ Yes �dlqo
Yes No
❑ Yes o
❑ Yes / No
❑ Yes ❑ No
05103101

N17
Type of Visit _oCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Foflow up O Emergency Notification O Other ❑ Denied Access
[)ate of Visit: r% 3 O! Time: � •���
Facility Number 3 1 3
Q Not O erational Q Below Threshold
M Permitted [3 Certified 0 Conditionally Certified [j Registered Date Last Operated or Above Threshold:
Farm Name: ��.. �'~ __... .....
TCa 4 -�-5/�1 C'�!.. County:..........!? ..Len ......................
OwnerName: „ 0 `! f.. .� e............................................................ Phone No:................................................................ ...». ..._..
FacilityContact: ............................................................................... Title:................................................................ Phone No:..............................................
MailingAddress: ...............................................................
OnsiteRepresentative: h4''��q �A.j-.�} a`` Integrator: e1''t;✓ ,?p� r4..................
..............................................I...................... .'"? ..... a......
Certified Operator:
Location of Farm:
................. ......... I............................. Operator Certification Number:...........................................
❑ Swine ❑ poultry ❑ Cattle ❑ Horse Latitude ' ' " Longitude 0 6 46
M
Design Current
wine.. ranacity-Pnnnhit n
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Boars
Design Current
Poultry - Ca aci Po ulition -Cattle
❑ Layer ❑ Dairy
❑ Non -Layer .' ❑ Non -Dail
❑ Other
Total Design Capacity
_ Total.SSLW
Design -.
Nui nbler of Lagoons Z ❑ Subsurface Drains Present [❑ Lagoon Area . j❑ Spray Field Area
Holdtng Ponds / Solid_Traps .. " ❑ No Liquid Waste Management System
Disc�har ess & Stream Im acts
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
Identificr:
Freeboard (inches)
5/00
Structure l Structure 2
..? .... ...G: rk.............I...................
33
Structure 3 Structure 4 Structure 5
❑ YeS'I<Io
❑ Yes�No
❑ Yes i�rN(o'7ot
❑ Yes o
❑YesAj"No
❑ Yes �No
❑ Yes o
Structure 6
Continued on hack

Facility Number: 3 J — `p 3 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 maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type (Ser,"VA pay) 5�411 crol;r
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
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?
244. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes '0No
❑ Yes ZNo
❑ Yes (2rNo
❑ Yes Jallo
❑ Yes oNo
❑ Yes ,EfNo
❑ Yes dNo
❑ Yes JE(No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ZNo
❑ Yes ONO
❑ Yes ONO
❑ Yes QNo
❑ Yes )ZrNo
❑ Yes P'No
❑ Yes 'Jallo
❑ Yes ,0No
❑ Yes )E!rNo
❑ Yes RNo
❑ Yes P111
0
iliyeo 'u;t�r; igrisodfcencrepQtl dxing fhis'vsti Yoh 'Will Xeee[P.a;reiil . • ; I
• coriksp deiii& allouti this visit:
Comments (refer to gnestton #) Explain aay YES answers andlor any"_`recamutendations orany other commeat4.,
1Jse drawingsyof facility to:better explain si640p s. (use adclitioiaal'Aag" as necessary)
--
5�s..
`rye fzrr;1,- 6-o recolds ogre well ke 1. -re �c,ti,
l,� g need �
W e4 6j 61¢ a Cs -Are s � Zrmjyt , p>7 a 1 �� Qd qs� c�;�� w� 1,11,1 � Ferords
Reviewer/Inspector Nameaa'jt'lWG3�-
Reviewer/Inspector Signature: lV Date: r7 3 41 5100

FacilityiNumber: _?l - 3 Date of Inspection O
OBor 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 J2NO
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes J'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 ^2'1` o
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 ` 3No
31, Do the animals feed storage bins fail to have appropriate cover? ❑ Yes-'ONo
32. Do the flush tanks lack a submerged fill pipe or a permanent/tempormy cover? [] Yes ❑ No
lAdditional-Cornments an or_ rawinp
J
5100

