310066_INSPECTIONS_20171231

q 4 .-
µxResourcS,k
Factlily Number ®- ioiv ion oi,soil and�Water:Conservatton
.. Ai.a�,,� �.. ���� , � " �.� y 3 ,�+� "-0' � • s 4 ° � T
gei
type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral Q Emergency Q Other 0 Denied Access
Date of Visit: I f t Arrival Time: Departure Time: �p ; r County: l Region-. l
Farm Name: w Lam. Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: ` _ ' Title: Phone:
Onsite Representative: ctp� j ( s Integrator: Certified Operator: k Certification Number: Z—`4 { 2,,b
Sack -up Operator: Certification Number:
Location of Farm: Latitude:
Longitude:
DesignCurrent* Des�gnCurrent es a Current
Swine
t� {attle �CapactyPop
Capacity Pop Wet Pauttry Capacity Pop
tE';,
Ed
Wean to Finish
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? ([f 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? ([f 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
Nf No ❑ NA ❑ NE
[:]Yes
[:]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
[DNA
❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
� No
❑ NA
❑ NE
Page I of 3 2/4/2015 Continued

Faeili Number: IDate of Inspection:
Waste Collection & Treatment
,jam,
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
y� � No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
1❑j No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: ( Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
0
❑ NA
D.
(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
r�{] No
❑ NA
❑ NE
waste management or closure plan?
TT��LL
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?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
I�
I l . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure
to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
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
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes N
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El YeskNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
o DNA ❑NE
❑ NA ❑ NE
Page 2 of 21412015 Continued

Facilitj Number: 1 - Date of inspection:
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
No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
KNA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
,.�f
j � (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
aAl�t
gVi.(V�k � �- � o� Z�d� � �7W cicw�- III Iqlm
44/ .43 )
Reviewer/Inspector Name: U{S ' M,'j aw Z'
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
2/4/2015

A ypw U1 V 131t. %,J S—ULLIP Iu my 11 puctlUll `/ llt/CJUt1UU ilCV1CVV LJ Otl UCtVIC r VA1UUUVU %_J AtWIII MMI t'lbbl MUgzC
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: d Departure Time: County:
Farm Name: "� let-L'c 1 a,.'_a ` Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swme Capacity #Pap Wet;
Wean to Finish La e
Wean to Feeder Non -
Feeder to Finish..
• . Farrow to Wean
.�
Farrow to Feeder
Farrow to finish I Lave:
Title:
Latitude:
Gilts Non -La ers
Boars Pullets
Turkeys
- .Other.. Turkey Poults
..
Other her
Phone:
Phone:
Integrator: M /%j
7
Certification Number:
Certification Number:
Discharees and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Cy ow
Cy alf
y Heifer
Cow
Beef Stocker
Beef Feeder
Beef Brood Cow
Region: 61 "A
❑ Yes C^No ❑ NA ❑ NE
❑ Yes �4 No 0 NA ❑ NE
❑ Yes ;E'No ❑ NA ❑ NE
❑ Yes
,ETNo
❑ NA
❑ NE
❑ Yes
e�FNo
[DNA
❑ NE
❑ Yes
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

,
Facili Number: 31 - Date of Inspection: �.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ED-No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes r-1--k10
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: 2,
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes !D No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes ,f'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 f:�6No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes �' o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
J�2
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes F.] No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes 2�r-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 P] No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ENo
❑ 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 C2-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 Ej No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes EfrNo
❑ 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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? 0 Yes nNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 6No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection: j2 .1g
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes j 'No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes O No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes Lallo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes .E�rNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[] Yes .EffNo
❑ 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 P],No
❑ NA
C] 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 allo
❑ 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 ,E�'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 P3'hfo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes J2'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes FZ % o
❑ NA
❑ NE
Reviewer/Inspector Signature: Date: 19
Page 3 of 3 21412015

ivision of Water Resources
Facility Number - �,," O"Division of Soil`and Water Conservation
r C Other Agency
type of visit: Compliance Inspection 0 Operation Review Q Structure Evaluation p Technical Assistance
[Zeason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:
! Arrival Time:
Departure Time: County: 'C
Region: �!L'
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: S � r Les �az A lja:) ft ,_ Integrator: /P"�,&
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:. , ` Latitude: Longitude:
Design", a, Current..: Des C e -
- g - �" urrent• Design ..Current
Swine . Capacity Pop. Wet Poultry . Capa_city Pop Cattle,— - Capacity71
Pop
Wean to Finish
Wean to Feeder
Feeder to Finish 3
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other"
Other
Discharges and Stream Impacts
Layer
Non -Layer
Ilesign Current
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 ,❑'i No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes n No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes en No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes (4n—No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes �o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes �b
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facili Number: - Date of Ins ection: Z . j 2
Waste Collection & Treatment
4. Is storagq,capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �3 No ❑ NA ❑ NE
e
a. If yes, is waste level into the structural freeboard? ❑ Yes �No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 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 6o ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes P'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 ff No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 7] No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes 6 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
_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.
❑ Yes _D No ❑ NA ❑ NE
❑ Yes 2] No ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
❑ Yes E] No ❑ NA ❑ NE
❑ Yes ,n No ❑ NA ❑ NE
❑ Yes .,ffNo ❑ NA ❑ NE
❑ Yes Z'No ❑ NA ❑ NE
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EI—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 .0 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes allo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continuer)

Fl
Facili Number: - Date of Inspection: 2 2
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is4the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �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 M No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes V' No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes o1 No ❑ NA ❑ NE
❑ Yes �TNo ❑ NA ❑ NE
❑ Yes Ef No ❑ NA ❑ NE
❑ Yes O No ❑ NA ❑ NE
❑ Yes INo
❑ Yes No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑NA ONE
Reviewer/Inspector Signature: Date: 2- b Z �/
Page 3 of 3 2/ 12014