AXDivision of Water Quality
Q Division of Soil and Water Conservation -
Q Other Agency _
Type of Visit Xcompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ARoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 Date of Visit: roT%oa Time: I I k I Printed on: 7/21/2000
0 Not O erational Q Below Threshold
Permitted © Certified 0 Conditionally Certified ('] Registered Date Last Operated or Above Threshold
�--_ County :......_.. ..�
Farm Name .......... __.......... ........................................
Owner Name: ........................... Phone No:
Facility Contact: .............................................................................. Title:
MailingAddress: ........ .................. .................................................................
Phone No:
Onsii#e Representative: . Integrator: .....1`j._g14•,5.................................................
Certified Operator: ................................................... ................................... _........................ Operator Certification Number:..........................................
Location of Farm:
IT
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �0 C�' LT��� Longitude �• �� ���
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer , ❑ Dairy
Feeder to Finish 7 ❑ Non -Layer ,1❑ Non -Dairy
Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
Gilts
❑ Boars Total SSLW
Number of -Lagoons ❑ Subsurface Drains Present ❑ Lag,wn 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?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed -.vas the conveyance than -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. hoes 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: .p'^i" r.1.n.................. ................. ........................... ......... .............................
Freeboard finches): a-
5/00
❑ Yes j(No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
P 'No
❑ Yes
kNo
❑ Yes J�(No
Structure b
Continued on back

7FAcifityI�eumber: 3 — 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, ❑ YesNo
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 ONO
8. Does any part of the waste management system other than waste structures require maintenance/improvement? kYes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? _ ❑ Yes XNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes jR'No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ HydrauIic Overload ❑ Yes NrNo
12. Crop type 6LIZ
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
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?
Viol"atioris:oi- de#icieneies -Were hated- du in'Abis:visit; -'Y:ou will-r'e 6*6 iio further
corres�o deik about: this visit: .:.: ... .... : .
❑ Yes kNo
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes D'No
❑ Yes ONO
❑ Yes J<No
'Yes ❑ No
❑ Yes ONO
❑ Yes JVNo
JVYes ❑ No
❑ Yes LOO
❑ Yes W o
❑ Yes VNo
❑ Yes 9No
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):
g�1 C,-, lees ►-�ee� �ti#e�` . �Gr Gue `
s
qVP
Reviewer/Inspector Name
Reviewer/Inspector Signature:'
Date: 1c) - IS
x aae
5100

' aci�it )ate of Inspection C7 ^w 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 at/or below ❑ Yes )�No
liquid level of lagoon or storage pondwith no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes VNo
28, is there any evidence of wind drift during land. application? (i.e. residue on neighboring vegetation, asphalt, Yes 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 biade(s), inoperable shutters, etc.) _ ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ko
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes kNo
AdditionWComments an or rawings:
CL..t—��•-�� \\C2�--;rSL S 15��[ �� CiL---A-R- — !AL\
.5��
5100

of Visit @ Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit @) Routine 0 Complaint 0 Follow up 0 Emergency Notification C) Other U Denied Access
aciity Number 31 63 Date of Visit: Tie: �� Printed on: 10/2012000
FQ Not Operational 0 Below Threshold
Permitted 0 Certified 11 Conditionally Certified M Registered Date Last Operated or Above Threshold:
Farm Name: B.c&vh1s1=dJFw= ...................................................................................... County: D.upAu .................................... WJRQ ......
Owner Name: jkMAa.& ...................
- --------------------- 1111gPkJk ........................................ Phone No: . .. . . . .. ............... .
Facility Contact. Title: Phone No:
Mailing Address: JP.Q_Ru;Lj26 ............................................................................................ Rculayilk-Ac ....................................................... 28.518 ..............
Onsite Representative: Qwnpm. ................................................................... Integrator. DoglxwAEUM .......................................
Certified Operator: Thomas_ Thigprn Operator Certification Number: 2443fi
Location of Farm:
South of BeulaviHe. On West side of SR 1801 approx. 0.8 mile North of Hwy 111 and Lyman. L&
Swine C1 Poultry [] Cattle ❑ Horse Latitude F-34
F 2 Longitude
77 •... iTT 40
...... . ..... ................ ........
. ..... Current....:,,..:.. ....
.....
re n
Cur
.
..CtM
D Wean to Feeder
0 Feeder to Finish
5328
El Farrow to Wean
0 Far -row to Feeder
E] Farrow to Finish
El Gilts
E] Boars
Discharges Ar Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [I Lagoon El Spray Field 0 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 DWO)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
[] Yes X No
0 Yes El NO
0 Yes 0 No
[]Yes 0 NO
[:]Yes 0 No
0 Yes 19 No
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway [I Yes H No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier -
Freeboard (inches):