'r
Division of Water Quality
Facility Number - O Division of Soil and Water Conservation
Q Other Agency
type of visit: 97compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: 611outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: FRETEMArrival Time: '$; Departure Time: i County:
Farm Name: &?ke Lgt,Pi _ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
Other
Latitude:
Region:
Integrator:
Certification Number: 40(41A 0,3
Certification Number:
Longitude:
Design Current Design Current .
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -Layer
Discharges and Stream Imnacts
Design Current
Dry Poultry Canacitv Pon.
Layers
Non -Layers
Pullets '
Turke" s
Turkey Poults
Other
Design • Current°
Cattle Capacity ,-:Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cowl
I
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
r
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[:]Yes
[] No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
dNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
6No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ` L—a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 0 No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes VfNo
❑ 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 F1 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes [ TNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes ONo
❑ 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 4 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 2 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 71 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes Zt No 0 NA ❑ NE
❑ Yes �TNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes V'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PEt-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 P 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 )K] No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [5No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes VrNo 0 NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 4 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 ILJ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues j
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
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?
Comments (refer to question #):
Use drawinus of facility to better
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
any YES answers and/or any addi
situations (use additional pages as
❑ Yes 7 No ❑ NA ❑ NE
❑ Yes e No 0 NA ❑ NE
❑ Yes 56 No ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
ons or any other comments. '.
Phone: D6>6 r
Date:
21412011

Division of Water Quality
Facility=Number AODivision of Soil and Water Conservation
Other Agency.
Type of Visit: Compliance Inspection O 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 Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: G14AIXES FQDt. ,caUl _ _ Integrator:
Certified Operator: aU1
p �(.��C.�C�IhJL/y�L��Qt�)QQ.��[Z, Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish �b
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
-Other
Other
Latitude:
Longitude:
Design Current
Wet Poultry Capacity Pop. Cattle
Layer
Non -La er
Design". Current _
Drv, Poultry •Capacity Pop.
Non-L,
Pullets
Other
Poults
G L/1a.4
Design, Current'
Capacity Pop.
Dairy Cow
Daiy Calf
Dairy Heifer
Dry Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes x
No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [:]Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
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?
0 Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 21412011 Continued

FAili plumber: - Date of Ins ection: S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 9 .S
Observed Freeboard (in):ab
�
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
�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 o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? 'A
Waste Application �[
10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes V`{�No D 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, et .)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window rr `❑ Evidence of (Wiind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): SG try t/.. LFLa2._S Y� 2ks ( Y') S
13. Soil Type(s): /v n 621AGC1 1VnW
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
0,No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
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
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 appropriate box.
QWUP ❑Checklists ODesign ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
Waste Application ❑ Weekly Freeboard [] Waste Analysis ❑ Soil Analysis
❑ Waste Trans
ers
Q Weather Code
0 Rainfall ❑ Stocking ❑ Crop Yield [] 120 Minute Inspections 0 Monthly and V Rainfall Inspections
Q Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
JA No
❑ NA ❑ NE
Page 2 of 3
21412011 Continued

Facility Number: 31 - Wo I I Date of Inspection: O S /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes tNo
o ❑NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ 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 ANo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal? IM
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. A
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 ANo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑Yes 1 ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #1): Explain any'YES answers and/or any additional recommendations.or any.other.comments.-.y:.; :.: , .•;
Use drawings of facility to better explain situations (use additional pages as necessary)." _.
w.a.
Iws
sJi31n
2.a
i.4
6
1 you Luc y
Reviewer/Inspector Name:
Reviewer/Inspector Signature;
Page 3 of 3
Phone: 910 ' 7 1i9 3a1
Date: M
21412011

. _ Division of Water Quality
FacilityNumber0 - L�J 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: J1/ Region:
Farm Name: C age Qa6L Owner Email: t
Owner Name: ��] �_ E ���Q S Phone: 9 is — 99
00- SLID }
Mailing Address:
Physical Address:
91 )EU L A U 1 LLli= . NC 4N8 4 e)
Facility Contact: Title: Phone:
Onsite Representative: Cq 4RLLS rV'XW A QZ� S
Certified Operator: ('g4aL -5 U�llozeu.-�waRDs,
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Integrator:
It
Certibcation Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Nan -La er
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
I. 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:
Cattle
DL4 W o
Design Current _..
Capacity Pap.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes XNo ❑ NA ONE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Faciti Number: - Date of Inspection: 711
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: 9-
Spillway?:
Designed Freeboard (in): 19.5
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes A
No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed andlor managed through a ❑ Yes KNo ❑ 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 �No ❑ NA ❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes jysNo
❑ 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): � C� & (L CO" w A E A 7-
13. Soil Type(s): %y() A C %V Q r3 QGx:;� A&F(Y-f,
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 kNoNA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑Yeso
❑ NA
❑ NE
Re uired 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.
QWUP ❑Checklists 0 Design ❑ Maps ❑ Lease Agreements
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ YesIsfers
o
Waste Application 0 Weekly Freeboard Q Waste Analysis ❑ Soil Analysis ❑ Waste
Q Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
0 Weather Code
Q Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: —� ] - to ; Date of Inspection: 5
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes tNo
o❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes )6No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes 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 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 o ❑ NA ❑ NE
Comments refer to question # • Explain an YES answers and/or an additional recommendations or.an other cominents':-A�« ';i�'
( q )• p Y y Y � *
Use drawings of facility to better explain situations (use additional pages as necessary).
cALfP.�I.A7 b(A(5 aol
W. V4-
E�J��110 1• � 1.(�
wA5 X� 0APT �w L
A�-
Reviewer/Inspector Name:
ReviewerfInspector Signature:
Page 3 of 3
ao 11-- M Fr 1'�' to OUE
Phone:
Date: l�
21412011

Divisr
ry of
on Wa
u
FaCt�tty"Nmber 3 l Q`Drvision of Soiland Water Canservatton - - �
8
-
Type of Visit Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit'0 Routine O Complaint O Follow up O Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: bTf10 f Arrival Time: ® Departure Time: County: ��� Region:
Farm Name: C EDp�c LANE- Fpq_m Owner Email:
Owner Name:_ cyl(4 -_ES Phone: 9 j0-a98-SyQ 1
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: �ES �LJS Integrator:
Certified Operator: CNPALC--S 0,D1 1?_GLL RINwAebS fZ1- Operato Certification Number: C
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: o = f = Longitude: =° 0
- DesEg`n Current � DesEgi wine Capacity Population Wet PoultryCapaci
❑ Wean to Finish: ❑ Layer
❑ Wean to Feeder ❑ Non -Layer
Feeder to Finish
El Farrow to Wean -y- Poultry
:}
❑ Farrow to Feeder
ElFarrow to Finish ❑ Layers
❑Gilts ElNon-Layers
❑ ❑Pullets
Boars
- ❑ Turkeys
Other El Turkey Poults
`. ❑ Other El other
y Cow
Cy alf
y Heifer
Cow
Beef Stocker
Beef Feeder
Beef Brood
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 1�No ❑ NA ❑ NE
❑Yes
❑No
El NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
�No
❑ NA
El NE
El Yes �No ❑ NA ❑ NE
12128104 Continued