J/UU
Facility -Number: 31-63 Date of Inspection 10-18-2000 printed on:
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?
1. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
l2. Crop type Coastal Bermuda (Hay) Small Grain Overseed ,
Conlrnuea on back
10/20/2000
❑ Yes No
❑ Yes ® No
❑ Yes
N No
® Yes
❑ No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes N No
16. Is there a lack of adequate waste application equipment? ❑ Yes N No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes N 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.) N Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes N No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes N No
21. Did the facility fail to have a actively certified operator in charge? N Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes N No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes N No
24. Does facility require a follow-up visit by same agency? ❑ Yes N No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes N No
No violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
8. A few small foundation leaks need to be sealed. Also, old feed needs to be disposed of better.
18. Obtain lagoon design for newest lagoon from District.
19. Suggest taking separate soil sample for each field (rule of thumb -- 1 sample for each 10 acres).- Thus should take 3
samples for this farm.
21. Database does not show OIC. Grower took test again this year and has current license. Designation form left on -site an
needs to be sent ASAP within next 30 days.
Records & fields in good shape.
"** No copy left on -site — copy to be sent within next week.
Reviewer/Inspector Name Dean';H. .. e393..3900 X ?26 ..:...;:
.:....
f

treviewenioaPertur 31guature: Late: S/OU
Facility Number: 31-63 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 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,
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?
[j Yes ® No
❑ Yes 0 No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No

' ` [ Dtvaton'of Soil and Water�Conservation Operation Review
13Divisi6ii of S 'iI and,Water Conservation - Compliance -Inspection
Dtvisinn of Water " ' ® Quality -Compliance Inspection
©'OtheriAgency;- Operation Review"
JV Routine Q Complaint Q Follow-up of DWQ inspection tQ Follow-up of DSWC review- Q Other
Facility Number Date ol' I nspection
Time. (if Inspection �14 � 24 hr. (hh:mm)
Permitted. Certified 0 Conditionally Certified 0 Registered JE3 Not O er:itional Date Last Operated:
Farin Name: qi Co�inty:.......... �11n�....................... .
...c. ......-...L.... ....... {L��.......................... ... .......................
Owner Name:
.......................1.! i ......................
FacilityContact: ............................................................................... Title:....
Mailing Address. -....-. .Q.....-&x...-_....? ...........-.
Onsite Representative .............% w .-... .
Certified Operator: ................. 5.......���a(L.,............
Location of Farm:
Phone No: ....��1Q�..���..��?..............................
PhoneNo: .............................. .................
........ .... �?uAc.► aLL.... 1...I\jC......................................... ma.-.........
........ Integrator :......... b. - d............................. I...........................
........ Operator Certification Number:..... �.!� ......................
................l sa ...1R.IfS............. iv.1... ........................
......................................................................_-..................--................
Latitude �] 0 ° .9 Longitude ' 9 «
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Capacity Population
❑ Wean to Feeder
❑ Layer
❑ Dairy
Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
3 zg
❑ Gilts
❑ Boars
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present IFE1 Lagonn Area ❑ Spray Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
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 Waters ❑ Waters of the State
c. If discharge is observed. what is the estimated slow in oaUmin.'
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 & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1 4-2
Freeboard(inches): ...................... ....... .................................... --.---..............._................................................................................
❑ Yes 0 No
❑ Yes
k] No
❑ Yes
No
A)IN
❑ Yes
No
❑ Yes
PO No
❑ Yes
® No
❑ Yes ,E No
Structure 6
1/6/99 Continued on hack