facility Number:- —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
❑ Yes X'No
El Yes ❑ No
❑ NA ❑ NE
El NA ❑NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: L .- j Sok
Spillway?:
Designed Freeboard (in): -
Observed Freeboard (in): S
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes �No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 14No ❑ NA ❑ NE
8_ Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Wo ❑ 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 Drift ❑ Application Outside of Area
12.
,Wind
Crop type(s)
13.
Soil type(s)
li f, r_Clam( LQ [--c 1U ,
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P] 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
kNo El NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
El Yes
ANo ❑ NA
❑ NE
J.
:.Comments (refer to gneshona#} ,Explain any YESanswers and/or any recommendations or any other oients ; y
Use drawings of facility to bettejr explain situations (use additional pages as necessary): �«
_.. , .. K
Reviewer/inspector Name Phone:
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection S 0
Required Records & Documents
t9. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box. WUP El Checklists 0 Design U] Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
�No
❑ NA
❑ NE
❑ Waste Application 0 Weekly Freeboard [] Waste Analysis El Soil Analysis ❑ Waste Transfers ❑ inual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield 0 120 Minute inspections ❑ Monthly and 1"
Rain Inspections 0
Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
NA
XNE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
VNo
❑ NA
[] NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
1;(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
5�No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
dNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
AL
�a
I
$�lLI
7
Page 3 of 3 12128104

DiVi0on of Water Quality
Factlity'Number. �j } Q'DMsion of Soil and Water Conservation
.. � 0"Other°Age©cy. •_ � �-`
a
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
6-Routine O Complaint
O Follow up O Referral O Emergency
0 Other ❑ Denied Access
Date of Visit: i Arrival Time: Departure Time: County: �✓ Region:
Farm Name: ����aCZ �- Cr �6A \ Owner Email: �
Owner Name: (2wOR-LDS ��WP1ZIS -S Phone: C)n- Qc78-SqQ/
Mailing Address: � C�I�AK GZ�1 C'yLAgCN ruLAU1u /VC 100'
Physical Address:
Facility Contact: /Title: �y�j Phone No:
Onsite Representative: Ctrs ms t 1C[.+>1G?CI~L.j9 s ��- Integrator:
Certified Operator: CJWAQ4e5 LA Jl N'ZCLL GhopQDS. �Q. Operator Certification Number: OrY 100
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: = o = I =Ig Longitude: = ° = ,
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ on -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharses & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑Beef Feeder
I
❑ Beef Brood Cod
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes A No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
V�No
❑ NA
❑ NE
❑ Yes
�CNo
❑ NA
❑ NE
Page I,of 3 12128104 Continuer)

i
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 I Structure 2 Structure 3 Structure 4
Identifier: SM 1.4
Spillway?: n
Designed Freeboard (in): ►9.5 Ill.
Observed Freeboard (in): 19 W
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 [�No
❑ Yes ❑ No
Structure 5
El NA El NE
❑NA El NE
Structure 6
❑ Yes �No ❑ NA ❑ NE
❑ Yes C&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 iANo []NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes o ❑ NA ❑ NE
maintenance or improvement?
Waste Anplication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes A No ❑ NA ❑ NE
maintenance/improvement?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes $,No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) (L 1 ► lA-'i't tc,
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
V1 No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
9 No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
P,No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): ,Explain any. YES, answers and/or any recommendations or•anyother commen '
�.
drawings of facility to bettei.-explain siva'tions.w use °additional p g"esnecessary):'-
Reviewer/Inspector
Page 2 of 3 12128104 Continued

4
Facility Number: Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes )J No ❑ NA ❑ NE
the appropirate box. Q WUP ❑ Checklists ❑ Design El Maps El Other
21, Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )Y No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ 1�aste Transfers ❑/nual Certification
❑ Rainfall ❑ Stocking ❑ C/op Yield ❑ 120 Minute Inspections [] Monthly and 1" Rain Inspections El Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes N] No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
❑ Yes
ANo
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
N No
❑ NA
❑ NE
❑ Yes
4,No
❑ NA
❑ NE
❑ Yes
$No
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
ONo
❑ NA
❑ NE
A"dditioonal�C m eiits�' ndlor�D`�r` .aw`" g � 0
Cebu
C.0 a
`
�1�,10$ 1.9
�•�
��1�i1og 1•S
�.5
H
Page 3 of 3 12128104

Division of Water Quality
Facility Number 3 ] 0 Division of Soil and Water Conservation
- - -- -- 0 Other Agency 11
Type of Visit `Z) Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 00 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 0�`7 Arrival Time: f® Departure Time: County: Al Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
OnsiteRepresentative: CAQ71S ?-jQ Zt,J)C.l` % AGLC�S b-�Att1aS integrator:
Certified Operator: Ck4ece S {�cN c,� � Ln� _ �t2. ^ Operator Certification Number: Q Lj 1 g(3
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Back-up Certification Number:
Latitude: [—] o a ' Longitude: [=] ° = ,
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_ ❑ Layer
1I ❑ Non -Layer
Other
❑ Other - --
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: =.
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 RNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
9,No
❑ NA
❑ NE
❑ Yes
[5No
❑ NA
❑ NE
12128104 Continued

Facility Number:
Date of Inspection o'1S Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0,1�o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: # ! w
Spillway?:
Designed Freeboard (in): . S J9..��
Observed Freeboard (in): el) � D t
S. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes KN. ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 4No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes RNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 9'No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes gNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes i�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes RNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes KNo
❑ NA
❑ NE
17. Does the facility tack adequate acreage for land application?
❑ Yes ONo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes PNo
❑ 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):
I
Reviewer/Inspector Name Phone: 9/6 ---r(o - 3-3 a?
ReviewerAnspector Signature: - Date: 5' b
12128104 Continued

L
r
Facility Number: 3 Date of Inspection 3
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes PNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes qNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design [I Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ;'No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 14No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes PNo ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ONo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
64 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
RNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�fNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[R'No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
qNo
❑ 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
E�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
M 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
MLNo
❑ NA
❑ NE
33,
Does facility require a follow-up visit by same agency?
❑ Yes
'VNo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Division of Water Quality
Facility Number Q Division of Soil and Water Conservation
- - - - 0 Other Agency
Type of Visit fi� Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referr�all00 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ; parture Time: I/I County: G� Region:
Farm Name: _ �4w Z Ac.-LF Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: 4 Phone No:
094d�c
Onsite Representative: 24,65 !C2&:s) QD5 66" 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:
Latitude: = o = 6 = Longitude: = ° ❑ 4 ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
I - - - II ❑ Non -La er - _-
Other
❑ Other i
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
EfDry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ITJ
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 VNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA ❑ NE
❑ Yes X No
❑ NA ❑ NE
❑ Yes XNo
❑ NA ❑ NE
Page l of 3 12128104 Continued

Facility Number: 1— 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 i ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: A,
Designed Freeboard (in):
Observed Freeboard (in): % �i _ Ci
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PlNo ❑ 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 Id
#No
No ❑ NA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑yes ❑NA ❑NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ yes X
No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes y No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [AlNo ❑ 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? El Yes
Yes No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ElYes VNo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
/�: !� �i✓ l7 ����,r CltGao� s /� S� DP i+1 p�/fG /*c�t-�Q
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 2 of 3
Phone: (M) W6— 73Z
Date: 3/-2_S hD'.7
12128104 Continued

Facility Number: Date of Inspection�_!j/y_��/U�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P(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
El Design ❑Maps El the appropriate box. ❑ WUP Checklists / 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )IfNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Cade
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
�0
XNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
ElNE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
A
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
ElNA
ElNE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�5
XNo
❑ 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
El NA
El 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
�dNo
El NA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ONo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
P/No
❑ NA
❑ NE
Additional Comments and/or Drawings:
44 o!!5-4 Al-
�7
-` � � n'l j�p � � f?ft`✓f ��/��7✓ ��GI� �l/,�-� Cjrl ` �J�4
Hi
Page 3 of 3 12128104

Hog producers frequently turn on their hog waste sprayers when heavy rains
are predicted. Most sprayfields have pipes just under the surface. The
tops of these pipes are perforated to collect and carry off liquids.
These drain pipes lead to ditches and streams. When storm water mixes with
hog waste it is taken up by these pipes and discharged to our public trust
waters. State officials do not consider this practice to be a violation.
But the river does.
Lower Neuse Riverkeeper
Flight 311107 2:30--4:15 PM
N34 54 330 w077 44 573

R]
Facility Number 1 !
Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit Q<ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit orfloutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: rL Arrival Time. 7i a Departure Time: County: T,)UPL,r)J Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
Title: Phone No:
Onsite Representative: %uA R—Us- 6Dw A mn S I Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Operator Certification Number:
Back-up Certification Number:
Latitude: E--] o E__1 ' = « Longitude: = ° = 4 =
is
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
[E Feeder to Finish
I -CL
Po
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other I
Dry Poultry
Pullets
Poults
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
i
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes 2 o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
2No
❑ NA
❑ NE
❑ Yes
9 o
❑ NA
❑ NE
12128104 Continued

Facility Number: 31 — Date of Inspection t G
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: tA6 0 % !A&-Ou Z
Spillway?:
Designed Freeboard (in): (� „( h • S
Observed Freeboard (in): S 9(.
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 �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes [7No ❑ NA ❑ NE
❑ Yes Ld 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 D No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Q'io ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes [YNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑,f4o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes WNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [:]Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) tJynQ —W ✓Q6 lfl4AWA (
13. Soil type(s)
6
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
ONo
❑NA
❑NE
[2 No
❑ NA
❑ NE
2"'No
❑ NA
❑ NE
�o
❑ NA
ElNE
ao
❑ 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):
')-I) c713 IAT ✓ Go PY OF Uo r SeL-L,6ArnPL1c W u7 &ACE l.JZ]7'P &_ Lon0J,
Reviewer/Inspector Name �o j-�i✓ A yZ�% t� V Phone g 11�
Reviewer/Inspector Signature: Date: t/ a I
['age L of 3 12125/04 L'onthnued

.
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 al] components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box b ow.
❑ Waste Application [I Weekly Freeboard ❑ Waste Analysis Soil Analysis
❑ Rainfall ❑ Stocking
❑ Yes 0<0 ❑ NA ❑ NE
❑ Yes ZrNo ❑ NA ❑ NE
Yes ❑ No ❑ NA ❑ NE
❑ Waste Transfers ❑ Annual Certification
❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did ReviewerAnspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes O No ❑ NA ❑ NE
❑ Yes
Er<o
❑ NA
❑ NE
❑ Yes
rN
❑NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
2 o
❑ NA
❑ NE
❑ Yes
L-'Ka
❑ NA
❑ NE
❑ Yes
B No
❑ NA
❑ NE
❑ Yes
Pi o
❑ NA
❑ NE
❑ Yes
2No
❑ NA
❑ NE
❑ Yes
EIN"o
❑ NA
❑ NE
❑ Yes
9No
❑ NA
❑ NE
❑ Yes
2No
❑ NA
❑ NE
Page 3 of 3 12128104

Facility :Number j (� (o
I
fp Division `of Water. Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit Co pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint ' 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: $ Departure Time: County: O U PLZ J•1 Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: CNS �DtR� ,fat.
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
Title:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = e = Longitude: = ° = 1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
1 ❑ Non-Layet
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouits
❑ 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?
❑ Yes LEI No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
ElE Yes
,['No
No
❑ NA
❑ NE
12128104 Continued

Facility Number: 31 — (.(, Date of Inspection olti vs
Waste Collection & Treatment
dNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: LA%d 1 CA(_'<0t Z
Spillway?:
c
Designed Freeboard (in):
Observed Freeboard (in): 3l
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 E 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 Ip No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes E No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes Zo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes VNo
❑ NA El NE
maintenance/improvement?
11. 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 l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Croptype(s) i3E(2.MU01A C&) 'MiaTyA
13. Soil type(s) O'rLr-ot4C
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 7NNoo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ElEj Yes o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination❑ Yes WNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes VNo
'❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ NA ❑ NE
Comments (refer to.question. #) ` Ezplam any YES'answers and/or aay recommendations or any oilier cowmen .
Use drawings ofifaciiityto bette�begpiam situahons(u eaddifional pages as necessary°):
Z flC� 2A S A tJ D f7A CLr.^ Csao 0 $46;61 -
Reviewer/Inspector Name j j1 .. [, x ;Y Phone:
Reviewer/Inspector Signature: JUDate: S
12128104 Continued

Facility Number; 31 Date of Inspection ? 0
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 appropiate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes L{J No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes rNo
6o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes � o El NA ❑ NE
El Yes o ❑ NA ❑ NE
El Yes No El NA El 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
Ld N
❑ NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
L�f No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
L✓ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
dNo
❑ 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?
El Yes
,,��
LdNo
❑ 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
LQ No
UK
❑ 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
2rNo,
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[;?N
❑ NA
❑ NE
Addrhnal Commenfsaand/or Drawings r: __ ar
12128104