Facility Number:! — 6 Date of Inspection Z y 9
5. Afe there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, El Yes Pa 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 [ANo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public stealth or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? Yes ❑ No
8. Does any pact 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
0 No
11.
Is there evidence of over application? ❑ Ponding ❑ Nitrogen
❑Yes
In No
12.
Crop type ........... +LV r..lti�k�:..................... ................................ .......................................................................................................
................
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
[N No
14.
Does the facility lack wettable acreage for land application? (footprint)
tr
Yes
00 No
15.
Does the receiving crop need improvement'?
Ig Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
[VNo
Renuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑Yes
1P 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.)
El Yes
� No
19.
Does record keeping need improvement? (ie/ irrigation• freeboard, waste analysis & soil sample reports)
❑ Yes
10 No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
O 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?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
E�?No
24-
Does facility require a follow-up visit by same agency?
❑ Yes
(A No
�: N.o.violations.or. def7cle. n. des.were. noted during.tliis:visit:.I'.ou vinh1.reeeive not urther .:.
cgfrespgaidehee: about: this : ; ...
::::: :: ; • : • : ; ; • ; • ; • ; • ; • ;
Cotitments,(refer to question, #): Explain any YES answers and/or any„Yecommendations 6r any: oiUr comments
Use`drawings'of facility -to better.explainsituations. (use additional pages as necessary): = v
1�'- �+l�•- �'14i Y>Q�.jh.. ila.�i�� �r A- W1'� �L�f^��hCxn .
1 • CC Yt 10. - WmY tln or, jVV A� l �Mlh U*D�.
0
Reviewer/Inspector Name
Reviewer/Inspector Signature: ,� , % Date:
1 /6/99

•*
i [3 Division of Soil and Water Conservation Cj Other Agency
x , (3Division of Water Quality �$
IC.Routine O Complaint O Follow-up of DWQ inspecti
Facility Number D_1= J
Follow-up of DSWC review O Other
Date of Inspection
Time of Inspection '7O 24 hr. (hh:mm)
0 Registered [3 Certified [3 Applied for Permit Wermitted JE3 Not Operational 1 Date Last Operated:
Farm Name:....... 'r ............................................ I ........ I............. County:..'... ......---� `� ......
Owner�....................................................... Phone No: .(a�)... ....--------.--...------
Facility Contact:.............................................................................. Title:.................... Phone No:
..... ................................................................................
Mailing Address: 1.Z db , 5�i....................................... ... .... ................ ....... ...L�....�..... �.. .............................. ..
t... j...(..`...
�.�.!1. . Integrator:...... _......... d T -�
Onsite Representative:. r......................................................... t :06......... ............... ................................
Certified Operator;............................................................................................................... Operator Certification Number: -
Location of Farm:
rr.... ... 4...........�....................i .... :........!^ ........... 4t`^...............................1`'1..........:...........................................
............................................................. ....--- ........................... ............ .....--......
Latitude 00 6 064 Longitude • 4 °6
General
1.
Are there any buffers that need maintenance/improvement?
❑ Yes
XNo
2.
Is any discharge observed from any part of the operation?
❑ Yes
Ej No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
®h No
c. If discharge is observed, what is the estimated flow in gal/min?
i `1 rT
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
M No
3.
Is there evidence of past discharge from any part of the operation?
❑ Yes
53 No
4.
Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
1gNo
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
1H No
maintenance/improvement?
6.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
CgNo
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
C4No
7/25/97

Facility Number: ` —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LagoonsMoldine Ponds, Blush, Pits, etc.)
9. Is storage cipacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: A Q_
.....
Freeboard(ft): .....ldZ:. .............. `..Re- ................................... .......... ...-............_.......................,
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenancetimprovement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
I3. Do any of the structures lack adequate minimum or maximum liquid level markers?
'waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ......... ....---...... __
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 chop 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?
0• No. violations' or. & ciencies4e-re-noted•during this.vi_s L Yoit:vtrill receive -no' Airiher
corresppndepce Ei out-this:visit:, : .
❑ Yes
t5 No
❑ Yes
XNo
Structure 6
❑ Yes
19 No
❑ Yes
EgNo
N(Yes
❑ No
X Yes
❑ No
❑ Yes
IgNo
---------------------------------------
❑.Yes
0 No
❑ Yes
rgNo
IM Yes
❑ No
❑ Yes
9No
❑ Yes
N No
❑ Yes
IXNo
,Yes
❑ No
❑ Yes Q(No
❑ Yes &J No
❑ Yes 9KNo
tA
c.: �e s` k e. e ram,
7125/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: _Jr1 Date: 9 { t I ` y