(Type of Visit oCompliance Inspection O Operation Review O lagoon Evaluation i
Reason for Visit OfRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number r Date of visit: O Time:
�p Q Not Operational Q Below Threshold
0 Permitted © Ce * edd © Conditionally Certified © Registered Date, Last Operated or
Above Threshold•.
..... .
/Farm Name: County:
Owner Name: -------- �������.� Phone No:.
Mailing Address:
Facility Contact: _ __ . ____ Title:. _ Phone No:
Onsite Representative: '" "�� ✓—/giQ Integrator./*'"Ocr%/'�
Certified Operator:
Location of Farm:
Operator Certification Number:
I IT:
,J Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude "
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify 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 ;ffNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes PrNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes XNo
Structure 1 S;Iructure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ._i — _
Feecboard (inches):
12112103 Continued

Facility Number: JL--&6 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ;?No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes Zj 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 maintenance/improvement? ❑ Yes 0 No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 2fNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes )M No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes WNo
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes eM No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground. ❑ Copper and/or Zinc
12. Crop type (A f/IA A(19 g /%r
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes to No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes JoNo
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 PNo
I6. Is there a lack of adequate waste application equipment? ❑ Yes A No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes �No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 0A No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes WNo
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 .,KNo
Air Quality representative immediately.
❑ Field Copy ❑ Final Notes
�iQF�i ,Pp K,Z.Yi�
PF
�AaO �J�ZSS�,-► �E7��-IQE��p� � �1Dg0�
1 0"'
W,�7f . , / ;�� �" W-0 6'we'
Reviewerliaspector Name
Reviewer/Inspector Signature: /J Date:
1 !L/lL/U3 Uona 1uea

Facility Number: — Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes R( No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes JZ No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes El No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes JZNo
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes Q�No
26. Fail to notify regional DWQ of emergency situations as required by General Permit? /
(iel discharge, freeboard problems, over application) ❑ Yes )9 No
27. Did Reviewer/Inspector fail to discuss review/mspection with on -site representative? ❑ Yes )2rNo
28. Does facility require a follow-up visit by same agency? ❑ Yes P'No
29. - Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes .ONo
NPDES Perrnitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) J6 Yes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes RfNo
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes PNo
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ja No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ZNo
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ;2(No
❑ Stocking Form ❑ Crop Yield Foam ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

r
i
Type of Visit 9D Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification O Other ❑ Denied Access
Date of visi : ® Time: D 3
Facility Number17 (I'�(od�
Not O erational 0 Below Threshold
© Permitted ❑ Certified [3 Conditionally Certified [3 Registered Date Last OperaT7LAPL:__
Above Threshold:
Farm Name: 'r1 U A R i R tJ C. as nl County: Pi
OwnerName: L__{� AQ F� Phone No:
Mailing Address:
Facility Contact: Title: Phone No:
{�
Onsite Representative: 1.% w o el? Integrator: l _NRP_y/_C.
Certified Operator:
Location of Farm:
Operator Certification Number:
Op Swine ❑ Poultry Cl Cattle ❑ Horse Latitude ' • u Longitude 0' 01 0
Svvine _
Wean to Fe
Design : Current Design `Current = Destgn'ti = :C rrt nt
_- - _
iranarity Pnnnktinn -Poultry _ rnnaritv`-.P156111ntian Cattl@T
:Cnnar�ty.-. PnnEitat�hn
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lsgoons� ®i ❑Subsurface Drains Present ❑ Lagoon Area ❑ S rav Field ea
Holding Ponds I Solid.Traps W ❑ No Liquid Waste Management Svstem
Discharges 8c Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes V No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d_ Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ;9No
Waste Collection & Treatment
4, is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillwav ❑ Yes .J6 No
Structure I S cture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: C IGZ
Freeboard (inches):
05103101 Continued

Facility Number: 3 j — (v Date of Inspection / 4
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Aonlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes Z No
11. Is there evidence of over application? , ❑ Excessive Ponpg ❑ PAN ❑ Hydraulic Overload ❑ Yes ID No
12. Crop type
13. Do the receiving crops differ with those dtesignated in the Certifted Animal Waste Management Plan (CAWMP)? ❑ Yes 21 No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
ElYes
KNo
c) This facility is pended for a wettable acre determination?
❑ Yes
'No
15. Does the receiving crop need improvement?
❑ Yes]
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
, No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
ONo
I & Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
TVNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
VNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
V No
24. Does facility require a follow-up visit by same agency?
❑ Yes
9No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Coinntents (refer to_questiva #) _ Explaiii:any Y answers antilor any re�amuxeadatioas'cir anv. otherFcommet'am
Use drawings of facdEty to better explaw situattoa (use iddtt�eonal pages as necessary) = _ Field Cony 4� Final Notes,
_
N©rE IJo W Y Gorr:. 7-
0 _ E>r Knn up 7�
oar
�R�2z NG_ S ��s-r��,r, Fort Rcc v�� �r�vP. Ii��-70 11442
Jb rN LJi&s Cofc)z�� % Ear P�c�rer_-�
DO
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: l 2d,
05103101 Continued

Facility Number: 742Date of Inspcctieur
doe- issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
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 Comments.and/or'DraK•ings:.__
�7� ;cQpST PLF . ND �N2Z�p
LJV &t_ e
05103101
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes 'NO
❑ Yes ( No
❑ Yes /� No
❑ Yes ❑ No
J

vi
Type of Visit %Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Poutine O Complaint. O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time:
Q Not Operational 0 Below Threshold
13 Permitted [3 Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold:.... .....
FarmName: ._ ...�I .x..l� a .....` f+t ..... J.......................... County:........................................................ ........ _.
Owner Name: ..... L.......1Y�11f�f.......................... Phone No:
............... ....... .............. ...............
.. .�» . ..
FacilityContact: ............... .................................................... ............ Title: ................................................................ Phone No:..................................................
MailingAddress: ...............................................................................
Onsite Representative:.... ,. . Integrator: lf:.,,r5............................. ....
Certified Operator: ....... Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �' �'1" Longitude �• �' 0"
Design„ Current' Design Current Design CurtYat
Swine Ca ci PoWaboa-- PouM7, Capacity Population Cattle pacity...Population:;
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Nunitbei of Lagoons M Subsurface Drains Present ❑Lagoon Area ❑Spray Fidel Area
Holdiig Poiiids /solid Traps ❑ No Liquid Waste Management System 4 R
Discharges & Stream Imaacts
1_ Is any discharge observed from any part of the operation? ❑ Yes )2fNo
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.Lhe 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 9No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes P(No
Structuure I Structure 2 Structure 3. Structure 4 Structure 5 Structure 5
Identifier: ......... ���.1L................ ........... eg—f...........
Freeboard (inches): T2� 42'r
5100
Continued on hack

Facility Number: % — Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes #140
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 a4
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 maintenancerimprovement? ❑ Yes [(No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ;YNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes WNo
11. Is there evidence of over application? 0 Excessive Podding AN ❑ Hydraulic Overload es ❑ No
y��tT>rii�.�Illi�.l rite=��i/.�1�/1•L�i%%��� !3
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes Z No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes ,0 No
b) Does the facility need a wettable acre determination?
❑ Yes 0No
c) This facility is pended for a wettable acre determination? n
❑ Yes 2040
15. Does the receiving crop need improvement?
❑ Yes 2rNo
16. is there a lack of adequate waste application equipment?
❑ Yes ONo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ,rNo
I& Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes 7No
l9. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes JEONo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes 'Of4o
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 43No
24. Does facility require a follow-up visit by same agency? ❑ Yes .,0l0
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ YesU'No
viol t�ign�s:or d fc�en�ies v re itQte d4tri g �his'vis�t; Yot wii� >fee�iye Oc futthgr .
correspondence. about this visit.
Comments (refer to gnesfion #) Explain-ariy YES'answers a iud/or atiy recut inendfations os_any otlrer comments. ry
Use di=awitigs of,ka iIity to Wner;expldn siidatioim (use additional pages`as n ) _
.. -.. _r... ..._ter .
114
�lD �/ ��GiFIJ D S/r�JJ}Gcr (��ig DNS ��'��'lc/r1'1 �� J��
��Uc/[/J l%/�UC (�i✓L � �F_ Ei.1 /iP,01.�F!J ��I��/+JG. �,y� � �� � � ��
A rplP
i WUa,q a a�
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: / Z% 5/00

Facility Number: Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes O-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 ,EJINO
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ,0'hlo
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 ,Pf4o
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 -0
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes �No
32. Do the flush tanks lack a submerged fill pipe or a permanenYtcmporary cover? ❑ Yes �No
AddJtioomments: an or' ravings:.:
�GGIz�$iQ� W/Vo yes
/ 1
1/1% � �pi✓�D�TG4rJ5' -
5/00

a
10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection ZS Gt�
Time of Inspection I 73676 17,4 hr. (hh:mm)
0 Permitted © Certified 0 Conditionally Certified © Registered 113 Not O erational Date Last Operated:
Farm Name: .....0 . ..... -4-�e.. .f ....................................................... County: .. Py .. �' �1
f_�......................... .................. ...............
Owner Name: ....v_. t �.r, 5.... OI Wr, -0t s Phone No: ..........................
Facility Contact: .............................................................................. Title:
Phone No:
Mailing Address: ........................................................ .....
ii TT ,
Onsite Representative: ....G`l..r..J..�. s..... .....w!f ft
1... `�..r ....................... Integrator:....t''YU.1..._.................................................
Certified Operator:..', ... .................................. .................................................. Operator Certification Number:..........................................
Location of Farm:
Latitude 0 6 46 Longitude 0 4 44
tt�
Design Current
$wine s Capacity,.To uEation Poi
❑ Wean to Feeder
Feeder to Finish
Z B a
.$Z gi)
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons C
Holdin g`Ponds I Solid 'TrapspC
.. Design Current : .s
.-
it ,
I❑ Non -Layer I I ]'-.I❑ Non -Dairy
❑ Other -
Total Design Capaity
s
_- Total SSLW
=IQ Subsurface Drains Present 4IE Lagoon Area �❑ Spray Field Area
-_
❑ No Liquid Waste Management System +
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes fZ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ["No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes C�rNo
c. If discharge is observed, what is the estimated flow in gallmin? hlG{
d. Does discharge bypass a lagoon system? (Ifycs, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 2Q
Freeboard (inches): ..........z..L.......... 3 1
.........................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes V No
seepage, etc.)
3123/99 Continued on back

Facility Number: 3% — Date of inspection j p
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ETNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes $No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes S No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes J�q No
Waste ADDlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ;9 No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes EKNo
12. Crop type �ef+Ytuda roll ed G,-Q Ze , �rvzs I j Grg &rrvdoi Hee
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [SrNo
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?ITyes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes ONo
Re uired Records & Documents
t7. 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.)
❑ Yes IffNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes [5No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes WNo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes ffNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes Wo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes 2f No
24. Does facility require a follow-up visit by same agency?
❑ Yes P No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes R�No
: �'Vo yi6.Wioris:oi• riefciencies w. erh6,fed during •this:visit' • Y:oik ;wi' Leeceiye fio; furtper
Corres Oridence A"f th, Visit. ......... ... . . . . . . . . ........... . . . . . . .
_ __-- _ -
Coriitnents (refer toagnestton #} ��Explam"any YES answers.andloi any recointnendations or_any other comments
Use drawings of facility to'better explaiin situations (use additionalpages as necessary)
�7 r 4 I
[. veGiEe+q lej96oP\ Z .157210L41d SQOh e .nCWed
�
111o0
IS. Work Td rern'OVe /tanbN?,rmul�,O, 1r;e1,Of_
e�,.--Lvdol
inrv4s' o� 6�� �d�
1 , s�% yf �-- h -5 nzol rece;ved CeL�
6epicrol �crvti�. I- w;1L IhVel-O").1 Z sekxd PTr:(-acor es
40
Reviewer/Inspector Name
Reviewer/Inspector Signature:
3/23/99

Facility Number: — Date of Inspection 7 S d
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30_ Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes g; No
❑ Yes J3 No
❑ Yes O No
❑ Yes t No
❑ Yes No
❑ Yes No
❑ Yes ;9 No
-Additiona[iC-omments.andtor,.,,Dr2WingS:_ �F _ , ` 'rzj z -
T