❑ DSWC Animal Feedlot Operation Review
® DWQ Animal Feedlot Operation Site Inspection
LORoutine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other
Dale of Inspection . D "'} •7
Facility Number 31
Time of Inspection 24 hr. (hh:mm)
© Registered IlCertifiedrr 0 Applied for Permit Permitted [j Not Operational Date Last Operated:
FarmName: lz` { / ................... County: ..... �Y&...............................................................
OwnerName:...... w,,c 1......... i�G�1.. �....................................................................... Phone No: .`?.�6�.. `) .-....L !..............................................
Facility Contact: ........`ai`..,..]+�?iN- ......................... Title :....... .Ic?.hs......................................... Phone No: a7`.............
Mailing Address: ...... ........... ?.y.......'...................................... �WIA uL(1s...,..,t`r�........... ... .......................... Ir............
Onsite Representative: ..... pit.Fy..-.....t.hJ tarp ......................................................... Intel;rotor:....... �s? i�;ac.........................................................
Certified Operator;...-...T'k n S............................ -........... Operator Certification Number:............................ -.. -
Location of Farm: �}
...: ��......%ir.t. '�.t..x� 1�nay►,......�,ian,ti;:n...... a � '"";... II �
0 ...S.R.....��0.1....,. a�rra-..... iS....... ... (...+a,. s-.-.a.t�.....I .�S ... �t�e .....�1 ...............................................I..---..---........................................... .
Latitude 0 44 Longitude • 0` ==`
Design
S wme
Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
ropulatton
Design Current Design. Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer IM Non -Dairy
❑ Other
Total Design Capacity .
Total SSLW
Number of Lagoons / Holding Ponds ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
❑ No Liquid Waste Management System
General
I. Are there any buffers that need maintenance/improvement? ❑ Yes JRNo
2. Is any discharge observed from any part of the operation? ❑ Yes JA No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ®'No
b. If discharge is observed. did it reach Surface Water? (If ycs, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in al;min'
cl. Does discharge bypass a lagoon system? (If yes. notify DWQ) ❑Yes No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes [%No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than laaoons/holding ponds) require
main tenancelimprovement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes EZ No
56 Yes ❑ No
❑ Yes 19 No
❑ Yes 0 No
Continued on back

rrI
Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures tLaQoons.floldini! Ponds. Flush Pits, etc.
❑ Yes 16 No
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
MNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard(ft): S...........................................................................
.............................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
I& No
It.
Is erosion, or any other threats to the integrity of any of the structures observed?
M Yes
❑ No
12.
Do any of the structures need maintenance/improvement?
•MYes
❑ 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
J,No
Waste Application
l4.
Is there physical evidence of over application'?
❑ Yes
0 No
(If iri excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type........6-U01tlL.......... .............................................................................. ......sl?!J...! Vdih.............................
16.
Do the receiving crops differ with those designated in the Animal Waste ]Management Plan (AWMP)`?
❑ Yes
® No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
® No
18.
Does the receiving crop need improvement?
(9 Yes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
ER No
20.
Does facility require a follow-up visit by same agency?
64 Yes
❑ No
21.
Did ReviewerMspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
22.
Does record keeping need improvement'?
%Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
�No
0 No.violations or deficiende's.rvere-noted during this',visit.-:You.will receive 'no' ftirttier
: cofrespotideike ahoutthis:visit::
to
Use drawings of facility to better: explain:situations (use additional pages as,necessary)
:
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Reviewer/Inspector Name i t,
Reviewer/Inspector Signature:— 41 t,_� Date:

Site Requires Immediate Attention:
q
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANEVIAL FEEDLOT OPERA T-10 ITE VISITATION RECORD
DATE: 1995
Time: f
Farm Name/Owner:
Mailing Address: C7 f k ZW ��
County: �GI
Integrator. 11�� �'�I L7 Phone:
On Site Representative: Phone:
Physical Address/Location: IAQ Z A A41, Al AJC-
%�
Type of Operation: Swine Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: '' " Longitude: 77 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) Yes No A al Freeboard Ft. 6Inches
Was any seepage observed from the lagoon(s)? Yes N Was any erosion observed? Yes r N
Is adequate land available for ray? Yes r No Is the cover crop adequate? es r No
Crop(s) being utilized: Ld
Does the facility meet SCS minimum setback teria?. 200 Feet from Dwellings? e r No'
100 Feet from Wells?
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 t9o
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 /
Additional Comments:
Inspector Name
cc: Facility Assessment Unit
S
Use Attachments if Needed.
4