0 Division of Soil and, Operation Replay 7
r � 13ivision of Snit and -Water Conservation - Compliance Inspection ,;7.1
y ri
Division of Water Quality ' Coinpliarice Inspection
ry r
13;0ther-Ag y, Operalaont Review :
JMRoutine Q Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Numbers f�{� Date of inspection q s �9
Time of Inspection �30 24 hr. (hh:mm)
Q Permitted Xf Certified © Conditionally Certified [3 Registered JE3 Not O erational Date Last Operated:
Farm Name: Grp-QA ~... L AiJ ... A2i ... County: ....... D,s3 S.,..l.^L...__..............................................
Owner Name:................................................... ...... Phone No:..._.
FacilityContact: ........................................................................:..... Title:................................................................ Phone No:...................................................
MailingAddress: ............................................................................................p........................................................................................................... ..........................
Onsite Representative: ..... G1i�. .�.... 1e •�Js- .................. Integrator:........R.S............................ ................
Certified Operator:,,.,
Location of Farm:
......................................................................... Operator Certification Number:..........................................
i
.............................................................................................................................................................................................................................................I........................... 1
Latitude �• �� �•� Longitude �• �� �«
Design Currents ....._..Design Current
Swine Capacity Population = Poultry :Capacity Population Cattle
❑ Wean to Feeder
eeder to Finish
S780
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Design Cirrent
.apacity Population.
-Number-of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
_,Holding Ponds SolidTraps �: ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes Y�No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
ElYes 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 X,�,
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes;7No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes JANo
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard(inches): .......... ........................................................................................
...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes E�No
seepage, etc.)
3/23/99
Continued on back

facility Number: 3r — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes VNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify. DWQ)
7. Do any of the structures need maintenancelimprovement?
❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
elevation markings?
/EfNo
Waste Application
ld. Are there any buffers that need maintenance/improvement?
❑ Yes J'No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes,ZNo
12. Crop type C„ op. (, o•t !.� .
13. Do the receiving crops differ with those designated in We Certified Animal Waste Management Plan (CAWMP)?
❑ Yes VNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes PrN0
b) Does the facility need a wettable acre determination?
P'rYes ❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes )allo
15. Does the receiving crop need improvement?
❑ Yes ON
16. Is there a lack of adequate waste application equipment?
❑ Yes ,eN0
Required Records & Documents
IT Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes Z<O
18- Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
[]Yes ZNo
(ie/ WUP, checklists, design, maps, etc.) / //
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste arfalysis� & soil sarnple reports)
❑ Yes ONo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes VTo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes ZNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
discharge,
❑ Yes XNo
(ie/ freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes J 'No
24. Does facility require a follow-up visit by same agency?
❑ Yes XNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ,?j No
r, ..
•v�olattons :or, def c�enctes •were n ed• dirritn ' #his, visa; • Y:oit wt�:: eceiye itio fu�th�r • : -
... .... .
correspondence. about_ this visa_ .. r
Eam><nents (refer to question #) Explain any YFS answers and/or any ricommendations;oir" any.other comments: -
W- -'' _
Use drawings of €acth to better ez lain situattons. use adcLtzanal a es as.necessa )
tY P _.P g t5
V RAC rl FAu_ TN "'-s moe d: nfG NN jtjz.� cIs.re t)1CJ%r Uy f- Arta Arcjtj 4
LJiTT-14 i Iu/�•R.t�c-aL Fe o� '1a / O"A� W . Se i,I CwJTA cr t,3; rt�
tiA.1lG Cam.-IcE.�-�s Ar3�•�T �+a� 2 L.+�Ge� . C��1�C'r• DccP[..�'d S�.iC.:O c;€- CAP-WLt.`S
Piet— CA 4 CZ94f's d gs u r _A T-E S .S�rA tL G 4 %iS A 40 VZLisr.C3
Tt- r lwusr PsiM PEa AS 4- -R-VTuLr OF- 12V-CJE"1T•
Z / � -r,4tX. 4 1EXAnn , %u'r ^.h U-S NAS E AS Y ET- : E47k1Aeu?f
/ W; 9_jz� 9I03gy- 35 oz
Reviewer/Inspector Name
yTQ:: C3►yam'? rr=�f�7
Reviewer/inspector Signature: �j (�� .....d- Date: 199
3/23/99

Facility Number: 31 — Date of lirspection
• Odor Issues
26. 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?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes [�To
28. 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)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ONO
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 01No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes )eNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes JZINo
lAdditional Comments and/or Drawm s
3/23/99

Division of Soil and Water Conservation Other A encNfr- �{
Division of Water Quality
IQRoutine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other
Date of Inspection {r
Facility Number
Time of Inspection ,� 24 hr. (hh:mm)
©Registered © Certified 1❑ Applied for Permit Permitted 0 Not O erational Date Last Operated:
G�..•
Farm Name: .... t.7.?.(�z-Al...-)....... ox.�Am..w........................................ County:.... ��i.................................................,
!.r ,rr# ............... Phone No Z5'� ri . �..............................................
Owner Name: ..................... - ................7,S
FacilityContact: . `
....... Title: Dc:viJ.�.��..L......................... Phone No:...................................................
....................................................................... .........
Mailing Address: /� fir//s�'f'...................�..
�r!.�... .... _44.7-02,11.7 ............ ........................................... .. 1✓ /.%.....
Onsite Representative:..#r?aj",...6.... ... �F!. ... .................................. Integrator:...... 1 f u/..<................................................
Certified Operator;---vt��.................... .... Operator Certification Number;...............-.
Location of Farm:
Latitude 0 i " Longitude • 4 96
General
I. Are there any buffers that need maintenance/improvement?
❑ Yes
[9 No
2. Is any discharge observed from any part of the operation?
❑ Yes
0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
1,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
fig No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
K No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
R No
5. Does any part of the waste management system (other than lagoons/hotding ponds) require
❑ Yes
Ed No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
EQNo
7/25197

ti Facility Number:
t"
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,Ilolding Ponds, Flush Pits, etc.)
9. is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
............................................................................................................................................. ......
Freeboard (ft): ..........t 3 3 -
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 maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(if in excess of WMP, or runoff entering waters of the State, notify DWQ)
Structure 5
15. Crop type .........,__-.'E:t...- ............................ Sr..�?-
.... ..............................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan'(AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0_ No. vioIaitions•or. deficiencies.were noted during this'. visit. - You:vvill ieceive:na:furfheril
:•:�etirresppndepceaboutthis:visit:�:�::.�,•:�� :��•: :. .. ::.: .�. .. .•�•. .•. .•�
❑ Yes No
❑ Yes No
Structure 6
❑ Yes 19 No
❑ Yes [ No
❑ Yes Qa No
❑ Yes ,� No
❑ Yes No
❑ Yes RNo
❑ Yes P3 No
® Yes ❑ No
❑ Yes 10 No
❑ Yes jallo
❑ Yes L9 No
❑ Yes Ed No
❑ Yes [9 No
EdYes ❑ No
ER Yes ❑ No
h. �' FL E -- 1n - -�FK N^ � ,2dP !"
Comrttffer to question #) #Explain any YES atiwers and/or any recommendons of any other eoetats
Use drawtigs of iacthty to better explain sttuahons (use additional pages as necessary)��
�. x:: ••k•�... ! `< -ti.-:`tic ,nn '.' ". '� �. '�` �., ,r'§ v, 5Q :,..c;^ , .,[E KaE,, lc, 43r-Y.
..
i O, G,�y.�/r �i,s'Li 'yr�j [�Il� � 0'� / •�y��d(/i : ✓� [�d✓'`f LTy�p� iJ- �l�w��ri n dLI'�
Z�/ZS' !�-G''''`t!S �r+�/`�� Qy�p�O�cwl�� .•1� �.s�v�2 d�4 -^`^' ..C,
..ti `�/lv�rr pip/,�/..-... �G...�GC. v►� �ty r� ,�;�°P��pf.:-e�i
7/25/97
Reviewer/Inspector Name Y . -, x ` $gIT
Reviewer/Inspector Signature: Date: /L

❑ DSWC Animal Feedlot Operation Review
E3 DWQ Animal Feedlot Operation Site Inspection
liSRoutine O Cant taint O Follow-u of !)W ins eetion Q Follow-up of DSWC review O Other
Date of Inspection-'
Facility Number 3
Time of Inspection � 24 hr. (hh:mm)
0 Registered 10 Certified 0 Applied for Permit © Permitted [3 Not Operational I Date Last Operated:
Farm Name:.........cd4... ....... LaS,d.r....... ri& 1. .. County:........ 4�kk.............................. ....................
Owner Name: .. Phone No: ... �`!1Q). Zg '..�.35cl.........................................
Facility Contact:...:.. .....W .............................. Title: ......... DukAr ...................................... Phone No:...1``�1.Q�. q�-,. .75.�1......
I
Mailing Address: &!A... ..� ip, `�[�
1-...................................................................... ........ u .V.t . f......A G...................................... .. $ %$........
Onsite Representative:........--.. ................•........ Integrator:.. (.' rxtl �S..-----------.......
Certified Operator; .......................... ..................................................................................... Operator Certification Number....... Z.
Location of Farm:
-TAN4...1..4....... ap............�......13f-p1A.vV Tvr................
..,...!^3.......ar...........5....( At. t..... ....�s..Mo."M.......
1�.5...
,t.z... ...... ... c
rvm...... ..... ... (,(...e.. i.....................•---...............................................-.-......................................------.................................------- .. .
Latitude • �"
Design Current
Swine Capacity Population
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Longitude ff�]• �' �:'
Design Current Design: Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer I I[] Non -Dairy
❑ Other
Total Design Capacity �z
Total SSLW
Number of Lagoons I Holding Ponds` - Subsurface Drains Present ❑ Lagoon Area IMSPray
❑ No Liquid Waste Management System
Field Area
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
allo
2. Is any discharge observed from any part"of the operation?
❑ Yes
No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
ElYes
No
b. If dischar-e is observed, did it reach Surface Water" (if yes, notify DWQ)
❑ Yes
No
c. If discharge is observed, what is the estimated flow in gaUmin?
J. Does discharge bypass a lagoon systmi ? (If yes, notify DWQ)
❑ Yes
M No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
allo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
KNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
&�No
7/25/97
Continued
on back

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes No
Structures (Lagoons bolding fonds, Flush Pits, etc.1
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ........�� ................... ............ . ......
Freeboard(ft): ................................. 1_..3 ......... ............. I.....................
10. is seepage observed from any of the structures? ❑ Yes 'P No
•11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes 0 No
12. Do any of the structures need maintenance/improvement?
E(Yes
❑ No
(1f 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
RNo
Waste Application
14. Is there physical evidence of over application"
❑ Yes
K No
(If in excess of WMP, or runoff entering} waters of the State, notify DWQ)
15. Crop type---........L' S�Ya`........�R,Y.`fklld.vo......................................................................................................................................................................
l6. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
Ej No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
CR No
18- Does the receiving crop need improvement?
Yes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
19No
20. Does facility require a follow-up visit by same agency?
❑ Yes
Q No
21. Did Reviewerlinspector fail to discuss review/inspection with on -site representative?
❑ Yes
O No
22. Does record keeping need improvement?
RkYes
❑ 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
El
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
RNo
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
[;&No
No.violations or. deeciencie's.rvere noted•during this.visit..Vou:will receive no further
correspondence aboat this. visit'. ... ..... , . : ;
ed— fainents (refer to question #): -Explain, any'YES answer's' and/or adf recommendations or any,`other'ctlintnents
Use lrawmas of facility: 6better explain;situations (use addittonapages as<necessary):
AL
t2. 1r,nur Wc+�IS aF (&5wn5 shovla 6e waver).
zz, [V-VM13
Vn �ccwr�s SG�o�ri {is+ u 1u��`��4o,• 4tck "sk -V s pumej +
T Y1om6eY. I� i �*o CP , +pa6AILc S 4r 't'I U 4dk SPiooO toe. v 0o W .WtoAf
y
karn f�2Sioar sWbe. an 5,k
7/25/97
Reviewer/Inspector Name7.
Reviewerlinspector Signature: &. Date: )& a AA

11
a.
Site Requires Immediate Attention: #JQ
Facility No._� ��va
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: g ' a 11995
Time: f 4-4-j
C
Farm Name/Owner:MailingAddress: � o �c m s1$
County: J)V �_L rj
Integrator. S Phone:
On Site Representative: Phone: 59
Physical Address/Location:
Type of Operation: Swine Poultry Cattle
Design Capacity: 6 o Number of Animals on Site: 5 ��
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: +4 ' 1-7 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) es r No ® Actual Freeboard: 6 Ft. Inches
Was any seepage observed from the lagoon(s)? Yes o Was any erosion observed? Yes or o
.
Is adequate land available for spray? 6r No Is the cover crop adequate�r No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria?. 200 Feet from Dwellings �r No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes ofrft- 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:
r
(N)'e'str _
Inspector Name
cc: Facility Assessment Unit
'%S
Signature
Use Attachments if Needed.